On TRT (Xyosted) 75 mg weekly. Labs on TRT: TT ~820, Free T ~1.15, SHBG 46, E2 63 (high), HCT normal.

[TRTJack]

Since starting TRT starting getting severe Achilles tendinitis(although I did get it pre-TRT from too much jump roping ), but lately I’ve had significant elbow tendon pain and just 3 weeks ago doing shoulder presses within hours of workout started getting severe elbow pain in both sides,and yesterday at work pulling cables and I severely injured my right elbow and now I can’t go to work and might have to get on PMFlA! I’m not in a good situation at the moment , and my Achilles flares regularly. but TRT seems to have made recovery harder.
Has anyone had tendon issues improve by splitting injections, lowering dose, or managing estrogen differently?
Also considering short-term peptide injection threw my clinic , which strictly to help healing while I keep working — curious if anyone has real experience with that combo (TRT + split dosing + short peptide run).
Not looking to stack long-term, just trying to stabilize and heal. Appreciate any input. Seriously looking for input. I am a novice with this and learning a lot more now but still so many questions and not sure. I can trust these doctors now.

 

[Willyt]

What day was your lab taken? At day 7 trough? (assuming Xyosted is 1x per week)

Xyosted peak is 1.8x trough according to their studies. If the TT 820 is trough, your peak would be a whopping TT 1470

I point this out because I have noticed that higher TT levels seem to aggravate my tendonitis in knees and elbows.

 

[JorgeF]

man that sounds brutal, sorry you’re dealing with that. especially when it starts messing with work and you’re talking leave… that’s not just “normal soreness”

couple things i’ve seen over and over with guys who start trt and then suddenly feel like tendons are falling apart

one is they get stronger and more “game” fast, so training volume/intensity creeps up without noticing. muscles adapt quicker than tendons, so the weak link becomes achilles, elbows, shoulders, all the classic spots. even if you had the issue before, trt can make the mismatch worse because you’re able to push through warning signs

another big one is estradiol getting too low, usually from using an ai, or from just being a weird converter. low estradiol can feel like dry, cranky joints/tendons and recovery that feels worse, not better. so if you’re on an ai at all, or if your estradiol is suppressed, that’s worth looking at with your doc before you assume you “need peptides”

also, the acute elbow injury part worries me more than the chronic ache. if you felt a pop, sudden sharp pain, bruising, weird weakness, or you can’t rotate the forearm like normal, i’d get that checked properly asap (sports med or ortho). cables + sudden elbow pain can turn into a tendon tear situation and you don’t want to wait on that

on peptides… i’d be careful. a lot of what clinics push there is pretty thin evidence, quality control is a question, and it’s easy to end up masking pain while still loading a tendon that needs actual rehab and time. if you do anything like that, i’d only do it with a legit doc who can explain risks, not just “yeah bro it heals everything”

splitting injections or lowering dose can help if you’re having big peaks/troughs or you’re overreaching, but it won’t magically heal a tendon if you’re still hammering it. the biggest “fix” tends to be stepping back, getting the injury assessed, and making sure hormones arent being pushed into a bad spot (especially estradiol)

are you taking an ai right now or just testosterone? what’s your injection schedule like and did you ramp training hard once you started trt? and with the elbow injury, do you have bruising or a weird loss of strength/grip, or is it mainly pain? if you want, dm me your last labs (testosterone, estradiol, hematocrit) and i can tell you what stands out and what i’d ask the clinic to look at next, does that help?