Testosterone/TRT and Sleep

[alwaysphil1]

I am in my mid sixties and have been severely compromised by low back pain and osteoarthritis. Seven physicians, spine surgeons, rehab, accupuncture, two spinal ablations this summer, blocks, PRP, weight loss, have all led to one thing, nothing. I have also had both hips replaced and the onset of OA in lower back started 25 years ago and ended in surgery to help 'clean' it up. I was also very involved in athletics since I could walk and it paid my way through college. I'm certain this all contributed along with some bad genetics. I also helped developed long acting opioids with deterrents for abuse so I'm familiar with how they work, dangers etc.. In the end, it was the same, wake up exhausted and wake up at 2 or 3 EVERY NIGHT, TAKE A PAIN PILL and wait for it to work and then return to try and sleep. I'm also an a fib patient so NSAIDS ARE OUT OF THE QUESTION DUE TO RISK OF BLEEDING given I'm on blood thinners. My blood tests always resulted in same thing. First reading (8AM fasting) always low, 125 or so. The second, seemed to go up but only to 300 or so and my endocrinologist was reluctant to prescribe. Finally, after noticing I was having issue with my short term memory about 6 months ago, I needed to revisit TRT. Forget no energy, no libido. Now I was very concerned. I approached my physicians, cardiologists and endocrinoligists with yet another request. This time the results were very low the first time 120 and borderline the second time 260 but also complimented with low LH, FSH and estradiol and free testosterone.

I have only been on TRT for 3 weeks (200mg every 2 weeks) and have seen fleeting signs of encouragement. Energy seems to be improving but it's hard to quantify. Not much improvement if at all in libido and hence sexual dysfunction and hard to say about short term memory. But, here is why I am posting. After 2-3 years of waking every night, I have now had 6 days of uninterrupted sleep for 6-7 hours a night which has not happened in years and I know the only change in my routine has been TRT. Not only am I encouraged, but elated. I believe other benefits will follow shortly. But for someone like me, who has not had a sound night's sleep consistenly for more than a day over the last +2-3 years, you can imagine how I feel. I haven't been able to determine if the anti-inflammatory properties are reducing the back pain because it remains but primarily when on my feet a few hours or even sitting legs not up.

Sleep is often not talked about with TRT or at least in most of my research. I hope this helps anyone who may be encountering similar issues that I have.

 

[madman]

I am in my mid sixties and have been severely compromised by low back pain and osteoarthritis. Seven physicians, spine surgeons, rehab, accupuncture, two spinal ablations this summer, blocks, PRP, weight loss, have all led to one thing, nothing. I have also had both hips replaced and the onset of OA in lower back started 25 years ago and ended in surgery to help 'clean' it up. I was also very involved in athletics since I could walk and it paid my way through college. I'm certain this all contributed along with some bad genetics. I also helped developed long acting opioids with deterrents for abuse so I'm familiar with how they work, dangers etc.. In the end, it was the same, wake up exhausted and wake up at 2 or 3 EVERY NIGHT, TAKE A PAIN PILL and wait for it to work and then return to try and sleep. I'm also an a fib patient so NSAIDS ARE OUT OF THE QUESTION DUE TO RISK OF BLEEDING given I'm on blood thinners. My blood tests always resulted in same thing. First reading (8AM fasting) always low, 125 or so. The second, seemed to go up but only to 300 or so and my endocrinologist was reluctant to prescribe. Finally, after noticing I was having issue with my short term memory about 6 months ago, I needed to revisit TRT. Forget no energy, no libido. Now I was very concerned. I approached my physicians, cardiologists and endocrinoligists with yet another request. This time the results were very low the first time 120 and borderline the second time 260 but also complimented with low LH, FSH and estradiol and free testosterone.

I have only been on TRT for 3 weeks (200mg every 2 weeks) and have seen fleeting signs of encouragement. Energy seems to be improving but it's hard to quantify. Not much improvement if at all in libido and hence sexual dysfunction and hard to say about short term memory. But, here is why I am posting. After 2-3 years of waking every night, I have now had 6 days of uninterrupted sleep for 6-7 hours a night which has not happened in years and I know the only change in my routine has been TRT. Not only am I encouraged, but elated. I believe other benefits will follow shortly. But for someone like me, who has not had a sound night's sleep consistenly for more than a day over the last +2-3 years, you can imagine how I feel. I haven't been able to determine if the anti-inflammatory properties are reducing the back pain because it remains but primarily when on my feet a few hours or even sitting legs not up.

Sleep is often not talked about with TRT or at least in most of my research. I hope this helps anyone who may be encountering similar issues that I have.

I have only been on TRT for 3 weeks (200mg every 2 weeks) and have seen fleeting signs of encouragement. Energy seems to be improving but it's hard to quantify. Not much improvement if at all in libido and hence sexual dysfunction and hard to say about short term memory. But, here is why I am posting. After 2-3 years of waking every night, I have now had 6 days of uninterrupted sleep for 6-7 hours a night which has not happened in years and I know the only change in my routine has been TRT. Not only am I encouraged, but elated. I believe other benefits will follow shortly.


Glad to hear you are feeling somewhat better jumping on trt but unfortunately you are going to miss out on many of the beneficial effects of having healthy testosterone levels due to the piss poor protocol you were started on.

Keep in mind that the metabolites estradiol and DHT are needed in healthy amounts to experience the full spectrum of testosterones beneficial effects on (cardiovascular health, brain health, libido, erectile function, bone health, tendon health, immune system, lipids, and body composition).

*Natural testosterone is viewed as the best androgen for substitution in hypogonadal men. The reason behind the selection is that testosterone can be converted to DHT and E2, thus developing the full spectrum of testosterone activities in long-term substitution

200 mg T every 2 weeks is a protocol prescribed by those with a neanderthal mindset.

Such dose let alone injection frequency will have your TT, FT, and estradiol levels sky-high post-injection (8-12 hrs)/during the first few days only to be followed by lower levels come weekend end let alone back to being hypogonadal before your next injection (2-week mark) due to the half-life (TC/TE).

Most men on trt are injecting 100-200 mg T/week whether injected once weekly or split into twice weekly (every 3.5 days), M/W/F, EOD, or daily.

Even then most men would never need the higher-end trt dose of 200 mg/week to achieve a healthy let alone high trough FT.

Most men can easily achieve a high end let alone very high and in some cases absurdly high FT level injecting 100-150 mg T/week split into twice weekly (every 3.5 days), M/W/F, EOD let alone daily.

FT 5-10 ng/dl would be considered low.

FT 16-31 ng/dL (high-end) is healthy.

Most men will do well with FT 20-30 ng/dL.

Some may CHOOSE to run higher levels.

Notice I stated choose as it is highly unlikely most would NEED a trough FT >31 ng/dL.

Critical to have healthy thyroid/adrenals as any dysfunction will have a negative impact on the outcome of trt.

If anything you need to be injecting once weekly and to be honest most would fair better injecting twice-weekly (every 3.5 days).

The downfall of injecting higher doses of T once weekly is there will be a significant difference in the peak--->trough and blood levels will not be as stable throughout the week as T levels will be very high post-injection (8-12 hrs)/during the first few days only to be followed by lower levels come weeks end which can have a negative effect on mood, energy, libido, erectile function, recovery.

The main advantage of injecting more frequently is you will be clipping the peak--->trough and blood levels will be more stable throughout the week which will have a beneficial effect on symptom relief/overall well-being.

Keep in mind that although TT is important FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

Critical to know where your SHBG level sits as it will have a significant impact on TT/FT level achieved and can also dictate what injection frequency may suit you best.

Most men with lowish/low SHBG tend to do better injecting more frequently EOD/daily.

Comes down to the individual and what injection frequency suits you best.

The best piece of advice is to start low and go slow on a T-only protocol (100mg T/week) whether once weekly or split into twice-weekly injections (50 mg every 3.5 days) as we want to see how your body reacts to testosterone and where said protocol (dose of T/injection frequency) will have you trough TT, FT, estradiol let alone other important blood markers such as RBCs/hemoglobin/hematocrit 6 weeks in.

You have barely gotten your feet wet as you are only 3 weeks in let alone on a piss-poor protocol of 200 mg T every 2 weeks.

You are basically shooting your T levels through the roof post-injection/during the first few days only to be followed by much lower levels come weeks end (most likely still fairly high due to the whopping dose of 200 mg T) but more importantly, 7 days in and your T levels will continue to plummet only to be absurdly low (hypogonadal) by day 14.

A rollercoaster ride anyone!

I would strongly consider changing your protocol to 100 mg T once weekly and even then splitting your dose into twice-weekly injections (50 mg T every 3.5 days) would most likely have you better off.

Forget the 3 weeks you have wasted and start over.

Keep in mind that due to the half-life of the ester used (TC/TE) it will take 4-6 weeks for your blood levels to stabilize then blood work will be done as we want to see where your trough TT, FT, estradiol, and RBCs/hemoglobin/hematocrit sit

The first 6 weeks can be very misleading and it is common for many to experience ups/downs during the transition as hormones are in FLUX and the body is trying to adjust.

Even then once blood levels have stabilized it will take time for the body to fully adapt to the new set-point and this is the critical time period when one should gauge how they truly feel overall regarding relief/improvement of low-t symptoms/overall well-being.

Every protocol should be given a fair chance (12 weeks) to claim whether it was truly a success or failure.

Do not expect everything to be fine and dandy 6 weeks in and your dose of T should not be increased 6 weeks in unless your trough FT level is too low (highly doubtful).

Patience is key!




My blood tests always resulted in same thing. First reading (8AM fasting) always low, 125 or so. The second, seemed to go up but only to 300 or so and my endocrinologist was reluctant to prescribe. Finally, after noticing I was having issue with my short term memory about 6 months ago, I needed to revisit TRT. Forget no energy, no libido. Now I was very concerned. I approached my physicians, cardiologists and endocrinoligists with yet another request. This time the results were very low the first time 120 and borderline the second time 260 but also complimented with low LH, FSH and estradiol and free testosterone.

This is pathetic and typical of many endos/GPs!

Clear as day that TT 120 ng/dL is horribly low let alone 260-300 ng/dL would have anyone feeling the death grip of piss poor T levels.

FT would be in the gutter.

 

[Systemlord]

I have only been on TRT for 3 weeks (200mg every 2 weeks) and have seen fleeting signs of encouragement.

I suggest you find a doctor that knows what the hell he's doing. These protocols make it difficult for the body to find homeostasis as your hormones are all over the place.

The typical endo/GP is batshit stupid when it comes to male hormones. The guidelines for TRT are deplorable and it takes a good doctor to recognize this fact.

Most success stories on TRT inject one or more times a week, those who don't either quit thinking TRT doesn't work or continue to struggle as the benefits to TRT seem elusive.

 

[Systemlord]

First reading (8AM fasting) always low, 125 or so. The second, seemed to go up but only to 300 or so and my endocrinologist was reluctant to prescribe.

You should have been put on TRT years ago, but western medicine isn't exactly at the forefront of knowledge in male hormones.

To make matters worse our healthcare system is into treating men's diseases, their not in tune with men's health and are more likely to deny care than they are to provide it.

 

[alwaysphil1]

I have only been on TRT for 3 weeks (200mg every 2 weeks) and have seen fleeting signs of encouragement. Energy seems to be improving but it's hard to quantify. Not much improvement if at all in libido and hence sexual dysfunction and hard to say about short term memory. But, here is why I am posting. After 2-3 years of waking every night, I have now had 6 days of uninterrupted sleep for 6-7 hours a night which has not happened in years and I know the only change in my routine has been TRT. Not only am I encouraged, but elated. I believe other benefits will follow shortly.


Glad to hear you are feeling somewhat better jumping on trt but unfortunately you are going to miss out on many of the beneficial effects of having healthy testosterone levels due to the piss poor protocol you were started on.

Keep in mind that the metabolites estradiol and DHT are needed in healthy amounts to experience the full spectrum of testosterones beneficial effects on (cardiovascular health, brain health, libido, erectile function, bone health, tendon health, immune system, lipids, and body composition).

*Natural testosterone is viewed as the best androgen for substitution in hypogonadal men. The reason behind the selection is that testosterone can be converted to DHT and E2, thus developing the full spectrum of testosterone activities in long-term substitution

200 mg T every 2 weeks is a protocol prescribed by those with a neanderthal mindset.

Such dose let alone injection frequency will have your TT, FT, and estradiol levels sky-high post-injection (8-12 hrs)/during the first few days only to be followed by lower levels come weekend end let alone back to being hypogonadal before your next injection (2-week mark) due to the half-life (TC/TE).

Most men on trt are injecting 100-200 mg T/week whether injected once weekly or split into twice weekly (every 3.5 days), M/W/F, EOD, or daily.

Even then most men would never need the higher-end trt dose of 200 mg/week to achieve a healthy let alone high trough FT.

Most men can easily achieve a high end let alone very high and in some cases absurdly high FT level injecting 100-150 mg T/week split into twice weekly (every 3.5 days), M/W/F, EOD let alone daily.

FT 5-10 ng/dl would be considered low.

FT 16-31 ng/dL (high-end) is healthy.

Most men will do well with FT 20-30 ng/dL.

Some may CHOOSE to run higher levels.

Notice I stated choose as it is highly unlikely most would NEED a trough FT >31 ng/dL.

Critical to have healthy thyroid/adrenals as any dysfunction will have a negative impact on the outcome of trt.

If anything you need to be injecting once weekly and to be honest most would fair better injecting twice-weekly (every 3.5 days).

The downfall of injecting higher doses of T once weekly is there will be a significant difference in the peak--->trough and blood levels will not be as stable throughout the week as T levels will be very high post-injection (8-12 hrs)/during the first few days only to be followed by lower levels come weeks end which can have a negative effect on mood, energy, libido, erectile function, recovery.

The main advantage of injecting more frequently is you will be clipping the peak--->trough and blood levels will be more stable throughout the week which will have a beneficial effect on symptom relief/overall well-being.

Keep in mind that although TT is important FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

Critical to know where your SHBG level sits as it will have a significant impact on TT/FT level achieved and can also dictate what injection frequency may suit you best.

Most men with lowish/low SHBG tend to do better injecting more frequently EOD/daily.

Comes down to the individual and what injection frequency suits you best.

The best piece of advice is to start low and go slow on a T-only protocol (100mg T/week) whether once weekly or split into twice-weekly injections (50 mg every 3.5 days) as we want to see how your body reacts to testosterone and where said protocol (dose of T/injection frequency) will have you trough TT, FT, estradiol let alone other important blood markers such as RBCs/hemoglobin/hematocrit 6 weeks in.

You have barely gotten your feet wet as you are only 3 weeks in let alone on a piss-poor protocol of 200 mg T every 2 weeks.

You are basically shooting your T levels through the roof post-injection/during the first few days only to be followed by much lower levels come weeks end (most likely still fairly high due to the whopping dose of 200 mg T) but more importantly, 7 days in and your T levels will continue to plummet only to be absurdly low (hypogonadal) by day 14.

A rollercoaster ride anyone!

I would strongly consider changing your protocol to 100 mg T once weekly and even then splitting your dose into twice-weekly injections (50 mg T every 3.5 days) would most likely have you better off.

Forget the 3 weeks you have wasted and start over.

Keep in mind that due to the half-life of the ester used (TC/TE) it will take 4-6 weeks for your blood levels to stabilize then blood work will be done as we want to see where your trough TT, FT, estradiol, and RBCs/hemoglobin/hematocrit sit

The first 6 weeks can be very misleading and it is common for many to experience ups/downs during the transition as hormones are in FLUX and the body is trying to adjust.

Even then once blood levels have stabilized it will take time for the body to fully adapt to the new set-point and this is the critical time period when one should gauge how they truly feel overall regarding relief/improvement of low-t symptoms/overall well-being.

Every protocol should be given a fair chance (12 weeks) to claim whether it was truly a success or failure.

Do not expect everything to be fine and dandy 6 weeks in and your dose of T should not be increased 6 weeks in unless your trough FT level is too low (highly doubtful).

Patience is key!




My blood tests always resulted in same thing. First reading (8AM fasting) always low, 125 or so. The second, seemed to go up but only to 300 or so and my endocrinologist was reluctant to prescribe. Finally, after noticing I was having issue with my short term memory about 6 months ago, I needed to revisit TRT. Forget no energy, no libido. Now I was very concerned. I approached my physicians, cardiologists and endocrinoligists with yet another request. This time the results were very low the first time 120 and borderline the second time 260 but also complimented with low LH, FSH and estradiol and free testosterone.

This is pathetic and typical of many endos/GPs!

Clear as day that TT 120 ng/dL is horribly low let alone 260-300 ng/dL would have anyone feeling the death grip of piss poor T levels.

FT would be in the gutter.

 

[alwaysphil1]

Thank you! I really appreciate these replies. I have already split the dose to weekly injections so that much I recognized. Now it will be a matter of getting the dose right so I can get out of this gutter. It doesn't sound like much but I can tell you, getting 6-7 hours sleep now for a week has been like a God send. I'm glad I found this forum to hear from all of you because quite frankly, it's been a tough road. Appreciate the messages and advice from all.

 

[alwaysphil1]

I have only been on TRT for 3 weeks (200mg every 2 weeks) and have seen fleeting signs of encouragement. Energy seems to be improving but it's hard to quantify. Not much improvement if at all in libido and hence sexual dysfunction and hard to say about short term memory. But, here is why I am posting. After 2-3 years of waking every night, I have now had 6 days of uninterrupted sleep for 6-7 hours a night which has not happened in years and I know the only change in my routine has been TRT. Not only am I encouraged, but elated. I believe other benefits will follow shortly.


Glad to hear you are feeling somewhat better jumping on trt but unfortunately you are going to miss out on many of the beneficial effects of having healthy testosterone levels due to the piss poor protocol you were started on.

Keep in mind that the metabolites estradiol and DHT are needed in healthy amounts to experience the full spectrum of testosterones beneficial effects on (cardiovascular health, brain health, libido, erectile function, bone health, tendon health, immune system, lipids, and body composition).

*Natural testosterone is viewed as the best androgen for substitution in hypogonadal men. The reason behind the selection is that testosterone can be converted to DHT and E2, thus developing the full spectrum of testosterone activities in long-term substitution

200 mg T every 2 weeks is a protocol prescribed by those with a neanderthal mindset.

Such dose let alone injection frequency will have your TT, FT, and estradiol levels sky-high post-injection (8-12 hrs)/during the first few days only to be followed by lower levels come weekend end let alone back to being hypogonadal before your next injection (2-week mark) due to the half-life (TC/TE).

Most men on trt are injecting 100-200 mg T/week whether injected once weekly or split into twice weekly (every 3.5 days), M/W/F, EOD, or daily.

Even then most men would never need the higher-end trt dose of 200 mg/week to achieve a healthy let alone high trough FT.

Most men can easily achieve a high end let alone very high and in some cases absurdly high FT level injecting 100-150 mg T/week split into twice weekly (every 3.5 days), M/W/F, EOD let alone daily.

FT 5-10 ng/dl would be considered low.

FT 16-31 ng/dL (high-end) is healthy.

Most men will do well with FT 20-30 ng/dL.

Some may CHOOSE to run higher levels.

Notice I stated choose as it is highly unlikely most would NEED a trough FT >31 ng/dL.

Critical to have healthy thyroid/adrenals as any dysfunction will have a negative impact on the outcome of trt.

If anything you need to be injecting once weekly and to be honest most would fair better injecting twice-weekly (every 3.5 days).

The downfall of injecting higher doses of T once weekly is there will be a significant difference in the peak--->trough and blood levels will not be as stable throughout the week as T levels will be very high post-injection (8-12 hrs)/during the first few days only to be followed by lower levels come weeks end which can have a negative effect on mood, energy, libido, erectile function, recovery.

The main advantage of injecting more frequently is you will be clipping the peak--->trough and blood levels will be more stable throughout the week which will have a beneficial effect on symptom relief/overall well-being.

Keep in mind that although TT is important FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

Critical to know where your SHBG level sits as it will have a significant impact on TT/FT level achieved and can also dictate what injection frequency may suit you best.

Most men with lowish/low SHBG tend to do better injecting more frequently EOD/daily.

Comes down to the individual and what injection frequency suits you best.

The best piece of advice is to start low and go slow on a T-only protocol (100mg T/week) whether once weekly or split into twice-weekly injections (50 mg every 3.5 days) as we want to see how your body reacts to testosterone and where said protocol (dose of T/injection frequency) will have you trough TT, FT, estradiol let alone other important blood markers such as RBCs/hemoglobin/hematocrit 6 weeks in.

You have barely gotten your feet wet as you are only 3 weeks in let alone on a piss-poor protocol of 200 mg T every 2 weeks.

You are basically shooting your T levels through the roof post-injection/during the first few days only to be followed by much lower levels come weeks end (most likely still fairly high due to the whopping dose of 200 mg T) but more importantly, 7 days in and your T levels will continue to plummet only to be absurdly low (hypogonadal) by day 14.

A rollercoaster ride anyone!

I would strongly consider changing your protocol to 100 mg T once weekly and even then splitting your dose into twice-weekly injections (50 mg T every 3.5 days) would most likely have you better off.

Forget the 3 weeks you have wasted and start over.

Keep in mind that due to the half-life of the ester used (TC/TE) it will take 4-6 weeks for your blood levels to stabilize then blood work will be done as we want to see where your trough TT, FT, estradiol, and RBCs/hemoglobin/hematocrit sit

The first 6 weeks can be very misleading and it is common for many to experience ups/downs during the transition as hormones are in FLUX and the body is trying to adjust.

Even then once blood levels have stabilized it will take time for the body to fully adapt to the new set-point and this is the critical time period when one should gauge how they truly feel overall regarding relief/improvement of low-t symptoms/overall well-being.

Every protocol should be given a fair chance (12 weeks) to claim whether it was truly a success or failure.

Do not expect everything to be fine and dandy 6 weeks in and your dose of T should not be increased 6 weeks in unless your trough FT level is too low (highly doubtful).

Patience is key!




My blood tests always resulted in same thing. First reading (8AM fasting) always low, 125 or so. The second, seemed to go up but only to 300 or so and my endocrinologist was reluctant to prescribe. Finally, after noticing I was having issue with my short term memory about 6 months ago, I needed to revisit TRT. Forget no energy, no libido. Now I was very concerned. I approached my physicians, cardiologists and endocrinoligists with yet another request. This time the results were very low the first time 120 and borderline the second time 260 but also complimented with low LH, FSH and estradiol and free testosterone.

This is pathetic and typical of many endos/GPs!

Clear as day that TT 120 ng/dL is horribly low let alone 260-300 ng/dL would have anyone feeling the death grip of piss poor T levels.

FT would be in the gutter.

My SHBG levels were borderline low but didn't exceed the low threshold. I forget the number and could retrieve it but it wasn't anywhere near anything but low.

 

[JimGainz]

First of all congratulations on getting on testosterone replacement therapy. It sounds like you were definitely in need. Echoing the other posters, your current protocol is far from optimal. In fact, longer-term you might experience some unwanted side effects with the roller coaster levels from injecting every two weeks. You can search this forum details but typically we inject multiple times per week, the minimum usually being twice per week to help balance things out.

Regarding your improved sleep:. This is definitely one of the benefits I have seen with testosterone replacement as long as the results are in therapeutic ranges. Balancing out your hormones has this effect. Remember when you were a teenager or early 20s – you’d wake up in the middle of the night, maybe thinking about something, but would be like “ah - forget it” and go right back to sleep and wake up a few hours later? .

Lastly - At some point you may want to consider adding nandrolone to your protocol to reduce pain and inflammation. Many of us here do this and I personally have found it life-changing for arthritis and other injuries. I am not trying to push drugs on you but here is a video of a Doctor who explains the effect and how it’s much better than taking painkillers.

If you want a great remote TRT specialist - book an appointment with Defy Medical. They can straighten out your protocol.

 

[sammmy]

For pain/inflammation, you could try Boswellia Serrata (Indian Frankincense) extracts. I've seen a lot of reviews of people with arthritis. However, Boswellia has anti-coagulant properties (like many herbs) and may interact with blood thinners:

Boswellia summary by Sloan Kettering Center

 

[madman]

First of all congratulations on getting on testosterone replacement therapy. It sounds like you were definitely in need. Echoing the other posters, your current protocol is far from optimal. In fact, longer-term you might experience some unwanted side effects with the roller coaster levels from injecting every two weeks. You can search this forum details but typically we inject multiple times per week, the minimum usually being twice per week to help balance things out.

Regarding your improved sleep:. This is definitely one of the benefits I have seen with testosterone replacement as long as the results are in therapeutic ranges. Balancing out your hormones has this effect. Remember when you were a teenager or early 20s – you’d wake up in the middle of the night, maybe thinking about something, but would be like “ah - forget it” and go right back to sleep and wake up a few hours later? .

Lastly - At some point you may want to consider adding nandrolone to your protocol to reduce pain and inflammation. Many of us here do this and I personally have found it life-changing for arthritis and other injuries. I am not trying to push drugs on you but here is a video of a Doctor who explains the effect and how it’s much better than taking painkillers.

If you want a great remote TRT specialist - book an appointment with Defy Medical. They can straighten out your protocol.

Would be something to look into down the road once he gets on a sensible trt protocol let alone give it enough time to see how his body reacts to testosterone and what impact it will have on blood markers such as RBCs/hemoglobin/hematocrit.

Even then although many may get relief/improvement of joint/bone pain when using therapeutic doses of 50-100mg ND/week it is not a given.

Let alone nandrolone is not healing/preventing any degeneration/damage of the joints/tendons/ligaments which many of the misinformed tend to claim.

It will enhance lubrication in the joints.

Its main advantage is its strong anabolic/anti-catabolic properties and is known to bind strongly to the AR (>testosterone).

ND is a potent available anabolic steroid with minimal androgenic side effects.

Keep in mind that there is no guarantee of a free lunch when using therapeutic doses of nandrolone long-term.


*It is unclear to what extent, if any, these risks would apply to nandrolone administration at a more reasonable dosage in a clinical setting. Thus far, the controlled clinical trials of nandrolone have been too small and too sparse to confidently assess the risks of physician-prescribed and monitored nandrolone treatment at appropriate dosing




Nandrolone decanoate relieves joint pain in hypogonadal men: a novel prospective pilot study and review of the literature (2019)


Historical clinical applications Nandrolone was initially FDA approved in 1962 for the treatment of anemia resulting from chronic kidney disease (CKD) (18-20). While quite capable in this regard with fewer androgenic side effects compared to testosterone (the previous standard of care), nandrolone’s use in the treatment of anemia was largely supplanted in the late 1980s with the introduction of recombinant human erythropoietin (EPO) (21). Interestingly, nandrolone is still occasionally used as an alternative for select patients who cannot tolerate EPO and for patients in resource-limited countries (21-23). Outside of its historical indication for anemia, nandrolone has also shown promise in the treatment of osteoporosis and the sarcopenic states commonly observed in advanced chronic obstructive pulmonary disease (COPD), and acquired immunodeficiency syndrome (AIDS), and end-stage renal disease (ESRD) (24-27). Unfortunately, nandrolone decanoate (ND) is no longer commercially available within the United States and, therefore, must be compounded.




Side effects

Nandrolone has been shown to possess a generally favorable side effect profile compared to most other AAS. Although any androgenic stimulation of the hair follicle and sebaceous sweat glands may result in alopecia, hirsutism, and acne, nandrolone’s weak androgenic activity makes these side effects uncommon (28). As an injectable oil, nandrolone is not subject to first-pass hepatic metabolism and is not hepatotoxic. Interestingly, although not well-described in the literature, some users of nandrolone have complained of temporary ED that resolves with cessation of therapy (13). This anecdotal side effect appears to be highly dependent on nandrolone dosage and the use or absence of concomitant testosterone. Although further studies regarding this are needed, plausible mechanisms for this include the insufficient androgenic activity of nandrolone itself and negative-feedback induced suppression of the HPG axis resulting in both reduced testosterone and DHT, the latter of which crucial to nitric-oxide mediated erectile function (13,29). Interference with the HPG axis also poses a significant risk to fertility and may risk the possibility for hypogonadism with long-term use in men who are not already testosterone deficient (30).

It is important to note that the majority of the literature, which describes the adverse effects of nandrolone, does so in the setting of illicit AAS abuse (11,31,32). This patient population is notorious for utilizing very high doses of AAS and is fraught with polypharmacy. Thus, the usefulness of extrapolating these studies’ findings to appropriate medical therapy with nandrolone is extremely limited (33). In human studies, illicit, long-term AAS abuse has been associated with cardiovascular complications, such as cardiomyopathy and coronary artery disease (34,35). In rat models using approximately 20× doses of nandrolone used clinically; cardiomyopathy has also been observed (36-38). It is unclear to what extent, if any, these risks would apply to nandrolone administration at a more reasonable dosage in a clinical setting. Thus far, the controlled clinical trials of nandrolone have been too small and too sparse to confidently assess the risks of physician-prescribed and monitored nandrolone treatment at appropriate dosing.




Novel pilot study

*As evidenced above, there is very little concrete data referencing any effect nandrolone may have regarding the alleviation of joint pain. However, nandrolone does have well-documented advantageous effects on bone and muscle along with quality trials showing its benefit in osteoporotic bone pain and historical documentation of its efficacy for patellofemoral pain syndrome. Therefore, it is reasonable to postulate that the anecdotal evidence ascribing non-inflammatory joint pain relief to nandrolone may be accurate. Additionally, male hypogonadism is linked with comorbidities such as diabetes and obesity, which are often associated with significant and debilitating joint pain (69,70). In such patients, the addition of nandrolone to their testosterone replacement regimen would avoid the potential side effect of ED, as discussed earlier, resulting in a highly tolerable option for pain management, if efficacious.



post #9

BPC 157 - amazing healing results.

I wanted to share my recent experience running BPC 157 for the first time. I have had a nagging, chronic Rotator cuff injury for the past five months or so. The injury has been persistent and has been increasing in pain and lack of mobility. Recently, it got so bad that I had to pretty much...

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post #2

Tendonitis and TRT

I’ve read that using exogenous testosterone, and in particular having high TT/FT levels, can cause some “stiffening” of tendons. I’m experiencing extremely painful, chronic tennis elbow. It didn’t occur in isolation - it is an overuse injury. But one that simply will not heal. It’s not as if...

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[madman]

Kinda funny many of these same individuals jumping on the magical properties of ND bandwagon are the same individuals who still continue to lift heavy and beat up their joints/tendons/ligaments...go figure!