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chroninc no interest in sex low testosterone

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1. No interest in sex at all. 2. Chronic depression even though I have been taking antidepressants for the last 13 yrs. Cymbalta for the last 5 yrs. 3. Chronic fatigue no matter how much sleep I get... never feels like it's enough. 4. Significantly decreased strength and endurance... I can't do the things I used to do anymore like running. I was used to running 6 to 12 miles daily, but I don't have the endurance to run 2 miles anymore... get too tired to quickly (actually exhausted). I was able to bench press 170lbs, no only able to do 135 lbs and it feels really heavy! I was able to do 45 lbs single arm curls, but not I am only able to do a maximum of 30 lbs. 5. Change in sleep pattern, i.e., I can't sleep through the night. I have difficulty getting to sleep, staying asleep, and waking early. I have a hard time sleeping even though I am chronically tired. 6. I never had motivational issues before, but have no motivation to much of anything. I have to force myself to get things done. 7. Cognitive changes: I have difficulty concentrating and remembering things... I am always forgetting things as though they never happened. 8. Physical changes: increase in hair loss all over the body; decrease in muscle mass (biceps, chest, neck, and legs are all smaller)... I used to have a 42 inch chest; now I have a 38 inch chest. I used to have 20 Inch thighs; now I have 16.5 thighs. Increased weight around my stomach... I've gone up 2 inches in my waist. I'm normally a 29 to 30". My testosterone levels were "normal", but is it possible that what is considered to be within the "normal range" may be somewhat low for me? Is it possible that this could be a primary factor in what I am experiencing above?

Category: Internal Medicine Specialist

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Category: Internal Medicine Specialist
 27 Doctors Online

Hello,

Thank you for asking the query :
Low testosterone levels could cause some of these symptoms especially the sex relaxed ones and the muscle mass loss. However it will not explain the decrease in exercise capacity, sleep problems, weight gain and depression.

A normal testosterone level definitely indicates the levels are normal for you.  So we should focus elsewhere for any derangement. Since you are having this amount of symptoms, a thorough clinical examination followed by a set of lab tests is recommended. The following blood tests ( if not done earlier ) are recommended.

·         Hb and Complete blood cell (CBC) count

·         Thyroid-stimulating hormone (TSH)

·         Vitamin B-12 levels

·         Electrolytes, including calcium, phosphate, and magnesium levels

·         Liver function tests (LFT)

·         Blood urea nitrogen (BUN) and creatinine

·         Dexamethasone suppression test

·         Cosyntropin (ACTH) stimulation test

 

This will give an idea on what is the possible underlying pathology for the above mentioned symptoms.
Also please note: Depression itself is potent enough to cause all the symptoms mentioned. Since you are on treatment it needs to optimised in discussion with your Doctor. Lack of sexual desire is a possible side effect of anti-depressive medications.

Regarding exercise , you need to stay physically active even though you feel the endurance level is low. Otherwise chances are that your aerobic and anerobiccapacity will decrease over the time. Moreover the endorphins released during exercise will elevated you mood can help in insomnia.

Hope this helps. Please feel free to ask followup questions. Thank you. 


Dr. Steve Merris
Category: Internal Medicine Specialist
Experience: 
Medical School - New York University
Internship in Internal Medicine - Beth Israel Medical Center
Residency in Internal Medicine - Beth Israel Medical Center
Fellowship in Pulmonary and Critical Care Medicine - Columbia University Medical Center
Dr. Steve Merris and 4 other Medical Specialists are ready to help you

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