Issues with TRT

[Unknownn]

I’m having a lot of issues with TRT.
I started TRT at the end of May 200mg a week split into two injections. Also 600 UI of HCG. I never really felt great just spurts here and there.
I did a blood test in July and my test was above 1500 and my estradiol was 40. My doctor had me start an AI which I ran for about a month but stopped due to research on AI and how bad they are.
I was coasting along feeling good and times and not that good other times.
Near the end of November I had a serious crash of some sort. I had no energy and no will to even get off the couch. I had ED which I had never had in my life and 0 libido, depression and anxiety, very dark mood.
My doctor had me start AI again which may have helped a little I tried that for a few weeks but to no avail. I had my test checked which had my total at 1200 and my free test was 360, shbg was 18.5. I did not have my estradiol tested I just paid out of pocket for this.
I told my doctor that I think the dose is just way high and I didn’t want to be on a AI
He changed my dose to 120mg a week split into 3 doses and continuing the HCG
I’m at 2 and a half weeks of this new dose and I feel terrible. Intense depression, ED, no libido, moody.

I’m just looking for opinions if I just need to hang in there and things will improve or I don’t know I guess.
Just some background info. I’m fit, probably about 15% body fat,work out multiple times a week, eat well no fast food. Just saying these things because I no bad food and high body fat will effect

 

[Seagal]

Thread 'Why Some Men on TRT Experience Anxiety and Brain Fog Despite Optimal Testosterone Levels'

Tuesday at 8:27 AM

Understanding the Role of Neurosteroids, Upstream Hormones, and Practical Solutions

Curated By Nelson Vergel | ExcelMale.com​

Introduction: The TRT Paradox​

One of the most frustrating experiences reported by men on testosterone replacement therapy (TRT) is the persistence of anxiety and brain fog despite achieving optimal testosterone levels. As one ExcelMale forum member described:

"I've been on TRT for almost 5 weeks... Most of my social anxiety went away and I started experiencing a calm focus that felt amazing. I even started for the first time in my life to want...

• Nelson Vergel
• testosterone anxiety trt anxiety trt insomnia trt low mood trt side effects
• Replies: 4
• Forum: When TRT Is Not Enough (ED, Libido, & More)

• 

 

[Phil Goodman]

If I had to guess I’d say you likely just fried your CNS with too high of a dose for too long and then crashed from the burnout. Good call on lowering the dose, though that is quite the drop so it may take a while to settle in. I’d say for it at least 6-8 weeks before even considering a change, and track how you feel throughout that time with regard to days you feel better or worse and if it seems to get better over time, or if you’re still in a similar boat at the end of the 8 weeks.

The bigger issue here seems to be your provider though. Started you off with what is very likely too high of a dose, threw HCG on top of that, and then when levels were understandably way too high they just threw an AI on top of everything. The results are… well, you know better than anyone the results. Providers response?? Cutting the dose by 40%. Now, I will say 120 is certainly a much better dose than 200, but it’s gonna be a bumpy ride getting settled in.

 

[Unknownn]

If I had to guess I’d say you likely just fried your CNS with too high of a dose for too long and then crashed from the burnout. Good call on lowering the dose, though that is quite the drop so it may take a while to settle in. I’d say for it at least 6-8 weeks before even considering a change, and track how you feel throughout that time with regard to days you feel better or worse and if it seems to get better over time, or if you’re still in a similar boat at the end of the 8 weeks.

The bigger issue here seems to be your provider though. Started you off with what is very likely too high of a dose, threw HCG on top of that, and then when levels were understandably way too high they just threw an AI on top of everything. The results are… well, you know better than anyone the results. Providers response?? Cutting the dose by 40%. Now, I will say 120 is certainly a much better dose than 200, but it’s gonna be a bumpy ride getting settled in.

Thank you for the reply, this does help me feel a little better knowing relief may be coming. It’s frustrating reading all of the great effects people get from TRT and me only experiencing them briefly and few and far between.

 

[madman]

I’m having a lot of issues with TRT.
I started TRT at the end of May 200mg a week split into two injections. Also 600 UI of HCG. I never really felt great just spurts here and there.
I did a blood test in July and my test was above 1500 and my estradiol was 40. My doctor had me start an AI which I ran for about a month but stopped due to research on AI and how bad they are.
I was coasting along feeling good and times and not that good other times.
Near the end of November I had a serious crash of some sort. I had no energy and no will to even get off the couch. I had ED which I had never had in my life and 0 libido, depression and anxiety, very dark mood.
My doctor had me start AI again which may have helped a little I tried that for a few weeks but to no avail. I had my test checked which had my total at 1200 and my free test was 360, shbg was 18.5. I did not have my estradiol tested I just paid out of pocket for this.
I told my doctor that I think the dose is just way high and I didn’t want to be on a AI
He changed my dose to 120mg a week split into 3 doses and continuing the HCG
I’m at 2 and a half weeks of this new dose and I feel terrible. Intense depression, ED, no libido, moody.

I’m just looking for opinions if I just need to hang in there and things will improve or I don’t know I guess.
Just some background info. I’m fit, probably about 15% body fat,work out multiple times a week, eat well no fast food. Just saying these things because I no bad food and high body fat will effect

This is the problem with most of those run of the mill dime a dozen T-clinics starting men on an absurd weekly dose of T and to make matters worse throwing in an AI off the hop or trying to manage elevated estradiol when it is not even a given that its the culprit here.

Throwing in hCG off the hop is a bad move too as it will be hard teasing out any issues that may arise.

Most sensible fix have been dropping the AI and lowering the dose as your FT would have been through the roof.

Have no clue how many days post-injection your blood work was done but even then you were hitting a whopping TT 1500 ng/dL with lowish SHBG which means your FT would be absurdly high.

We always want to test at the true trough (lowest point) before your next injection which would have been 7 days post-injection as you were injecting once weekly.

Your doctor it out to lunch here as not only did he eventually drop the dose which should have been done instead of throwing in the AI but it was a drastic cut which is going to make it much harder to deal wilh over the following weeks until blood levels have stabilized.

Much harder coming down than going up.

As we always say on here start low and go slow on a T-only protocol so we can see how your body reacts to testosterone and where said protocol (dose T/injection frequency) has your trough TT and more importantly FT, estradiol and critical blood markers RBCs. hemoglobin and hematocrit.

Any doctor in the know would tell you that the standard starting dose is 100 mg T or better yet 50 mg T twice-weekly.

Most men on T-therapy are injecting 100-200 mg T/week whether once weekly or split into more frequent injections as in twice-weekly (every 3.5 days), M/W/F, EOD or daily.

The majority of men can easily hit a healthy/high trough FT injecting 100-150 mg T/week especially when split into more frequent injections.

Some men can hit stellar levels injecting <100 mg T/week when split into more frequent injections.

As always yes there are those outliers who may need the higher-end therapeutic dose 200 mg T/week but its far from common as in rare.

Such dose would easily have the majority of men overmedicated on T.

Keep in mind when starting therapy or tweaking a protocol it is common to experience ups/downs as hormones will be in flux during the weeks leading up until blood levels have stabilized (4-6 weeks TC/TE) as the body is trying to adjust.

Even then once blood levels have stabilized it will still take a few more months for the body to adapt to its new set-point and this is the critical time period when one needs to gauge how they truly feel overall regarding relief/improvement of low-T symptoms.

Every protocol needs to be given a fighting chance as in 12 weeks before claiming whether it was a success or failure.

No one should be tweaking their dose 6-8 weeks in unless your trough FT was too low which is highly doubtful in the majority of cases.

The first 6-8 weeks means nothing when looking at the bigger picture here.

Be prepared fore a bumpy ride a your absurd starting dose 200 mg T/week is overkill and the drastic drop to 120 mg/week is going to result in a bumpy ride.

Need to bite the bullet and tough it out as things will eventually get better!

 

[Vince]

Many physicians will typically start patients with a low dose of testosterone, ranging between 50-75 mg, to allow the body time to adjust to the medication before gradually increasing the dosage every week; but, in most cases, the average dose is usually 75 mg at the beginning of treatment.

 

[Seagal]

Many physicians will typically start patients with a low dose of testosterone, ranging between 50-75 mg, to allow the body time to adjust to the medication before gradually increasing the dosage every week; but, in most cases, the average dose is usually 75 mg at the beginning of treatment.

That would be smart but I think it is rare.

 

[Unknownn]

This is the problem with most of those run of the mill dime a dozen T-clinics starting men on an absurd weekly dose of T and to make matters worse throwing in an AI off the hop or trying to manage elevated estradiol when it is not even a given that its the culprit here.

Throwing in hCG off the hop is a bad move too as it will be hard teasing out any issues that may arise.

Most sensible fix have been dropping the AI and lowering the dose as your FT would have been through the roof.

Have no clue how many days post-injection your blood work was done but even then you were hitting a whopping TT 1500 ng/dL with lowish SHBG which means your FT would be absurdly high.

We always want to test at the true trough (lowest point) before your next injection which would have been 7 days post-injection as you were injecting once weekly.

Your doctor it out to lunch here as not only did he eventually drop the dose which should have been done instead of throwing in the AI but it was a drastic cut which is going to make it much harder to deal wilh over the following weeks until blood levels have stabilized.

Much harder coming down than going up.

As we always say on here start low and go slow on a T-only protocol so we can see how your body reacts to testosterone and where said protocol (dose T/injection frequency) has your trough TT and more importantly FT, estradiol and critical blood markers RBCs. hemoglobin and hematocrit.

Any doctor in the know would tell you that the standard starting dose is 100 mg T or better yet 50 mg T twice-weekly.

Most men on T-therapy are injecting 100-200 mg T/week whether once weekly or split into more frequent injections as in twice-weekly (every 3.5 days), M/W/F, EOD or daily.

The majority of men can easily hit a healthy/high trough FT injecting 100-150 mg T/week especially when split into more frequent injections.

Some men can hit stellar levels injecting <100 mg T/week when split into more frequent injections.

As always yes there are those outliers who may need the higher-end therapeutic dose 200 mg T/week but its far from common as in rare.

Such dose would easily have the majority of men overmedicated on T.

Keep in mind when starting therapy or tweaking a protocol it is common to experience ups/downs as hormones will be in flux during the weeks leading up until blood levels have stabilized (4-6 weeks TC/TE) as the body is trying to adjust.

Even then once blood levels have stabilized it will still take a few more months for the body to adapt to its new set-point and this is the critical time period when one needs to gauge how they truly feel overall regarding relief/improvement of low-T symptoms.

Every protocol needs to be given a fighting chance as in 12 weeks before claiming whether it was a success or failure.

No one should be tweaking their dose 6-8 weeks in unless your trough FT was too low which is highly doubtful in the majority of cases.

The first 6-8 weeks means nothing when looking at the bigger picture here.

Be prepared fore a bumpy ride a your absurd starting dose 200 mg T/week is overkill and the drastic drop to 120 mg/week is going to result in a bumpy ride.

Need to bite the bullet and tough it out as things will eventually get better!

Thanks for the reply.
When I was at 200mg I was injecting Monday and Thursday night. My blood tests were also the morning before my injection later that day. So that > 1500 was in the trough. I’m currently doing M/W/F at 40mg each injection. Unfortunately they did not test my FT. When I got it tested a month ago that was on my own accord which it was at 360.
I’m with TRTnation right now, I definitely agree they are not doing well at treating me. I had to push for the lower dose and I do think it’s the right call.
I will hang in there and keep eating well and trying to stay positive. Honestly I don’t feel to far off of where I was before starting TRT and having a TT of 253 so I can get through this.

 

[Vince]

That would be smart but I think it is rare.

It's been a long time since the average clinic would prescribe higher than 100 mg of testosterone per week.

 

[Unknownn]

Is continuing to run 500 UI of HCG a week (split into 2 doses) a good idea in my situation