Sleep issues caused by TRT

[stx359]

I would consider myself a TRT success story except for one thing. I have never at any time in my life had an issue with sleep but now that I have my numbers dialed in, TT of 1000, FT of 25, SHBG, E2 and DHEA all within normal range, I wake up at 3:00 AM every single night and am unable to get back to sleep.

My current regimen is 80 mg test cyp every 3.5 days, HCG 150 IU daily, DHEA 25 mg twice a day and pregnenalone 30 mg twice a day. I take melatonin before bed and it knocks me out but only for a few hours then I am wide awake.

I had the same issue early on in my TRT journey but it went away and I slept normally for months. Now it is back and it appears to be persistent and not going away. Anyone have any experience with this? Would dropping my testosterone levels a bit help?

 

[Vince Carter]

This is actually extremely common if you google "why I wake @ 0300" lots of opinions, ideas to work with it, but Ive not found a cure. As far as on this forum people have looked in to Thyroid, Adrenal/Cortisol, blood sugar, and any number of things. Some times something works for one guy and not for the rest. I've looked at a weighted blanket that claims to offer some anxiety relief.

 

[sh1973]

I had the same problem for years, and getting my total t level under 800ng was the key to alleviating the problem.

 

[HarryCat2]

How old are you? For older guys, over 50 or so, poor sleep with levels over 700 seems to be fairly common. So you can try dropping your dose a bit.

You can also try dropping the DHEA and pregnenolone unless you are convinced they actually help you sleep. DHEA made it almost impossible for me to get to sleep, even if I took it in the morning. I do find preg helpful for sleep.

 

[HealthMan]

Your DHEA and Pregnenolone dosage are on the high side. I would try to reduce that or stop for a few days and see if that helps. You can also try sustained release melatonin. Douglas labs has a very good one

 

[blackebob]

mine comes and goes, right now it is reveille at 0430 not 0630. Instantly wide awake. My doc told me as long as I feel rested, its just my body saying battery full get up. I roll with it, and take a nap later.

 

[stx359]

How old are you? For older guys, over 50 or so, poor sleep with levels over 700 seems to be fairly common. So you can try dropping your dose a bit.

You can also try dropping the DHEA and pregnenolone unless you are convinced they actually help you sleep. DHEA made it almost impossible for me to get to sleep, even if I took it in the morning. I do find preg helpful for sleep.

I just turned 49 so entering 50's territory. Perhaps I need to explore reducing my test cyp dose. I also might try skipping my DHEA or preg for a week or two to see if that helps. Honestly I don't know if they help or not. When I started on TRT I also started DHEA and Preg so it was hard to tell. If I had it to do all over again I would have started TRT alone and then began adding one thing at a time if I needed it.

 

[Nelson Vergel]

Chew on one or two of these when you wake up at 3 am
https://www.amazon.com/gp/product/B00020I6YK/ref=oh_aui_search_detailpage?ie=UTF8&psc=1

Here are posts from people with your same problem:

melatonin excelmale.com site:www.excelmale.com - Google Search

 

[ratbag]

When do you take your doses of DHEA? at what times?

 

[stx359]

When do you take your doses of DHEA? at what times?

I take the DHEA and Preg with breakfast and dinner, which is about two hours before bed.

 

[ratbag]

I used to take my DHEA in the morning and I read here many find it helps your sleep if you take it at bedtime. So I switched and now take it at bedtime and I found it improved my sleep immensely. Your only 2 hours off but it could make a difference. Also you can try to take it all at bedtime and see if that helps your sleep.

 

[captain]

Try injecting your HCG at bed time. The times I have injected HCG at bed time I wake up and have to think what was on my mine the day before. It seems to shut off everything that was on my mind and I wake up clear of it. I think this is why normally you inject in the morning to help you though the day.

 

[Dwhit]

This is an issue I've been struggling with for the past couple years. I used to be able to tolerate total testosterone levels of around 1000. But I just turned 50, and now I try to keep my level around 600 to 700. I also stopped HCG since that seemed to make things worse. I also switched to daily shallow IM, for more consistent levels. The latest thing that is helping a lot is carb cycling throughout the day, starting off high protein low carb, and ending low protein high carb. This dietary approach is supposed to maximize your cortisol levels earlier in the day and minimize them later in the day to help you sleep. It is also supposed to help with serotonin production at night. I went from 4 hours of sleep a night to six to seven hours of sleep a night and I am feeling much better.

 

[lowtdunce]

Do a little more research/thinkin' before taking melatonin regularly. I've seen sources say that if you use it too frequently your body will adapt and stop making less of its own plus it can screw up the balance of others substances in your body. Good for a little restlessness now and then but maybe think about another method to use on a regular basis. I've heard good things about about magneseum, thianine and glycine. Plus the dose size you can buy of melatonin is often many times more than what your body makes normally.

I have the 3-4am wakeup issue and it was terrible for awhile about 4 months after I started TRT but somewhere along the line the anxiousness and worry about it went away about 90% of the time. I still frequently wake up around that time but I'm able to just chill out and get back to sleep fairly easy. Sometimes just getting up, getting a drink of water and getting back to bed does the trick. That "second sleep" if I get to sleep past 7 or 8 in the morn is usually very refreshing too.

I will add that when I had period of getting my E2 too low, that made the 3am wakeup thing much worse. But low e2 makes everything hell so no surprise there.

 

[captain]

I recall that melatonin is not suppressive. I know of people taking 50mg of melatonin everyday. I heard a doctor say the only way melatonin will hurt you is if you have a case of it fall off a shelf and hit you. I heard other doctors say it should be prescription only. If you know someone that is blind ask them if melatonin is bad.

 

[Vitamin_C]

with melatonin, the lower dose the better.

 

[Vince Carter]

This is really getting me the last two nights, basically up at 0200, flop around for 90 minutes and then fall back asleep for 30 minutes. But I'm knocked out dead for 6 hours prior to that. Sometimes this awake at 2 or 3 is worse than others. I get up, pee, walk around, I've tried eating something, nothing really helps. I'm overly warm and simultaneously too cool. I can't take something at that time as I have to be up and at work by 0600.

 

[Gman86]

Melatonin is definitely not something you want to be dependent on or take long term. It’s best use would probably be to help with jet lag and reset your circadian rhythm after flying through different time zones. Here’s a great video explaining why melatonin supplementation isn’t optimal

There’s many things you can do to improve sleep quality, but definitely try magnesium before bed if you haven’t already. That stuff works. I’ve had great success with it in regards to improving sleep quality. I had an ex that had so much trouble sleeping that she had to take trazodone every night, she took it for years. I turned her on to magnesium, and she eventually was able to stop taking the trazodone. I’m a homecare nurse, and I also have a patient that needed seroquel to sleep everynight, and she was able to stop taking the seroquel once I got her to consistently take magnesium prior to bed. They were both so happy to get off those meds, due to them both leaving them with a hangover and groggy feeling in the morning even though they slept like logs.

I also agree with Healthman, your dosage of DHEA is very high, I’d be very surprised if you really needed that high of a dose to reach optimal levels of DHEA

And lastly, I’ve heard of a few people recommending to take pregnenolone in the evening, due to it’s conversion into allopregnenolone, which is supposed to help with sleep. Both Jim Meehan and Rob Kominiarek from the TOT round table both take, and recommend to their patients to take pregnenolone in the evening. They both use around 30mg for their patients. So not sure if your pregnenolone dose is on the high side as well.

 

[stx359]

Melatonin is definitely not something you want to be dependent on or take long term. It’s best use would probably be to help with jet lag and reset your circadian rhythm after flying through different time zones. Here’s a great video explaining why melatonin supplementation isn’t optimal

There’s many things you can do to improve sleep quality, but definitely try magnesium before bed if you haven’t already. That stuff works. I’ve had great success with it in regards to improving sleep quality. I had an ex that had so much trouble sleeping that she had to take trazodone every night, she took it for years. I turned her on to magnesium, and she eventually was able to stop taking the trazodone. I’m a homecare nurse, and I also have a patient that needed seroquel to sleep everynight, and she was able to stop taking the seroquel once I got her to consistently take magnesium prior to bed. They were both so happy to get off those meds, due to them both leaving them with a hangover and groggy feeling in the morning even though they slept like logs.

I also agree with Healthman, your dosage of DHEA is very high, I’d be very surprised if you really needed that high of a dose to reach optimal levels of DHEA

And lastly, I’ve heard of a few people recommending to take pregnenolone in the evening, due to it’s conversion into allopregnenolone, which is supposed to help with sleep. Both Jim Meehan and Rob Kominiarek from the TOT round table both take, and recommend to their patients to take pregnenolone in the evening. They both use around 30mg for their patients. So not sure if your pregnenolone dose is on the high side as well.

Thanks for the feedback. Was just curious on the comment on DHEA dose. I checked my last labs from a month ago and my DHEA was 273 on a scale of 71-375 so not high by any means. In a consult with Dr. Crisler he actually advocated an even higher dose. Is there a downside to shooting for a DHEA level at the top of the scale?

 

[Gman86]

Thanks for the feedback. Was just curious on the comment on DHEA dose. I checked my last labs from a month ago and my DHEA was 273 on a scale of 71-375 so not high by any means. In a consult with Dr. Crisler he actually advocated an even higher dose. Is there a downside to shooting for a DHEA level at the top of the scale?

No I don’t think so. In fact, Dr. Rob Kominiarek likes his patients to have Dhea levels as high as possible as long as they are without any side effects. He likes his patients between 500-800. Even as high as 1000 in some cases. Maybe 50mg isn’t too too high of a dose. I don’t think I’ve seen anyone on higher doses though. Usually 50mg is the top end of the range as far as doses go. Usually the average is around 25mg from my understanding.