Fatigue, bloat, etc

[Drofeyes21]

I finally got a comprehensive set of labs done. I’ve been on T now for 8 months and I’ve been dealing with moderate fatigue and bloat for several months now. My pre T free T was 4.8pg/ml (6.8-21.5). I didn’t have anything else drawn. My urologist put me on 300 mg IM q2 weeks. At the 3 month mark total T was >1500 and free T was 45.6 (same range as above). The labs were done 4 days after my last injection. I changed the dosing to 75mg q4 days subq and felt much more mellow but libido decreased and fatigue began to set in. Still on the current regimen my total T is 808ng/dL and free T is 15.0pg/mL. Labs were drawn 2 days after injection. Thyroid is mid range for TSH, T3, and T4. PSA is 0.6. Essentially all labs are normal. However, E2 is 53.0pg/mL (7.6-42.6). It was not the sensitive test. Is my dosing still appropriate? Do I need an AI? I know I should fork over the cash for a SHBG. What do you guys think?

A final question. Why the drop in T numbers from q2 weeks IM to q4 days sub q?

 

[Drofeyes21]

I also forgot to mention that I suspected that my E2 was high because I’ve found myself getting weepy at the chick shows my wife watches. I could just be a sap too.

 

[Sean Mosher]

I never felt as good on SubQ either.
Don't have a good answer for that other than switching back to shoulder IM did the trick for me at least.

IMO a boost in that FreeT may help.
If symptoms returned after the dose reduction I think you probably have an answer there.
Those numbers don't look bad but as you've indicated they're clearly not optimal.
Also, really need to see thyroid numbers (a complete workup) as mid-range doesn't equate to optimal.

And of course there are the other things that must be considered: sleep, diet, lifestyle choices/habits, exercise.

 

[Drofeyes21]

TSH 2.2uIU (0.45-4.5)
T4 5.1ug/dL (4.5-12.0)
T3 free 3.1 pg/mL (2.0-4.4)
TPO <6IU/mL (0-34)

I do lift 3 days a week with squats, bench, rows, deadlift, and overhead press. It’s a 3x5 regimen. I’m making decent strength gains. I’m 6’3” and weigh 240. I’ve been lifting for about 14 months and have put on 10lbs and gained 2” in biceps and thighs and 4” in chest.

I do have sleep apnea and have been using a bi-pap for well over a year with strict compliance and an avg AHI of 3. My numbers are always lower the night I inject or after I lift. I average 6.5hrs of sleep a night and sleep well every night when I don’t get too hot. I got a Bear mattress and it’s awesome.

My diet is also decent. Mostly home cooked meals with protein, carbs, fat, and fiber.

 

[Drofeyes21]

I don’t have a problem returning to IM. Subq is definitely more comfortable as I was injecting in my thighs with a 1” 25g. I currently go with 5/8” 28g for the subq. I know that’s a little bigger than most go with, but I haven’t had any issues.

 

[Drofeyes21]

I'm trying not to fall asleep in between patients and reading through the rest of the forums. Something's got to give. I used to pop 200mg caffeine every morning but stopped a month ago when I started to get desensitized.

 

[OMI100]

Your FT3 is below mid range. Some refs say best in upper 1/3 of range.
No FT4 or RT3 to look at.
I suggest you might want to look around the restartmed BLOG and start at thyroid basics and work up (may be review on some subjects for you but may also be some new info to consider OR pick and choose BLOG post that interest you). I think you will be impressed with the BLOG post. I have no idea when he sleeps, but the post are top notch and well documented.
Blog - Dr. Westin Childs
He also has an extensive YouTube page where he gives the "Cliff Notes" on each of the BLOG post. And it now looks like he is branching out into the podcast area.

 

[OMI100]

Dr. Westin Childs

 

[fifty]

Try 150 once a week? Going every 2 weeks to every 4 days is a big change. Also if you’re feeling off I would recommend going back to IM also.

 

[Drofeyes21]

I did an IM injection last night. I was pole vaulting all night under the covers.