Will it always be a roller coaster?

[Jiu Jitsu Dude]

Hi Guys,

Will this TRT journey always be an emotional roller coaster? Is it for you guys/most? Starting my 4th week of cyp injections 200mg every 2 weeks. I know I said my doc would allow weekly but when I asked he said no. So I've had 2 shots now since my 7-23-18 start date. Each time it is intense and emotional (anger) for a few days then intermittent anxiety and sleepiness tender nipples, sleepiness then some good days and great libido at times. I do see some benefits already but the emotional roller coaster is not fun and not me. I might still have a bit of clomid left in my system (stopped on 7-1-18 was 12.5mg eod). That clomid was way worse than this.

1) If I just switch to weekly 100mg injections will he know (Dr)? will it help e2? I never operate that way but I'm trying to survive here emotionally etc. He's not going to see me for three months.

2) I have extra weight and a gut (and muscles too lol) so I think my big 200mg shot is converting to e2? If so will that decrease what's available at the end of the 2 weeks? was having nipple tenderness and bloating for a few days after each shot. I may just pay out of pocket for an e2 test from one of the labs here (excel)...

3) Started 100mg of DIM per day to help process extra e2. At least I'm assuming that's what's happening. I want to avoid an AI if possible. Might this pass after a few more weeks?

4) My insurance pays for trt so I'm hoping to avoid AI and I'm not having more kids so HCG does not seem necessary? Can I just dial in my cypionate protocol(myself) and keep same doc (urologist)? And pay for some strategic labs...Also not looking for high trough T levels 500 plus would be ok? I'm Rambling sorry...

I'm going to give this 6 months before I ditch it. I do have low T (below 300) and I see signs that this could help...

Advice?

 

[HealthMan]

200mg every 2 weeks is a terrible protocol for most. So no surprise you are on this hormonal rollercoaster. You have a huge peak and a low valley. Depending on your SHBG these can be really extreme.
DIM won’t do much if you need to really lower estradiol. But you better inject more frequently before worrying about estradiol (smaller frequent injections will most definitely help lower estradiol) Do you know your SHBG? A good start point would be 50mg twice a week. Given your doctor seem to be clueless i don’t think he will know if you are injecting more frequently.
In my opinion HCG is an important part of a protocol but many do well without. Do your own research and decide by yourself. You will see that the vast majoriry here uses HCG and some feel some subjective benefits some don’t other than keeping your balls from shrinking.

 

[MarkM]

That roller coaster is coming from that gigantic injection all at once. Since your doctor is clueless about a proper protocol then he will be clueless if you are injecting twice or three times per week. The reason you are wanting to give up after 6 months is because of what you doctor has done to you. Don't let him do that. TRT can be a great thing and millions of men can attest to that.

I looked back over your previous posts and can't find where you stated what your SHBG is. Let us know what your SHBG is and we can give you some better advice.

 

[DragonBits]

I am not at all sure how any doctor no mater how knowledgeable they were would be able to tell whether you were injecting 200 mg every 2 weeks or 50 mg 2 x a week.

Without labs you are just guessing about your total T and E2. I have found it not reliable to guess.

I doubt insurance would pay for an AI or HCG. I didn't take HCG in the past, I take it now, so far I haven't seen a change in how I feel,but it's early.

Depending on how much money you want to spend out of pocket, I would get a TT / e2 sensitive test done at the trough of your current 200mg protocol then proceed from there. If you decide to change to 100 mg once a week or 50mg twice a week, just get the regular blood test you need to get at the end of the 3 month period so you can compare.

Your doctor should have done blood tests that included at least TT, FT, SHBG. If you don't have a copy, you should ask him how to get it.

 

[Jiu Jitsu Dude]

200mg every 2 weeks is a terrible protocol for most. So no surprise you are on this hormonal rollercoaster. You have a huge peak and a low valley. Depending on your SHBG these can be really extreme.
DIM won’t do much if you need to really lower estradiol. But you better inject more frequently before worrying about estradiol (smaller frequent injections will most definitely help lower estradiol) Do you know your SHBG? A good start point would be 50mg twice a week. Given your doctor seem to be clueless i don’t think he will know if you are injecting more frequently.
In my opinion HCG is an important part of a protocol but many do well without. Do your own research and decide by yourself. You will see that the vast majoriry here uses HCG and some feel some subjective benefits some don’t other than keeping your balls from shrinking.

Thanks Healthman.

My SHBG was 45nmol/L range 10-50. And Total T was 727ng/dl, Free T was 82.3pg/ml and Bio Avail was 151.3 ng/dl That was one day after stopping Clomid on 7-3-18. So I did respond well to low dose clomid. But the emotions were 10x worse than this time with cypianate.

PS: I just finished Jiu Jitsu Sparring and feel 100% fine, lol. Only if it would stay for a while...

What if I had to come off TRT for BPH issues (currently ok), without HCG would my testicles restart ok?

 

[Jiu Jitsu Dude]

That roller coaster is coming from that gigantic injection all at once. Since your doctor is clueless about a proper protocol then he will be clueless if you are injecting twice or three times per week. The reason you are wanting to give up after 6 months is because of what you doctor has done to you. Don't let him do that. TRT can be a great thing and millions of men can attest to that.

I looked back over your previous posts and can't find where you stated what your SHBG is. Let us know what your SHBG is and we can give you some better advice.

Thanks Mark, I did add SBHG to Healthmans post reply...

Next monday I will inject 100mg every week instead of 200mg every 2 weeks. I think that I could quantify the results from that change thereafter and then make small adjustments. I will probably know a little right away if i'm not a raging maniac the first 3 days. lol.

 

[HealthMan]

Thanks Healthman.

My SHBG was 45nmol/L range 10-50. And Total T was 727ng/dl, Free T was 82.3pg/ml and Bio Avail was 151.3 ng/dl That was one day after stopping Clomid on 7-3-18. So I did respond well to low dose clomid. But the emotions were 10x worse than this time with cypianate.

PS: I just finished Jiu Jitsu Sparring and feel 100% fine, lol. Only if it would stay for a while...

What if I had to come off TRT for BPH issues (currently ok), without HCG would my testicles restart ok?

You have been on testosterone for just a few weeks right? So you shouldn’t have issues getting back to producing testosterone on your own. However it will take some time and you might feel blah along the way.
Are you planning to resume clomid therapy? Or stop everything? If the later how long you were on clomid therapy and what was your protocol?

 

[MarkM]

Good deal. Keep us posted on how you do with that change.

 

[Jiu Jitsu Dude]

I am not at all sure how any doctor no mater how knowledgeable they were would be able to tell whether you were injecting 200 mg every 2 weeks or 50 mg 2 x a week.

Without labs you are just guessing about your total T and E2. I have found it not reliable to guess.

I doubt insurance would pay for an AI or HCG. I didn't take HCG in the past, I take it now, so far I haven't seen a change in how I feel,but it's early.

Depending on how much money you want to spend out of pocket, I would get a TT / e2 sensitive test done at the trough of your current 200mg protocol then proceed from there. If you decide to change to 100 mg once a week or 50mg twice a week, just get the regular blood test you need to get at the end of the 3 month period so you can compare.

Your doctor should have done blood tests that included at least TT, FT, SHBG. If you don't have a copy, you should ask him how to get it.

Thanks Dragon Bits, I will get those tests especially the sensitive e2. My GP is my friend and he will order tests but they dont have the right e2 test. My Urologist is nice but i'm losing confidence in him but he will provide trt scripts...

 

[Jiu Jitsu Dude]

Oh Yeah, are most of you guys off the big emotional roller coaster? I don't mind a less intense/energy day here and there I just don't want the super emotional get me the F out of here crap. lol.

 

[HealthMan]

Oh Yeah, are most of you guys off the big emotional roller coaster? I don't mind a less intense/energy day here and there I just don't want the super emotional get me the F out of here crap. lol.

You just need a proper protocol. I think 50mg twice a day is a good start point. With your SHBG 100mg once a week might work as well. Once a week will raise estradiol more though.
Given you already switched to once a week give it a try and see how you feel and how your labs look.

 

[Jiu Jitsu Dude]

You have been on testosterone for just a few weeks right? So you shouldn’t have issues getting back to producing testosterone on your own. However it will take some time and you might feel blah along the way.
Are you planning to resume clomid therapy? Or stop everything? If the later how long you were on clomid therapy and what was your protocol?

No I want to continue and give this a try for 6 months and if I can have positive results I will stay on all my life God willing. Even though Clomid got my T levels up I was miserable on it. Way more than trt so far. I cant imagine being on clomid again. No sex drive, crazy emotional, depressed, anxiety thru the roof, weird etc and with a 727 T level. So higher T with no benefits - No Thanks.lol.

 

[Jiu Jitsu Dude]

Hi guys,

So far the switch from 200mg every 2 weeks to 100mg each week made an immediate difference. The first few days after the shot did not have any of the previous issues. I'm staying on this simple protocol for now. I'm feeling pretty good this week too. I'll let my body stabilize for 5 more weeks and report back. Thanks for the advice everyone!

 

[mooseman109]

Glad to hear of the improvement. It is a journey to get this thing dialed in. Not a bad thing. I appreciate the go slow mentality, i have adopted that as well.
I also started at 200mg every two weeks while with my pcp, who is a great dr, just not in this area. I did not experience the ups and downs you did. But hct went thru the roof. I swithc to defy and we changed things. Went to evey other day, things improved, hct settled a bit. Now i just started every day about a week ago. Maybe it stablizes hct more and brings up free t.. if not, what i was doing worked so i can easily drop back. So when i say journey that is what i mean.
For m ter was a positive life changer, enough to put up with a few bumps along the way. Stay the course

 

[KenLowT]

I know exactly how you feel. The roller coaster for me was real and so unpleasant. My endo, who is also very good but not in this area, originally started me at 150 mg every two weeks. I was expecting this huge libido surge, but all I got was a pissy attitude. I was miserable and thought this may not be for me. Because of the guys here on Excel I decided to switch my protocol down to 100 mg per week, 2 50 mg shots per week. I learned more about TRT here than I did from any doctor in the last 10 years. When I dropped down the 1st week went fine, but I fell flat Week 2 and 3 and I was miserable. I got all depressed, anxious, and wondered why I was feeling so emotional and sad about everything. According to others on Excel who also went down huge in dosage this was typical. At around Week 5 I started to come out of the clouds and felt much happier and less moody. Even though my libido is non existent I knew that the dosage lowering was good for me, my estradiol was like an 81 which is way too high.

Yesterday was my first consult with Defy and we both agreed that my dosage is too low and that I need to go up to 140 mg per week. It's much easier going up than down so I'm looking forward to it. My Free T needs to be in the high normal for my libido to resurface, but now I will have an AI to keep my estradiol in check, along with thyroid medicine to finally help me shed some body fat that has made it's home for far too long. I wish you good luck, we're all in the same boat. There is strength in numbers.

 

[MarkM]

I know exactly how you feel. The roller coaster for me was real and so unpleasant. My endo, who is also very good but not in this area, originally started me at 150 mg every two weeks. I was expecting this huge libido surge, but all I got was a pissy attitude. I was miserable and thought this may not be for me. Because of the guys here on Excel I decided to switch my protocol down to 100 mg per week, 2 50 mg shots per week. I learned more about TRT here than I did from any doctor in the last 10 years. When I dropped down the 1st week went fine, but I fell flat Week 2 and 3 and I was miserable. I got all depressed, anxious, and wondered why I was feeling so emotional and sad about everything. According to others on Excel who also went down huge in dosage this was typical. At around Week 5 I started to come out of the clouds and felt much happier and less moody. Even though my libido is non existent I knew that the dosage lowering was good for me, my estradiol was like an 81 which is way too high.

Yesterday was my first consult with Defy and we both agreed that my dosage is too low and that I need to go up to 140 mg per week. It's much easier going up than down so I'm looking forward to it. My Free T needs to be in the high normal for my libido to resurface, but now I will have an AI to keep my estradiol in check, along with thyroid medicine to finally help me shed some body fat that has made it's home for far too long. I wish you good luck, we're all in the same boat. There is strength in numbers.

Nice post Ken.

 

[Jiu Jitsu Dude]

Thanks Guys I'll keep you posted

 

[jws1300]

I too recently stopped clomid 12.5mg EOD, on July 31 (24 days ago). Numbers were awesome but didnt feel awesome. My PCP wanted to do 200mg TCyp every 2 weeks as well, but I pushed for 100mg weekly and he's ok with it and injections are free at his office. Depression/anxiety/panic/fatigue is what brought me here... So far i've had 3 injections, so i'm only on week 3, and havent really noticed any improvements. Maybe I do have some spurts that I feel better than I did months ago, but hopefully those increase steadily. I have increased anxiety the day after injections it seems but labs dont reflect why.

100mg Tcyp per week only. No other meds besides fish oil.
Dhea-s = 261
Peak TT = 838
Trough TT = 600
Trough FT = 12.1
Peak E2 = 24
Trough E2 = 18.8

Anxiety, ugh!

 

[Vince]

Is that the right estradiol test, Estradiol Sensitive, LC/MS/MS assay? What's your shbg level?

 

[jws1300]

Is that the right estradiol test, Estradiol Sensitive, LC/MS/MS assay? What's your shbg level?

The Trough E2 = 18.8 was a sensitive test that I ordered. The peak E2 my doctor ordered and i'm not 100% sure its sensitive...I may have to call the office and check bc I dont see "sensitive" on the result but its a vague system.