Extreme Fatigue

Please delete this thread.

You have no testosterone available to the body, it’s all bound up in SHBG. One thing that happened to me once I lost my testosterone productions is I became a diabetic overnight, some men lose glucose control when testosterone is low. Your FT is bottomed out, stupid doctors!

Your situation will continue to deteriorate, TRT is really the only thing that can force down your high SHBG. Most doctors will fail to understand much of anything regarding male hormones as it’s not even taught in med school.

You need to find an cash pay only doctor to get competent care, insurance doctors aren’t permitted to spend the necessary time to balance your hormones. Once you hit normal ranges whether it be 450-800 their done with you, they will refuse to balance your other hormones that are affected by restoring testosterone levels.

You have a lot of similar systems I had when I was low T, the fatigue and inability to climb stairs was the worst.

Any meds?

According to whom, your doctor? This is ending up more difficult for your doctors than most informed patients, this should concern you. Low thyroid function can mimic low T symptoms and most doctors also fail at diagnosing thyroid disorders. Your doctors are clearly struggling.

Labs always tell the full story.


Obviously if fT3 is in range but at the bottom of the ranges, this isn’t fine. It’s disease management, mainly doctors will wait until things are really bad up before acting. This saves healthcare costs while you suffer.

Thyroid labs?

Your FT is low, 14.7 ng/dL = 1.27 %, needs to be 2-3% to be normal. Clueless doctors go by FT measured directly, it’s wildly inaccurate do to the short 1 hour half life, your FT could be low an hour later. You need to calculate FT using SHBG calculator. fT3 looks great.

You need to go private, TRT is too difficult for most doctors. The truth is doctors don’t learn anything about male hormones in med school, so everything they learned is through trial and error, don’t go down on their error and become a negative statistic.


Your iron is too high and fatigue is a common symptom of this. Furthermore, high iron can damage vital organs if left too long.

When trt raises my iron, I donate blood and this fixes the issue. You might want to look into why your iron is raised and keep an eye on it in future.

What was your iron level, before you donated blood? And also, did you have fatigue when iron was high, like I do?

You have something similar to what I have going on. Your iron is too high which is a very bad thing. You also need to get your ferritin and iron saturation tested. If both of those are elevated then you need to be tested for hemochromatosis. Once your iron stores are full in your body it will begin to store iron in other places like; pituitary, heart, testicles, liver etc. Which will damage all of them over time.


I would say you need to evaluate your diet and see where all the iron is coming from. If you can, donate a pint of blood or two,to get rid of the extra iron. Your ferritin is at a nice level so your body isn’t storing extra iron in places it shouldn’t be and you don’t have uncessecary inflamation so that’s a good thing.
This is just my interpretation from my own research though, it’s still a good idea to get an opinion from a doctor if you can. As for your hormones I don’t know too much on that topic as I’m waiting for similar help on my own thread.

You are acting like a dumb ass doctor saying that things are normal when you really needed to post everything with ranges. Does not matter that docs say…

SHBG is screaming out for deeper understanding.
Sex hormone-binding globulin - Wikipedia
SHBG is made in the liver to scavenge sex hormones for return and metabolization. Some liver conditions/diseases can increase SHBG. You need to find what has changed in your liver. Higher E2 increases SHBG and higher T levels decrease SHBG.

Your non-bioavailable SHBG has inflated your TT so that TT overstates your T status while FT is reduced.

Have you been in a tropical climate with associated diseases?
Has anyone actually looked at your blood under a microscope?

Post your waking and mid-afternoon oral body temperatures so we have them.

When things started to go badly for you, was that preceded by a blow to the head or whiplash?

Have you used an oral hair loss drug, steroids or prohormones?
Some react very badly.

Do you get leg cramps or can tighten a muscle and have it lock up? That is magnesium deficiency, see ZMA sold in this site’s Biotest store.

Are you Vit-D3 deficient?

When things go bad with one’s body, problems that your body used to ignore or tolerate can be significant.
Serum iron is affected by what you age the day before and should not be used alone to drive changes.

FT=.49 midrange
SHBG - very high
AM cortisol - do at 8AM or 1 hour after waking up.

10,000iu Vit-D3
fish oil
100mg Ubiqinol form of CoQ10 - get the spelling correct, this is not ubiquinone.
natural source Vit-E
high dose B-complex multi-vit with trace elements including 150mcg iodine and 200mcg selenium

Energy levels affected by fT3, CoQ10, anti-oxidants.

You may not have an iron problem, need to see CBC and hematocrit. Ferritin is actionable. Serum iron is greatly affected by what you ate the day before so you cannot act on it alone. I have had low iron and high iron lab results and doctors running on that.

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re Thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab numbers and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.



What should someone look for on there labs that mite show they could possibly be a diabetic??

not systemlord but its usually fasted blood glucose levels.

thanks for the reply

If diabetic status is suspect, “A1C” is the best lab. Your high end fasting glucose does create a concern.

Liver labs look perfect. So that is not a concern re increased SHBG. Some cases of high or low SHBG are not explainable.

TSH=2.33 is too high, should be nearer to 1.0 two years ago
ft3 appears good two years ago

Temperature=98F is low

What has been your history of using iodized salt. This may be the problem.

@KSman - Yes, my high end fasting glucose does create a concern. I still haven’t found an explanation for it. Yesterday I did again fasting glucose test and the result is 5.10 mmol/l. It’s not so high, but it will be better if it is lower than that. However, these levels can’t cause my fatigue.

I did A1C lab test. HbA1c is 5.3% (NR: 4 – 6 %).

TSH was 2.33 two years ago, but now is 1.80, which is better.

I use mainly iodized salt. I don’t calculate how much I consume, but I can increase it to test what will be the result. How many grams should I consume daily? Or you can suggest me an iodine supplement.

And also, do you think that the fatigue can be caused by something that I haven’t tested yet? Because I am running out of ideas.