Low Cortisol Issues

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DarkMan X

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I was diagnosed with lower-than-normal cortisol about a year before starting TRT. This was not your standard blood test - which can bring erroneous results. This test was a "saliva test" which means that 4-5 times a day, I had to spit inside a tube, and then have that tube shipped to the lab and have my results a week later.

The reason I ask this is because I think my TRT is further lowering my Cortisol to unsafe levels (OR just really screwing up my adrenals or other hormones). I have lost the initial TRT effects like better mood, more strength, and more libido.

The reason I suspect Cortisol over other hormones is because I am diabetic (type 2).... and I have a Libre continuous glucose monitor - So I can frequently confirm that i do indeed get very low sugars. This is kind of the opposite of what diabetes is supposed to do (HIGH sugars).

Nobody even talks about cortisol unless it has reached deadly extremes like Addison's or Cushing's disease. The only site I could find about low cortisol symptoms is here below:


I would really like to hear from any other folks who have had cortisol issues!

Cheers!
 
Defy Medical TRT clinic doctor
You may be talking about the honeymoon phase of TRT and not low cortisol. I also have low cortisol issues. For me, it’s been a challenge, but the things that have worked best were figuring out different schemes of pregnenolone, T3 and T4, rhodiola, and potentially using cortisone acetate or adrenal glandulars. Playing with your T dose and form can also help.

It’s also possible that it’s more of a cortisol regulation issue than low cortisol, which is a theory of mine based on me extensive experience trying things out over time. Cortisol has active and inactive forms, and it’s possible that in some people like maybe me that your body shifts more to run on the active forms, which has negative effects, and has less inactive forms to transport it where it needs to be, which also has negative effects.
 
The reason I suspect Cortisol over other hormones is because I am diabetic (type 2).... and I have a Libre continuous glucose monitor - So I can frequently confirm that i do indeed get very low sugars. This is kind of the opposite of what diabetes is supposed to do (HIGH sugars).
What do you take for medication for the diabetes? Is it possible you need less due to TRT improving your insulin sensitivity?
 
Is it possible you need less due to TRT improving your insulin sensitivity?
This ^^^^

TRT can improve glucose levels in a matter of days, but full glycemic control can take 6-9 months. If you have low glucose, you might talk to your doctor about significantly reducing or stopping insulin injections.

The low blood glucose is the elephant in the room here.

I was diagnosed with lower-than-normal cortisol about a year before starting TRT.
TRT can suppress cortisol and in someone with already low cortisol, can make TRT challenging.
 
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I hope it's okay that I posted this here, but if not - I will repost to another part of this site.

More than 6 months ago, I was started on Nandrolone decanoate PLUS my regular TRT because Defy judged that my back pain would greatly benefit from beefing up/strengthening my back muscles. I was assigned to take 0.15 mL's twice a week. But even at such a small dose, the Nandrolone always worsened my insomnia and headaches.
On July 19th, I did my first ever blood donation to lower my hematocrit and to lower my blood thickness caused by too many red blood cells. I was reading that Nandrolone also "doubles" the amount of red blood cells created as opposed to T-cypionate alone.

TL; DR: I think Hematocrit levels are an unreliable indicator of when you know you must perform a blood donation to flush out the extra red blood cells.
 
How significant/powerful is Testosterone therapy's ability to improve insulin sensitivity in a type-2 diabetic?
My A1C pre-TRT was 12% and after almost a year is 5.8%. During the first week on TRT, glucose went from 368 -> 136 two hours after meals.

TRT can reverse type-2 diabetes and in fact if the reason for low-T is the result of type-2 diabetes, then there is a chance years down the road if you were to stop treatment, after reversing the diabetes, your testosterone may go back up on its own.
 
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My A1C pre-TRT was 12% and after almost a year is 5.8%. During the first week on TRT, glucose went from 368 -> 136 two hours after meals.

TRT can reverse type-2 diabetes and in fact if the reason for low-T is the result of type-2 diabetes, then there is a chance years down the road if you were to stop treatment, after reversing the diabetes, your testosterone may go back up on its own.
Wow, that is quite strange. Despite starting TRT and experiencing more frequent hypoglycemic episodes, my A1C actually went UP from about 5.8 to 6.xx.. I know this sounds very unorthodox from what people have come to believe, but I have learned that I am, indeed, that 1% of patients that always has unorthodox or "paradoxical reactions" to drugs or hormones.

I couldn't explain it to you any better if I tried.
 
Wow, that is quite strange. Despite starting TRT and experiencing more frequent hypoglycemic episodes, my A1C actually went UP from about 5.8 to 6.xx.. I
The first time I went on TRT I was iron deficient, which is common in people with type 2 diabetes.

I felt nothing on TRT when iron deficient, no benefits at all and eventually things got worse than pre-TRT.

When someone is iron deficient, the half-life of the red blood cells increases and you get a false elevation in A1C.

What's your iron status?
 
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FALSELY ELEVATED A1C​

Any condition that prolongs the life of the erythrocyte or is associated with decreased red cell turnover exposes the cell to glucose for a longer period of time, resulting in higher A1c levels. Iron deficiency anemia is a commonly reported condition associated with falsely elevated A1c.

 
Since my last blood test did not explicitly test IRON itself, I will give a small screenshot of relevant markers which may help your question:

1660448096803.png
 
Low cortisol can affect thyroid function, so TRT may be making things worse for you.

I would still test your ferritin levels to be sure, because there is such a thing as iron deficiency without anemia with normal hemoglobin.
 
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Low cortisol can affect thyroid function, so TRT may be making things worse for you.

I would still test your ferritin levels to be sure, because there is such a thing as iron deficiency without anemia with normal hemoglobin.
Okay, I will ask for a ferritin test in that case.

Are you diabetic? Can diabetes catabolize (waste away) your existing muscles?
 
Type 2 diabetes can cause a decline in skeletal muscle mass. High blood sugar levels can lead to muscle atrophy.


Yes, type 2 diabetes.
It’s probably more that one of the mechanisms of Type 2 diabetes is too much fat getting stored in the wrong cells like muscles and that blocks the ability of them to receive nutrients.
 
It’s probably more that one of the mechanisms of Type 2 diabetes is too much fat getting stored in the wrong cells like muscles and that blocks the ability of them to receive nutrients.
Most people love saying that cortisol is bad for you, cortisol will kill you... etc...

But lower-than-optimal cortisol levels are just as dangerous (if not MORE dangerous) than high cortisol.

Dr. Forest Tennant (a very prominent pain specialist nationwide) - says that many pain patients have low cortisol levels. He was able to reduce their opiate dosages by increasing and supplementing to make cortisol higher. here is the link:

 
Beyond Testosterone Book by Nelson Vergel
Most people love saying that cortisol is bad for you, cortisol will kill you... etc...

But lower-than-optimal cortisol levels are just as dangerous (if not MORE dangerous) than high cortisol.

Dr. Forest Tennant (a very prominent pain specialist nationwide) - says that many pain patients have low cortisol levels. He was able to reduce their opiate dosages by increasing and supplementing to make cortisol higher. here is the link:

I’ve historically had low cortisol levels so you’re preaching to the choir with that! Mine’s been bad enough before that my A1C gets flagged as too low. I see people complaining about theirs being higher and their cortisol being too high and their blood pressure going up and I’m almost envious.
 
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