3rd week of TRT - Crash?

[S1W]

Hi Guys - new here and have enjoyed reading and learning from this forum.

This is the middle of my 3rd week on TRT. 38 year old male, athletic, overall good health. Pre-TRT: Total T low 300s ng/dl. Free T around 50 pg/ml.


I have been prescribed a 200mg/gram compounded cream, applying 1/2 gram daily, for 100mg/day. I have been applying this to the scrotum every morning.


During the first week, I felt the effects almost immediately and felt great - fog gone, boost in energy levels and moods. Week 2 was roughly the same, perhaps some moderation of energy levels. Now in the middle of week 3, I feel like maybe I have crashed? The improved moods and energy levels I felt the past 2 weeks are gone. I am tired most of the day, moods generally low, feel foggy. I now feel more sluggish than I did pre-TRT.


Is this a normal part of the experience as levels are in flux and adjusting, and things will eventually improve and stabilize? Should I be rotating application sites for the cream? Any other thoughts?

Thank you.

 

[Systemlord]

Welcome to Excelmale,

It only takes 1-3 weeks for your pituitary gland to realize you have plenty of T circulating in your blood therefore shutting down your HPTA system, it happens to most of us. Until this point you had your natural production and bioidentical test floating around in your blood, we call it the TRT honeymoon phase. It's going to be months before you start to feel normal again, if you're SHBG is low it could take longer. Do you have your pre-TRT labs?

 

[CoastWatcher]

Welcome to Excelmale. You may well be experiencing the end of your "TRT honeymoon." That's the phrase applied to guys in the early stage of their protocol. The application of exogenous testosterone combines with the testosterone their own body is still producing, endogenous testosterone, and it's a bliss-filled ride for a short period period of time. Natural production shuts down...and the stars and dazzle disappear.

It it can happen to anyone, no matter the mode of delivery, but we seem to see it a bit more often with men who use topical testosterone. You may be one of those men who simply fail to absorb topical testosterone, research shows that there are many, or you simply will need to have a protocol adjustment. Either way, you're in the early, early stages of your journey. When is your first follow-up testing scheduled?

 

[madman]

Welcome to Excelmale. You may well be experiencing the end of your "TRT honeymoon." That's the phrase applied to guys in the early stage of their protocol. The application of exogenous testosterone combines with the testosterone their own body is still producing, endogenous testosterone, and it's a bliss-filled ride for a short period period of time. Natural production shuts down...and the stars and dazzle disappear.

It it can happen to anyone, no matter the mode of delivery, but we seem to see it a bit more often with men who use topical testosterone. You may be one of those men who simply fail to absorb topical testosterone, research shows that there are many, or you simply will need to have a protocol adjustment. Either way, you're in the early early stages of your journey. When is your first follow-up testing scheduled?

Is the 1/2 gram (100mg) compounded cream not a large dose to be applying directly to the scrotum (5 fold higher resorption rate) http://www.eje-online.org/content/153/2/317.long

 

[Loki]

I agree, that seems like a very low dose... I was doing 175MG cream and a gram in the morning and a gram at night... And I used inner thigh and delts to apply, a much larger surface area... Once you shut down you might have lower T now than when you started...

 

[CoastWatcher]

Is the 1/2 gram (100mg) compounded cream not a large dose to be applying directly to the scrotum?

I had wondered...scrotal application should bump DHT levels.

 

[S1W]

It only takes 1-3 weeks for your pituitary gland to realize you have plenty of T circulating in your blood therefore shutting down your HPTA system, it happens to most of us. Until this point you had your natural production and bioidentical test floating around in your blood, we call it the TRT honeymoon phase. It's going to be months before you start to feel normal again, if you're SHBG is low it could take longer. Do you have your pre-TRT labs?

My pre-TRT labs (note - doc did run all of the recommended tests that I've read about since beginning):

Total T (LC/MS/MS) 355 nl/dl (range of 348-1197)
Free T 51 pg/ml (range of 35-155)
LH 3.3 mIU/ml (range of 1.7-8.6)
FSH 2.8 mIU/ml (range of 1.5-12.4)
Prolactin 11.7 ng/ml (range of 4.0-15.2)
Vitamin D 32.3 ng/ml (range of 30-100)

The doc has scheduled follow up labs for 3 months from beginning of treatment - so mid-January, which seems a bit long. Should I push to get in earlier?

When you say it may take months to feel normal again, would that be feeling like I did pre-TRT? Is there a point where guys get back to feeling like they did (or better than they did) during the honeymoon phase?

Also, some guys replied that they thought that was too much to apply to the scrotum - do you think I would have better results applying to shoulders, etc?

Thanks again everyone - really appreciate your replies and please let me know if I'm leaving out any information that might be useful.

 

[Systemlord]

My pre-TRT labs (note - doc did run all of the recommended tests that I've read about since beginning):

Total T (LC/MS/MS) 355 nl/dl (range of 348-1197)
Free T 51 pg/ml (range of 35-155)
LH 3.3 mIU/ml (range of 1.7-8.6)
FSH 2.8 mIU/ml (range of 1.5-12.4)
Prolactin 11.7 ng/ml (range of 4.0-15.2)
Vitamin D 32.3 ng/ml (range of 30-100)

The doc has scheduled follow up labs for 3 months from beginning of treatment - so mid-January, which seems a bit long. Should I push to get in earlier?

When you say it may take months to feel normal again, would that be feeling like I did pre-TRT? Is there a point where guys get back to feeling like they did (or better than they did) during the honeymoon phase?

Also, some guys replied that they thought that was too much to apply to the scrotum - do you think I would have better results applying to shoulders, etc?

Thanks again everyone - really appreciate your replies and please let me know if I'm leaving out any information that might be useful.

I've been on TRT for 7 months now and I'm still not 100 percent yet, my honeymoon phase lasted only 3 days. I have low SHBG and was put on weekly injections when I should have been on injections EOD, it likely prolonged my recovery. Without knowing where your SHBG is at it's hard to nail down how often you require injections, a lot of doctors fail to run this important test. It usually takes several months to get your protocol dialed, this is where SHBG becomes useful. It could take you longer because you're shooting in the dark on dosing and injection frequency. You should notice improvements after the first month and continued symptom improvements beyond, I would say if your SHBG isn't too low you should feel great by the 6 month mark. Maximum effects take longer though, like muscle and erection quality.

 

[S1W]

I've been on TRT for 7 months now and I'm still not 100 percent yet, my honeymoon phase lasted only 3 days.

Would you say that now at 7 months you at least feel better than you did pre-TRT?

 

[HarryCat]

My pre-TRT labs (note - doc did run all of the recommended tests that I've read about since beginning):

The doc has scheduled follow up labs for 3 months from beginning of treatment - so mid-January, which seems a bit long. Should I push to get in earlier?

If you don't notice improvement in the next week or so then definitely.

When you say it may take months to feel normal again, would that be feeling like I did pre-TRT? Is there a point where guys get back to feeling like they did (or better than they did) during the honeymoon phase?

Some do, some don't, after the initial honeymoon phase I returned to baseline and never felt any better than I did before I started.

Also, some guys replied that they thought that was too much to apply to the scrotum - do you think I would have better results applying to shoulders, etc?

Back when I was doing TD I did not find it a problem applying that much to the scrotum. If you switch to another area absorption will definitely be less. You should not make any changes to your protocol until you get labs and know what is really going on with your levels.

 

[Systemlord]

Would you say that now at 7 months you at least feel better than you did pre-TRT?

I feel a ton better, pre-TRT I literally felt like I was dying. I had horrible muscle pain, zero strength and horrendous brain fog that felt like death was at my door. My pre-TRT levels were 119 ng/dL so I'm coming from a much lower point than you, it's for this reason you should recover quicker since your levels are nowhere near mine. I'm getting closer and closer the way I felt during the honeymoon phase, there are moments on some days where I feel like that again for a few hours, it's exhilarating!

 

[S1W]

Some do, some don't, after the initial honeymoon phase I returned to baseline and never felt any better than I did before I started.

I am assuming that based on this statement you have discontinued TRT. If so, how long were you on for and did you have any issues recovering after you stopped?

It is very interesting to hear people's responses, and I guess somewhat discouraging too since there seems to be a tone of "it might not get any better than pre-TRT" in a few responses.

 

[Systemlord]

There are a few reasons why TRT might not work, an undiagnosed thyroid issue and super low SHBG. An increase in E2 can inhibit testosterone's effects on the body. Low thyroid function can lower SHBG, there are guys with low SHBG who have fully recovered. Mostly the reason why TRT doesn't work is because of the doctors who are failing, not TRT. When I went on TRT I was given huge injections that made me feel worse than my pre-TRT state, my doctor clearly operating outside his field of knowledge and instead of informing me of this he continued blindfolds on.

One thing I've seen a lot of on these forums is self doubt, "maybe I'll never recover at all" low T is the cause of all this. It affects your mind in many ways, you can't let it grab hold. I've had a lot of self doubt in the last 7 months and questioned if I getting better at all, I see it everyday on the forums and nowhere else.

How about this, you will recover and you will enjoy doing the things that you used to do, like going on a date or going to the gym.

 

[Forty2]

If clomid works for you, then you could try cycling between clomid and test cream. I have a friend who takes testosterone for 2 weeks, then clomid for 3 weeks, then repeats the cycle. He says he has great libido, much better then when he was taking testosterone continuously for months on end. Doing it this way lets you experience that honeymoon period over and over again.

 

[HarryCat]

I am assuming that based on this statement you have discontinued TRT. If so, how long were you on for and did you have any issues recovering after you stopped?

It is very interesting to hear people's responses, and I guess somewhat discouraging too since there seems to be a tone of "it might not get any better than pre-TRT" in a few responses.

I tried coming off for a couple of months but my levels never returned to where they were before I started. Maybe a longer restart attempt would work but I haven't tried.

 

[S1W]

I tried coming off for a couple of months but my levels never returned to where they were before I started.

This was my biggest concern starting TRT, and the reason for some of my concern now that I'm not feeling any different than I did pre-TRT. I understand that this may seem like self-doubt, etc that is indicative of low T levels in general, however I think some of this concern is reasonable.

In my case, I was far from feeling terrible pre-TRT. My primary concern was ED - this was a new thing, and I'm married and have a great relationship with my wife (basically safe to rule out anxiety/psychological factors). Also, decreased energy levels, far less enthusiasm in general for activities that I used to get pretty excited about, and occasional moodiness that were not characteristic. But I still managed to get to the gym a few days a week (although with less results) and generally live life. In summary, the feeling I had was that life was ok, but almost like someone had turned the volume down. Also of note - puberty was late for me, and I've always looked young for my age - my doc seemed to think that was also relevant.

My doc said he thought it was worth trying TRT and that if it did not work for me or that if I saw no benefit, I could simply stop and things would go back to normal eventually. Having read through countless threads on various forums, it seems that it does indeed take a lot of time (up to a year) to realize the benefits of TRT. However, my concern is that after a year plus with a shut down HPTA, will simply going back to normal be an option? And if the feeling I had the past 2 weeks is not the norm, and this third week feeling might be the norm, then is it all worth it?

 

[Systemlord]

I've never heard of someone stopping TRT and not returning to a pre-TRT state, after the medicine clears out of you system you will return to baseline. There's no doubt about it.

 

[HarryCat]

I've never heard of someone stopping TRT and not returning to a pre-TRT state, after the medicine clears out of you system you will return to baseline. There's no doubt about it.

Well, you heard it here first.