Hello T-Nation! I’m new here and I desperately need some TRT guidance. I’m a 27 yr old male, been on TRT for about 20 months now and I’m MISERABLE!!! It took almost a year for me to get dialed in and in May this year, I got my blood work done and it showed:
TT: 918
FT: 19
Estradiol: 83!!
Since E was a little high, doc prescribed Arimidex (.5 tab 48 hours after injection once a week for 6 weeks) and lowered my dose 10mg (270mg to 260mg). Doc guaranteed that should do the trick and said we’ll test again in 6 weeks. TT dropped to 622 but E dropped to 22 but I still felt like crap! Doc upped my dose to 280mg and I laid off the Arimidex. Tested another 6 weeks later and E was still 22 but my TT dropped even FURTHER to 317! What the he’ll is going on?! Doc doesn’t even know. His recommendation is up my dose to 320mg of test cypionate (I get once a week injections). We’ll test again in 6 weeks but I’m so tired of this trial and error crap. I’m so miserable low energy, no libido, lost confidence, lost muscle mass this is horrible! So many questions, will this 320mg dose bounce me back fast? Since my E is low, should I take arimidex? If so how much and when? I know most of you will say split my dose but I can’t. It’s already a hassle getting to the clinic once a week so I need to know how to make this work best! Please help!!
So you were feeling great and started taking an AI?
83 was the the sensitive test?
Either way you can not chase numbers. Ratio matters with testosterone:e2
How do you feel for the first couple of days post injection? What is SHBG? If your SHBG is decreasing, which is very possible after being on TRT for a while, it would explain your TT levels dropping, especially if you are getting blood drawn at trough.
No AI.
As far as strength, muscle mass and confidence yeah I felt like a beast! I was experiencing some ED and my Doc said it was because E was high and had me take AI for 6 weeks. I’m not sure if it was a combination of things but I feel like ever since I took the AI, I’ve been all out of wack. So I don’t know.
A few months ago the first few days post injection, I felt HUGE! Muscles were full and was super confident. Lately, I feel miserable all week long (no energy, no confidence, ED, etc)
My SHBG is at 15.81. When you say no AI are you saying I should stop taking it? My current dose since my most recent lab draw last week has been 320mg cypionate once a week. Doc thinks I should take .5 tab once a week to keep down E conversion but my E is at 22 right now
I take that to mean you are not yet taking an AI and your E2 is 22 right now.
Yes, not taking an AI and E2 is 22 currently. I was, which got my E2 down from 83 to 22 but stopped taking it since. The AI seems to have dropped my TT also. So now I’m on this new dose of cypionate 320mg. Will it get me feeling better ASAP? I’ve been on this new dose since last Thursday
Oh all of a sudden I have insomnia! For the last month I haven’t been able to stay asleep and I feel that may have something to do with my TT and FT. Bought some over the counter sleep aid today…hope it helps.
At 320mg/week, your E2 will elevate and eventually get back up there. I think you should decrease the dose and go to twice a week injections, so your test level will not drop so much.
Your SHBG is low and you should be injecting T daily or every other day with everyday being the biggest chance for sucess. Low SHBG men need frequent dosing since you’re unable to hold onto testosterone for long. You hyper excrete testosterone into your urine so frequent dosing is a must!
These massive doses of Test will drive estrogen sky high, your E2 is sky high because your T dose is sky high, smaller more frequent injections = lower estrogen.
Most men quit TRT do to doctors being TRT ignorant, all my endo’s had no clue or how this TRT game is played and was force to go private. This doctor isn’t going to be able to help you, he’s doing everything wrong. It doesn’t matter what this doctor does, it will always end badly.
I seriously doubt he’s even using the correct LC/MS/MS estrogen test for men, probably using the standard E2 test for females.
I inject 20mg every other day do to my low SHBG (16 nmol/L). Each time I move my injections closer together and lower the dosage, estrogen is more controlled even with similar Total T scores.
Systemlord is correct, lwatt, mine is 15 and I pin 17mg EVERY DAY for a total of 120mg a week. Trying to up it on next visit to 150mg a week and will then pin 22mg EVERY DAY.
It’s already a pain to get to the clinic once a week I can’t go twice. What’s the best way to make once a week work? My doc said the 320mg dose is just to get my T back in the 600-700 range quickly then he will decrease. Its only been a week, how fast will my E2 shoot up? Should I take an AI post injection or not since my E2 is low normal and my SHBG is 15?
systemlord, appreciate your response (thank you all!) Why is my SHBG low? Does it vary person to person? You reminded me, when you say hype excrete the Test, my doc did say my body was “burning through the Test”…same thing? He said my insomnia could be the reason for my dramatic decrease in TT and Free T.
918 to 317 and 19 to 9
I don’t have the ability to dose daily. What’s the best way to make once a week injections work? I just want to feel better.
Will the doctor let you self inject? In your case, there is no way to make once a week injections work. Your test will shoot up quickly with 320mg, and it will decrease just as quickly with your SHBG in the teens.
Ask your doctor, if he thinks 320mg/wk will get you into the 600-700 range, why it will stay in that range when you decrease the dose.
Regarding E2, it will ramp up there with that protocol, more frequent injections would be better for this too. If I were you, I would take 100mg test every 3.5 days, observe symptoms, check labs in six weeks and go from there. You may need to go with more frequent (eod) dosing, but you don’t know that yet. If the doctor will not let you self inject, you will need to find someone else who will work with you. Right now, what you know for sure, is that your current protocol is not working. You have to try something different.
Really appreciate you. No my current doctor won’t allow self injections so I guess I’ll have to find another doc. Are injections the best route for TRT?
Is there a way I can increase my SHBG? Once a week injections were working ok then just crashed
I will try split dosing, 160mg every 3 days, starting this week if my clinic will allow it. Will I need an AI? Should I feel better fast with this protocol?
It sounds like your current doctor is unknowingly sabotaging your recovery by insisting on a ridiculous infrequent injection schedule that doesn’t sit well given your SHBG level. Most doctors are extremely ignorant when it comes to TRT.
I don’t know why you keep insisting on the massive doses, 160mg every 3 days is insane for a low SHBG guy. You need to leave this clinic, these TRT clinics are the worst because they inconvenience you by forcing you to come in for your injections.
Low thyroid function can be a reason for low SHBG, these clinics don’t usually staff competent doctors to be able to diagnose complex medical conditions.
Perhaps we are focusing too much on your testosterone and that is because TRT can drive SHBG down. How is your thyroid doing? Thyroid hormones can increase SHBG. Do you know your E2 level prior to TRT? What is your height and weight? Glucose levels? Low fat diets can increase SHBG and reverse prediabetes. Sleep apnea? Heavy exercise, losing weight and cleaning up your liver may help.
Yes the docs at the clinic I go to now are very careless with TRT treatment. They’re think higher dose, better result and high T. Simpletons. If am at least able to do twice a week dosing, what dose would you recommend given my symptoms for fastest recovery?
After awhile this clinic is going to wonder why people don’t return for services, what they are doing is attempting to sell the most drugs possible to turn a profit without a care in the world for their patients.
The reason why they have you come in once weekly for your injection is because this is how they pay the nurses, administering the injection. How the nurses get paid is NOT your problem.