3-4 Weeks Into TRT - Mentally Slow, Tired, Sluggish

I started TRT on 6/2, doing 40mg EOD cypionate.
I’m also on T3 and T4.

The first week I felt sleepy during the day, but thought maybe it was just an adjustment period, but nothing has really changed.

During those first few days, one hypothesis was it was just a matter of getting more calories since I was burning more on the T, but since then I have increased my calorie intake, and am eating well, and am finding no relief from the mental exhaustion and lack of focus.

As a comparison, prior to starting the TRT, and on the thyroid alone, I could sit 12 hours a day and do non-stop technical work, but now I’m lucky for a few hours a day.

However I am physically motivated. I can get myself into the gym every other day. (Nothing too crazy, just an hour of cross-fit.)

Face is looking a little bloated according to others. Weight has increased almost 8 pounds in that time.

I’m getting new bloods tomorrow. It would be nice I guess if it’s something easy to pick out, like high E2 for example.

I thought I’d seed this thread first to see if other’s had any similar experiences and anything they might have done to get things working right.

One other change was in the last 6 days I have stopped taking Wellbutrin. I was on about 75mg for 4 weeks prior to that. But the tiredness was there prior to getting off that, so don’t think that’s it.

Thanks for reading.

More background:

40 mg every other day of T cyp is quite a bit of T cyp and I do not understand why you are injecting a long acting T drug so frequently in such an amount. Most do fine with 100 mg per week in one shot. Some split 100 mg in two shots per week, but I believe the “peaks and valleys” issue is largely overblown and I doubt that most men can even discern negligible differences in T values while in the mid-to-high normal range, say 500 to 100 ng/dl.

That’s an average of 140 mg per week versus the standard 100 mg per week. Do you need this much? What are your T and E2 values?

Hey BH,

Thanks for the reply.

I just got back my results.

7/29:

Estradiol 62.1 pg/ml (reference <39.8)
(Note - this is not sensitive. This compares to 26.8 pg/ml on 6/20 prior to starting TRT)

Testosterone (Total) 846 ng/dl (reference 241-827)
(This was 311 ng/dL on 6/20 prior to starting TRT. The reference for that test was 160-728. Interesting that the reference range is changing over the period.)

TSH .2 (reference .35-5.5)
T3 Free 3.6 (reference 2.3-4.2)

Ferritin 90 ng/ml (ref 20-250)
(This was 178 ng/mL on 6/20)

Iron 67 ug/dl (ref 70-177)
(This was 62 ug/dl on 6/20)

Cortisol 9.6 ug/dl (This was 14.2 ug/dl on 6/20. No reference range provided)

[quote]Magister06 wrote:
Hey BH,

Thanks for the reply.

I just got back my results.

7/29:

Estradiol 62.1 pg/ml (reference <39.8)
(Note - this is not sensitive. This compares to 26.8 pg/ml on 6/20 prior to starting TRT)

Testosterone (Total) 846 ng/dl (reference 241-827)
(This was 311 ng/dL on 6/20 prior to starting TRT. The reference for that test was 160-728. Interesting that the reference range is changing over the period.)

TSH .2 (reference .35-5.5)
T3 Free 3.6 (reference 2.3-4.2)

Ferritin 90 ng/ml (ref 20-250)
(This was 178 ng/mL on 6/20)

Iron 67 ug/dl (ref 70-177)
(This was 62 ug/dl on 6/20)

Cortisol 9.6 ug/dl (This was 14.2 ug/dl on 6/20. No reference range provided)

[/quote]

My suspicion was right: you’re estradiol is quite high, which I’m convinced is likely caused by too much medicine. I am not a doctor, but I strongly suggest you go to 100 mg per week (one injection is fine, but if you feel you must split 100 mg in two shots, fine) and THEN see how your E2 is and if an AI is needed.

50 and under is an acceptable value for E2 provided T is in the mid to high normal range.

BH,

Thanks for the response.

Would you be willing to share your experience getting your protocol right? Did you try different amounts of T and do blood tests and see different responses? Did you ever find your E2 swinging high while you were finding the right setting for you?

What is your current protocol, I think I remember you are doing T and HCG w/ no AI is that right?
What level of T and E2 do you find yourself at now?

Thanks man.

PS. I let a day lapse in my EOD pattern to transfer to a 60mg E3D to try that out for a bit.

[quote]Magister06 wrote:
BH,

Thanks for the response.

Would you be willing to share your experience getting your protocol right? Did you try different amounts of T and do blood tests and see different responses? Did you ever find your E2 swinging high while you were finding the right setting for you? [/quote]

Like I’ve said elsewhere, I used gels for years, then switched to injections for the past two years, except a three month stint of HCG mono therapy that did not work as planned.

My doctor never had to prescribe anything different than 100 mg per week of testosterone cypionate for injections. In the times I’ve been tested post-mid week on injections, my T values have been in the 700’s and 800’s with estradiol in the 30’s and 40’s. So I haven’t had much of an issue with getting things right for injections.

[quote]

What is your current protocol, I think I remember you are doing T and HCG w/ no AI is that right?
What level of T and E2 do you find yourself at now? [/quote]

When the HCG mono therapy didn’t pan out about six weeks ago, my doc put me back on T cyp 100 mg per week and added HCG for 500 IU twice per week. This combo feels very good! I go back for my quarterly visit in early September, so I will then see what are my E2 and T values. I’m guessing T will likely be in the 800’s with E2 in the 40’s.

You’re welcome.

That might work. Have you ever tried 100 mg once per week or 50 mg twice per week?

I’m not feeling that great on the lower dosage, although admittedly I haven’t tried it that long.

I am going to be running an experiment with some research liquid AI today.

I was wondering if anyone would be able to suggest whether it makes sense to front-load the initial dosage (say, take 1mg immediately), since I am starting for the first time.

If I don’t get a response, I think I will just work with .5mg, and once the ball is rolling, do .4mg with my E3D cypionate.

Thank you.

[quote]Magister06 wrote:
I’m not feeling that great on the lower dosage, although admittedly I haven’t tried it that long.

I am going to be running an experiment with some research liquid AI today.

I was wondering if anyone would be able to suggest whether it makes sense to front-load the initial dosage (say, take 1mg immediately), since I am starting for the first time.

If I don’t get a response, I think I will just work with .5mg, and once the ball is rolling, do .4mg with my E3D cypionate.

Thank you.

[/quote]

How long have you been on this lower dose? Do you have values for this lower dose?

I am unsure what is causing you to feel tired. You feel tired at a relatively high dose and you feel tired at a standard dose which is likely putting you at over 500 ng/dl for much of the week. This leads me to believe something other than T level is at work here if is not the high estradiol.

Did you speak with your doctor bout this situation?