On TRT (Xyosted) 75 mg weekly. Labs on TRT: TT ~820, Free T ~1.15, SHBG 46, E2 63 (high), HCT normal.

TRTJack · Thursday at 4:35 AM

Since starting TRT starting getting severe Achilles tendinitis(although I did get it pre-TRT from too much jump roping ), but lately I’ve had significant elbow tendon pain and just 3 weeks ago doing shoulder presses within hours of workout started getting severe elbow pain in both sides,and yesterday at work pulling cables and I severely injured my right elbow and now I can’t go to work and might have to get on PMFlA! I’m not in a good situation at the moment , and my Achilles flares regularly. but TRT seems to have made recovery harder.
Has anyone had tendon issues improve by splitting injections, lowering dose, or managing estrogen differently?
Also considering short-term peptide injection threw my clinic , which strictly to help healing while I keep working — curious if anyone has real experience with that combo (TRT + split dosing + short peptide run).
Not looking to stack long-term, just trying to stabilize and heal. Appreciate any input. Seriously looking for input. I am a novice with this and learning a lot more now but still so many questions and not sure. I can trust these doctors now.

Willyt · Thursday at 10:27 AM

What day was your lab taken? At day 7 trough? (assuming Xyosted is 1x per week)

Xyosted peak is 1.8x trough according to their studies. If the TT 820 is trough, your peak would be a whopping TT 1470

I point this out because I have noticed that higher TT levels seem to aggravate my tendonitis in knees and elbows.

JorgeF · Thursday at 1:52 PM

man that sounds brutal, sorry you’re dealing with that. especially when it starts messing with work and you’re talking leave… that’s not just “normal soreness”

couple things i’ve seen over and over with guys who start trt and then suddenly feel like tendons are falling apart

one is they get stronger and more “game” fast, so training volume/intensity creeps up without noticing. muscles adapt quicker than tendons, so the weak link becomes achilles, elbows, shoulders, all the classic spots. even if you had the issue before, trt can make the mismatch worse because you’re able to push through warning signs

another big one is estradiol getting too low, usually from using an ai, or from just being a weird converter. low estradiol can feel like dry, cranky joints/tendons and recovery that feels worse, not better. so if you’re on an ai at all, or if your estradiol is suppressed, that’s worth looking at with your doc before you assume you “need peptides”

also, the acute elbow injury part worries me more than the chronic ache. if you felt a pop, sudden sharp pain, bruising, weird weakness, or you can’t rotate the forearm like normal, i’d get that checked properly asap (sports med or ortho). cables + sudden elbow pain can turn into a tendon tear situation and you don’t want to wait on that

on peptides… i’d be careful. a lot of what clinics push there is pretty thin evidence, quality control is a question, and it’s easy to end up masking pain while still loading a tendon that needs actual rehab and time. if you do anything like that, i’d only do it with a legit doc who can explain risks, not just “yeah bro it heals everything”

splitting injections or lowering dose can help if you’re having big peaks/troughs or you’re overreaching, but it won’t magically heal a tendon if you’re still hammering it. the biggest “fix” tends to be stepping back, getting the injury assessed, and making sure hormones arent being pushed into a bad spot (especially estradiol)

are you taking an ai right now or just testosterone? what’s your injection schedule like and did you ramp training hard once you started trt? and with the elbow injury, do you have bruising or a weird loss of strength/grip, or is it mainly pain? if you want, dm me your last labs (testosterone, estradiol, hematocrit) and i can tell you what stands out and what i’d ask the clinic to look at next, does that help?

ZALEMAX · 2026-02-06T19:21:24-0600

JorgeF said:
man that sounds brutal, sorry you’re dealing with that. especially when it starts messing with work and you’re talking leave… that’s not just “normal soreness”

couple things i’ve seen over and over with guys who start trt and then suddenly feel like tendons are falling apart

one is they get stronger and more “game” fast, so training volume/intensity creeps up without noticing. muscles adapt quicker than tendons, so the weak link becomes achilles, elbows, shoulders, all the classic spots. even if you had the issue before, trt can make the mismatch worse because you’re able to push through warning signs

another big one is estradiol getting too low, usually from using an ai, or from just being a weird converter. low estradiol can feel like dry, cranky joints/tendons and recovery that feels worse, not better. so if you’re on an ai at all, or if your estradiol is suppressed, that’s worth looking at with your doc before you assume you “need peptides”

also, the acute elbow injury part worries me more than the chronic ache. if you felt a pop, sudden sharp pain, bruising, weird weakness, or you can’t rotate the forearm like normal, i’d get that checked properly asap (sports med or ortho). cables + sudden elbow pain can turn into a tendon tear situation and you don’t want to wait on that

on peptides… i’d be careful. a lot of what clinics push there is pretty thin evidence, quality control is a question, and it’s easy to end up masking pain while still loading a tendon that needs actual rehab and time. if you do anything like that, i’d only do it with a legit doc who can explain risks, not just “yeah bro it heals everything”

splitting injections or lowering dose can help if you’re having big peaks/troughs or you’re overreaching, but it won’t magically heal a tendon if you’re still hammering it. the biggest “fix” tends to be stepping back, getting the injury assessed, and making sure hormones arent being pushed into a bad spot (especially estradiol)

are you taking an ai right now or just testosterone? what’s your injection schedule like and did you ramp training hard once you started trt? and with the elbow injury, do you have bruising or a weird loss of strength/grip, or is it mainly pain? if you want, dm me your last labs (testosterone, estradiol, hematocrit) and i can tell you what stands out and what i’d ask the clinic to look at next, does that help?

I got the same problem about 2 weeks ago I noticed poping at left elbow and tendons between the elbow and hand I thought it would get better and last workout I did felt pain but I always have a slight pain in the joints especially shoulder right and left. I use Xyosted 75mg 1 time a week and I use an ai anastrozole either 1/2 mg-or 1/4 mg 1 time a week I am trying to dial the dose in can not seem to get the perfect dose so I am experimenting the anastrozole use and I've been for about a month now also on Xyosted 75mg for approx. year and half. I work out on Tuesday and Saturday with gym weights this last Tuesday was a regular workout with moderate weight. The next day Wednesdays I inject woke up with left arm pain I could not get my arm to move up past my shoulder with extreme pain and some slight numbing in fingers about 6 months ago my neck had done the same thing anyways, I took some Advil and winging it out till Thursday in the morning I went to urgent care and told them to give me injection I think it was Torodol and within 15-20 minutes I went from a pain level of 8 to about 4 took a half of Advil last night and crashed out. I totally skipped my AI this round. My labs where done December 15 2025 I took labs at trough that would be on Tuesday TT-650 ng/dl FT-103.20 sex hormone binding globulin 38 estradiol-33 at 1/2 mg 1 once a week. my Hematocrit is up 52-Hemoglobin-16.9-iron-79 Ferritin 35.upon injection I get tired for about 2 days but start to feel better around Friday less tired and at Monday my libido is off the charts and rock solid also Tuesday libido is up but energy levels are falling I need caffeine during workouts160 mg will be good or more..my recovery is good overall Saturday workouts are good still need a caffeine boost. My joints are going out ill need to recover again from this flare up I hate stepping back from injury. I have had a few MRI etc etc and basically the surgeon said I will need joint replacements in the future. some stenosis in my neck and back I'm dealing with some tearing and x2 herniated disks. On another note my ears have been like turning red I mean hot red. I think it could mean my Hematocrit is up I'll get blood work soon and donate again I think its time I just don't like it at all. I have gained weight 190 lbs at 6ft 1" muscle and fat I was about 180lbs. Dr. gave me tomoxafinhe wants me to take that with my anastrozole but I have not started that. Can anyone give me advise on what might help my joints and my sleeping after my TRT shot injection all responses appreciated.