Im a doctor who frequently works up patients with debilitating brain fog/fatigue/lethargy (and have dealt with this myself.
This is a difficult presentation to workup and the differential is very wide. The vast majority of cases have nothing to do with your testosterone levels. Please stop obsessing over your T levels and find a doctor who isn’t obsessed with T levels either and if you do learns the benefits and risks of such treatment
Can we please cool it with the T posting?
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Here’s an original copy of /u/KingNobit’s post (if available):
Im a doctor who frequently works up patients with debilitating brain fog/fatigue/lethargy (and have dealt with this myself.
This is a difficult presentation to workup and the differential is very wide. The vast majority of cases have nothing to do with your testosterone levels. Please stop obsessing over your T levels and find a doctor who isn’t obsessed with T levels either and if you do learns the benefits and risks of such treatment
Can we please cool it with the T posting?
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Seems like something someone with low T would post..
Joking, obviously. Never actually have seen a post about testosterone in this sub, must be a more popular discussion topic in the fitness subs?
Edit: clearly I don’t browse this sub often, thanks for the responses.
My brain fog was from this shit called binocular vision dysfunction.
Sounds like a ploy by big thyroid to sell more levothyroxine
People just straight up ignore the search function, and/or dont know how to use it. On every single sub, whatever it is you want to ask… chances are someone has already asked it.
I have low t and have been on TRT for almost a year and still have brain fog so fml
Dudes just want muscles and the energy boost from T. They lie and pretend it’s for “health” but most are pushing supratherapeutic levels. Watch them come cry that “TRT doesn’t cause heart issues” with their inability to interpret a scientific study asses. They’ll find out when their heart starts giving out in their 50s from starting this shit in their 30s for no reason other than vanity.
It’s not testosterone, it’s long covid! 🌈
I am interested what other conditions can result in brain fog from your experience other than testosterone related issues?
Personally my T levels were good, but my SHBG was very high, and according to doctor, bonded all my free testosterone leaving less than desired in my system. I am now taking Boron supplements, fingers crossed it fixes the issue, and I feel better soon.
I’m not a doctor, but it usually isn’t real when one treatment is marketed as a cure-all.
The testo train is hilarious to me, a good friend has been legally juicing and his problems just keep evolving and so his justifications for taking it.
Just be honest. You want to look fit asf, you like feeling a little aggro and more dominant than you actually are. Good for you. But don’t give me the ”it’s healthy” bs like the weed people did a decade ago. ”But bro, it cures cancer”
Can you suggest some common treatments that you end up offering for those symptoms?
I really struggle with them, and while I haven’t gone down the testosterone route, every doctor I see just kind of shrugs. I think that’s what leads people into self diagnosing online.
Give us a top 10 of things to obsess over besides t
What **would** make you or any Dr. order a testosterone bloodwork?
Stress, lack of sleep, poor diet, and lack of exercise seem like things that should all be addressed first before jumping on something that shuts your testicles down.
Funnily enough all 4 of those also helo with energy, muscularity, brain fog, and low test levels.
Haha, okay, thank you doc. I certainly see a lot of this here
but Dr. Youtube prescribed it for me!! Along with learning blacksmithing, cutting my hair a certain way, and drinking yak jizz.
For some people, low testosterone and the symptom of low energy could be from unmitigated alcoholism or other bad habits. A lot of benefits came to me when I got on a diet because of my acid reflux disorder. I started supplementing magnesium glycinate, got off Omeprazole, stopped drinking, and uninstalled Instagram. BOOM. No insomnia, no sleep apnea, no reflux.
I’ve always been exhausted all my life but it never prevented me from being functional. When should one be worried about low Ts?
Pharma advertising has worked well
Advertisement is a hell of a drug that some people are extremely susceptible to. So many influencers and media personalities push this shit because it makes them bank and too many people take what they say at face value
Read, read.
I’ve gotten my testosterone tested and it was near the low end of the normal range. I find that if I eat well, exercise well, sleep well, have reasonably low stress, good sunshine in my life…I feel fine.
Not very interesting. Which is just what I want.
In residency the only patients my attending would prescribe testosterone for were the ones with orchiectomies. Everyone else got referred to endocrine because so many of them refused to do the other things to improve their testosterone (lose weight, use their CPAP, exercise, etc).
I think a lot of this is driven by AI/bots set up to sell TRT scam products. Dead internet theory and all that.
Testosterone clinics advertise on many podcasts/shows that young men watch and it’s marketed as a cure all miracle juice.
Very true. Most inquiries are from unhealthy people who don’t want to do the work. T is legit, but not near how it’s portrayed. And I’m pretty sure some of the responders in favor of it, stoking the energy to commit to it have exterior motives.
Manhood as a subscription service. I fucking hate it.
Edit- I didn’t make this up, some dude on YouTube named Atlas Power shrugged I think did. I’ll try and find the video later. I posted it here before and they deleted it
The radio and online ads make it seem like everything is caused by low T levels, and of course, they can fix it.
In my case, I had primary hypogonadism with only 1 testicle that was not working right and so TRT actually helps to get me back up to the 300 range.
However the main driver for me was sleeping in a separate room from my wife. I could not get good quality sleep using my apple watch to track. When I got a sleep study done (wife was not there) I slept much better and no sleep disturbance. Put two and two together now sleep like a champ.
I took 200mg weekly of testosterone for 14 years at the advice of a men’s clinic doctor. Felt great for the first 10, then my energy started dropping and after a battery of tests I had found myself in heart failure.
No, but, see, *I’m* different because…
YES IT IS YOU WANT TO FIGHT ABOUT IT?! Sorry bad joke about aggression and T. Anyway I agree the one solution fits all is rarely the magic bullet, just another tool in the toolbox. Get a list and start with the simple stuff as others recommended, sleep etc.
My levels are naturally over 1000 ng/dL and I feel just average at 36. Libido is great, workouts feel good, but I’m just very lazy and deal with brain fog every day.
I’m on TRT. The seduction of it, is it works. It probably won’t cure what’s actually wrong but it’ll mask it so it’s super easy for someone to feel like shit, get a shot and feel better and think “that must be what’s wrong”.
That said, my T levels are maintained in the mid 400-low 500 range, nowhere near the 1000 that is the common recommendation from a wellness clinic and I feel a lot better having T levels that might be considered lowish. My muscle mass is plenty fine, wiener works fine, energy is good, mental clarity is good.
The big needle movers are sleep, exercise, diet, and stress. It takes a fair amount of commitment to get those right but if you want to fix the foundational issues that are causing you to feel bad then you’re going to have to do the work. It doesn’t matter if you’re in the 400s or 1200.
PSA: Get a PSA test
Perhaps you can explain to us about and why the 40% drop in T levels since the 70s ?
And if overall T levels are lower, why Don’t men need a T supplement ?
Do you test T levels in your male patients ?
Do your results prove or disprove the national T levels ?
I’d be interested to know what you find is the major cause for debilitating brain fog/fatigue/lethargy ?
I was struggling real hard with lethargy and general old man changes… enclomiphene did boost my T levels quickly and significantly, with the accompanying quality of life improvements. That said, I’m very attentive to the performance triad: sleep, exercise, nutrition. I average 7 hours of sleep (yes a bit low), workout efficiently and effectively at least 4 days a week, walk almost every day, and live off a healthy general diet with chicken/broccoli/rice/cheese as the cornerstone. I do drink but I keep it under 6 drinks per week, usually in one night per week. My completely uneducated non-doctor opinion is that men need to establish a healthy lifestyle first (I consider my lifestyle an example of that), but if that isn’t working they should hunt out underlying issues and T is a *very common* example of an underlying issue in men over 30.
I will always advocate for having your testosterone levels checked and advocate for treatment only if you have done all you can to mitigate or correct your symptoms and have blood work to see what the facts are.
T is a great indicator to of smoke being fire. Sleep diet exercise to naturally raise t
I’ll give my experience with TRT. I was prescribed by an endocrinologist after a referral from my primary care.
I had all kinds of symptoms from extreme fatigue, low muscle mass, no appetite, absolutely zero sex drive or ability to get an erection, depression, and more. I was damn near ready to eat a bullet because of how I felt.
I met with a primary care and started down a year long path. I went to a psychiatrist, kept daily journals of food, sleep, sun exposure, and some other habits. Taking vitamins, healthy eating, easy exercise, and prioritizing sleep. After a month or so my doctor ran a hormone test among many others. My level on that test was 25 with a reference range of 300-800.
I continued with all the life style efforts for nearly a year, basically trying to turn my daily habits around to make any improvement. My doctor ran a hormone test again and my level rose to 90.
After this my doctor referred me to the endocrinologist. I was put on testosterone injections. Levels went up to around 600.
The kicker is, the treatment doesn’t feel like so many of these advertisements. Definitely feel good, but it’s not a magic fountain of youth kinda thing. I still see a counselor for depression. Still keep up the habits I built. Unfortunately still have a mediocre sex drive. Not shredded, not massive, definitely no “never ending” energy. Just able to live my life much easier now. I will be on it for life and I am ok with that.
I don’t judge anyone for wanting to use testosterone. The industry around it and these clinics are absolutely disgusting though. Test isn’t a supplement, it’s a hormone and has major effects on the body.
Lack of hydratation too, I meet so much people asking me how I do to drink at least half a gallon a day of water, drinking enough is so important
The obsession with addressing testosterone seems to be like people’s obsession with dopamine and other neurobabble terms. It’s just a backwards way of thinking in some cases. “I don’t sleep well + I’ve been stressed, so now my testosterone is low. I should raise my testosterone”. No, you should address sleep and stress. The testosterone portion is not practically important.
All of this is beside the point that testosterone testing is dubious, because it often doesn’t address bound testosterone. Barbell Medicine has a solid podcast on this.
I’m starting to think a lot of this talk might be astroturfing by one of the numerous companies out. There are trying to tell men that they have low testosterone that needs to be supplemented with their pills. It’s a simple marketing trip you go into a place where there’s a bunch of older men talking and you just start talking incessantly about your low testosterone levels and how easy it is to fix by just talking to your doctor or trying this simple plan.
Don’t forget on the modern Internet everybody is just trying to con you into something and if they’re not, they’re selling your porn.
I would kill for a doctor who is “obsessed” with T levels and I have to talk him down, most don’t know jack shit and say everything is “fine”