Expert Answered Long-Term Chronic Fatigue, Severe Energy Fluctuations Despite Testosterone, Primobolan, HGH and Peptides — Looking for Medical Advice and Bloodwork

[wiegetz]

Hi everyone,

I’m 27 years old, approximately 178–179 cm tall, and currently weigh around 88–90 kg, down from approximately 102 kg. My goal is to reach around 80 kg while preserving muscle mass and improving my overall health and energy levels.

I’m seeking medical advice because I’ve been struggling with longstanding fatigue and significant fluctuations in my energy levels.

This is actually a problem I’ve experienced since adolescence, long before I started testosterone or any other hormonal treatments.

My current regimen:

• Testosterone: Approximately 200–250 mg/week, divided into three injections.
• Primobolan: Approximately 200–250 mg/week.
• Retatrutide: Restarted approximately one week ago after a month-long break during my travels. My intended target is around 5 mg/week.
• Somatropin (HGH): Approximately 1–2 IU.
• hCG: Approximately 500 IU twice weekly.
• Ipamorelin and CJC-1295.
• NAD+.
• BPC-157: Approximately 500 mcg every other day.

I’ve been using testosterone since approximately March 1, 2026. During the first three months, I received a physician-prescribed 1,000 mg depot testosterone formulation, which unfortunately made me feel quite unwell. I subsequently switched to my current regimen.

My main concern: Chronic fatigue and fluctuating energy

I experience periods when I feel energetic, motivated, and physically well, followed by bouts of pronounced fatigue, lethargy, and exhaustion. Sometimes these episodes are severe enough to significantly affect my daily functioning.

What particularly concerns me is that I’ve struggled with fatigue for a very long time, even before using any of these compounds.

Another potentially relevant factor is sexual activity and post-orgasm fatigue.

I’ve noticed an association between sexual activity and significant fatigue dating back to around age 12, when I first discovered masturbation. Over the years, this has become an ongoing struggle for me.

Sometimes, even after partnered sexual activity, I experience particularly pronounced fatigue and tiredness.

I’m now fully committed to abstaining from pornography and masturbation, and I’ve maintained approximately two weeks of abstinence from both.

I’m hoping that this lifestyle change will help improve my energy and overall well-being. However, I strongly suspect that there are additional physiological or medical factors involved, especially given how longstanding and significant the fatigue has been.

My questions for the medical staff:

1. What could explain such longstanding fatigue and significant fluctuations in energy, particularly when some days I feel excellent and other days almost completely exhausted?
2. Could my testosterone and Primobolan regimen be contributing through estradiol fluctuations, hematocrit changes, or other hormonal effects?
3. Could HGH, hCG, retatrutide, or any of the peptides be contributing to fatigue or metabolic disturbances?
4. Could there be an underlying thyroid, adrenal, metabolic, hematological, sleep-related, or other medical issue that has gone undetected?
5. Is there a recognized medical explanation for particularly severe fatigue following orgasm or sexual activity, especially when this has been occurring for many years?
6. Which specific blood tests and other investigations would you recommend to comprehensively evaluate these symptoms? I would particularly appreciate a detailed list of relevant markers.
7. Are there any safety concerns regarding my combination of medications and compounds that should be evaluated or addressed?

Fortunately, I have an excellent and very supportive GP here in the Netherlands who can arrange medically indicated blood tests through my health insurance.

Therefore, if you could recommend specific laboratory investigations, I would be happy to discuss them with him and arrange the necessary testing.

My primary goal is not simply to lose weight or improve my physique, but to finally understand and address the persistent fatigue that has affected me for so many years.

I would sincerely appreciate your medical insights, suggestions for differential diagnoses, and recommendations for further investigation.

Thank you very much in advance!

 

[SalvatoreCorvus]

Hi.

First of all, none of us here is a doctor.
We are not a medical staff. We have knowledge related to ped's and sport and weelbeing but no medical diagnosis can be given instead of a doctor.
So one round of research in a medical course is to be done on your side as well about thyroid issue or something wrong in your bloodwork.
The Internet is good but it is not equivalent to medical advice.

Then the first thing I would say about your fatigue is that it is not chronic. Otherwise you wouldn't have an effect a yo-yo as you mention with moments when you feel energetic and other times not.

In fact, that's the reality of life..
Everyone has periods, even someone who is usually in good shape can feel tired for a long period of time. It is environment and lifestyle that have to look at in this case.

I would like to be able to answer your questions but they are all related to bloodwork values that you don't seem to have yet.
It's discussed around a hypothesis and it's not efficient.
So start there, do a complete hormonal bloodwork and for vitamin/mineral. A doctor could make the complete list he knows what needs to be looked at if you clearly explain what is wrong.

From there we can discuss possible improvements.

And If everything goes well it may just be psychological or multifactorial also related to your lifestyle and environment or just because you're in a caloric deficit for to long and you need a diet break or a "deload".

 

[hiscycle]

(I'm not a doctor):
Why you might be tired
Fatigue before any compounds points to a baseline cause: sleep apnea, thyroid, low iron, B12 or vitamin D, depression.
Your stack (testosterone, Primobolan, GH, retatrutide) can make energy swing more.
Tiredness after sex can be normal, but a rare condition called POIS exists.
Blood tests to ask for
Blood count and hematocrit, ferritin, B12, vitamin D
Thyroid (TSH, free T4) and morning cortisol
Glucose, HbA1c, kidney, liver
Cholesterol (with ApoB)
Testosterone, SHBG, estradiol, LH, FSH, IGF-1
Main risks
Hematocrit too high (above ~50-52%)
Blood pressure, cholesterol, blood sugar
Thats great that you have a good supportive doctor on hand and will they give you continued blood work ?

Make sure to tell your doctor your full regimen with doses. They can't spot a drug effect they don't know about.

 

[Sam Bjorn]

Hi everyone,

I’m 27 years old, approximately 178–179 cm tall, and currently weigh around 88–90 kg, down from approximately 102 kg. My goal is to reach around 80 kg while preserving muscle mass and improving my overall health and energy levels.

I’m seeking medical advice because I’ve been struggling with longstanding fatigue and significant fluctuations in my energy levels.

This is actually a problem I’ve experienced since adolescence, long before I started testosterone or any other hormonal treatments.

My current regimen:

• Testosterone: Approximately 200–250 mg/week, divided into three injections.
• Primobolan: Approximately 200–250 mg/week.
• Retatrutide: Restarted approximately one week ago after a month-long break during my travels. My intended target is around 5 mg/week.
• Somatropin (HGH): Approximately 1–2 IU.
• hCG: Approximately 500 IU twice weekly.
• Ipamorelin and CJC-1295.
• NAD+.
• BPC-157: Approximately 500 mcg every other day.

I’ve been using testosterone since approximately March 1, 2026. During the first three months, I received a physician-prescribed 1,000 mg depot testosterone formulation, which unfortunately made me feel quite unwell. I subsequently switched to my current regimen.

My main concern: Chronic fatigue and fluctuating energy

I experience periods when I feel energetic, motivated, and physically well, followed by bouts of pronounced fatigue, lethargy, and exhaustion. Sometimes these episodes are severe enough to significantly affect my daily functioning.

What particularly concerns me is that I’ve struggled with fatigue for a very long time, even before using any of these compounds.

Another potentially relevant factor is sexual activity and post-orgasm fatigue.

I’ve noticed an association between sexual activity and significant fatigue dating back to around age 12, when I first discovered masturbation. Over the years, this has become an ongoing struggle for me.

Sometimes, even after partnered sexual activity, I experience particularly pronounced fatigue and tiredness.

I’m now fully committed to abstaining from pornography and masturbation, and I’ve maintained approximately two weeks of abstinence from both.

I’m hoping that this lifestyle change will help improve my energy and overall well-being. However, I strongly suspect that there are additional physiological or medical factors involved, especially given how longstanding and significant the fatigue has been.

My questions for the medical staff:

1. What could explain such longstanding fatigue and significant fluctuations in energy, particularly when some days I feel excellent and other days almost completely exhausted?
2. Could my testosterone and Primobolan regimen be contributing through estradiol fluctuations, hematocrit changes, or other hormonal effects?
3. Could HGH, hCG, retatrutide, or any of the peptides be contributing to fatigue or metabolic disturbances?
4. Could there be an underlying thyroid, adrenal, metabolic, hematological, sleep-related, or other medical issue that has gone undetected?
5. Is there a recognized medical explanation for particularly severe fatigue following orgasm or sexual activity, especially when this has been occurring for many years?
6. Which specific blood tests and other investigations would you recommend to comprehensively evaluate these symptoms? I would particularly appreciate a detailed list of relevant markers.
7. Are there any safety concerns regarding my combination of medications and compounds that should be evaluated or addressed?

Fortunately, I have an excellent and very supportive GP here in the Netherlands who can arrange medically indicated blood tests through my health insurance.

Therefore, if you could recommend specific laboratory investigations, I would be happy to discuss them with him and arrange the necessary testing.

My primary goal is not simply to lose weight or improve my physique, but to finally understand and address the persistent fatigue that has affected me for so many years.

I would sincerely appreciate your medical insights, suggestions for differential diagnoses, and recommendations for further investigation.

Thank you very much in advance!

Hi,

Thanks for reaching out to us. Your story is quite interesting, and we’ll try to figure it out using all our experience.

Let’s start with this — what tests and diagnostic have you already had while trying to find the cause of your fatigue and lack of energy? I’d like to see everything you have — blood tests, heart ultrasound, and so on. There could be many possible causes, or even several at the same time, ranging from iron deficiency to gut problems.

I also need to understand which specialists you’ve seen — an endocrinologist, gastroenterologist, psychiatrist, and so on — and what conclusions they came to.

I can’t promise that we’ll solve everything, but by discussing it together, we may get closer to finding answers and exploring different hypotheses.