6 weeks on TRT - Is there a Honeymoon Phase or Too high a Dose Perhaps ???

[Drug350]

I don't want to make this post too long, so I'll condense as much as possible. 54 yrs old, been feeling shitty for several years. My testosterone came back as follow:

Testosterone = 169 NGDL
Free Testosterone = 3.1 NGDL
Bioavailable Testosterone = 72.6 NGDL
SHBG = 34 nmol/L
TSH = 2.64 uiU/ml
Prolactin = 14.6 ng/ml
Estradiol = 21 pg/ml
LH = 3 mlU/ml
FSH = 4 mlU/ml
PSA = .5 ng/ml

My doctor started me on TRT 6 weeks ago @100 MG's Testosterone Cypionate once a week, along with daily 5 MG'S Cialis. I immediately felt sooooooooo much better. My libido was off the charts, literally wanting, able to, and having, sex 3 - 5 times a day. I was a walking hard on and loved how easily I could be turned on, even shortly after just having sex for the 2nd, 3rd, or 4th time that day. Waking up with rock hard morning wood and my ED problems completely disappeared. My sleep before TRT, was horrible, waking up constantly throughout the night and exhausted trying to get out of bed. Now on TRT I fall asleep in 5 minutes and don't wake up for 6 - 8 hours. Feel amazing. But starting in week 4, my libido took a huge dive and my ED is back. In the first few weeks, I could get hard just from "hitting a bump in the road". Now I go to Pornhub, and I don't even feel turned on. I don't get fully hard, like semi-hard, and it's very difficult to climax. Did I just experience a "3 week TRT Honeymoon" phase ??? My doctor had me get blood work, 7 days from previous 100 MG's shot, immediately prior to this week's shot, and my numbers came back like this:

Testosterone = 610 NGDL (normal range = 200 - 745 NGDL)
Free Testosterone = 11.8 NGDL (normal range = 3.1 - 12.8 NGDL)
Bioavailable Testosterone = 275.6 NGDL (normal range = 71.7 - 300 NGDL)
SHBG = 40 nmol/L (normal range = 13 - 74 nmol/L)
Estradiol = 20 pg (normal range = 13 - 70 pg)
PSA = 1.5 ng/ml (normal range = 0.0 - 4.0 ng/ml)

I thought these numbers looked pretty good for being what would be my absolute lowest numbers of the week. But why has my libido crashed and my ED issues back, along with difficulty getting off ??? Is it possible my levels are too high now, especially earlier in the week, and causing my libido, ED, and difficulties being able to climax ??? Would injecting half a dose, 50 MG's, twice a week, instead of 100 MG's once a week, help or is this dose too high ??? She didn't run my Prolactin levels with this 6 week blood work. Could it be too high Prolactin ??? Should I get blood work done mid-week and see what those numbers might reveal ??? I just want to feel, and be able to perform, like I did the first few weeks, if that's possible. Perhaps it's not and it was a TRT Honeymoon Phase. I just don't know what changed and need to know what is normal on TRT and what my expectations should be. I greatly appreciate any advice or guidance.

 

[sammmy]

It's a typical honeymoon phase while the brain neuroreceptors are not yet adapted to the new higher level of testosterone. After they sense the higher level in a few weeks, the neuroreceptors downregulate and the initial excitement goes away.

You can try to split the dose twice weekly - you will have less variation between trough and peak. With lower more physiological levels of testosterone, the neuroreceptors may adjust and some of the benefits may return.

 

[Systemlord]

I believe the once weekly injections could be the problem, it’s just too hard to tell this early in. I didn’t respond to TRT at all injecting 1-2 times per week for 6 months even with higher numbers than you. My response started injecting every other day and daily.

I’m doing even better on oral T gel capsules, Jatenzo @ 237 mg twice daily. The first week on Jatenzo was amazing, then the next 3 weeks was miserable and then things slowly started getting better.

So far me very frequent dosing is the only way TRT will work. Some guys need the hormones to peak high and drop low to respond, for others it means a non-response to therapy.

My doctor started me on TRT 6 weeks ago @100 MG's Testosterone Cypionate once a week

The surge in hormones after being low for so long gave you a dopamine increase above what is normal and now your body is trying to regulate itself. Things don’t happen overnight in the TRT world.

For most significant changes occur at 4-6 months.

 

[Systemlord]

Your Brain On Testosterone, The War On Masculinity.

 

[Drug350]

OK. That's what I was thinking. Damm. Wished I could've stayed feeling like those first few weeks. It must've been some form of "dopamine rush" cause I remember feeling like I was on some kind of sweet drugs, especially the day after my injection. I remember thinking "now I know why my Doctor made me sign a testosterone contract and why it stated being on exogenous Testosterone can be addictive". I guess when you're super low for a long time, year's in my case, it's a huge over stimulatiion for your brain. God, I thought that's how I was going to feel forever being on TRT. Bummer. Thanks for the input.
I'll switch to every 3rd day injections and halve the dose, or just under, and than have labs run again in 6 weeks to see where my numbers are. While my libido isn't where it was those first 3 weeks, luckily my improved sleep has stayed the same. I can't believe the difference in my sleep. I swear I haven't "dreamed" in year's because I'd wake up, non stop, every hour. Now, I look forward to going to bed. I enjoy sleeping because I fall asleep in minutes, dream all night long, and wake up after 8 hours and feel FANTASTIC. I did not anticipate ANY sleep changes, but within a couple of days of that first shot, I slept all night through and woke up amazed. It's been that way each and every night for 6 weeks. I so hope this side effect at least sticks.

 

[Willyt]

Also keep in mind that your body is shutting down its natural T production after the first couple of weeks. At that point you are no longer supplementing, but rather replacing your endogenous T.

As has been said here before, enjoy then forget your TRT honeymoon because it's a one-time thing. If you chase that dragon you are bound to be disappointed.

 

[Drug350]

Also keep in mind that your body is shutting down its natural T production after the first couple of weeks. At that point you are no longer supplementing, but rather replacing your endogenous T.

As has been said here before, enjoy then forget your TRT honeymoon because it's a one-time thing. If you chase that dragon you are bound to be disappointed.

I won't "chase it". I don't think there's any possible way to get that "first 3 week unbelievable feeling" unless I was to go off and on repeatedly, and I'm certainly not putting my body through that. I just wanted to know if that was normal. Those first 3 weeks it felt like I was "high", literally, all the time. Just wonderful.
I've taken "gear" before, plenty of testosterone cypionate, enanatate, propionate, and suspension, in years past but all from UGL sources (underground labs). I NEVER felt like I did starting this pharma grade testosterone, but than again, I doubt I was ever starting from a really low testosterone number to begin with. So that's probably the reason. Either that, or my gear was bunk (LOL), which could also very well be possible.
While I may not feel as incredible as I did the first 3 weeks, I definitely feel a shit ton better than I did prior to starting when my numbers were abysmal. I'm going to try every 3 day injections and see how I feel and what my numbers come back like. I could even micro-dose and go to daily injection if that works even better, we'll see. With cypionate, daily injections might not really make any difference vs every 3 day's. I don't know how guys go every two weeks. Those "highs and lows" must be brutal, but I imagine you probably feel amazing for the first few days after the injection, but the last few prior to the next injection must be terrible. That's definitely not a trade off I want any part of.

 

[Willyt]

Best of luck and keep us posted on how its going. Quite a few guys around here respond better to daily injections, but its really just a matter of experimenting with what works best for you.

 

[surferuk]

@Drug350 just wondering if your libido is any better ? Curious as mine is crap and trying to get some pointers thanks

 

[Drug350]

@Drug350 just wondering if your libido is any better ? Curious as mine is crap and trying to get some pointers thanks

I wish I could help you. I've experimented with higher doses, Arimedex, and now HCG. Nothing has really helped me. I crashed my Estrogen about 6 - 8 weeks. It was below "2" on sensitive Estradiol test. I felt really shitty. The non-stop backache was probably one of the worst things. It's not like a muscular pain or nerve pain. It felt like "bone" pain. It made it impossible to lay flat on any bench and work out. I got on HCG, 250 IU's, twice a week, and so far, I noticed absolutely nothing except the first two weeks, the night of the shot and next day, it felt like I had constant "blue balls". Miserable walking around and standing. That passed though by the 3rd week. My nipples started killing me, so I was certain my estrogen must be significantly higher. They started hurting so much, I started taking 1/2 MG of Arimedex every 5 days. Well it's been 2 weeks plus on Arimedex, my nipples still hurt, yet I just got tested, and my estrogen is low, "10" now. So honestly, I don't know WTF is going on. Plus, I lowered my testosterone dose to like 40 MG's the last 2 weeks, and my dick absolutely refuses to get hard, at all, any time. No morning wood, no hard ons jerking off. Nothing. Yet I'm somewhat horny and trying, so I'm completely confused. No fukin idea WTF is happening. I'll have my testosterone levels back tonight. See where they come in. I'm going back to 100 MG's weekly, daily doses, like 7 units a day of testosterone cypionate.

 

[Cataceous]

You need to slow down a little. With any major protocol change you're not going to be able to evaluate the results unless you wait for at least two to three months. I would have spent less time chasing my tail at the start of TRT if somebody had emphasized the need for patience. I know it's difficult. When sexual function is broken you want it fixed immediately. Unfortunately hormones don't work that way. If you keep making changes every few days/weeks then you're just going to delay figuring out what works best for you. Lab testing gets tiresome, but it's also needed more frequently when dialing in. I notice that your pre-TRT prolactin was already on the high side. This is something that can directly affect sexual function and libido. Sometimes TRT sends it higher, particularly with higher doses, making things worse.

 

[Drug350]

You are 100% correct. I'm not going to lie. I've been in a somewhat state of panic since week 4 on TRT because I'm having all sorts of dick issues. I'm pretty certain I aromatize testosterone really bad. I have a bit of gyno and my nipples seem to hurt me on any testosterone dose above even the lowest doses of 50 MG's weekly. My estrogen was crashed as I mentioned earlier, so I stopped all AI's, like 8 weeks ago and started HCG 3 weeks ago. My nipples started killing me around 2 weeks ago, the same week I started the 250 IU's of HCG twice weekly, because I was told HCG could raise estrogen and for a few select men, they require some kind of testicular function in order to have good quality erections, libido, etc.... Because of my nipple pain getting worse, I assumed my estrogen had to have rebounded and in fact was most likely "high" now so I started taking 1/2 MG of Arimedex every 5 days. I haven't noticed any changes in my nipple pain two weeks later, and I had a sensitive Estradiol blood test done yesterday and it came back marked "Low" at 10 PGML. I get my testosterone cypionate from a Urologist, and through my insurance, not a paid TRT Clinic. Because of this, my Urologist insists I must be somewhere around 550 - 600 for total testosterone, definitely no higher than 700. She goes by government guidelines BS, not how I'm feeling, and if I come in higher, she'll no longer see me. So I have to see her on April 19th so I went for blood work yesterday, after stopping ALL testosterone shots for the past 12 days, and I'm waiting my results. Remember, I was taking 14 units daily for 200 MG's total weekly, and when I had my blood work done at discounted labs, my total testosterone came in at 1143 NGDL, DHT at 87 NGDL, Free T at 324.1 PGML, Prolactin at 4.2 NGML, PSA at 1.2. I stopped ALL testosterone for 12 days and I'm now awaiting the results. My dick issues have been the very worst now these last few days. Zero erections whatsoever, even trying to jerk off or have fun with my hot GF, but I'm certain it's because my testosterone levels must've dropped by quite a bit. I'll find out in the next few hours. I only have to see this Urologist once a year from now on for blood work so for me, saving tens of thousands of dollars over my lifetime is worth a shitty week or two once a year. I actually receive 2 x 1 ML 200 MG's Testosterone Cypionate weekly, or 400 MG's a week because these are "single use only / no preservatives", and I'm prescribed 50 MG's twice a week, so I'm supposed to use 1/4 of each vial and throw 3/4's of it away twice a week. So now that I gave blood yesterday, I couldn't wait to come back home and take my first shot in almost 2 weeks. I took 30 MG'S total, hoping to jump start my sex drive and to start being able to have erections again. Unfortunately, 24 hrs later, I notice absolutely nothing. I know it's too soon, but I felt my very first testosterone shot back in December when I first started TRT later the same day, and by the following day, I felt a libido increase, lots of erections, and a great sense of well-being. So now I'm thinking of taking around 75 MG'S total weekly and see what my numbers come back at, see if my libido comes back, along with good quality erections.
I was thinking "Prolactin" could be an issue, but when I was on 200 MG's Testosterone Cypionate weekly, my Prolactin came back at "4.2 PGML" which is actually low, so I've ruled that out. I'm still searching for the right solution. Now that I won't have to worry about my Urologist and doing her blood work for another year, I have time to wait each change out, although the lack of erections is extremely concerning. I've tried Cialis, 5 MG's daily, up to 20 MG's as needed. I did not notice any real improvement. The ONLY drug that helped me was a peptide called PT-141 Bremelanotide. That shit gave me erections all day and night long even with my estrogen crashed.

 

[Cataceous]

Something else that needs to be hammered into our heads is that it doesn't take that much testosterone to have normal sexual function and libido. Probably 95+% of guys can function normally on a total testosterone of 550-600 ng/dL, assuming normal SHBG—so that free testosterone is also mid-range. In many cases higher testosterone is detrimental due to its disruption of many other hormones; only the muscles benefit.

Taking 75 mg TC per week is reasonable if it's in divided doses. Be aware that this is still above the average testosterone production rate for healthy young men; odds are it's more testosterone than you made naturally in your prime. Be consistent with this and give it some months. I don't think it's unreasonable to continue with low hCG dosing, though some argue in favor of starting with T only. However, I lean towards avoiding testicular atrophy, and 250 IU hCG twice a week is low enough to lessen the odds of side effects.

Personally I think PT-141 should be for emergency use only. It's so strong in typical doses that I worry about the potential for long-term side effects when it's used more than occasionally.

 

[Drug350]

Something else that needs to be hammered into our heads is that it doesn't take that much testosterone to have normal sexual function and libido. Probably 95+% of guys can function normally on a total testosterone of 550-600 ng/dL, assuming normal SHBG—so that free testosterone is also mid-range. In many cases higher testosterone is detrimental due to its disruption of many other hormones; only the muscles benefit.

Taking 75 mg TC per week is reasonable if it's in divided doses. Be aware that this is still above the average testosterone production rate for healthy young men; odds are it's more testosterone than you made naturally in your prime. Be consistent with this and give it some months. I don't think it's unreasonable to continue with low hCG dosing, though some argue in favor of starting with T only. However, I lean towards avoiding testicular atrophy, and 250 IU hCG twice a week is low enough to lessen the odds of side effects.

Personally I think PT-141 should be for emergency use only. It's so strong in typical doses that I worry about the potential for long-term side effects when it's used more than occasionally.

I just want to sincerely thank you for taking your time to post. I really appreciate your advice and opinions. So, my Urologist originally started me out at 100 MG's Testosterone Cypionate once a week. I found that I started feeling shitty by day 5,and days 6 & 7 got worse. Than I'd take my weekly shot and I'd feel great again, but shitty starting day 5, so my Doctor told me to split the dose and take 50 MG's twice a week. This seemed to work. I didn't have any "bad feeling" days. My numbers came back in the 700's with this dose and my Free T was in range, high normal. I decided to start shooting small amounts daily, ala micro dosing, after reading all the benefits, including lower estrogen conversion. So my plan is going to be to shoot 5 units of Testosterone daily, so around 75 MG's weekly total. 7 units = approximately 100 MG's / 14 units = approximately 200 MG's. I will stay on the 250 IU's twice weekly of HCG, and if my lab numbers for Estradiol come back too high, possibly a tiny bit of Arimedex, but hopefully not. I'm going to see how I feel on this lower dosage and see if my morning erections reappear along with hopefully good erections during sex. I loved the PT141 and it worked great but why do you not like it ??? I plan on trying a newer peptide called Kisspeptin. It's supposed to work really well to increase libido. Do you have any knowledge or experience using Kisspeptin ??? Thank you!!!!

 

[Drug350]

Well, got the rest of my blood work back today;

Total Testosterone = 546 ngdl
SHBG = 8 nmol
Bioavailable = 452.. 2 ngdl
Free Testosterone = 19.3 ngdl

II'm guessing my nipples are hurting even though my Estrogen is low at 10 PGML, because of my low SHBG allowing a lot more hormones, testosterone and estrogen to be available for my cells.
Does a higher Free Testosterone, Bioavailable Testosterone or Low SHBG affect erection quality, libido, etc... ???

 

[Systemlord]

hCG stimulates the LH receptor in the breast tissue and therefore can trigger gyno.

 

[Drug350]

hCG stimulates the LH receptor in the breast tissue and therefore can trigger gyno.

OK. Thank you. Similar to whatever it does to my balls, making um feel painful, like Blue Balls. I'm flying down to Houston, TX and having gyno surgery next month to remove the entire glands. I'm sick of dealing with this BS all the time.

 

[Cataceous]

... I loved the PT141 and it worked great but why do you not like it ??? I plan on trying a newer peptide called Kisspeptin. It's supposed to work really well to increase libido. Do you have any knowledge or experience using Kisspeptin ??? Thank you!!!!

Nothing very specific about PT-141. A quick guesstimate suggests that receptors are being activated by at least an order of magnitude more than usual. Anything that non-physiological makes me uneasy. I experienced some long-lasting functional problems after trying it a few times, though I'll be the first to acknowledge that they could be unrelated.

Well, got the rest of my blood work back today;

Total Testosterone = 546 ngdl
SHBG = 8 nmol
Bioavailable = 452.. 2 ngdl
Free Testosterone = 19.3 ngdl

II'm guessing my nipples are hurting even though my Estrogen is low at 10 PGML, because of my low SHBG allowing a lot more hormones, testosterone and estrogen to be available for my cells.
Does a higher Free Testosterone, Bioavailable Testosterone or Low SHBG affect erection quality, libido, etc... ???

The high testosterone has crashed your SHBG. Contrary to popular belief, falling SHBG has little, if any effect on free testosterone and free estradiol; these are governed by the dose rate. However, low SHBG does suppress total testosterone. Though speculative, it's possible that low SHBG reduces androgenic signaling relative to estrogenic signaling, leading to the estrogenic side effects. For free testosterone, I would target 13-15 ng/dL, mid-range for young guys in the Vermeulen calculated free T scale. This should help with recovery of SHBG.

Reiterating, research suggests that there is a threshold effect for testosterone when it comes to libido and sexual function. When testosterone is below the individual's threshold these can be impaired. But once you're over the threshold there are not additional improvements to be had by raising testosterone more. The threshold is not that high. For most guys it's going to occur with free testosterone in the range of 10-15 ng/dL.

 

[Drug350]

Once again, I sincerely thank you for taking your time to respond. I greatly appreciate it. I'm going to stay at 70 MG's a week, no AI's, 500 HCG weekly for 2 months and see if I get any improvements.

 

[CHunter32]

Once again, I sincerely thank you for taking your time to respond. I greatly appreciate it. I'm going to stay at 70 MG's a week, no AI's, 500 HCG weekly for 2 months and see if I get any improvements.

Any progress on your journey Drug350?