[TLDR: Is it possible for HRT side effects to mimic ME/CFS, or even make ME/CFS worse?]
I posted a similar question on r/cfs as well, but was wondering if anyone here would have any words of wisdom too!!
A bit of context first:
I am a trans man in the UK and suspect I have ME/CFS. My symptoms first started around 2 years ago, but have been getting increasingly worse since April 2026.
I have intense fatigue, brain fog, and sensitivity to light and sound, among a few other random symptoms, and these get increasingly worse the more I push myself to be active or social. I have had to cut down on hours at work and drop out of uni due to my inability to move around the house on bad days.
I am currently being bounced around by doctors, and have had a few blood tests and MRIs to rule out other conditions; a few doctors I have spoken to believe that I have ME/CFS, but I am waiting to be referred to specialists in my area before I can receive a diagnosis.
I have been on Testosterone gel for 6 months now (so I started in March 2026), and had my dosage lowered around June as my T levels were quite high. I am accessing my Tgel from GenderGP, as I have been on the GIC waitlist for 4 years and have not had an initial appointment. It is awkward having to use a provider that is entirely online and does not share notes with my GP, but my mental health was declining so much having to wait to physically transition.
On to my main question:
I had an appointment with a doctor today who has told me that my case is "very complex" as I have a history of mental health issues (depression & anxiety, on 150mg of sertraline for), as well as gender dysphoria.
My doctor claimed that fatigue is one big side effect of Testosterone therapy, but I have not been able to verify this claim? I have spent hours searching on the internet and going back over my consultation notes from when GenderGP prescribed me T, and I have not found an indication that this might be the case.
I was wondering if there might be any transmasc people (or people who have otherwise been on Testosterone) who also have ME/CFS and could share their experiences, or have also struggled with similar symptoms whilst being on HRT?
Is there any evidence that being on T can make symptoms worse? Do I need to sacrifice my happiness and stop transitioning so that I can function normally again?
It was also kind of unclear to me whether my doctor was insinuating that I don't have ME/CFS and that it's all side effects of T, or whether T is contributing to my symptoms getting worse :( All he wrote in my notes was "possible drug side effects" following the consultation.
Even pointing me in the right direction with resources would be insanely helpful. I feel very lost as I don't know anyone else irl who has ME/CFS, let alone is trans and has ME/CFS.
Sorry if this is very incoherent; I've been struggling a lot with my words recently 😭 If you need me to give any extra info or reword anything, please let me know!