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Old 05-22-2012, 10:08 PM   #1
Paul Kemp
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HRT?! Sleep Apnea, Insomnia, Hypogonadism? – Whats going on?

Hey there Crossfitters,

Ive been reading so much out of these forums for a long time, but never really had the urge to post. But now I’ve got a problem and I don’t really have anyone else to ask- so.... thanks in advance for the shoulder, eh?

History: Ive been “working out” since I was 18. Nailed the nutrition down and periodization when I was about 23-24. In the last four years I have been doing crossfit combined with a reduced “bodybuilding” routine, switched to a SS routine, and then most recently have been trying to do 5/3/1.

Bottom line is I’ve never been able to get my weight up. I am 5’11” 85kg, at about 13-16% bf. My lifts are embarrassing. Every time I have been getting stronger, having great workouts, I wont be able to sleep no matter how tired I am. In bed at 10pm, only to wake up routinely at 2-3am.

(Tried all the drugs, sleep hygene, rituals, and casting spells- nothing worked)

I originally thought (through researching lots of different info) that it was adrenal fatigue, somehow related to the release of cortisol that kept waking me up at 3am. Took some time off (I take 2-3 weeks off every 6 weeks as it is...) but the problem kept on coming.

I went to the doctor and did a sleep test. The diagnosis was that I have UARS (a form of apnea). Stuck the hose up my nose (CPAP) and found I slept better- but not like I should be- still dancing to the 2am disco every now and then.

At the same time I was getting my sleep tested, I went to see an Endocrinologist who did a blood test. Despite having the same problem, my cortisol levels came back regular- but Testosterone was very low. I did another test about two months after the first, my T was even lower, so were LH and FSH. Hypogonadism was written on the medical form. The doctor is suggesting hormone replacement therapy, or testosterone replacement therapy.

Does anyone have any advice, thoughts... ?

I am not really sure of the sleep ~ low hormone thing. Like the chicken or the egg, the riddle remains, which came first?

What about this TRT, HRT, deal? If I start shooting T, am I going to have to keep doing it until the grim end? Doesn’t that shut down my natural production of T (however limited it is right now)?

(I will post the lab results later today...dont have them with me right now.)
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Old 05-23-2012, 03:21 AM   #2
Paul Kemp
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Re: HRT?! Sleep Apnea, Insomnia, Hypogonadism? – Whats going on?

Test Numbers:

March:
Free T4 1.00 ng/dl (0.65 - 1.26)
TSH 1.299 uU/ml (0.340-5.6)
Cortisol 15.8 ug/dl
ACTH 27.4 pg/ml

Total T 438 ng/dl
SHBG 49. nmol/l (10-60)
Albumin 39 gm/l (38 - 50)
Free Androgen Index 30
Free T 72 pg/ml (90-300)
% Free T 1.63% (2-4.8)
Bioavailable T 153 ng/dl


May
Total T 377 ng/dl
SHBG 37.2 nmol/l
Albumin 38 gm/l
Free androgen index 35
Free T 75 pg/ml
% Free T 1.99
Bioavailable T 156 ng/dl
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Old 05-23-2012, 04:13 AM   #3
Bob Herald
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Re: HRT?! Sleep Apnea, Insomnia, Hypogonadism? – Whats going on?

TRT will get your weight up , if it's low due to low test. I went from 195 lbs at 6'3" to 295-210 lbs. and im much thicker. I never was able to gain strength before. Not I'm routinely adding reps and weight . I do 531 as well. When I was crossfitting my strict press was 115x5. Yesterday I put up 155x3. My bench press was 215x5. , the other day I did 245x5. This isn't due to the TRT but also , smart strength programming, eating like a horse, and limiting conditioning.

But with the TRT I have slept better. And I have a better appetite .

Why are you worried about trt shutting down already non existent test levels? You are low in Testosterone, and you will always be low.
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Old 05-23-2012, 05:15 AM   #4
Paul Kemp
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Re: HRT?! Sleep Apnea, Insomnia, Hypogonadism? – Whats going on?

Im concerned because I don't like the idea of being on shots for the rest of my life in order to feel well. (Thats my impression of TRT- please correct me if I'm wrong!).

Im also concerned because I don't quite know WHY my T was low. Was it because of a terrible nights sleep (due to UARS)?
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Old 05-25-2012, 08:34 PM   #5
Steven Low
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Re: HRT?! Sleep Apnea, Insomnia, Hypogonadism? – Whats going on?

What does your diet look like?

What is your routine for a week?

How much sunlight do you get?
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Old 05-27-2012, 08:13 PM   #6
Paul Kemp
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Re: HRT?! Sleep Apnea, Insomnia, Hypogonadism? – Whats going on?

Diet is strict-ish paleo with a little milk a day (about 250ml). Lots of chicken, a reasonable sized steak every other day, an high in fat.

Most recently my routine was SS, which I trained for several months working on a six week on, two off schedule. Then I moved on to SS plus a few extra things thrown in on the side (two more exercises, not heavy compound, 3 to four sets at 8-10 reps). I was working out every other day.

I don't get much sunlight for living in the tropics, but more than I would if I was living in Canada (home). Went to sit by the pool once or twice a month for an hour or so.
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Old 05-30-2012, 12:07 AM   #7
Paul Kemp
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Re: HRT?! Sleep Apnea, Insomnia, Hypogonadism? – Whats going on?

The endocrinologist prescribed Andriol for me 40mg 2x a day after doing an MRI and not finding anything wrong with my glands.

I asked him about the effects of estrogen, and if I should be worried. He said he didn't know(!!!). I also asked if I should get my liver and estrogen levels tested, he said they are "probably" normal.

Thanks to the two people who replied to this thread, and tried to provide some advice.
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Old 05-30-2012, 07:45 AM   #8
Drew Cloutier
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Re: HRT?! Sleep Apnea, Insomnia, Hypogonadism? – Whats going on?

Very surprised he didnt know go with an injectable since those can be used very long term. Orals are fairly harsh on your liver, so you wouldn't want to keep doing them your whole life, this is what i've gleaned from textbooks at least. From a practical standpoint i would think always remembering to take your pills would be annoying, and i'm sure you'd forget from time to time, and this is something that needs to stay constant so your levels aren't in flux all the time.

i'm guessing HRT/TRT doses are pretty low and would not bring about nasty side effects involving estrogen, but if you're worried you could always take a low dose of aromatase inhibitor, or anti-estro (like a nolvadex or clomid)
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Old 06-06-2012, 09:54 AM   #9
Robert William Hornback
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Re: HRT?! Sleep Apnea, Insomnia, Hypogonadism? – Whats going on?

I have struggled with low test (low was 99ng/dl) and also thyroid issues (hypo) for years. Endoc couldn't find any cause (I believe it's adrenal related). Anyway, if i stay too low carb for too long, I feel like crap. As anectdotal as it sounds, Robb Wolf has talked about this effect on his podcasts before.

You mentioned strict paleo, but didn't give any breakdown of what you are eating.

Also, what kinds of workouts are you doing besides 5/3/1 (if any). I know for me, if i push the conditioning too hard or get too crazy with volume on the assistance lifts (I'm into my 7th cycle), then everything goes in the crapper for me and I have the same sleep issues (waking up at 2-3).

As far as the HRT, it will blunt your body's ability to make it's own. Now weather your body can actually do that is up for debate. I believed mine could so i got off of HRT as quickly as possible (doc put me on it to get me feeling better and to bring weight up. I was at 128 at 5'8". Now at 175).

For me i feel like i'm always walking a fine line. If i keep my lifestyle factors in check (sleep, food, recovery) and be smart with my training, i feel much better and sleep better. But as soon as i push the envelope of let for example, my food choices slide, I go a little over the edge and feel like crap and then end up sleeping worse, which gets me further over the edge.

Hope this helps. And just for reference, 2005 was when i had first bloodwork done. I stopped taking synthroid 4 months ago. Haven't had T levels checked in over a year, but at one point they were up to 650ng/dl, without HRT.
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Old 06-07-2012, 08:29 PM   #10
Paul Kemp
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Re: HRT?! Sleep Apnea, Insomnia, Hypogonadism? – Whats going on?

I have been resting for over a month now, with the odd workout thrown in every now and then when I just can't stand it anymore.

Yesterday I did a little bit of exercise (last workout was last week-6 days ago);
lunges 10kg@ 3x10
shoulder press 20kg@ 3x10
shrugs 30kg@ 3x10

Again I woke up at 2am. Had to take sleeping pills.

My diet at the moment is not strict paleo. It had been in the past, but I have been eating fairly "normally" - surplus calories (gaining fat), lots of carbs, veggies, fat, and meat. Thats not to say i eat junk, however. I am getting 150g of protein a day, about 1/4 to half of my calories come from fat.
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