Feels like I’m dying. Blood work post

Age: 40 | On TRT | Symptoms: Headaches, fatigue, insomnia, feeling terrible Background: Been on TRT through a clinic with preloaded syringes.

Lab Results Summary:

Hormones:

• Total Testosterone: 209.5 ng/dL (Optimal: 600-1400) ⬇️
• Free Testosterone: 51.9 pg/mL (Optimal: 180-350) ⬇️
• Estradiol (Sensitive): 14.4 pg/mL (Optimal: 15-50) ⬇️
• Prolactin: 21.0 ng/mL (Optimal: 3.5-9) ⬆️
• DHEA-S: 144.6 μg/dL (Optimal: 300-550) ⬇️
• SHBG: 20 nmol/L (Optimal: 20-40) ✅

Inflammation:

• CRP (C-Reactive Protein): 17.0 mg/L (Optimal: <0.75) ⬆️ Massive inflammation

Thyroid:

• TSH: 5.32 uIU/mL (Optimal: 0.25-1.5) ⬆️
• Free T4: 1.30 ng/dL (Optimal: 1.5-3) ⬇️
• Free T3: 4.2 pg/mL (Optimal: 3.5-5) ✅

Lipids & Heart Health:

• LDL (Bad Cholesterol): 101 mg/dL (Optimal: 30-90) ⬆️
• Triglycerides: 131 mg/dL (Optimal: <90) ⬆️
• Lipoprotein(a): >85 nmol/L (Optimal: <50) ⬆️ Genetic risk for heart disease
• HDL (Good Cholesterol): 37 mg/dL (Optimal: >40) ⬇️

Vitamins & Minerals:

• Vitamin D: 34.4 ng/mL (Optimal: 60-100) ⬇️
• Magnesium (RBC): 4.6 mg/dL (Optimal: 5-6.8) ⬇️

Other Concerns:

• Homocysteine: 14.3 μmol/L (Optimal: 2-9) ⬆️ Risk for cardiovascular issues
• Uric Acid: 6.8 mg/dL (Optimal: 2.5-5) ⬆️ Gout risk

Symptoms I’m Dealing With:

1.  Constant headache
2.  Severe fatigue and poor recovery
3.  Insomnia (can’t sleep)
4.  Feeling generally terrible

My Questions:

1.  Could my TRT protocol (preloaded syringes) be causing these issues?
2.  Is my elevated CRP due to systemic inflammation from TRT or another cause?
3.  Should I start cabergoline for high prolactin? How safe is it?
4.  Do I need to address my thyroid with meds like NDT or levothyroxine?
5.  Any advice for lowering CRP and improving symptoms while on TRT?

Looking for advice from anyone who’s dealt with similar issues!

Feel free to chime in with experience, insights, or suggestions. Thanks!