Can TRT Cause Addison's Disease or Adrenal Suppression Syndrome?

Pharma / TRT Testosterone Replacement
1

So, I’m on Levothyroxine 100mcg/day + TRT.

I did a couple of Testosterone shots 2 months ago, didn’t feel good and stopped. I was in India.

Returned to NYC and asked the US doctor and he gave me a new TRT prescription and protocol:

  • 65mg Test twice a week
  • HCG 250 iu twice a week
  • No Anastrazole for now, only if estrogen goes out of control. Some people don’t need it.

After I got the prescription, I had travel to Colombia. So, I got my prescription and flew to Colombia. That’s where I started my new TRT protocol. Been 4 weeks.

Everytime I take Testosterone shot, I feel extreme tiredness lasting couple of days. I can barely get out of bed. Just extreme fatigue.

I thought body was just getting adjusted to it so I decided to keep patient but after 4 shots (2 weeks) of Testosterone injection and same fatigue after every shot, I got worried.

I spoke to an endocrinilogist here in Colombia and she has no time to see me until Friday. But meanwhile, on the phone, she said: you could have steroid induced Adrenal Suppression Syndrome (aka Addion’s Disease). Try Predinosone 50mg (OTC) for 5 days and then I’ll see you on Friday.

I took it and within an hour, my fatigue disappeared.

Can TRT cause this? Or did I already have this and taking Testosterone increased imbalance between Cortisol and Testosterone and hence the onset of extreme fatigue?

What tests should I get done? She said she’d need to get a comprehensive hormonal panel done including **Thyroid related tests, ACTH, Testosterone, Estrogen related tests, DHEA, igf-1, shbg ** and so on. Plus well as Vitamin/Mineral testing (A, B12, D, Iron, Mg, Calcium, Potasium etc) Anything else I should add to it?

2

UPDATE:

I met with the endocrinologist here and lot of tests were done. She determined that:

  1. I’m borderline diabetic:

  • Fasting blood sugar was 236. She is repeating that test just to be sure.
    → HbA1c : 6.03%
    → Good cholesterol was low and bad cholesterol was high
    Total Cholesterol: 258 mg/dl (range: major > 250)
    HDL: 22 mg/dl (range: 40-60)
    VLDL: 62/mg/dl (range: 0-30)
    LDL: 173 mg/dl (range: 0-130)
    Triglyceride: 311 mg/dl (range:0-150)

  1. She said that is probably why TRT is not helping with ED

  2. She also said because your cells are not absorbing glucose, it is probably why you feel fatigue.

  3. Also, B12 was deficient so she prescribed B12 shot that I plan to take tomorrow.

**I was wondering if anyone here had any opinion on it. Anything I should watch out for? Investigate further? Could diabetic glucose levels really be causing ED and fatigue?

I’m already skinny (155 lbs, 5’10 height) so she didn’t ask me to lose weight as such but suggested some lifestyle changes (eat more whole foods, exercise more, sleep 7+ hours)

And said after glucose test is repeated, she is probably going to prescribe me metformin to control blood sugar. Would that fix ED?

3
4

Diabetics can have Ed .

Trt can help

Also Viagra / Cialis Can help restore penile function in those with diabetes. There are studies search internet. Metformin should help. Get it as soon as you can. May need to start with 500 mg and go up quickly to 1500-2000 mg a day.
Should help with insulin resistance too. Check insulin?

Dr should keep an eye on tsh numbers too to see if dose is fine for thyroid meds.

Check am cortisol too. And acth.

5

Hi @anon10230041
Thanks for replying.

  1. Doctor suggested I reduce levothyroxine medicine - I take 100mg right now. Because TSH is close to 0 (.02 actually). But my T4 and T3 are a little below middle range. So, I am unsure if I should lower Thyroid dose though.

  2. Viagara/Cialis have stopped working on me for over a year. They only work if I take 5x the previous dose. Eg: I used to take Cialis 5mg 2 years ago when I started having ED. About one or two times a week. Now, I have to take 25mg/30mg and the effect only lasts a day.

  3. Doctor prescribed Metformin but she told me to hold on it until we have re-done Glucose test to be sure it wasn’t a lab error.

Morning Cortisol is 9 (range: 4 - 22)

ACTH is middle too.

6

Viagra doesn’t work well when e2 is low.

7

Thanks, @anon10230041,
e2 is not too low. It is in 40s. But actually, pre TRT, my e2 was in 20s and Viagara/Cialis still didn’t work as they used to work on me at the begining of ED problems.

Doctor was suggesting that because I’m pre-diabetic, it may have caused nerve damage in the penis area preventing blood flow. So, with lifestyle changes and control on blood sugar, those nerves will likely recover. I’m not sure if thats even possible.

She didn’t think my ED was hormone related especially now that I’m on TRT. She believes there is something (eg: nerve damage) physically preventing blood flow.

8

Makes sense. I believe they can do a penile utra sound or a nerve test. Not sure if that will help diagnose

9

Thanks, @anon10230041

So, I suppose, I can trust the doctor and start taking medications she prescribed?

  1. Metafarmin 1000mg
  2. Continue TRT protocol (65mg Test E twice a week + 250 iu HCG twice a week + Anastrazole as needed)
  3. Lower Thyroid dose - not sure if I should though. Because I was told to target my T4 and T3 to be in middle of normal range and ignore TSH. But looks like the doctor is asking me to lower Thyroid med based on TSH. My T4 seems to be in the lower-half of normal range.
  4. Statins for cholesterol - but we’ve now decided to wait 3 months to see if cholesterol reduces on its own with lifestyle changes
  5. DHEA 25mg once or twice a day
    Hopefully, this will fix both fatigue issues (upon TRT shots) and Erectile Dysfunction - anyone knows how long it takes for ED to fix once you go on diabetes medicine?

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