First post here, but long-time lurker. Running out of ideas and hoping to lean on the experts here for advice or info… many thanks in advance.
Backstory:
The last six years have been a real journey. Had to do a year of chemo for liver disease, resulting in screwy hormones (thyroid, testosterone) and other autoimmune problems (Hashimoto’s, autoimmune hepatitis). Soon after chemo ended, the docs discovered thyroid problems (found to be Hashimoto’s), and began T4 meds. Things still didn’t iron out, and they eventually discovered low testosterone levels (Total of 230) and began HRT with Androgel. Unfortunately, no tests were ever run for the -why- question of low test.
From there it’s been a roller-coaster, with lots of docs, opinions, and egos. Finally, I’ve got some I can trust and that are open-minded. At this point, I’m in my mid-30s, trying to put the puzzle pieces back together. Had to learn a lot along the way, and am still learning.
TRT:
Began on 5g Androderm patches. Skin irritation like a mofo, so we switched to Androgel 1% @ 5g. Was on that for about five years. Total Testosterone numbers varied anywhere between 300s - 600s, typically in the 400s - 500s. Libido and E.D. was persistent most of the time. Naturopath even briefly tried sublingual compounded testosterone – but that didn’t pan out. So last summer we tried doing injectable T (testosterone enanthate) at home dosing 100mg/week. No A.I. at that point. Only problem was it felt like I had been hit by a truck after each injection, and had constant diarrhea (perhaps high E2 or reaction to sesame oil binder?). FYI, E2 Estradiol numbers before starting Test. Enan. were upper 20s/low 30s.
A few weeks in after starting Test E. injections, libido got much, much better and far less E.D. Starting sweating like crazy, too. It was like being a horny teenager for a few days. Shortly thereafter, things seem to get worse again quickly, almost like I missed the target – with minimal libido, E.D. back again, depressed/moody. Labs at the end of the weekly cycle were a Total T of upper 600s. Not great, but better than before. We continued on at 100mg/week dosing for the next few months. TRT lab numbers looked good on paper, except E2 crept into the low to mid-40s, and thyroid numbers took a dump (TSH went from 1.xx to 3.5x). Still had the crushing fatigue, no energy, minimal to no libido, and ongoing unexplained diarrhea.
So back I went to Androgel, although this time we went for 10g/day. Libido was still shot, E.D. returned. However, fatigue got better, less moody/depressed and diarrhea went away. Doc was okay with trying an A.I., so we did generic Anastrozole at 0.25mg twice a week. Irritability and moodiness got less, and I didn’t feel as bloated. But this dropped my E2 Estradiol down from mid-40s to 16. So we reduced dosage of A.I. to 0.25mg once a week. Still have E.D. and no libido at this point. My most recent Total Test. on the 10g Androgel was in the upper 500s.
Thyroid:
Started with just 50mcg of T4 years ago. Things briefly improved on the thyroid front, then got worse. Eventually it was discovered I have Hashimoto’s (autoimmune thyroid disease). I had no idea I was under-medicated. New docs increased T4 meds to 88mcg a couple of years ago, then eventually switched me over to Nature-Throid at 1 1/2 grains. So, unfortunately, my thyroid numbers are still bouncing around a bit and an ongoing work in progress. Not exactly sure how many of my issues are from thyroid vs. testosterone problems (or something else). Ultrasounds of thyroid show some enlargement and a few smaller nodules (all <1cm in size).
Adrenals:
Naturopath doc ran a couple of salivary adrenal tests. Past endocrinologist did a 24-hr urine collection for adrenals. None of these tests indicated adrenal problems. Interestingly, taking small amounts of Prednisone at various times for other autoimmune issues seemed to help here and there. Only conclusion I can come to with that is it was helping to keep thyroid antibodies and inflammation down. Presently on 5mg of Prednisone and doing a trial run of compounded Low Dose Naltrexone (LDN) to see if it helps fatigue and autoimmune problems.
Diet/Exercise:
Went from eating crap years ago to being gluten-free and adopting a more paleo approach. Naturopath discovered the bad gluten-sensistivity which helped somewhat overall. Not much exercise tolerance on my part, just walking around the block can be exhausting, depending on the day. Used to be very active with hiking, biking, gym, etc.
Current Issues:
Very low libido, E.D., bad brain fog, awful fatigue, poor stamina, anxiety (seems tied to hormone fluctuations).
Questions and Thinking Out Loud:
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Is it possible to get testosterone enanthate with a different oil (no sesame, perhaps cottonseed instead)? Or is that only found in the cypionate offerings? Wondering if I had a reaction to it.
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Has anyone heard of ongoing diarrhea as side effect or reaction from injectable T?
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My goal has been to get E2 in the low 20s, now that I know a little more about it. How potent is Estradiol as far as blocking thyroid hormone absorption? My thyroid numbers seemed to get worse after starting TRT injections and having an E2 increase.
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Would re-trying injectable Test. at a lower dose (say, 80mg/week instead of 100mg) and splitting that into twice-a-week dosing be a better way to ease back into things, keeping E2 sides minimized?
(Labs to follow in another post…)