I have been on TRT treatment for about a year and a half. I was diagnosed with Low T early last year at age 47. Other than Low T(total T count was about 250) , I don’t have any other major medical issues.
I have been on testosterone gel the whole time until recently. The gel has worked well. Every time I have taken a blood test, my total testosterone level have been over 1,300. With the increased Testosterone levels and my workout supplements, I have had very good gains in the gym this past year which I am very happy about.
The downsides of using testosterone has been the following
Severe acne on both shoulders where I have applied it. Prescribed Dosage is for one tube per arm(50 mg of testosterone per tube) per day. Gel is very oily/greasy and coupled with the fact that my T levels have always measured over 1,300 on every test since taking it, this “excess” testosterone maybe causing the severe acne. I spoke to my doctor about it and he suggested ½ of the recommended dosage. I tried doing that for about a week and I literally felt like I was going to “die” so I went back to the regular dosage to that I could feel normal again.
About maybe 2 months ago, I found myself “crashing” every evening after dinner. I would eat dinner, relax on the couch a bit and always fall asleep. I guess I felt as if the testosterone was “wearing off” by late evening and would not carry me through the rest of the day.
My Estradiol level has been up and down and the last test I did it was normal after settling down with ½ tablet of Arimedix once a week.
After discussions with my doctor(Urologist/TRT specialist), he suggested/I asked him if I could switch to Testosterone injections to see if the downsides I mentioned above would go away. I have been on the injections for about 3 weeks now and things are not going too well. I feel a lot “weaker” now than I have ever felt since starting TRT treatment last year. My prescribed dosage is 0.4 ml of Testosterone Cypionate twice a week. After the first week, felt so terrible and thus in week 2, I increased it to 0.5 ml twice a week. I am on week 3 and still feel “weaker” compared to how I felt when I was on Testosterone gel. . I currently “struggle” to complete “lower” weight sets when I go to the gym now. Never had a problem when completing and increasing sets when I was on the gel.
How much dosage of Testosterone Cypionnate are you all on that works for you? I normally only see the doctor(Urologist) only twice a year for blood work so I won’t see him for awhile.
Should I continually increase the amount of “ml” of Testosterone Cypionate until I get to an “acceptable level” where I don’t feel “weak” anymore.
What is the strength of your test cypionate? They can come in 100mg/ml, 200mg/ml and 250mg/ml. You listed volume that you’re injecting which does not tell us how many mg of the test. Depending on strength you could be injecting 100mg to 250mg a week with your current dosing.
You also switched protocols and it can take 6-8 weeks for you to feel better because your body has to adjust. Everytime you adjust dosage, injection frequency etc you may have to go through this adjustment phase.
We are all over the place on how much we inject and how high our levels get with certain amounts due to we all metabolize test different from person to person. I personally do 175mg a week divided into daily shots.
Why did you switch to injections if you were able to get T levels over 1000 on Topical? It sounds like you might have needed to slightly lower the overall dose. Or start to backfill some of the T pathways by adding in some Pregnenolone and DHEA.
Also, relaxing on the couch and falling asleep to me seems like a good thing. I wish I could do that. How was your energy during the day? We’re you unable to do things that you had planned in the evening? How was your libido? Also, arimidex can be a nasty little drug. Even at very low doses it can crash your E which can explain your ‘feeling weak’ and bad.
Let us know what strength T you’re using so we can see where you are dosage wise
Likely either an increase or just more time and you’ll be fine on injections. It takes me 6-7 weeks to get back to feeling normal when I’ve made changes like that.
Another alternative you could consider IMO is a compounded creme. They absorb much better, no greasy oily feel. They come up to about 10x stronger than gel so you need very little. Usually I tell people they’re stronger but it seems the gel is working fine for you in that regard so a small amount of creme would work fine as well.
I Agree with the compounded cream. He can also look at applying it to somewhere other than his shoulders. The part of his story that is the focus is that 2 months ago he started to feel like he was crashing in the evening. This is a common phenomenon. T ends up modulating many pathways that effect cortisol, progesterone, etc. that play a huge role in our sense of well being and physical function. Switching T administration routes before looking at some of these other issues would seem to just muddy the waters over the next 2 months as he tries to normalize his T levels again.
There’s not a lot of information here to be able to offer advice on protocol decisions, pre-TRT Free T, estrogen and SHBG are critical. If you don’t have these then that would suggest your doctor is a poor choice to manage your TRT protocol.
I have low SHBG (14) and need injections either daily or EOD. A guy with high SHBG, well his needs are a little different. A lot of men are lost going to sick care doctors for TRT especially in HMO’s.
In the beginning of treatment, you will need closer supervision otherwise it’s going to be years before you figure your TRT protocol. Be prepare to seek private care and pay out of pocket unless you want to figure this out on your own.
You can utilize Discount Labs where you can order labs online to check progress.
Thanks for all the responses. It is very much appreciated. The strength of the Testosterone Cypionate is 200mg/ml
Here are the results from my labs from the beginning of October just before I started on the Testosterone Cypionate. I have put in parentheses the results that are (high) based on the guidelines of the Labcorp report
Prostate Specific Ag Serus : 2.3
Total Testosterone: >1500(high)
Free Testosterone: 43.9(high)
Estradiol: 20.8
Estrone, Serum: 51
Hemoglobin: 16.6
Hematocrit: 51.8(high)
Sex Horm Binding Glob, Serum: 32.8
My “tiredness’ in the evenings may not be totally caused by the T gel wearing off. I have a very stressful job, long commute and my baby daughter that wakes up in the middle of the night(almost every night) and thus, I don’t get a lot of sleep. All of the above is just maybe catching up to me eventually in the evenings while I relax on the coach.
Just a few quick responses to some specific question posted above.
My energy levels during the day feels just “okay”. The primarily issue is that I definitely can’t lift as much in the gym now like I used to when I was on the T gel and so I am definitely feeling much weaker in the gym.
I did lower my T gel dosage for a week. I felt like crap(not a good feeling) and thus, I went back to the regular dosage.
My libido is “okay” even when I was on the T-gel and my total testosterone levels were >1,1500 . I don’t get “regular” erections like when I was in my twenties but I do get hard primarily when I “try” to have sex. When I want “rock hard “ erections, I have a prescription for Cialis which works great. I use it only on occasion.
The prescription for the T-gel says it should be applied to the shoulders. Is there another area of the body where I could apply it and get the same results?
Sleep is key. I’ve found I need more sleep on TRT than I did before TRT. I used to be able to get away with 6 hours but on TRT I need the full 8-9 hours or I feel like blah. I know that doesn’t answer any of your questions or tell you anything you don’t already know.
I definitely need more sleep. Right now, how much sleep I get is usually dependent upon my daughter’s sleep habit. She like to wake up “early” on a Saturday morning when I try to catch up.
BTW, how often do folks here change needles? I got 2 sets of needles with my prescription. Large needles to draw the Testosterone out of the bottle and a smaller needles for injections.
I draw and shoot with the same 28g 1/2 inch needle 1CC insulin syringe. The switching needle shit wastes too much for me. Plus 100 syringes is like $17. I use them 2 or 3 times before I throw away.