Fatigue, Anxiety, Irritability. Changing protocol, trying to stay on TRT, Help needed

[DeadCatB]

Hi, You can start to read after the **** if you don't want background not to lose time.

A bit of background - Currently 32yo, M, I always felt really good and looked really well and young. Very manic about the food that I eat - mainly meat, animal fat, organs(brain,liver), small amount of vegies and fruit here and there, mainly in the summer,never carbs or sugar, no gluten or dairy as both give me problems. This is since I am 20yo, never cheated except popcorns at the cinema.

Everything was OK, except - my muscle building ability was always quite low. Looked "fit" at the most, but always small, if I stopped training my muscles shrank and I looked really bad, kind of soft looking. My beard was not very developed as well.

2 years ago decided to do blood tests and saw that my SHBG was super high - 85nmol/l (18-54 range) and free test was just below the lower range, while total T was quite normal 21nmol/l (10-28). Estrogen was barely detectable.

After some reading I decided to self-prescribe TRT because where I live, nobody will prescribe me TRT at 28th with normal total T. Read A LOT before I did it including Nelson Vergel. Decided to start @ 250mg E7D Omnadren which is the only legal Test where I live. Decided to do bigger amount first to build muscle and then go down. 1 month in and I got a bit of sides - brittle hair and acne. Decided to move to TRT protocol.

****

Moved down to 125mg per week with E6/7 D injections. Tried to implement HCG, cystic acne started coming out. Tried microdosing as small as 100ui 2/3xweek, still acne. Had to remove it. But FELT AMAZING on just T the whole time for about an year. More energy, the T combined with super strict diet made me look so nice. Got addicted to this, girls started to notice me more and as you know all of us men enjoy this so much, the beard filled up, my behavior changed. Just brilliant. Until the moment,18months later after the start, some problems started to arise without changing anything. Always the same 125mg per week dosage.

1. Lack of energy. It started with inability to sleep properly which as I realized is a BIG problem. Started having early morning awakenings. When I woke up I felt a bit shaky and nervous. This led to daytime fatigue and I am constantly worried if I need to do something after 14:00 as I will be super tired at this point and will need a nap to rejuvenate. Managed to somehow fix the early awakenings and the insomnia,now I get solid 6.5-7.5h sleep each night but the fatigue persists. When I get fatigued it feels as if my face is bending one side and the brain wants to switch off. I feel best in the mornings until 13:00, then I lose energy to about 18:00, then after 22:00 I get energy again. Does not matter if I eat or what I eat.

2. Irritability - this might be connected to the fatigue but the smallest mistake made by other people made me burst. If my GF or friend started arguing with me I started to act really touchy.

3. Overall sense of not being myself anymore. A bit riddled with Anxiety.

Decided to do some blood tests on the PEAK 24h after injection:

Estradiol 145pmol/l (41.40-159) ; Progesterone <0.159nmol/l (max 0.474) ; Test 51.50nmol/l(10-28) ; SHBG 52.56nmol/l (18-54) ; Did Spermogram - Its abnormal as expected after 2y of TRT - they coudlnt detect anything in it.

After I saw the levels, 6 weeks ago decided to change to EOD injections to smooth out the peaks. Zero change in the way I feel. I only got something I did not have before - bloating. Moved down to 100mg per week overall, the bloat is still there and still tired. Bought Progesterone cream to bump up the Prog levels as they are non-existant. Don't really feel any difference in terms of energy. But at least I have some Prog in the system now.

After searching for information, this week I ordered Test Prop and ditch the Sust(omnadren) and plant to start daily microdosing @ night, prior to sleep to mimic natural T cycle. It will arrive in about a week from today. Do you think this is a good idea ? Reason: When I moved to EOD and there was no dip in T I actually felt worse and more bloated. I think the body might need the dip that a fast ester provides.

What can you advise me ? What other blood tests should I do to gain additional info what is going on with my body ? Any ideas why my energy levels are so so low ?

Will be super grateful if you help me out how to return to normal without stopping TRT. Will post blood results and everything that you might think must be done to get down to the core of the problems.

Thank you so much in advance !!!!

 

[Vince]

Sounds like your biggest mistake was starting trt. You felt great, but had a hard time building muscle and growing facial hair.
I think you should get off of testosterone. Doesn’t seem like you’re getting any benefit?

 

[DeadCatB]

Sounds like your biggest mistake was starting trt. You felt great, but had a hard time building muscle and growing facial hair.
I think you should get off of testosterone. Doesn’t seem like you’re getting any benefit?

Thank you for response. At this point it seems so. First 18 months I got all the benefits and zero negatives, now I am constantly fatigued which trumps all positives that I get.

I am not sure I will be able to tolerate going back to my low T self, living with below the low range T most probably will suck after seeing "the other side". When I think about it I am truly afraid to be honest.

Will go back to natural if I am unable to feel better again in the next 2-3 months as otherwise continuing on this path will make no sense.

 

[madman]

Hi, You can start to read after the **** if you don't want background not to lose time.

A bit of background - Currently 32yo, M, I always felt really good and looked really well and young. Very manic about the food that I eat - mainly meat, animal fat, organs(brain,liver), small amount of vegies and fruit here and there, mainly in the summer,never carbs or sugar, no gluten or dairy as both give me problems. This is since I am 20yo, never cheated except popcorns at the cinema.

Everything was OK, except - my muscle building ability was always quite low. Looked "fit" at the most, but always small, if I stopped training my muscles shrank and I looked really bad, kind of soft looking. My beard was not very developed as well.

2 years ago decided to do blood tests and saw that my SHBG was super high - 85nmol/l (18-54 range) and free test was just below the lower range, while total T was quite normal 21nmol/l (10-28). Estrogen was barely detectable.

After some reading I decided to self-prescribe TRT because where I live, nobody will prescribe me TRT at 28th with normal total T. Read A LOT before I did it including Nelson Vergel. Decided to start @ 250mg E7D Omnadren which is the only legal Test where I live. Decided to do bigger amount first to build muscle and then go down. 1 month in and I got a bit of sides - brittle hair and acne. Decided to move to TRT protocol.

****

Moved down to 125mg per week with E6/7 D injections. Tried to implement HCG, cystic acne started coming out. Tried microdosing as small as 100ui 2/3xweek, still acne. Had to remove it. But FELT AMAZING on just T the whole time for about an year. More energy, the T combined with super strict diet made me look so nice. Got addicted to this, girls started to notice me more and as you know all of us men enjoy this so much, the beard filled up, my behavior changed. Just brilliant. Until the moment,18months later after the start, some problems started to arise without changing anything. Always the same 125mg per week dosage.

1. Lack of energy. It started with inability to sleep properly which as I realized is a BIG problem. Started having early morning awakenings. When I woke up I felt a bit shaky and nervous. This led to daytime fatigue and I am constantly worried if I need to do something after 14:00 as I will be super tired at this point and will need a nap to rejuvenate. Managed to somehow fix the early awakenings and the insomnia,now I get solid 6.5-7.5h sleep each night but the fatigue persists. When I get fatigued it feels as if my face is bending one side and the brain wants to switch off. I feel best in the mornings until 13:00, then I lose energy to about 18:00, then after 22:00 I get energy again. Does not matter if I eat or what I eat.

2. Irritability - this might be connected to the fatigue but the smallest mistake made by other people made me burst. If my GF or friend started arguing with me I started to act really touchy.

3. Overall sense of not being myself anymore. A bit riddled with Anxiety.

Decided to do some blood tests on the PEAK 24h after injection:

Estradiol 145pmol/l (41.40-159) ; Progesterone <0.159nmol/l (max 0.474) ; Test 51.50nmol/l(10-28) ; SHBG 52.56nmol/l (18-54) ; Did Spermogram - Its abnormal as expected after 2y of TRT - they coudlnt detect anything in it.

After I saw the levels, 6 weeks ago decided to change to EOD injections to smooth out the peaks. Zero change in the way I feel. I only got something I did not have before - bloating. Moved down to 100mg per week overall, the bloat is still there and still tired. Bought Progesterone cream to bump up the Prog levels as they are non-existant. Don't really feel any difference in terms of energy. But at least I have some Prog in the system now.

After searching for information, this week I ordered Test Prop and ditch the Sust(omnadren) and plant to start daily microdosing @ night, prior to sleep to mimic natural T cycle. It will arrive in about a week from today. Do you think this is a good idea ? Reason: When I moved to EOD and there was no dip in T I actually felt worse and more bloated. I think the body might need the dip that a fast ester provides.

What can you advise me ? What other blood tests should I do to gain additional info what is going on with my body ? Any ideas why my energy levels are so so low ?

Will be super grateful if you help me out how to return to normal without stopping TRT. Will post blood results and everything that you might think must be done to get down to the core of the problems.

Thank you so much in advance !!!!

If you are naturally small and tend to have a hard time gaining muscle mass than low-carb (keto/carnivore) is the wrong way to go about as you will never pack on any muscle mass cutting out complex low-gi starchy carbs.

Top it off with the fact that your FT levels are low as having healthy testosterone levels is critical to the improvements in body composition one would achieve when following a proper diet/training protocol.

Keep in mind that although healthy testosterone levels can lead to improvements in body composition (muscle gain/fat loss) when following a proper diet/training protocol that it will be minor when compared to the muscle/strength gains one would achieve when using steroid doses of T 300-600mg/week.

Top it off with the fact that your genetics will have the final say.

Jumping on the higher dose (Omnadren) was a bad move and injecting such dose once weekly would have your TT/FT/e2 levels through the roof let alone drive up your RBCs/hemoglobin/hematocrit.

Once weekly injections using higher doses of T would result in very high peaks post-injection and much lower levels come weeks end as there will be a big peak---> trough over 7 days and blood levels will not be as stable.

As you can see when you lowered your dose to 125mg/week that your peak TT levels were almost 1500 ng/which would be expected and your FT would have also been high.

You did not test your RBCs/hemoglobin/hematocrit which would also be elevated.

You would have most likely been better off dropping your dose down to 100 mg/week split twice weekly (50 mg every 3.5 days) instead of jumping on EOD as your SHBG is still on the higher end.

One critical thing that stands out is you never had a full thyroid panel done as healthy functioning thyroid/adrenals are critical and many of the symptoms of a dysfunctional thyroid can mimic low-t.

The best piece of advice is to start low and go slow with a T only protocol to see how your body reacts to said protocol (dose of T/injection frequency) and always follow up with blood work which is critical!

Not sure if daily prop would be the best move and keep in mind that injectable esterified T will never mimic the natural 24hr circadian rhythm of a healthy young male.

From a previous post in another thread, I responded to:


During the 24hr circadian rhythm of a healthy young male testosterone level will start to increase around 3-4 am reaching peak levels between 6-8 am and by 11-12 pm will start to decline late afternoon/early evening reaching trough between 6-8 pm.

Fluctuations from peak--->trough would be around 20-25%.

When using exogenous testosterone whether injecting daily/EOD/M/W/F, twice weekly (every 3.5 days) or once weekly although there will be a big difference n peak--->trough levels depending on the injection frequency chosen you would never mimic the natural 24hr circadian rhythm of a healthy young male.

Injections result in steady-state let alone most are forcing testosterone levels upon themselves which one could never produce naturally as many are running very high TT/FT levels 24/7 and you would be amazed at what these levels are at a trough.

Top it off with the fact that your hpta is SHUTDOWN.

 

[Vince]

When I did my last labs. I was injecting 16 mg of testosterone cypionate and 500 iu of hcg. I get pretty good results with daily injections.


I’m having new ones on September 15.


Testosterone, Serum 1118 Reference Range: 264-916 ng/dL
Free Testosterone(Direct) 27.3 Reference Range: 6.6-18.1 pg/mL
Estradiol, Sensitive 19.8 Reference Range: 8.0-35.0 of/mL
SHBG 47.7 Reference Range: 19.3-76.4 nmol/L
DHEA-Sulfate 424.8 Reference Range: 30.9-295.6 ug/dL (age adjusted)
Albumin 4.3 Reference Range: 3.6-4.8 g/dL
Tru T 38.46 range 16-31 ng/dL

 

[fifty]

Your story sounds similar to mine but I’m 40 and I never got the 18months of good results to start out with

 

[Cataceous]

You'll want to inject propionate first thing in the morning, not at night. The rise to peak serum testosterone is fast. For me it occurs within two or three hours of an injection. Be sure to measure so that you are not going too high. Also, I find the testosterone variation with propionate is more than is seen in natural men, moving 40-60% about the mean instead of the normal 25% or so. This can be corrected by using propionate together with a longer ester—even Sustanon would do the job if needed. Don't expect miracles. This kind of protocol may help with reducing side effects while preserving benefits. The key is to limit the peak free testosterone to a reasonable physiological level. I would use the Tru-T calculator and aim for the middle of the healthy normal range of 16-31 ng/dL.

 

[DeadCatB]

You'll want to inject propionate first thing in the morning, not at night. The rise to peak serum testosterone is fast. For me it occurs within two or three hours of an injection. Be sure to measure so that you are not going too high. Also, I find the testosterone variation with propionate is more than is seen in natural men, moving 40-60% about the mean instead of the normal 25% or so. This can be corrected by using propionate together with a longer ester—even Sustanon would do the job if needed. Don't expect miracles. This kind of protocol may help with reducing side effects while preserving benefits. The key is to limit the peak free testosterone to a reasonable physiological level. I would use the Tru-T calculator and aim for the middle of the healthy normal range of 16-31 ng/dL.

Got a couple of questions regarding your response:

1. From what I understand in the research T bottoms out around 8pm and starts to go up during the night around midnight after one is asleep- peaks in the morning and starts to fall down but has two little bounces along the way. https://bare5dotcom.files.wordpress.com/2015/05/img_1488.gif

Why should I avoid evening injections if T starts to rise after midnight ? Wouldn't that make more biological sense to have rising T levels @ night instead of morning, noon ?

2. The issue with the quick spike in T levels from Prop, would a subq injection help to have a higher peak ?

3. In order to mitigate the problem with big 50%+ variation in levels you mention, is it not possible to use a second smaller injection around 10 in the morning to mimic the little bounce in T levels that occur on the way down ? This way maybe test C and P mix is not needed ?

 

[Cataceous]

Got a couple of questions regarding your response:

1. From what I understand in the research T bottoms out around 8pm and starts to go up during the night around midnight after one is asleep- peaks in the morning and starts to fall down but has two little bounces along the way. https://bare5dotcom.files.wordpress.com/2015/05/img_1488.gif

Why should I avoid evening injections if T starts to rise after midnight ? Wouldn't that make more biological sense to have rising T levels @ night instead of morning, noon ?

2. The issue with the quick spike in T levels from Prop, would a subq injection help to have a higher peak ?

3. In order to mitigate the problem with big 50%+ variation in levels you mention, is it not possible to use a second smaller injection around 10 in the morning to mimic the little bounce in T levels that occur on the way down ? This way maybe test C and P mix is not needed ?

1. It's been suggested that higher testosterone levels are associated with action and lower levels with rest and recovery. This would be in line with an argument based on evolution, in which it's inferred that it's advantageous to have higher testosterone in the earlier waking hours. This is best imitated with a propionate injection at first waking. Many, myself included, find that rising testosterone interferes with sleep. An evening injection puts peak testosterone before midnight. So by morning you're significantly lower and falling through mean levels by noon, well out of phase with what's seen naturally.

The least natural part of propionate injections is the lack of a more gradual rise in serum testosterone in the early morning hours. Instead you get a much more abrupt rise after waking. But it could be argued that the natural pattern is slower because it has to be, not because it's necessarily better. That is, the signaling through the hypothalamus, pituitary and testicles takes time, as does ramping up production of testosterone.

Of course it's perfectly ok to be skeptical, as this isn't hard and settled science. It's a trivial matter to do your own experimentation to see what works best for you. The nice thing about propionate is that changes to dosing stabilize within a few days.

2. Subcutaneous injections have slower absorption than intramuscular. So they may help to reduce peak serum levels and raise trough levels. Average levels are about the same for either method. As I mentioned, the simplest way to control the magnitude of the variations is by adding in a longer ester that provides a fairly constant "background" testosterone level.

3. In theory, if you split your daily propionate dose into enough separate injections then you can imitate almost any waveform pretty well. If you're only splitting into two then ideally you'd want a smaller one around 2-3 am and a larger one around 5-6 am. But overall this won't mimic a natural rhythm as well as a single dose with two esters.