3rd Week on TRT - Still feel like crap

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I recently started TRT on a single weekly cyp injection. I'd go w/2xweekly shots, but insurance... My labs came in at Total T=307, Free=4.2, SHBG=53, prior to starting. I was trying to tackle this naturally by way of diet, exercise, and supplements since May, but no dice.

I've been experiencing a very low libido, brain fog, lack of motivation (though I force myself to workout 6 x week - Cardio 3 days, lifting 3 days). fatigue, and my mood just plain sucks being irritable and grumpy all the time. And for all the work I put in that the gym, I don't get much back. I maintain weight at best, only because I go back to <30g carbs/day one week out of each month. I eat clean, have my calories & macros dialed in, and use organic and natural foods and personal care products.

I did my due diligence with my primary care physician, followed by a trip to an endocrinologist. All labs are fine and I simply suffer from hypogonadism. After months of struggling through this, I finally threw in the towel and decided to get on TRT.

1st Test Cyp injection: 11/20, Dose @ 200 - Big improvement in mood. Felt happy, though nothing int the libido department.

2nd Test Cyp injection: 11/26, Dose @ 120 - Felt much like I did before I started TRT. Mood improvement gone, fatigued, libido still in the gutter.

3rd Test Cyp injection: 12/03, Dose @ 120 - Tired & grumpy. Libdo? Oh well, at least I have a distant memory of one.

I'm currently 3 weeks in, and frankly don't feel any better than I did before I got on therapy. Is this relatively normal?

Thanks in advance for any feedback!

 

[Nelson Vergel]

Sorry you are still struggling.

When will you have follow up blood work done?

Any sleep issues? Any other medications? Stress?

When Testosterone Replacement Doesn't Lead to Better Erections
Fatigue- When Testosterone Is Not Enough

 

[[email protected]]

Next blood work will be pulled this week, prior to my next injection.

Yes, big time sleep issues. This was one of my biggest problems prior to therapy. Sweat at night, wondering mind, tossing & turning all night. I got it somewhat under control by limiting caffeine intake to 200mg upon waking, and moving my workouts to early morning. I wake up at 5am and workout from 5:30am to 7am, M-F. Sat I wake up at 6am and workout at 7:30am. I drink a gallon of water a day and try to get the bulk in early and stop drinking liquids at 7pm to prevent trips to bathroom in the middle of the night. So again, sleep is better, but far from good at this point. Mostly due to the brain not shutting down, if that makes sense.

No other meds. I do take supplements. Fish oil, D3, Multi-Vitamin, BCAAs, Whey, Stinging Nettle (250/day), milk thistle, and saw palmetto (in the multi vitamin formula).

Nothing out of the ordinary w/stress levels.

For some additional background, I'm 40, don't smoke, don't drink, never used steroids. My health was shot about 4 years ago as I was obese, didn't think twice about what I ate, had hypertension and chronic lower back issues. During the last 4 years, I've applied nutrition and exercise to my lifestyle. Down from 315lbs 4 years ago to 230lbs.

 

[SuperDutyDave]

Usually you feel better with your initial few weeks of TRT as you have your natural level plus the extra drug level. But soon thereafter your body recognizes the androgynous T and shuts down your natural production so you crash and need to increase the med level to get to a healthy level.

Typically this dialing in process takes a while and yields some peaks valleys etc.

Also you will need to monitor estradiol levels and also consider HCG for testicular health

Bottom line no quick fix. Takes time adjustment and multiple drugs and supplements also.


Good luck


Ps. Try looking at sub-q injections and upping frequency to multiple times per week

 

[Hydranted]

It often takes time to get your protocol dialed in to one that works well for you. Even if you started on the perfect protocol, it still takes time for the benefits of TRT to show themselves. Many guys say that they start noticing positive changes around the 6 week mark. It can take several months on the right protocol to start experiencing the full benefits of treatment.

 

[[email protected]]

Thanks. I just wanted to make sure what I've been experiencing so far is normal. With my next labs next week, possible does adjustment, and HCG to begin the following week, hopefully I'll start taking a turn for the better. I appreciate everyone's input!

 

[Vision]

Im right there with you... I am on my 2nd month and still feel grumpy and blah.... Just emailed Dr Saya to see if I can do anything to kick me over the edge...

 

[SuperDutyDave]

Guys have faith.

Firet doc I went my GP gave me some androgel......immediately thought it would fix me within days. Ignorance of TRT treatment process both with me and him. Took another year of searching and learning what I needed. Then finally found a good doc who knew how to treat. Even with that it took well over six months of mesds supplements monthly labs etc. to start greeting dialed in and feeling like I should. Realistically it was more than a year to where I was happy with my health levels etc.

This may sound extreme but TRT is an art as much a science. Everyone reacts differently, has different needs and it takes time to hit the moving target of optimum levels. Think of it this way, for most of us it going down didn't happen overnight so neither will getting back on track.

Its far more complicated than just smear on this gel or take this shot twice a month

Be patient read and educate yourself. I understand the desire to be fixed immediately I was there.......it doesn't happen that way sorry to say

 

[CoastWatcher]

I understand your frustration. Eight weeks in as of tomorrow, I am now seeing real gains, but hope for continued improvement. My doctor told me she has seen it take several months for many of her patients to "arrive."

You our will get there.

 

[SoCalSurfer]

TRT is not going to give you an instant fix. You will hear that from a lot of us on the forum. I will take time to get to feeling better and finding that sweet spot level where you feel the best. Have faith you will get there it just takes some time. For me I cannot do the once a week shots to many highs and lows, so my doc agreed to the same dose just injections twice a week that i do myself in my quads.

ALM@ I will tell you that I had sleep problems till I took up cycling and I guess the extra cardio really helped. I fall asleep and stay asleep and wake fully rested. When I jacked up my neck I could not ride for a while and my old sleep patterns returned.
I see you hit the gym a lot so, how much cardio do you do and you could be over training a bit. Test your resting heart rate when you first wake in the morning.

 

[Vince Carter]

It's a journey of months of chasing a number on a test(s) and from there optimizing for the individual. When I was on weekly injections I knew days 5/6/7 I would be in a fade of sorts from a peak on days 2/3/4, as time wore on the fade got more pronounced to where I felt pre-TRT on Sunday and Monday, days 6 and 7.
I might surmise that what you're experiencing is an Estradiol increase. You might have to grin and bear it until your next labs and if an AI is needed, start small.

 

[Vision]

Spoke with the NP and she ordered a new set of tests. I should be getting those done next week. Be interesting to see if there is any difference.... Doesn't feel like much!! ?:^/

 

[SuperDutyDave]

Vision. I get you being anxious. We've all been there. As long as you're with a really good doc you aren't wasting time it's all good. It will take upwards of 6 months to get thing right if you're an easy case.....lif not it can take much longer.

With right plan it works but it is not instant gratification

 

[Vision]

I know Dave, and thanks... This is not my first bout with TRT... I started TRT 3 years ago, to much happiness!! I dropped 10lbs and libido was thru the roof, then 8 months later the estrogen kicked in, and libido was worse... put on 15 lbs and mucho depression!! To top it off my Doc would not address it... So I went off the Test about a year ago.... So when I decided to restart, I was hoping for the kick in the ass boost... but not this time....
Dr Saya is my Doc and he was confident he could address all my concerns, yes I know I have to be patient, however that is not one of my strong traits!!

 

[SuperDutyDave]

Tell me about it brother. I wasted over a year plus with wrong doc. Then with a great one it took another year plus to get things better....... Now two years later I finally feel consistently good and treatment plan is stable.

Still a lot of work on a daily basis to feel good but results are worth it. Wouldn't want it's step back

 

[Gene Devine]

I know Dave, and thanks... This is not my first bout with TRT... I started TRT 3 years ago, to much happiness!! I dropped 10lbs and libido was thru the roof, then 8 months later the estrogen kicked in, and libido was worse... put on 15 lbs and mucho depression!! To top it off my Doc would not address it... So I went off the Test about a year ago.... So when I decided to restart, I was hoping for the kick in the ass boost... but not this time....
Dr Saya is my Doc and he was confident he could address all my concerns, yes I know I have to be patient, however that is not one of my strong traits!!

You're in good hands with Dr. Saya...be patient.

 

[Nelson Vergel]

Alm

Make sure you do not have sleep apnea. It may get worse in some men on TRT and may explain why some men feel more tired than baseline.. Please let us know when you get your follow up tests.

 

[[email protected]]

I see you hit the gym a lot so, how much cardio do you do and you could be over training a bit. Test your resting heart rate when you first wake in the morning.

Overtraining very well may be the case. I hit a pretty bad low this weekend and spent most of it resting. While I can't say I feel like a million bucks, Monday on has been a little bit better. Tolerable anyways. I think I'm going to ease up a little bit on training until I get my TRT stabilized.

 

[[email protected]]

Alm

Make sure you do not have sleep apnea. It may get worse in some men on TRT and may explain why some men feel more tired than baseline.. Please let us know when you get your follow up tests.

No on the apnea. I made sure to have my wife gage my snoring levels from the get go. No noticeable difference. I got my blood drawn today. TT=678. FT, SHBG, Prolactin, and estrodial results should come in from lab tomorrow. This was on day 8 From my last shot. My injections are usually on Wed but I forgot to come in fasted for the lab yesterday. So I opted to wait another day before my T shot to see if I needed a dose adjustment. I'm also starting HCG this week, so hopefully that will help a bit as well.