On TRT for 4 weeks. Feel great except extremely tired (time for AI?)

[Wolfenstein]

I have been on Sustanon 250 mg for 4 weeks (hypogonadotropic hypogonadism)

Almost the whole time while on TRT i have been suffering from tiredness, nipple soreness and puffy nipples.

I get a good amount of sleep of 9-10 hours, but even if i sleep 12 hours, i am still tired and feel i need to sleep even more.

I nearly always feel a lot better in the evening.

Positives: Libido and especially mood have been great. Nearly all anxiety has disappeared. I am more social and happy. I suddenly love my wife a lot more. I don't have nausea and fatigue after eating anymore. Performance in the gym has improved a lot. I have gained 6.5 kg (14.3 pounds) in 4 weeks. I am now 103kg (227 pounds). My height is 195 cm = 6'4 feet.

Negatives: I sleep worse than before and wake up many times during the night. One time i woke up soaking wet form sweat. I was literally like i had gone to the shower. Heart seems to be working harder.

In the last 4 weeks, i have only had 3 days when i have not been tired. Many times i get a lot of energy after weight training, but i can not train every day of course. And like i said, i nearly always have more energy on the evenings.

I have nearly daily myokymia in my left eyelid. It started while i was 3 weeks on tamoxifen and has been going on since then.

I have now started splitting my dose 175mg/week (125 mg every 5 days)

I mailed my doctor asking for AI. He asked my to measure estradiol which i did. 9 days after the second 250mg injection, E2 was 0.13 nmol/l (22pg/ml). My doctor has not answered yet.

But should i still wait for estradiol to lower or start AI immediately?

 

[Wolfenstein]

I want to add that the tiredness has been worse 1-4 days after injection.

When E2 was measured after 9 days of the second injection, i was starting to have low t symptoms again. Mainly loss off confidence, low libido and social anxiety. But all of them were somewhat fixed soon after the third injection.

 

[Vince]

Sustanon 250 (250 mg of a mixture of cypionate, enanthate, and propionate). Since every ester may have slightly different blood level decay after administration, it is speculated that this combination may allow better distribution of testosterone blood levels in 14 days. https://www.excelmale.com/forum/showthread.php?1487-Testosterone-Replacement-Treatment-Options
Sounds like your outside the US, right estradiol test may not be available, the sensitive is more accurate than the standard.
If you crash your E2, you'll really feel terrible.

 

[CoastWatcher]

I have been on Sustanon 250 mg for 4 weeks (hypogonadotropic hypogonadism)

Almost the whole time while on TRT i have been suffering from tiredness, nipple soreness and puffy nipples.

I get a good amount of sleep of 9-10 hours, but even if i sleep 12 hours, i am still tired and feel i need to sleep even more.

I nearly always feel a lot better in the evening.

Positives: Libido and especially mood have been great. Nearly all anxiety has disappeared. I am more social and happy. I suddenly love my wife a lot more. I don't have nausea and fatigue after eating anymore. Performance in the gym has improved a lot. I have gained 6.5 kg (14.3 pounds) in 4 weeks. I am now 103kg (227 pounds). My height is 195 cm = 6'4 feet.

Negatives: I sleep worse than before and wake up many times during the night. One time i woke up soaking wet form sweat. I was literally like i had gone to the shower. Heart seems to be working harder.

In the last 4 weeks, i have only had 3 days when i have not been tired. Many times i get a lot of energy after weight training, but i can not train every day of course. And like i said, i nearly always have more energy on the evenings.

I have nearly daily myokymia in my left eyelid. It started while i was 3 weeks on tamoxifen and has been going on since then.

I have now started splitting my dose 175mg/week (125 mg every 5 days)

I mailed my doctor asking for AI. He asked my to measure estradiol which i did. 9 days after the second 250mg injection, E2 was 0.13 nmol/l (22pg/ml). My doctor has not answered yet.

But should i still wait for estradiol to lower or start AI immediately?

Why take an AI at all? The e2 test result, even if it is on the so-called standard test, is by no means high. I don't follow the logic of what an AI is going to do for you (other than send you to a special place of misery where men who've crashed their estradiol live until they recover). Give your new split-dose protocol time to balance.

 

[johndoesmith]

I doubt it's from high E2, as yours isn't even CLOSE to elevated.

Is this a trough or peak reading? When was it taken relative to injection?

What coastwatcher said is important because if this is a standard test, and it almost likely is, your E2 is likely much lower than what it says.

It's possible you have sleep apnea induced by TRT. I'd get that checked out.

 

[CoastWatcher]

I doubt it's from high E2, as yours isn't even CLOSE to elevated.

Is this a trough or peak reading? When was it taken relative to injection?

What coastwatcher said is important because if this is a standard test, and it almost likely is, your E2 is likely much lower than what it says.

It's possible you have sleep apnea induced by TRT. I'd get that checked out.

It it seems that in the past month or so many new members are presenting with sleep issues - an apnea study is a very good idea.

 

[Tommy Wall]

It´s high dose your are on. Why don´t you try to go down to 50-60 mg twice a week. If you post more lab work you might recieve more advice. I also used to inject 250 mg every third week. I really had a testo rush the first week and than feeling a bit better during the second and shit on the third week. Your E2 might go up and down and not is not stabilized yet. You might have to consider to change your protocol. Good Luck!

 

[Wolfenstein]

I doubt it's from high E2, as yours isn't even CLOSE to elevated.

Is this a trough or peak reading? When was it taken relative to injection?

What coastwatcher said is important because if this is a standard test, and it almost likely is, your E2 is likely much lower than what it says.

It's possible you have sleep apnea induced by TRT. I'd get that checked out.

E2 labs were done 9 days after second injection meaning it was day before the third.

I actually have sleep apnea, although not a severe one.

After starting TRT, my sleep apnea when using CPAP has actually improved. When using CPAP my AHI is now ZERO, meaning when using CPAP i have no sleep apnea at all. Even before TRT my CPAP machine almost completely prevented apneas.

But after starting TRT i have been struggling with the CPAP machine. I don't know why. I get anxiety with the mask and i have trouble falling a sleep (i used to fall a sleep easily before TRT)

When i used tamoxifen monotheraphy for 3 weeks, my usage with CPAP was very good, but i still felt like shit physically. Tired all the time, nausea and almost zero libido.

I still think i suffer from high E2 especially the few days after injection. As i said, being tired is no the only symptom. I also have very ticklish and puffy nipples.

Can't i just test what AI does? If it makes me feel better, then the reason was clear. If it does not improved my energy, then i will just dump it.

I will see what my doctor says. He is very experienced with TRT.

 

[CoastWatcher]

E2 labs were done 9 days after second injection meaning it was day before the third.

I actually have sleep apnea, although not a severe one.

After starting TRT, my sleep apnea when using CPAP has actually improved. When using CPAP my AHI is now ZERO, meaning when using CPAP i have no sleep apnea at all. Even before TRT my CPAP machine almost completely prevented apneas.

But after starting TRT i have been struggling with the CPAP machine. I don't know why. I get anxiety with the mask as i have now trouble falling a sleep (i used to fall a sleep easily)

When i used tamoxifen monotheraphy for 3 weeks, my usage with CPAP was very good, but i still felt like shit physically. Tired all the time.

I still think i suffer from high E2 especially the few days after injection.

Can't i just test what AI does? If it makes me feel better, then the reason was clear. If it does not improved my energy, then i will just dump it.

I will see what my doctor says. He is very experienced with TRT.

You should certainly discuss it with your doctor, but you can crash your estradiol quickly and the recovery can take some time. However, the question remains, why do you think you have elevated e2 when the labs say you don't? Estradiol falls more slowly than testosterone, e always follow t, so it would be surprising if you spiked your estradiol in the wake of your shot only to see it recover to the level you presented at this point.

 

[Wolfenstein]

You should certainly discuss it with your doctor, but you can crash your estradiol quickly and the recovery can take some time. However, the question remains, why do you think you have elevated e2 when the labs say you don't? Estradiol falls more slowly than testosterone, e always follow t, so it would be surprising if you spiked your estradiol in the wake of your shot only to see it recover to the level you presented at this point.

The estradiol before injection was not bad, no question about that. But my T might have been very low too in that point. I started to have low T symptoms again a couple of days before my third injection, but then it basically fixed them all again. I know it takes several weeks for the levels to rise to the top and stabilize.

How fast does estradiol rise and fall actually? Are there any graphs or data on this?

I don't actually want to take AI after watching Nelson Vergel's video about it on youtube, but i don't know if i really have a choice. Maybe i should just wait but then again i'm temped to try just a small amount like 0.25mg arimidex every five days and see what happens.

 

[CSI007]

The estradiol before injection was not bad, no question about that. But my T might have been very low too in that point. I started to have Low the symptoms again a couple of days before my third injection, but then it basically fixed them all again. I know it takes several weeks for the levels to rise to the top and stabilize.

How fast does estradiol rise and fall actually? Are there any graphs or data on this?

I don't actually want to take AI after watching Nelson Vergel's video about it on youtube, but i don't know if i really have a choice. Maybe i should just wait but then again i'm temped to try just a small amount like 0.25g arimidex every five days.

Look here:

https://www.excelmale.com/forum/showthread.php?9607-Labs-from-everyday-of-my-injection-cycle

That was a test that a forum member just did.

You should not even consider an AI unless you are showing obvious symptoms of high E2. Then confirm with blood work for sure! My E2 was in the toilet before starting TRT. It only has raised up slightly to around 18 or 19 at 6 weeks in. Not sure what it is now but will know on the next blood test.

 

[CoastWatcher]

Look here:

https://www.excelmale.com/forum/showthread.php?9607-Labs-from-everyday-of-my-injection-cycle

That was a test that a forum member just did.

You should not even consider an AI unless you are showing obvious symptoms of high E2. Then confirm with blood work for sure! My E2 was in the toilet before starting TRT. It only has raised up slightly to around 18 or 19 at 6 weeks in. Not sure what it is now but will know on the next blood test.

CSI007 is on the mark. You seem to be fixed on taking anastrozole - despite the fact that your issues don't present as being classically related to elevated e2, and your labs don't confirm it.

You will do what you will do, but I can't say I understand. Please think this over carefully.

 

[simeoni]

Your conversion of E2 seems to be wrong. 0.13 nmol/l is 35 pg/ml - not 22.
(At least according to this source: http://www.endmemo.com/medical/unitconvert/Estradiol.php )

If that was taken at the end of your injection protocol, it can be much higher during the first days.

You should test your peak e2 also - preferably using the best assay LC/MS.

When I first started TRT I used sustanon on a 0,35ml E5D protocol - 0.25 adex on the injection day - with pretty good succes.

 

[Wolfenstein]

Your conversion of E2 seems to be wrong. 0.13 nmol/l is 35 pg/ml - not 22.
(At least according to this source: http://www.endmemo.com/medical/unitconvert/Estradiol.php )

If that was taken at the end of your injection protocol, it can be much higher during the first days.

You should test your peak e2 also - preferably using the best assay LC/MS.

When I first started TRT I used sustanon on a 0,35ml E5D protocol - 0.25 adex on the injection day - with pretty good succes.

Thank you for the correction. Maybe i don't feel like that obsessed with AI to people here now

Here are my symptoms again:

- Bloating (first week only)
- Swollen and tender nipples (nearly every day since starting TRT)
- Moodswings (If i inject in the morning, i will be irritable at the evening, then it goes away)
- Sleeping difficulties (a couple of days before and after injection)
- Night sweats (only a couple of nights, one was extreme)
- Tired in the morning (extreme tiredness for a couple days after injection, then it starts to ease a little)

 

[SoCalSurfer]

I find that the day of my shot (Twice a week M -Thur) in find that I am a bit more tired that day then other days. I am assuming its that my T levels are low and that why I feel crappy. A hour or so after my shot I start to feel better. I take .40ml of cyp on shot days. I also moved to taking an AI for high E2.

I had tried years ago the once every two weeks crap and that didnt work for me at all. I would feel good for a week and then like shit for a few days before my next shot was due. I moved to twice and week and never looked back.

 

[Wolfenstein]

Splitting my dose has helped with tiredness, but i'm still tired. Before splitting, i needed 12-13 hours of sleep. Now i need 9-10 hours, which is still too much.

Here are my thyroid test results after 5 weeks on sustanon:
T4: 11.9 (11-22)
TSH: 2.0 (0.27-4.2)

So obviously TRT has affected my thyroid. My diagnosis was Hypogonadotropic Hypogonadism, which means my low T is pituitary releated. Could this too have been caused by pituitary?

My thryoid test history from 2016. All results are pre TRT.

3.5.2016 (here my thyroid seems to working well, but my Free T was the lowest ever and i felt like total shit. Worst i have ever felt in my life physically)
T4: 16.52 (10-21)
TSH: 1.52 (0.4-4.0)

24.11.2016
T4: 12.56 (10-21)
TSH: 1.90 (0.4-4.0)

7.12.2016
T4: 15.24 (10-21)
TSH: 2.06 (0.4-4.0)
T3: 5.83 (3.5-6.5)

I will be getting my E2 results taken 48 hours after 0.5ml injection (half dose) on monday.

 

[Wolfenstein]

Here are results with 5 weeks on sustanon. 48 hours after half dose (0,5ml)

Estradiol: 0,30 pmol/l (81,72 pg/mL) (<0.15)
Total Test: 35,3 nmol/l (8.4-28.7)
SHBG: 42 nmol/l
Free Test: 503 pmol/l (155-800)


Strength gain is awesome, libido is great, but energy 1-2 days after injection is very bad although it is a lot better than it was with full dose every 10 days. Weight gain is now 10kg (22 lbs) in 5.5 weeks. From 96 to 106 kg. Height 195 cm.

Fat percentage has not increased according to my body composition scale (Omron BF-511), but i think the water retention might cause it to show wrong numbers. Visceral fat has increased to record high numbers.

 

[madman]

Thank you for the correction. Maybe i don't feel like that obsessed with AI to people here now

Here are my symptoms again:

- Bloating (first week only)
- Swollen and tender nipples (nearly every day since starting TRT)
- Moodswings (If i inject in the morning, i will be irritable at the evening, then it goes away)
- Sleeping difficulties (a couple of days before and after injection)
- Night sweats (only a couple of nights, one was extreme)
- Tired in the morning (extreme tiredness for a couple days after injection, then it starts to ease a little)

Low morning cortisol can cause extreme tiredness. I would look into testing your cortisol 4 point saliva.

 

[Wolfenstein]

I have taken morning cortisol from blood 3 times in the last 3 months.

Results:

Range is 138-690

7.12.2016: 513 (Before any medication taken. One of the few days in whole year of 2016 that i felt great. Good libido and energy)

28.12.2016 720 (I had just suffered bad anxiety attacks for the last two days before this lab. I had used tamoxifen for 2 weeks)

17.2.2017 480 (Felt tired this day, but it was 48 hours after sustanon injection)

 

[madman]

If you have put on 22lbs in 5.5 weeks on 130mg/week trt that is insane! Guaranteed only a small percentage of that is actual lean tissue ( actin/myosin ). I would say if you are eating a shitload of carbs and lifting than a good percentage will be intracellular water as your muscle cells will be storing much more glycogen which will pull water into the muscle cells. If you have not increased your carbs that much and are eating a lot of calories overall than a good percentage will be bodyfat/extra cellular water either due to increased estrogen or you are consuming way too many calories!