I paused TRT before a surgery due to blood clot risks. I chose to stay off to determine if my body could return to normal testosterone levels. Three months later, I’m experiencing significant fatigue, weakness, and sexual side effects.
Here are my most recent test results, three months off TRT:
Testosterone: 372 ng/dL
LH: 9.8 IU/L
FSH: 15.3 IU/L
One month after stopping TRT, my results were:
Testosterone: 473 ng/dL
LH: 13.3 IU/L
FSH: 14.1 IU/L
My endocrinologist suspects primary hypogonadism. While I plan to follow my doctor’s advice and return to treatment, I’d like to get a second opinion from the BBM doctors.
Additional context:
I started Wegovy and lost weight, dropping from 261 lbs to 201 lbs. I’m 5’9", and my waist size is now 36 inches, down from 41 inches.
I’m constantly exhausted and have a sleep study scheduled for December. With an elevated BMI, I might have sleep apnea, raising concerns that the primary hypogonadism diagnosis could be a false positive.
I’m also worried that TRT might have disrupted my body’s natural testosterone production, as indicated by the elevated LH and FSH levels. Is it just a matter of giving my body more time to normalize, or is this a permanent change? The symptoms are significantly affecting my quality of life, and I’m struggling to cope. Thank you for taking the time to read this!
This is stretching a bit beyond what we can address in detail via the forum vs. a consultation, but some preliminary thoughts:
It’s not too surprising that within the first few months after stopping TRT you’re experiencing symptoms. Sometimes it can take longer than this to re-equilibrate, depending on how much testosterone the person was taking and for how long. Would be helpful to know some of the context for when you started TRT as well.
However, with your current total T levels in those ranges, and given the context of obesity with ongoing weight loss, it would be reasonable to SHBG and free T levels in this situation. I’m sure your endo has already addressed / checked other potential issues (you mention the sleep study, as well as ruling out anemia/iron deficiency and thyroid dysfunction would be relevant here too).
Prior to the surgery I was on TRT for about 5 years. Is there an estimated time to re-equilibrate?
As far as the other issues go, I actually haven’t been checked for anemia, so I’ll contact my primary care physician next week. I also have Hashimoto’s and the hypothyroidism that goes along with it, but it’s monitored and treated. The sleep study is scheduled for December and its an intensive two day affair.
Unfortunately I took my first dose of TRT yesterday on the order of my endocrinologist. I respect his diagnosis but at the same time I worry I influenced it by mentioning my lack of tolerance for my current symptoms.