Hi folks, great forum! Please bear with me…
I started TRT on 3/6/14, based on a total T result of 158ng/dl (low but within range LH and FSH, MRI ruled out pituitary tumor) and intense feelings of fatigue, insomnia, brain fog, depression, and anxiety; 200mg every 2 weeks of testosterone cypionate. A month later I dropped to 100mg per week, and started to notice that although all my symptoms were getting better, including my fatigue and brain fog, I was feeling closest to normal 1-2 days before my next injection.
Around this time I was also sleeping (overall) longer �¢�?�? from 6-7 hours to 8 or so �¢�?�? and decided to lower my 12.5mg Ambien CR to 10mg Ambien.
Things truck on for a few more weeks, and then I took my usual 100mg shot and BOOM, I experienced a surge of energy (no fatigue) and mental clarity, but also higher pulse (from ~60 to over 70 bpm), higher blood pressure (up to 140/85), felt a little jittery and anxious, looked like the incredible hulk during my workout that day, and didn�¢�?�?t sleep at all that night (and still felt good until around 2pm the following day).
This was a drastic change to my previously still lingering fatigue. All these symptoms went down within a day or two, but since then my fatigue turned more into sleepiness (more yawning, tired eyes) and worse insomnia, to the point that I�¢�?�?m sleeping around 5-6 hours a night. (I had a sleep study done a few months before TRT and no sleep apnea.) At around 3 days before this last 100mg shot, I started taking 50mg Zinc per night, but stopped after this happened.
I remember the inability to sleep that night after my last 100mg shot was very similar to the wide-awake feeling I had when I was going through a shitload of stress last August and had insomnia (during this time I was also experiencing iatrogenic hyperthyroidism, given that I was on 50mcgs of levothyroxine and my FT4 level ran at 1.73, which was .03 above the lab cutoff, but still lower than other cutoffs I�¢�?�?ve seen).
A week later my lab results come back (taken on day 6):
TT = 658ng/dl,
Free T = 10.7 ng/dl,
SHBG = 52 nmol/l,
E2 = 32pg/ml
(everything was fine on my CMP)
I talked to my doc about the energized feeling, and he mentioned increases in cortisol/adrenaline and possibly thyroid, but didn�¢�?�?t do a damn thing to test either, nor did he bring up the SHBG or low free T, and he didn�¢�?�?t think I was aromatizing, even though I showed him an E2 level I had pulled a few weeks before on day 2 at 42pg/ml. So now I�¢�?�?m looking for a new doc.
In an effort to reduce the chance of that rush happening again, I started injecting 40mg E3D (did my second injection yesterday), and so far I�¢�?�?m noticing very little bloat, my appetite is back to normal pre-TRT levels (thank God), pulse still goes up to ~70 until maybe the day of my shot, blood pressure is better (~128/65), but still sleep problems, sleepiness and just a little fatigue during half the following day, and I�¢�?�?m also having softer erections/difficulty maintaining despite plenty of sexual thoughts.
So something happened on that last 100mg shot, where I went from feeling fatigued with brain fog to less fatigue and brain fog , more sleepiness, insomnia, and ED problems. I also notice I�¢�?�?m feeling hot at night every few days (the last 3 or so have been fine).
I�¢�?�?m sure I was aromatizing at less frequent and higher doses of cyp, given that my E2 was 42pg/ml on day two of a 100mg shot, and (over a week later) 32pg/ml on day six; I was probably at least 50-60pg/ml a few days after I was doing 200mg shots. Maybe I�¢�?�?m still aromatizing too much now?
I�¢�?�?m paying out of pocket for a few tests this week, and will start experimenting with supplements based on the results while I�¢�?�?m looking for a new doc. My skin has been good (not as oily as with higher doses), so could this rule out high DHT?
I�¢�?�?m planning on getting DHEA-S (which I hear is a good gauge of cortisol, given that that DHEA is inversely related to it), E2, Zinc (to make sure I won�¢�?�?t be overdoing it with supplementation if E2 is above 30), free and total T, TSH, and if things come back fine I�¢�?�?ll get a cortisol test (either 4x saliva or 24 hour urine). I�¢�?�?m also planning on supplementing to bring down my SHBG, so any recs on that would be welcome.
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Any thoughts on the insomnia, sleepiness, and ED change after my last 100mg shot? IÃ?¢Ã??Ã??m guessing itÃ?¢Ã??Ã??s either slowly rising E2 levels, thyroid, or cortisol. My skin has been overall better (less oily) in the last few weeks, so would this reasonably mean that conversion to extra DHT is out of the question? Maybe I’m just being impatient (only on week 9 of treatment)?
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What day would be best for blood testing on an E3D schedule with high SHBG?
Thanks!