Drastic change in blood sugar at 3 weeks after starting TRT.

[Greyfox]

So I have a history of high blood sugar and insulin resistance. I had to be on a carb restricted diet for years because sugar and carbs cause me to put weight on rapidly. After starting TRT 3 weeks back I started noticing blood sugar drops at the end of the 3rd week. It seems that my low T may have been an issue farther back than I originally thought. Is it normal for TRT to have such a rapid effect on insulin resistance and does anyone have tips on how to keep my blood sugar stable since I am so use to not eating carbs and really don't want to put weight on since I am trying to lose it? I figure this is a good sign however its certainly not the norm for me. Its basically throwing me into a hypoglycemic state and it happens so fast I can't predict it to try and eat before it happens.

 

[Systemlord]

Just eat clean and stay away from carbs, sugar and processed foods and insulin levels will be improved. It will take 3-12 months on glucose control.

Onset of effects of testosterone treatment and time span until maximum effects are achieved.

Effects on sexual interest appear after 3 weeks plateauing at 6 weeks, with no further increments expected beyond. Changes in erections/ejaculations may require up to 6 months. Effects on quality of life manifest within 3–4 weeks, but maximum benefits take longer. Effects on depressive mood become detectable after 3–6 weeks with a maximum after 18–30 weeks. Effects on erythropoiesis are evident at 3 months, peaking at 9–12 months. Prostate-specific antigen and volume rise, marginally, plateauing at 12 months; further increase should be related to aging rather than therapy.

Effects on lipids appear after 4 weeks, maximal after 6–12 months. Insulin sensitivity may improve within few days, but effects on glycemic control become evident only after 3–12 months. Changes in fat mass, lean body mass, and muscle strength occur within 12–16 weeks, stabilize at 6–12 months, but can marginally continue over years. Effects on inflammation occur within 3–12 weeks. Effects on bone are detectable already after 6 months while continuing at least for 3 years.

The time-course of the spectrum of effects of testosterone shows considerable variation, probably related to pharmacodynamics of the testosterone preparation. Genomic and non-genomic effects, androgen receptor polymorphism and intracellular steroid metabolism further contribute to such diversity.

 

[Vince Carter]

Lots of things can be in flux @ 3 weeks, monitor it closely and stick with it.

 

[RLW]

Testosterone does increase insulin sensitivity from what I understand. Also, I am not sure what your daily activity looks like but studies have shown that hitting a certain amount of steps is one of the best things you can do for your blood sugar levels so simply getting some walking in everyday is great for you.

 

[dnfuss]

So I have a history of high blood sugar and insulin resistance. I had to be on a carb restricted diet for years because sugar and carbs cause me to put weight on rapidly. After starting TRT 3 weeks back I started noticing blood sugar drops at the end of the 3rd week. It seems that my low T may have been an issue farther back than I originally thought. Is it normal for TRT to have such a rapid effect on insulin resistance and does anyone have tips on how to keep my blood sugar stable since I am so use to not eating carbs and really don't want to put weight on since I am trying to lose it? I figure this is a good sign however its certainly not the norm for me. Its basically throwing me into a hypoglycemic state and it happens so fast I can't predict it to try and eat before it happens.

You mention that you're being thrown into a hypoglycemic state. What blood glucose levels are you experiencing at those times? Are you on any medications for your blood sugar (metformin, insulin, etc.)?

 

[Nelson Vergel]

Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes

in E European Journal of Endocrinology

 

[TucsonJJ]

Interesting... I am 4 weeks into TRT... 100mg/wk, I pin MWF... last two weeks I have been feeling REALLY lousy... weak, head in clouds, having some minor heart palpitations, sort of dizzy and feel ILL. Gets better after eating and much better in afternoon/evening...
Some guys, not many, have said they felt crummy at first... could it be my blood sugar is crashing? It has never been low before... usually get around 99 on blood test results... I'll try to find my Bro's glucometer and check in AM before eating... Any tips?

 

[madman]

Time-course of effects on glycemic control

Several studies indicate that upon testosterone administration, serum glucose is reduced after 3 months in men with impaired glucose tolerance (31, 36, 43). In a recent study, this was observed after 24 weeks only in men with baseline glucose >110 ng/ml (6.6 mmol/l) but not significantly in men whose baseline glucose levels were <110 ng/ml (6.6 mmol/l) (40). An early study reported a decrease in glucose and glucose disposal rate after 9 months (41).

A decrease in serum proinsulin and insulin was noted after 3 months (43) or 6 months (45), and a decrease in homeostasis model assessment index of insulin resistance (HOMA-IR) after 3 months (36) or 6 months (45–47).

A decline in HbA1c was observed after 3 months (31, 36, 43) with a further decrease after 12 months (43).

Low serum testosterone levels are associated with an adverse metabolic profile which may be explained by the observation that low testosterone levels and impaired mitochondrial function promote insulin resistance in men (48). And indeed, in an experimental study, stimulation of endogenous testosterone was shown to increase insulin sensitivity within 48 h (49).

Recently, it has been demonstrated that the interplay between insulin sensitivity, triglyceride levels, and androgens is practically immediate, as it occurs within a week, and is not facilitated by changes in body composition alone. Concomitantly increasing testosterone and decreasing estradiol (E2) levels had positive effects on both postprandial triglyceride handling and insulin sensitivity in elaborate clamp models during manipulation of these serum sex steroid levels (50). The effects on postprandial triglyceride handling can, therefore, be observed in line with previous results and seem to be of relevance for metabolic risk (51, 52). An improvement in insulin sensitivity upon testosterone administration resulted in reduced fasting glucose and insulin levels within a single week (50), corroborating the former reports about an increase in insulin sensitivity upon stimulation of endogenous testosterone within 48 h (49) and an acute reduction in insulin sensitivity 2 weeks after discontinuing testosterone replacement in severely hypogonadal men (53).

Such observations are most likely attributed to testosterone-induced changes in lipid metabolism and/or altered post-receptor insulin signaling in the muscle (54) and also improved insulin sensitivity enhancing muscle lipid uptake (55). Furthermore, the aforementioned intervention increased the response of postprandial glucose-dependent insulinotropic polypeptide (GIP) release (50). The effects of sex steroids on GIP had not been reported before. This is of specific interest, as the action of GIP is not limited to pancreatic cells and may affect lipid homeostasis (56) and intestinal glucose transport (57). The data are summarized in Fig. 3.

Time-course on glucose and insulin.