Can Testosterone Make You Tired? 

Some men start testosterone replacement therapy (TRT) to address low T and testosterone deficiency and find out their baseline fatigue and low energy get worse.

Testosterone and Energy Levels

Testosterone controls energy levels in men. When testosterone is within normal range, men feel more energetic and motivated. Testosterone supplementation can also help restore energy in men with low testosterone. Low testosterone can cause fatigue, lethargy, and feeling unwell. Testosterone helps regulate the body’s metabolism, which converts food into energy.

Studies have shown that testosterone levels are related to energy levels. Men with low testosterone have lower energy levels; men with normal or high testosterone have higher energy levels. Testosterone replacement therapy also helps improve energy in men with low testosterone. By getting testosterone levels back to normal range, many men feel a big boost in overall energy and vitality.

Why does TRT cause fatigue?

TRT can cause fatigue in some men for the following reasons:

  1. Overstimulation of the body: Increased testosterone can overwork the body and cause fatigue and exhaustion.

  2. Insomnia: Some men on testosterone therapy may have difficulty sleeping and get fatigue.

  3. Hormonal imbalance: Sudden increase in testosterone can cause imbalance with other hormones in the body and cause fatigue and other symptoms.

  4. Side effects of the medication: Testosterone medication can cause side effects like acne, fluid retention, and mood changes, which can also cause fatigue.

Testosterone injections, which are a common method of TRT, can cause these side effects.

As testosterone levels drop, men may feel more fatigue and lower energy levels, which can be worsened by TRT.

Note that testosterone therapy can also help improve energy and reduce fatigue in some men but it’s best to discuss the benefits and risks with a healthcare provider before starting treatment.

If no improvement in fatigue is seen after 6 weeks of testosterone replacement, other factors beyond hypogonadism may be present. This article will review a few ways to find out what causes TRT fatigue.

Low Testosterone Symptoms

Low testosterone can cause many testosterone deficiency symptoms, including:

  • Fatigue and lethargy

  • Low sex drive

  • Erectile dysfunction

  • Loss of muscle mass and strength

  • Increased body fat

  • Decreased bone density

  • Mood changes like depression and anxiety

  • Difficulty concentrating and memory problems

If you have any of these symptoms, consult a healthcare professional to find out if low testosterone is the cause. A proper diagnosis will help you explore treatment options, including testosterone replacement therapy, to alleviate these symptoms and improve your life.

Thyroid Function and Hormonal Imbalance:

The thyroid is a butterfly-shaped endocrine gland located in the lower front of the neck. It produces thyroxine or T4, which is converted to triiodothyronine or T3. T4 production is controlled by thyroid-stimulating hormone or TSH, which is produced by the pituitary. Hypothyroidism, or low thyroid hormone production, can cause sexual dysfunction and depression, fatigue, dry skin and hair, weight gain, and increased sensitivity to cold. Blood tests to measure TSH, T4, and T3 are available and widely used.

The American Thyroid Association (thyroid.org) has great info on how to find out if you have hypothyroidism that’s causing your fatigue.

Testosterone can decrease thyroxin-binding globulin and total T4 serum levels and increase resin uptake of T3 and T4. Free thyroid hormone levels remain the same and there’s no clinical evidence of thyroid dysfunction.

Once thyroid hormone levels are normalized, testosterone tends to increase naturally.

Check your thyroid hormones here: Choose Your Test | Discounted Labs

 

Adrenal Function and Chronic Fatigue:

The adrenal glands are located in the abdomen above the kidneys and regulate stress in the human body. When the body is in an emergency situation, the adrenal glands release hormones like adrenaline to enable the body to respond. You may have experienced this reaction called the “fight or flight” response if you were in danger, fear, or shock. Adrenal fatigue is the controversial idea that the adrenal glands can get worn out and cause illness if continuously overstimulated. Proponents of the “adrenal fatigue” theory believe that the adrenal glands may be overworked in some individuals and therefore get “fatigued” and unable to produce enough hormones. When your adrenal glands are exhausted, your cortisol levels drop significantly. Cortisol is your natural stress hormone. Low sex drive and infertility are symptoms of adrenal fatigue. Other symptoms include chronic fatigue, low blood pressure and low blood sugar, dizziness, headaches, anxiety or panic attacks, depression, and other equally debilitating problems.

Some doctors may prescribe low doses of corticosteroids if your morning cortisol levels (measured by blood, saliva, or urine tests) are low. But be careful with corticosteroids, as they can increase fat mass and decrease bone density if given in doses higher than what the healthy adrenals would produce. Check your adrenal health.

DHEA and Testosterone Levels:

The adrenal glands also produce dehydroepiandrosterone (DHEA), the most abundant hormone in the bloodstream. The body uses DHEA as the starting material to produce the sex hormones testosterone and estrogen in men. DHEA supplementation can increase DHEA levels, which in turn can support testosterone production. Studies show it only increases testosterone in women. DHEA production decreases in most people after age 40. In people 70 years old, DHEA levels will be 30% lower than what they were at age 25. Low DHEA levels are associated with many degenerative conditions.

Some studies are controversial and inconclusive that people with immune deficiencies and fatigue may benefit from supplementation with this hormone. It’s still available over-the-counter in the US. This may change soon, as a new bill was passed by Congress classifying it as a performance-enhancing steroid (no studies show it has such an effect).

One study showed that women with normal DHEA levels can convert it into testosterone as their body needs while men don’t benefit the same way. You need a blood test to know if you have low DHEA-S since most of the DHEA converts into this sulfated form. Common doses for women are 5-30 mg a day, while men benefit from 25-100 mg a day (to bring low DHEA-S to normal).

NOTE: Do not use DHEA supplements unless your blood levels of DHEA-S are low. If low, start at a low dose and get your DHEA-S tested again after a month. Men who use DHEA supplements may have problems with higher estrogen levels since DHEA can also convert into estradiol. This can cause gynecomastia and water retention. If you start taking DHEA, get your blood levels checked to make sure they are not above normal. There are many claims about DHEA being an anti-aging and anti-cancer cure but none of these claims have been proven with strong data.

To make diagnosis easier, we have created this new Fatigue Panel on DiscountedLabs.com at a discount.

Click here: Comprehensive Fatigue Panel

Sleep Apnea:

Sleep apnea is a sleep disorder in which a person stops breathing or breathes shallowly many times during sleep and therefore doesn’t get enough restful sleep; oxygen levels in the blood drop and the brain starves of oxygen. Besides causing daytime fatigue, it can increase blood pressure and cardiovascular risks. Testosterone replacement therapy has been linked to the worsening of sleep apnea or the development of sleep apnea, especially in men who use higher doses of testosterone or who have other risk factors for sleep apnea (high body weight, thick necks, snoring, alcohol consumption, etc.). Upper-airway narrowing doesn’t seem to be caused by testosterone replacement therapy; it suggests that testosterone replacement contributes to sleep-disordered breathing by central mechanisms rather than by anatomical changes in the airway.

Tell your doctor if your spouse or partner complains that you snore loudly at night and feel fatigued. The only way to know for sure if you have sleep apnea is to have your doctor refer you to a sleep lab for a sleep study. If you are diagnosed with sleep apnea, a continuous positive airway pressure (CPAP) machine can be prescribed to help open up your airways with a small air pump while you sleep. Some people love it; some hate wearing a mask while being hooked up to a machine at night. I have seen men regain their quality of life after starting CPAP. It’s covered by insurance, Medicare, and most HMOs.

A new option for those who hate CPAP machines with mild to moderate apnea is the use of oral appliances. Worn in the mouth like an orthodontic appliance during sleep, oral appliances keep the soft tissue from collapsing and interrupting normal breathing patterns. The purpose of the oral appliance may be to reposition the lower jaw, tongue, soft palate, and hyoid bone into a certain position; to keep the airway open with stabilization of the tongue and jaw; or to provide artificial muscle tone to prevent collapse and resulting airway blockage. The doctors will fit your oral appliance for comfort by using a mold of your mouth to design your unique fit.

Fatigue Management with Testosterone Therapy

Testosterone therapy can help manage fatigue in men with low testosterone. Testosterone gel is another way to get testosterone therapy to help manage fatigue. Testosterone therapy can bring many health benefits, including improved cardiovascular health, better blood sugar control and reduced risk of osteoporosis and diabetes. But it’s important to understand the benefits and risks of testosterone therapy and to discuss them with your doctor. Some men will experience a big boost in energy and overall well-being; others will find their fatigue persists or even worsens. This variability is why personalized medical advice and regular monitoring are important to tailor the treatment to your needs.

Energy Tips

In addition to testosterone therapy, there are several lifestyle changes that can help men regain energy and overall health. These are:

  • Regular Exercise: Strength training and cardio exercises can help build muscle and boost energy. Exercise also helps with better sleep and reduces stress, which can further increase energy.

  • Healthy Diet: Eating a balanced diet rich in protein, healthy fats, and complex carbohydrates can give you energy all day. Lean meats, fish, nuts, seeds, and whole grains are good choices.

  • Sleep: Aim for 7-9 hours of sleep per night to help regulate testosterone and energy. Good sleep hygiene practices like a consistent sleep schedule and a restful environment can make a big difference.

  • Stress Management: Meditation, yoga, or deep breathing exercises can help manage stress, which can help increase energy. Chronic stress can lower testosterone so finding ways to cope is important.

  • Hydration: Drinking plenty of water throughout the day is key to maintaining energy and overall health. Dehydration can cause fatigue and decreased physical performance.

Natural Testosterone Boosters

While testosterone replacement therapy may be needed for some men, there are also natural testosterone boosters that can increase testosterone. These are:

  • Exercise Regularly: Exercise, especially weightlifting and high-intensity interval training, can increase testosterone.

  • Eat a Healthy Diet: A diet rich in protein, healthy fats, and complex carbohydrates can support testosterone.

  • Get Enough Sleep: Sleep is key to testosterone production so aim for 7-9 hours of sleep per night.

  • Reduce Stress: High stress can lower testosterone so find ways to manage stress through meditation or yoga.

  • Get Enough Vitamin D: D: Vitamin D is important for testosterone production, so make sure you get enough through sun exposure, supplements, or fortified foods.

Implementing these lifestyle changes can support your body’s natural testosterone production, and if you’re already on testosterone replacement therapy,.

Testosterone Therapy Risks and Considerations

Testosterone therapy can be good for men with low testosterone, but there are testosterone side effects and considerations to be aware of:

  • Blood Clots and Stroke: Testosterone therapy can increase the risk of blood clots, which can cause stroke or other cardiovascular events.

  • Cholesterol and Cardiovascular Health: Testosterone therapy can affect cholesterol levels, which can increase heart disease risk. Lipid profiles should be monitored regularly.

  • Fertility and Sperm Production: Testosterone therapy can reduce sperm production. Men who want to have children should talk to their doctor.

What to Expect from Testosterone

Men on testosterone therapy can expect:

  • Increased Energy and Reduced Fatigue: Many men feel more energetic and less fatigued after starting testosterone therapy.

  • More Muscle and Strength: Testosterone therapy can increase muscle mass and strength for better physical performance and overall health.

  • Better Bone Density: Testosterone therapy can increase bone density, reducing the risk of osteoporosis and fractures.

  • Libido and Sexual Function: Many men experience improved libido and sexual function, which can improve their quality of life.

  • Overall Well-Being: Testosterone therapy can improve mood and overall sense of well-being for better quality of life.

But you need to have realistic expectations and understand that testosterone therapy is not a magic pill. It may take several months to see the full effects and regular monitoring and adjustments may be needed to get the best results.

Testosterone Monitoring

Monitoring testosterone levels is crucial to ensure treatment is working and to minimize side effects. This means working with a healthcare professional to track progress and adjust therapy.

Why Blood Tests

Blood work is needed to monitor testosterone levels and adjust treatment. These tests can:

  • Confirm Diagnosis: Blood tests can confirm low testosterone levels so testosterone therapy is appropriate.

  • Monitor Results: Testing helps to monitor testosterone therapy and ensure testosterone levels are in range.

  • Identify Side Effects: Blood tests can detect side effects like changes in cholesterol or liver function so treatment can be adjusted.

  • Healthy Ranges: Keeping testosterone levels in a healthy range is key to minimizing risk and maximizing benefits.

You need to work with a healthcare professional to determine the best testing schedule and to make sure testosterone levels are being monitored regularly. This proactive approach will get the best results and overall health. Get your own testosterone test here.

When to See a Doctor for Fatigue

If you have persistent or severe fatigue, you need to see a doctor. Fatigue can be a sign of an underlying medical condition like low testosterone, anemia, or diabetes. A healthcare professional can help figure out what’s causing your fatigue and develop a plan to treat it.

If you have any of the following, see a doctor:

  • Fatigue that lasts more than 2 weeks

  • Severe fatigue that affects daily activities

  • Fatigue with other symptoms like weight loss, fever, or night sweats

  • Fatigue that doesn’t go away with rest or sleep

A healthcare professional can do a physical exam, take a medical history and order diagnostic tests like blood work to figure out what’s causing your fatigue. Knowing the cause is key to developing a treatment plan and overall health and wellness.

References

Here are the clickable links with their corresponding titles: