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Are Fatigue And Unexplainable Weight Gain A Sign Of Increased Testosterone Levels?
Question: My first set of symptoms of fatigue, unexplainable weight gain, water retention first became noticeable about 2 years after I had my last son and tubal ligation. I am a personal trainer so I am very in tune with my body and know what it takes to lose weight (appropriate macros and calorie expenditure). I started to research and came to the conclusion of hormone imbalance. After 6 months of trying to go the natural route with foods that help balance, I decided to go to a clinic doctor (I did not have insurance at the time). The clinic doctor gave me a prescription for Tri-Sprintec to help balance out my hormones. Sure enough 3 months later, I woke up like my old self, lean. After 6 months of taking Tri-Sprintec, I stopped because I figured that everything should be balanced. I stayed the same for about 6 months then noticed water retention of about 10lbs before I started my period, extreme fatigue (I was getting enough sleep - yet still needed to nap but still felt tired afterwards), forgetful and cannot concentrate, hard to reach orgasm, excess hair shedding, and unexplainable weight gain that I could not lose.
At the beginning of March 2015, I made another doctor appointment with my PCP and told her my systems (explained above). She ran blood work for CBC, CMP, and Thyroid and wrote me prescriptions for Adderall, Lasix, LoEstrin Fe in the meantime. My bloodwork came back normal however I had a gallbladder attack a week after seeing her (I have never had one) so I made another appointment to get checked out and to review lab results. She told me everything was fine per my bloodwork and since my TSH is 1.12 there is no need to check any other hormone.
Fast forward to now, it has been about 3 weeks since I have been on LoEstrin Fe and now I notice a slight increase in energy, however I am extremely moody and my sex drive has dimenished. I also had some light bleeding last week but my menstrual is not due until next week. I also went to get my hormones checked at a clinic and my Testosterone came back at 32. I was told that my range should be between 70-80 and was offered testosterone cypionate injections at 12mg every 10 days. My Free T4 - 0.98, Free T3 - 3.1, and on this test, my TSH2- 0.78.
My questions:
What could be causing my testosterone to be out of range?
Get back on Tri-Sprintec since I know it works and did not experience the sides I am having with LoEstrin?
Which doctor should I start with? (PCP to Endo or Gyno)
Thoughts on Testosterone Cypionate for women?
At the beginning of March 2015, I made another doctor appointment with my PCP and told her my systems (explained above). She ran blood work for CBC, CMP, and Thyroid and wrote me prescriptions for Adderall, Lasix, LoEstrin Fe in the meantime. My bloodwork came back normal however I had a gallbladder attack a week after seeing her (I have never had one) so I made another appointment to get checked out and to review lab results. She told me everything was fine per my bloodwork and since my TSH is 1.12 there is no need to check any other hormone.
Fast forward to now, it has been about 3 weeks since I have been on LoEstrin Fe and now I notice a slight increase in energy, however I am extremely moody and my sex drive has dimenished. I also had some light bleeding last week but my menstrual is not due until next week. I also went to get my hormones checked at a clinic and my Testosterone came back at 32. I was told that my range should be between 70-80 and was offered testosterone cypionate injections at 12mg every 10 days. My Free T4 - 0.98, Free T3 - 3.1, and on this test, my TSH2- 0.78.
My questions:
What could be causing my testosterone to be out of range?
Get back on Tri-Sprintec since I know it works and did not experience the sides I am having with LoEstrin?
Which doctor should I start with? (PCP to Endo or Gyno)
Thoughts on Testosterone Cypionate for women?
Brief Answer:
To test testosterone off hormone pills
Detailed Answer:
Good day,
Noted your concern.
You had been on two different oral hormonal pills ( Tri Sprintec and then LoEstrin) . Both these pills are combined hormonal pills which can bring down the testosterone levels. So it is rather useless to do a Testosterone level while you are on them. The best way to do is to stop these pills for at least 3 months and check the Testosterone levels on day 2 or 3 of your periods. Hence at the moment, I believe your testosterone levels were spuriously low and you need further evaluation before embarking on Testosterone treatment.
Your Thyroid profile is very normal and you do not need any supplement.
The best person to meet would be an Endocrinologist who can examine you and come to a conclusion before ordering further tests.
Regards
Binu
To test testosterone off hormone pills
Detailed Answer:
Good day,
Noted your concern.
You had been on two different oral hormonal pills ( Tri Sprintec and then LoEstrin) . Both these pills are combined hormonal pills which can bring down the testosterone levels. So it is rather useless to do a Testosterone level while you are on them. The best way to do is to stop these pills for at least 3 months and check the Testosterone levels on day 2 or 3 of your periods. Hence at the moment, I believe your testosterone levels were spuriously low and you need further evaluation before embarking on Testosterone treatment.
Your Thyroid profile is very normal and you do not need any supplement.
The best person to meet would be an Endocrinologist who can examine you and come to a conclusion before ordering further tests.
Regards
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
So my testosterone level can decrease with just using birth control for 6 months (Tri-Sprintec) and 3 weeks (LoEstrin Fe) with almost a year gap in between the usage?
In the meantime to help with my fatigue if I do stop the birth control, what would you suggest I do to help me keep enough energy to go through my day?
I will definitely ask my PCP for a referral to an Endocrinologist.
In the meantime to help with my fatigue if I do stop the birth control, what would you suggest I do to help me keep enough energy to go through my day?
I will definitely ask my PCP for a referral to an Endocrinologist.
Brief Answer:
Relation of low Testosterone with birth control pills
Detailed Answer:
Thank you for the reply.
Birth control pills ( combined hormone pills) are the treatment of choice for reducing the male hormone levels ( testosterone ) in women who present with excess hair growth, acne and irregular periods. Birth control pills reduce pituitary gland secretion of LH hormone which further reduce testosterone levels.
Once you stop taking these pills, it takes several weeks to months for the testosterone to come back to normal levels. So, if you had done the testosterone levels while using the birth control pills or with in first 2-3 months of stopping them, there are chances that the low testosterone level was due to that. Besides, there are several other drugs including steroids which can suppress testosterone levels.
Again, testosterone levels can vary very much based on time of the day. It is best to check testosterone in the fasting state between 7 to 9 am on day 2 or 3 of your periods. Testosterone can be temporarily low in depressed persons too.
When an endocrinologist come across a low testosterone levels, always it is reconfirmed by a second test.
Other causes of low energy must be excluded which include sleep apnea ( snoring with apnea), lack of good quality sleep, depression, anemia , low Vitamin B12 level and low CORTISOL hormone levels etc. ( Your CBC was normal and hence you are unlikely to have anemia).
While talking to your PCP, it may be a good idea to get an 8 AM serum cortisol done.
Relax and please do stretch exercise. Have adequate sleep at night ( 8 hours minimum) . Eat a healthy balanced diet. While you are waiting to see the endocrinologist, these measures may help.
Relation of low Testosterone with birth control pills
Detailed Answer:
Thank you for the reply.
Birth control pills ( combined hormone pills) are the treatment of choice for reducing the male hormone levels ( testosterone ) in women who present with excess hair growth, acne and irregular periods. Birth control pills reduce pituitary gland secretion of LH hormone which further reduce testosterone levels.
Once you stop taking these pills, it takes several weeks to months for the testosterone to come back to normal levels. So, if you had done the testosterone levels while using the birth control pills or with in first 2-3 months of stopping them, there are chances that the low testosterone level was due to that. Besides, there are several other drugs including steroids which can suppress testosterone levels.
Again, testosterone levels can vary very much based on time of the day. It is best to check testosterone in the fasting state between 7 to 9 am on day 2 or 3 of your periods. Testosterone can be temporarily low in depressed persons too.
When an endocrinologist come across a low testosterone levels, always it is reconfirmed by a second test.
Other causes of low energy must be excluded which include sleep apnea ( snoring with apnea), lack of good quality sleep, depression, anemia , low Vitamin B12 level and low CORTISOL hormone levels etc. ( Your CBC was normal and hence you are unlikely to have anemia).
While talking to your PCP, it may be a good idea to get an 8 AM serum cortisol done.
Relax and please do stretch exercise. Have adequate sleep at night ( 8 hours minimum) . Eat a healthy balanced diet. While you are waiting to see the endocrinologist, these measures may help.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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