When testosterone isn't enough - major fatigue and brain fog.

[EnlightenedViking]

I started testosterone at 30, when my labs consistently came back around 250-300 ng/dL. Like most of you, it took a few years to dial in a protocol that worked. I had 3-4 years of great results that improved my life tremendously(career, workouts, relationships, etc)

Fast forward to the last 3 years. As I moved up in my career, moved states, and started a long-term relationship, I've slowly been going downhill.

After leaving my job last month after experiencing weeks of waking up with anxiety, and knowing it was the wrong environment for me, I'm nowhere near my best.

After I quit my job, I spent weeks sleeping until 11-noon, still feeling exhausted. I could get myself on a walk or two the gym, but the next day I felt the same.

Now, almost 6 weeks later, I wake up with poor motor function(spilling my coffee, dropping things, very tired) and don't have the energy to do anything until I've been awake for 4 hours+.

If you were in my shoes, where would you start? I'm doing a full comprehensive blood panel this week and without a job, I don't have insurance to cover finding a new Doctor to monitor my progress or new protocol.

 

[Systemlord]

I started testosterone at 30, when my labs consistently came back around 250-300 ng/dL. Like most of you, it took a few years to dial in a protocol that worked. I had 3-4 years of great results that improved my life tremendously(career, workouts, relationships, etc)

After I quit, I spent weeks sleeping until 11-noon, still feeling exhausted. I could get myself on a walk or two the gym, but the next day I felt the same.

Now, almost 6 weeks later, I wake up with poor motor function(spilling my coffee, dropping things, very tired) and don't have the energy to do anything until I've been awake for 4 hours+.

I don't understand your hesitation, what's the hangup?

Whether or not you should start TRT, fu** yeah!

As for not having insurance, there's always cash pay for treatment. Defy Medical is the first clinic that comes to mind.

 

[Vince]

I started testosterone at 30, when my labs consistently came back around 250-300 ng/dL. Like most of you, it took a few years to dial in a protocol that worked. I had 3-4 years of great results that improved my life tremendously(career, workouts, relationships, etc)

Fast forward to the last 3 years. As I moved up in my career, moved states, and started a long-term relationship, I've slowly been going downhill.

After leaving my job last month after experiencing weeks of waking up with anxiety, and knowing it was the wrong environment for me, I'm nowhere near my best.

After I quit my job, I spent weeks sleeping until 11-noon, still feeling exhausted. I could get myself on a walk or two the gym, but the next day I felt the same.

Now, almost 6 weeks later, I wake up with poor motor function(spilling my coffee, dropping things, very tired) and don't have the energy to do anything until I've been awake for 4 hours+.

If you were in my shoes, where would you start? I'm doing a full comprehensive blood panel this week and without a job, I don't have insurance to cover finding a new Doctor to monitor my progress or new protocol.

I would clean up my diet. Eat super low carbs with lots of good not-starchy vegetables. At least that would be my start.

 

[EnlightenedViking]

Just to clarify, I am on TRT and have been for 9+ years. It's only in the last 2 that I've seen a steady decline in how I feel. As of the last 6 weeks, it's fallen off a cliff

 

[Systemlord]

Just to clarify, I am on TRT and have been for 9+ years. It's only in the last 2 that I've seen a steady decline in how I feel. As of the last 6 weeks, it's fallen off a cliff

Then the real cause of your low testosterone is starting to progress. Remember low T is a symptom of something bigger going on and trying to circumvent a disease process doesn't always work and often buys time.

 

[Phil Goodman]

I would clean up my diet. Eat super low carbs with lots of good not-starchy vegetables. At least that would be my start.

I second the suggestion of cleaning up diet, though I wouldn’t necessarily say low-carb is a must. In the past I’ve done strict AIP diet for just one month and saw incredible results as far as mental clarity goes. That was the sharpest I’d ever been before starting trt. There are lots of ways to do it, and low carb certainly is one, but I think the most important aspect is reducing inflammation in the body.

For me, poor sleep will immediately affect me so if I sleep poorly two days in a row my mental abilities are substantially reduced. And I’d say sleeping too much may be just as bad, but more likely that’s just a result of other issues tbh at are telling your body it needs to recover, so again that may indicate inflammation as your body is constantly trying to put out fires and repair itself.

Lastly, Creatine can be a good supplement for many reasons, and mental cognition benefits are certainly a big one. It’s one of the cheapest, most studied, and safest supplements you can add to your routine.




I’d say a diet that greatly reduces inflammation and incorporating Creatine could be two hugely beneficial approaches to incorporate into your lifestyle.

 

[DS3]

Sounds like MDD - major depression. Diet, hormones, exercise, sleep…all are lifestyle factors can contribute positively or negatively to depression, but major depression is often resistant. For me, someone who personally experiences this form of depression, the only solution I’ve found is to tinker with my TRT protocol; increase dose, decrease dose, add / remove low dose Primo, add / remove / increase HCG, etc.

Another option would, of course, be to go to a psychiatrist for an evaluation and likely an anti-depressant. If that is the route that you take, I’d ask your doctor if you could start with Wellbutrin instead of SSRIs.

I’d press you not to wait. Make a determination of your next steps, and take them. MDD, which it sounds like you have it, will ruin your career, personal life, and your health. Take action.

 

[Dr.V.P.C.]

Consider trying some bupropion xl

 

[excelnelg]

Could literally be anything.

 

[Guided_by_Voices]

I started testosterone at 30, when my labs consistently came back around 250-300 ng/dL. Like most of you, it took a few years to dial in a protocol that worked. I had 3-4 years of great results that improved my life tremendously(career, workouts, relationships, etc)

Fast forward to the last 3 years. As I moved up in my career, moved states, and started a long-term relationship, I've slowly been going downhill.

After leaving my job last month after experiencing weeks of waking up with anxiety, and knowing it was the wrong environment for me, I'm nowhere near my best.

After I quit my job, I spent weeks sleeping until 11-noon, still feeling exhausted. I could get myself on a walk or two the gym, but the next day I felt the same.

Now, almost 6 weeks later, I wake up with poor motor function(spilling my coffee, dropping things, very tired) and don't have the energy to do anything until I've been awake for 4 hours+.

If you were in my shoes, where would you start? I'm doing a full comprehensive blood panel this week and without a job, I don't have insurance to cover finding a new Doctor to monitor my progress or new protocol.

Your symptoms scream infection or environmental toxin, and a good work-up from a holistic doc would be a good place to start but the tests would cost money. There are other things that can cause fatigue such as use of high-dose niacin, so I would look at everything you're taking and doing and investigate whether it could be the issue. Other than thyroid, it doesn't sound hormonal. You didn't say anything about your diet but if you're doing something extreme that could be an issue. I'm assuming you are still on your steady-state TRT. Lyme disease could explain what you're going through but requires a specialist to even diagnose correctly given the prevalence (AFAIK) of false negatives from the standard tests and the difficulty of treating it. If you feel better away from where your are living (like staying overnight in a hotel) that could be a clue that there is some sort of environmental toxin where you are. Getting wheat, seed oils and any kind of processed food out of your diet is an immediate must-do. I always recommend the book Perfect Health Diet as home base for diet choices, and the author of that book got into the field after having a severe rare infection that produced symptoms similar to yours.

 

[Belekas]

Yeah can be anything and a combination of things and already good advice above from the fellow forum OGs. Fiding the root cause of things is pain in the ass thats why most opt for a pill or any other bandage, but pay later down the line. This is mens TRT forum yet so little talk about the main genes and their mutations and theres tons of them. Some of the are crucial to detoxify meds, chemicals, hormones, like estrogen, and if you got them mutations then the buildup can and will def fuck you and your well-being up long-term. But nah, nobody is lookin at that, because its next level and requires a lot of work. Then the methylation cycles, liver detoxification, etc, etc. Also nobody checks Homocysteine when in reality its crucial for overall health and managing future issues down the line. And the list goes on and on and on. For some sticking a needle is all it takes for others, its far, far, more complicated. Ofc I would do all once I got all my other complete blood tests done to see where I'm at and then would get raw DNA and work from there. Amazing what you can and will find, I'm 100% sure and we barely scratched the surface here Hang in there, it will get better!

 

[sammmy]

Taking a mild stimulant, like Guarana powder, will help you be more active and optimistic during the day. It may not address the root cause, if it's not purely psychological like depression. Note: the effects of Guarana are not solely due to caffeine, it contains many other feel-good alkaloids; be warned of good mood crashes when it wears out - you may need to do two doses per day.

I agree with what was said about diet because there is a notable gut-brain connection and a hard to digest, pro-diabetic, or inflammatory diet can cause brain fog, sluggishness, and depression.

In any case, do some essential blood tests such as CBC with differential and CMP to see if there is something abnormal going on in the body. These two tests are very cheap and you can order them yourself without any doctor.

 

[FunkOdyssey]

Sounds like MDD - major depression.

This. It could be many other things of course, but based on the small amount of information provided, including multiple destabilizing life events, depression sounds most likely to me.

 

[EnlightenedViking]

Sounds like MDD - major depression. Diet, hormones, exercise, sleep…all are lifestyle factors can contribute positively or negatively to depression, but major depression is often resistant. For me, someone who personally experiences this form of depression, the only solution I’ve found is to tinker with my TRT protocol; increase dose, decrease dose, add / remove low dose Primo, add / remove / increase HCG, etc.

Another option would, of course, be to go to a psychiatrist for an evaluation and likely an anti-depressant. If that is the route that you take, I’d ask your doctor if you could start with Wellbutrin instead of SSRIs.

I’d press you not to wait. Make a determination of your next steps, and take them. MDD, which it sounds like you have it, will ruin your career, personal life, and your health. Take action.

Great call. Once my bloodwork comes back early next week I will post and see if Wellbutrin is a next step that needs to happen. Thank you

I've had this issues on and off again, coming in cycles for most of my life but always able to manage it with exercise, diet, and sleep. This is the first time I've slipped down the hill this far with no foothold to make progress back to my baseline. All options to get this corrected on the table.

Your symptoms scream infection or environmental toxin, and a good work-up from a holistic doc would be a good place to start but the tests would cost money. There are other things that can cause fatigue such as use of high-dose niacin, so I would look at everything you're taking and doing and investigate whether it could be the issue. Other than thyroid, it doesn't sound hormonal. You didn't say anything about your diet but if you're doing something extreme that could be an issue. I'm assuming you are still on your steady-state TRT. Lyme disease could explain what you're going through but requires a specialist to even diagnose correctly given the prevalence (AFAIK) of false negatives from the standard tests and the difficulty of treating it. If you feel better away from where your are living (like staying overnight in a hotel) that could be a clue that there is some sort of environmental toxin where you are. Getting wheat, seed oils and any kind of processed food out of your diet is an immediate must-do. I always recommend the book Perfect Health Diet as home base for diet choices, and the author of that book got into the field after having a severe rare infection that produced symptoms similar to yours.

You're on the same thought track I was on. I left my environment for 2 weeks to work outside for awhile. A family member needed help building a deck, but I was pretty worthless for the first few hours of the day, and exhausted at night.

Diet, Sauna, hot yoga and anything else I can do to clean out my system will be a key priority. Thank you for the book recommendation, I'll dive into it to see if there is any protocol I can add.

Really appreciate you all taking the time to reply fellas.

 

[Guided_by_Voices]

Another idea (unless you are already very lean) is to try doing a short fast of 24-36 hours, the idea being that if you feel better it could point to some sort of gut or food sensitivity issue. If you are in an environment where you can get fairly intense mid-day sun, that is likely to be helpful for your natural circadian rhythms. If you've ever lived in an environment where you might have had mold exposure, that could be another thing to look into.

 

[sammmy]

Also you may want to get tested for gluten intolerance and celiac. They present with fatigue and depression.

 

[Guided_by_Voices]

Or just stop eating wheat products and everything with gluten

 

[Nelson Vergel]

Consider trying some bupropion xl

I agree with @Dr.V.P.C.

This sounds to me like depression. You went through several life changes at once.

 

[Phil Goodman]

I agree that it could be depression, though I’m of the mindset that people should avoid medication to treat depression unless absolutely necessary, and it certainly shouldn’t be the first tactic utilized to resolve the issue. I think that in many cases, particularly when dealing with life events or other issues, depression is a signal the brain sends much like a part of the body sending a pain signal that something is wrong. If you break your arm, you fix the arm…you don’t just interrupt the signaling or else it will likely get worse. If you’re stuck in a bad environment or situation then your mind will tell you something needs to be addressed, whether that be dealing with external factors or processing internal feelings in order to come to peace with various things. Obviously these medications can be a useful tool, but should only be considered a longterm solution in rare instances. That’s just my view on it, though I would say it’s obvious anti-depressants are over-prescribed in this country. And as mentioned earlier, there could be other factors like inflammation that may not be easily recognized or considered key contributors to depression yet it is proven that in many cases they are. But if it sprung up suddenly after stressful life events, then diving into what factors may be contributing on that front would probably be a good place to start.

 

[Nelson Vergel]

I agree that it could be depression, though I’m of the mindset that people should avoid medication to treat depression unless absolutely necessary, and it certainly shouldn’t be the first tactic utilized to resolve the issue.

Antidepressants are not a way to resolve depression, but to give someone that has no drive to change circumstances (he mentions fatigue, etc) a way to take charge to make those changes. I have been in dark holes where I felt frozen and could not see the light. The last thing I wanted is to have people list the things I needed to do to "snap out of it".

Trintellix worked right away for me. I took it for three months and stopped when I had made enough changes because I had the energy to do so.