High T in week 5 of TRT, but w/ low T symptoms

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carpediem

New Member
So I started TRT about 5 weeks ago now (with a starting total testosterone level of 223 mg/dl), and my doctor - who it seems knows very little about TRT - prescribed 200mg every 2 weeks, though I knew enough to split that into 50mg 2x/wk.

I was surprised to feel positive effects during the first week since I thought I wouldn't feel anything until weeks 6-8, but things petered out after that. And in fact, I've noticed increased moodiness and achiness the night before my 4th-day injection, which I assumed meant that the dosage wasn't adequate to hold me over.

To recap the pros so far:
  • Increased energy
  • Less/no fatigue
  • Less back pain
  • Increased libido <-- only during first week or so and then faded away
  • Increased erection quality <--- mostly during the first week, but still some moderate improvements
  • Morning wood <--- happened nearly every day during the first week, and now rarely, if at all
  • Sleep went back to normal and felt great during the first week, but now have trouble sleeping again.
And the cons:
  • Moodiness/irritability
  • Low libido, possibly even lower than before I started TRT
  • No more/rare morning wood
  • Sleep issues returned
Not wanting to have to pay for another doctor's visit just to ask for a higher dosage, I decided to up the dosage to 75mg 2x/wk, but before I did, I took a blood test to see where my levels were at.

I figured that they would be laughably low, and possibly even lower than when I started (since natural production probably went lower with the introduction of exogenous test).

That night, I got good sleep, or at least better than what I was having before I upped the dose, so I was feeling confident that it was the right move.

...until I received the test results which showed:

Total Testosterone: 1363 ng/dl (!)
Free Testosterone: 28.6 ng/dl
SHBG: 45 nmol/L

So I'm shocked and baffled that my total testosterone jumped all the way from 223 to 1363 with just 100mg/wk, but of course the main point is that I FEEL like the dosage isn't high enough but the numbers seem to be screaming the opposite.

And it seems like even the guys who take more than 200mg/wk still tend not to go higher than 1200ng/dl unless they're into some serious bodybuilding (from what I can tell).

I'm going to try switching to daily injections instead of 2x/wk, but it seems reckless to stay at 150mg/wk when my numbers are blaring at 100mg/wk. So I'm really at a loss and feeling like my doctor will be even more clueless. (He didn't even know if pharmacies could give out needles in my State.)

I know that most results show up in 6-8 weeks, so I'm not there yet, but it sure seems odd that I would have such high levels without some of the best benefits. And from what I hear, after the first bump in week 1, things tend to go back to 'baseline' after that. But...if this is baseline, it's not good enough!

Anyone else been in the same boat? Any advice?


P.S. FWIW, I initially had my thyroid levels tested, and everything came back normal. So that doesn't appear to be a factor.
 
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Defy Medical TRT clinic doctor
I was surprised to feel positive effects during the first week since I thought I wouldn't feel anything until weeks 6-8, but things petered out after that.
The typical knee jerk reaction to countless men in your shoes is more testosterone, because if a little T makes me feel good, more is better.

This doesn't always work out.

So I'm shocked and baffled that my total testosterone jumped all the way from 223 to 1363 with just 100mg/wk
There is so much missing info here, are these peak or trough numbers?


I'm going to try switching to daily injections instead of 2x/wk, but it seems reckless to stay at 150mg/wk when my numbers are blaring at 100mg/wk.
You only just started TRT and you're making big changes to your protocol, best to start out 80 mg weekly split up x2 weekly. Maybe you'll end up needing even less.

Keep it simple and get another hobby.

If you can get your insurance to cover it, I recommend Jatenzo, a relatively new oral T gel capsule.

Steady states are achieved in 7 days, no more waiting 4-6 weeks for labs and relief.

Recommended starting dosages is 237 mg twice daily.

A new oral testosterone undecanoate therapy comes of age for the treatment of hypogonadal men
 
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You experienced the classic TRT honeymoon period followed by the reality of your HPTA shut ting down. The last thing you need is more T. Bring your levels into normal physiological range and see how you feel.

When starting TRT, I was conditioned to believe that 100mg is a low dose. That is nonsense. Average healthy young male produces 6-7mg per day. Keep that in back of your mind. This is why popular daily dose is 10mg of Enan/Cypionate (70mg per week), which equates to around 7mg after subtracting out the ester (=10mg x 70% for Cypionate).

There are ton of threads around here on daily "low dose" (even though the dose is not really low!). Best of luck and let us know how it goes.
 
You experienced the classic TRT honeymoon period followed by the reality of your HPTA shut ting down.
Thank you kindly for your response ...but if you don't mind me asking, what do you mean by HPTA? Hypothalamus? I see the term all over, but I don't see any definition of it.

I'm definitely surprised that 100mg/wk appears to be a bit too much for my body, but I'd rather max out and scale it back down than to spend forever ticking it up bit by bit and paying for labs and follow-ups the whole way.

Definitely hoping to get back to that honeymoon phase!

Update: I see now that HPTA is "Hypothalamus-Pituitary-Testicular axis", so since I know absolutely nothing about that, I guess I have some homework to do.
 
And it seems like even the guys who take more than 200mg/wk still tend not to go higher than 1200ng/dl unless they're into some serious bodybuilding (from what I can tell).

False. More info for your review:


Semi-log plot (green shaded region is physiologic range 300 - 1200 ng/dl):



Linear plot:



Example...expected mean TT range for 70 mg/week:

 
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Beyond Testosterone Book by Nelson Vergel
Definitely hoping to get back to that honeymoon phase!
This is impossible in the long term, many have tried to stay in this honeymoon state, and failed. It's similar to drug abusers, needing to increase the dosage to get the same effect because the body adapts and attempts to create normality.

Your body will find a new normal, genes basically dictates how you will respond to TRT.
 
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