Past 2 weeks I have been having a real issue with sleep. Not so much a problem getting to sleep , but staying asleep . I will wake up frequently around 3-5am wide awake. If i try and force myself to lay down and try and go back to sleep it makes me severely anxious. Im getting so tired of TRT lately to be honest. I am waiting on labs that I had done last Monday which is perfect timing as that is around the time it really started happening as well.
I took last Tuesday a .5mg anastrazole since I have a history of aromatizing pretty heavily. My last E2 was 36 taken a few months back on a similar dose. I have read so many contradicting things when it comes to E2. For some it seems to mimick what im going through.
Symptoms ive journaled lately :
High Libido but not great erection quality.
Generalized anxiety over nothing in particular.
Lack of motivation at the gym
Insomnia ( this bothers me the most i think )
Semi more emotional but not crying or anything.
No bloating. No itchy nipples or anything.
Could this be E2 related? I know it’s not going to matter without labs but I am seeing my doctor later today and want to know if i should ask for an AI. Ive done daily injections and it didn’t matter. Im low shbg and doing 40mg twice weekly for a dose of 80mg.
I’m low SHBG and went from 80 after a year down to around 53/mg week. I was having all your symptoms but I have never taken an AI. Lowering the dose cured everything. I know everyone says higher is better but not for me. After a year my free jumped and I am due to labs now so I will post. One things about waking up early is this: the more you worry the worse it is. I used to roll about bitching and moaning. Getting up and reading or whatever didn’t help. I finally laid back down and tried NOT to move at all. Laying perfectly still got me back to sleep. Try laying motionless and telling yourself to at least rest your muscles. It’s all about how we train oursleves. I still think it is probably your test dose.
Your serum E2 two is 36, but anastrozole lowers E2 inside the tissue. Too bad you can’t measure the tissue concentrations of estrogen. Depending upon the tissue, which can have different amounts of aromatase, and therefore more estrogen in some tissues versus others.
When you block E2 inside the tissue, you’re blocking it evenly across-the-board.
I understand, but as I feel now im ready to jump ship and just stop. The insomnia and anxiety are far too much. Ive been reading that Low SHBG can make Normal E2 feel like high E2 . Who knows though
Trying that causes me severe anxiety. Like I need to get up NOW . I can definitely consider lowering dose, but on 100mg last labs my total Test was 577. Not high or low, kinda midline. Im on 80 now and waiting on labs.
You’re barking up the wrong tree. This E2 is perfectly normal and couldn’t be causing the severity of these symptoms. You’re allowed to have other health problems on TRT that have nothing to do with it.
You’re jumping the gun here without knowing where your hormone levels currently sit.
Sure it’s possible, but never had any issues in my life with sleep or anxiety really until this. And it completely goes away with ai…… I know a few people that state they also feel like garbage with E2 greater than 30… also low SHBG guys ( maybe a link ). ?
I always had terrible insomnia and anxiety every time I tried to use AI. even with doses of 0.5mg/week. But unfortunately at trt everything is very personal and trial and error. So you need to know yourself to know what works for you.
Yeah seems like it . Just hard to trust myself as everyone it seems claims Audis the devil and my estrogen isn’t at fault .
Granted I know it’s fairly normal at 37 but for me it is def causing issue it feels like . I wish there was a cheap way to do daily labs with like a finger prick . Lol
There’s definitely a link. We don’t usually talk about or calculate Free E2 the way we do Free T, but just like Free T, that’s what matters for driving E2 symptoms. Your E2 of 36 in a low SHBG guy may feel like an E2 of 70 for a normal SHBG guy. You just had an experience of relief with an AI - don’t let anyone talk you out of your own experience.
You have at least a couple options. You can lower your dose of testosterone until you have relief from the high E2 symptoms. Sometimes this is the best option. Sometimes the dose reduction leaves you with low testosterone symptoms, defeating the purpose of TRT. The other option is to continue experimenting with the AI and try to dial it in using a combination of symptom tracking and repeated E2 labs.
I guess there are a couple more options too. You could increase injection frequency, which usually lets people tolerate higher doses with fewer side effects. There’s also the dark side of E2 management where you add a UGL compound like primobolan or masteron to counter E2 - I assume you don’t want to go there.
Appreciate the advice. Yes it seems to me like there is a strong correlation between shbg and tolerance of estradiol. Yet another night passes by with just 3 hours sleep.
I took ai just over 24 hours ago. When should I know if it’s working?
Yeah took the AI and don’t feel any better this time around. I have no idea what is going on. Im really close to just calling it quits. This isn’t worth it anymore
There’s a remote possibility you could be a hyper responder to androgens, which would present with higher hematocrit and hemoglobin on a moderately elevated (midrange) testosterone level.
I’d try lowering your dosage until you feel better. I would also leave the AI out.
I fought with changing my TRT protocols for seven years before I found something that worked, I can’t imagine where I’d be today if I quit!
I don’t want to lower too much and lose the benefit too. I think I may actually be better with twice a week at the same dose total . I think for me personally the daily injections were stimulating hct production daily vs twice a week ( not a doctor )
I think the only thing bothering me lately is the sleep and anxiety and I’m really starting to think that may be due to infection . ( infected tooth) started antibiotic tonight , is that works I’ll post back . My body doesn’t do well with hyper stress or infections . Funny too as I work in a hyper stressful university and get sick frequently
Tell me more about this condition. I recently increased my dose to 250mg/week. I felt short of breath, went for blood tests and saw that my hct was 57.
Until then, the maximum I had used was 125mg/week, which left me with T levels of 800 before application.
From what I understand, I can’t increase the dose
I recently had a HCT at 59% and was lethargic and shortness of breath, which made working out of the gym a challenge. I sweat more than usual and palpitations. This also has the effect of causing a vitamin D deficiency, that is from excess hemoglobin/iron which suppresses vitamin D synthesis in the liver.
At least you didn’t blame the shortness of breath on estrogen, bravo!
