@mikebarnes trt managed well isn’t contraindicated for anyone really. Perhaps if you’re had prostate cancer or had a stroke it’s impoetant to manage it very closely.
You touched on something very crucial. TRT affects every neurotransmitter as well as thyroid and adrenals. When guys jump on test and then find themselves exhausted, they assume it’s estrogen. No. Never.
It is typically testosterone’s effect on the adrenal glands. To combat this we suggest 2g vitamin c a day and low caffeine use. Higher testosterone also can cause the thyroid to ramp up work which in some guys actually makes them sleepy. People assume hyperthyroid feelings are always anxiety etc. no. The biggest recommendation is SLOW changes. No more than one drug change every 6/8 weeks. That includes dosage changes etc.