Sleep Issues with Protocol Change?

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bkb33

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A few things in my protocol changed recently: I switched from T cream (applied to the scrotum) to injections (200 mg), I added Danazol (25 mg EOD), and I added Metformin (500 mg AM & PM). Around the time of these changes, I started experiencing sleep issues: either waking up early in the morning (~3 AM), unable to fall back asleep, or struggling to fall asleep in the first place. I’ve also felt more “out of it” during the day, which may just be a product of the lessened sleep. Think these issues may be a side effect of one of the medications?
 
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Whenever my dose is too high I get every symptom you’re mentioning. I’ve found being in the 650-800ng range is the most bang for the buck without side effects.
 
I'll double down and say that I've experienced all of those things with both protocol changes and when my dose is too high. Around the 3rd week after a protocol change seems to be the worst of it for me at least.

Focusing just on T, what was your cream protocol and what is your new injection protocol? And when did you switch?
 
I'll double down and say that I've experienced all of those things with both protocol changes and when my dose is too high. Around the 3rd week after a protocol change seems to be the worst of it for me at least.

Focusing just on T, what was your cream protocol and what is your new injection protocol? And when did you switch?

Interesting. Previous cream protocol was 4 clicks/day, and new injection protocol is 200mg/week (split into 2 injections). I switched one week ago.
 
Whenever my dose is too high I get every symptom you’re mentioning. I’ve found being in the 650-800ng range is the most bang for the buck without side effects.

I wonder whether that is the issue -- too much T. My T is way over that range, though (and was before HRT), due to super high SHBG.
 
Interesting. Previous cream protocol was 4 clicks/day, and new injection protocol is 200mg/week (split into 2 injections). I switched one week ago.

I wonder whether that is the issue -- too much T. My T is way over that range, though (and was before HRT), due to super high SHBG.

I wouldn't sweat it at this point - way too soon. Ride it out and see how you feel/get labs after 7 or more weeks. It's super easy to second guess things during protocol changes precisely because things are out of whack. Whenever you make a protocol change, be aware of this tendency and force yourself to stick it out. Otherwise you'll be chasing your tail for years.
 
I wouldn't sweat it at this point - way too soon. Ride it out and see how you feel/get labs after 7 or more weeks. It's super easy to second guess things during protocol changes precisely because things are out of whack. Whenever you make a protocol change, be aware of this tendency and force yourself to stick it out. Otherwise you'll be chasing your tail for years.
I agree - you need to ride it out! Are you also taking an ai? If so, what is the current dose?

Indy
 
I agree - you need to ride it out! Are you also taking an ai? If so, what is the current dose?

Indy

I am definitely going to ride it out, for sure. Just wondering if maybe I can mitigate the sleep issues for the time being. Don't wanna be a zombie all day :) I am not taking an AI.
 
I am definitely going to ride it out, for sure. Just wondering if maybe I can mitigate the sleep issues for the time being. Don't wanna be a zombie all day :) I am not taking an AI.
Then you need to get bloodwork now to see if your E2 is high. Changing your protocol probably spiked it anyway but it would be good to see where your E2 is now and see if an ai helps bring it down and helps with your sleep. When my E2 gets high I get insomnia bad!
 
Then you need to get bloodwork now to see if your E2 is high. Changing your protocol probably spiked it anyway but it would be good to see where your E2 is now and see if an ai helps bring it down and helps with your sleep. When my E2 gets high I get insomnia bad!

My last bloods were 3 weeks ago. I was taking an AI for the first 8 months of my treatment, and that brought my E2 down to around 64 (yeah, I started super high!). When I started T therapy, I ditched the AI, and my E2 has since stayed steady in the low-to-mid 60s. I understand it may have spiked since switching to injections last week, but I think I’ll wait until my next bloods (6 weeks) to find out. That should give me more reliable data points, though it won’t accurately reflect what I’m feeling at the moment.

Also, I thought increasing my body’s access to estrogen (by way of lowering my high SHBG) could actually help with many of my symptoms (such as libido)? Is increasing access to estrogen known to impair sleep quality? I know this AI debate has been raging for a while now. I don’t currently plan to hop back on one.
 
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I can tell you my experience with my long lasting insomnia, before and after TRT.

When my E2 goes high (>60) I don't have problem falling asleep, but I wake up 300 times per night.
When my E2 is low and I get symptoms from that, I can't fall asleep. Sometimes I tossed and turned for hours, in few cases until the morning.

Also, be sure to check your cortisol level with a 24 hours test. A wrong cortisol curve pattern or chronically elevated levels can make your sleep experience terrible.
 
My last bloods were 3 weeks ago. I was taking an AI for the first 8 months of my treatment, and that brought my E2 down to around 64 (yeah, I started super high!). When I started T therapy, I ditched the AI, and my E2 has since stayed steady in the low-to-mid 60s. I understand it may have spiked since switching to injections last week, but I think I’ll wait until my next bloods (6 weeks) to find out. That should give me more reliable data points, though it won’t accurately reflect what I’m feeling at the moment.

Also, I thought increasing my body’s access to estrogen (by way of lowering my high SHBG) could actually help with many of my symptoms (such as libido)? Is increasing access to estrogen known to impair sleep quality? I know this AI debate has been raging for a while now. I don’t currently plan to hop back on one.

So other than poor sleep and feeling out of it during the day, what other changes have you noticed since switching to injections, adding danazol, and adding metformin? Libido, mood, energy, strength, morning wood etc.

Also make sure you supplement with B12 now that you’re taking metformin.
 
wow poor sleep is because of high T im only on week 2. im only taking 50mg every 5 days. 12 hours before my last injection I was back to being tired. slept like crap the night be fore injection. 18 hours after injection felt awake and alert and couldn't sleep last night at all. but like your have said after starting TRT I am tire. have difficulty falling asleep then wake up about 330 and have to fight to fall back to sleep for a hour. if figure it was because I was low and I am shutting down. cant wait for the roller coaster to be over.
 
wow poor sleep is because of high T im only on week 2. im only taking 50mg every 5 days. 12 hours before my last injection I was back to being tired. slept like crap the night be fore injection. 18 hours after injection felt awake and alert and couldn't sleep last night at all. but like your have said after starting TRT I am tire. have difficulty falling asleep then wake up about 330 and have to fight to fall back to sleep for a hour. if figure it was because I was low and I am shutting down. cant wait for the roller coaster to be over.

Yep. I've had really bad sleep on every injection day since starting TRT. I'll wake up at 2 a.m. and cannot fall back asleep. One thing I've been reading about/messing with is eating more carbs and protein shortly before bed. This supposedly makes you sleep more deeply.
 
I'm noticing the same lately. 2am issues. Maybe it's because I am changing around my ancillaries (hcg, anastrozole)....don't know.
 
Your testosterone is not actually high, it's low as SHBG binds up the actual unbounded free form of testosterone and increases the half life of testosterone. That , of course, makes your total higher. My total was 1100 when my shbg was high at 64 , now since my shbg came down , it is 700. Waking up early, my question would be if #1 your primary or secondary hypogonadism? The reason why I asked is that is often a symptom of adrenal insufficiency and if your free testosterone is going up it is increasing other demands like cortisol and also increasing deiodinase (thyroid conversion) at the same time. Not sure If you still wanted comments or not .
 
I'll double down and say that I've experienced all of those things with both protocol changes and when my dose is too high. Around the 3rd week after a protocol change seems to be the worst of it for me at least.

Focusing just on T, what was your cream protocol and what is your new injection protocol? And when did you switch?

I switched to a daily T injections solo protocol 3 weeks ago, and my sleep has been horrible this week.
I woke up at 3.30 am today and couldn't fall back asleep. Previous nights I was waking up 300 times. I am waiting a couple more weeks to pull out blood and see where I am at, but I'm just curious if in your experience the insomnia got better the week after.
 
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I switched to a daily T injections solo protocol 3 weeks ago, and my sleep has been horrible this week.
I woke up at 3.30 am today and couldn't fall back asleep. Previous nights I was waking up 300 times. I am waiting a couple more weeks to pull out blood and see where I am at, but I'm just curious if in your experience the insomnia got better the week after.

I have continued to have sleep issues since switching to injections about 5 weeks ago. I don't struggle to fall asleep, but often wake up in the middle of the night and stay awake for the day. That said, I have not lacked any energy. In fact, I've felt great all day, every day! One thing that has helped (albeit slightly) with my sleep problems is eating carbs before bed.
 
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