TRT, Low Energy, Weakness, and dopamine?

[dasein]

I have been on TRT for 8 weeks through Defy. My levels are perfect according to them and according to myself. I can post them, but I dont have time this second. Plus it is somewhat superfluous.

I am experiencing no libido, poor sexual response, no motivation, poor mood, almost apathy, muscle weakness, and lack of energy, to list a few symptoms. Defy says my levels are perfect. My problems arent hormonal.

Anyhow, I am on zoloft, and have been for most of the last ten years. I fully know what to expect on zoloft. It can lower libido and sexual response, but I have never felt the way I do currently before trt. Zoloft never prevent me from crushing workouts, even if it made me somewhat tired at times.

Without stating that it is a dopamine issue, Defy says that I should consider changing to a different medication, such as wellbutrin, because wellbutrin affects dopamine, not serotonin, and os energizing, etc.

I am caught between a rock and a hard place
I have spent close to $2000 on Defy, trt, and related stuff. I want to see the benefits of trt, but I am not seeing the proper results in my current state. I am considering switching to wellbutrin, in a last ditch effort, even though I am reluctant to take a drug that has so many sides?

Any advice? Does anyone have a similar experience? Has anyone seen benefits with wellbutrin? I am going to read more on the trt-dopamine connection. It seems that some people are affected in a similar manner.

I should note that I have never experienced a euphoria from trt. I find it hard to believe that that is even a thing. Since dopamine is invovled in motivation, among other things, I feel like it is a likely culprit. Even so, I dont understand why it would affect me and not others.

[systemlord]

You need to describe your TRT protocol, HCG or AI’s can ruin TRT for those that don’t tolerate HCG or AI’s? If you’re on an AI regardless of levels it’s a drug and drugs have side effects, fatigue being only one of them.

I have crushing fatigue on 0.050 anastrozole, I don’t tolerate AI’s at all. I can only imagine if I didn’t tolerate HCG either and was on both.

Also you could be going through HPTA shutdown which happens after the first couple of week and can last for weeks. Could also be your thyroid is unable to keep pace as testosterone attempts to restore metabolic rates. Zoloft could be working against TRT.

Your levels may be perfect, but are they perfect for you…? My muscles were sore for months in the beginning, energy didn’t come till months later.

Honestly it’s going to be difficult to help you without labs.

Onset of effects of testosterone treatment and time span until maximum effects are achieved

The time-course of the spectrum of effects of testosterone shows considerable variation, probably related to pharmacodynamics of the testosterone preparation. Genomic and non-genomic effects, androgen receptor polymorphism and intracellular steroid metabolism further contribute to such diversity.

[NH_Watts]

[dasein]

@systemlord

You need to describe your TRT protocol, HCG or AI’s … If you’re on an AI regardless of levels it’s a drug and drugs have side effects, fatigue being only one of them.

Fair point. Labs are on bottom.

I am on 80 mg test cypionate, 0.125 mg adex, and 500 ius hcg twice per week. I havent noticed any definite sides from adex, but of course, it is possible.

Defy says that adex can cause anxiety in people who have a history of anxiety. I dont feel like adex causes me anxiety, but I feel anxious if I dont take it at the time of injection. Anyhow, my current issues have less to do with anxiety than with ennui, and sometimes anger or slight depression. I just feel “off.”

I want to discontinue hcg for at least a couple weeks because I am experiencing the issues I mention above, as well as water retension or weight gain in the abdominal region. I feel like my issues could be due to hcg.

[quote=“systemlord, post:2, topic:251846”]
Also you could be going through HPTA shutdown which happens after the first couple of week and can last for weeks. [/quote]

I have been on the protocol for eight weeks. HPTA is totally shut down at this point.

@systemlord

Could also be your thyroid is unable to keep pace as testosterone attempts to restore metabolic rates. Zoloft could be working against TRT.

Could you explain the part about the thyroid? Defy blames zoloft, but I have never experienced the problems I am having now before trt. My periods of greatest clarity have been on zoloft. I find it offensive that Defy would suggest that zoloft is solely to blame and that they had nothing more to offer me.

I dont feel like zoloft is the problem and continuing trt without a mood stabilizer would be unwise, as my mood can be volatile. Zoloft never prevented me from getting a good workout. If anything, it has a greater negative effect on cognition and focus. My dose of 50 mg is not high. I have been on 100 mg or higher before.

Labs were conducted 4 days after prior injection. That means that my trough levels dont even get as low as the levels here, and the levels here are great.

[dasein]

Thank you. My problem is that week after week, I dont feel any better. I dont notice any improvements. I feel like I have to change something, whether it is subbing wellbutrin for zoloft, removing hcg, or something else.

I continue to have issues with mood, energy, and libido, memory, cognition, concentration, slight confusion, difficulty accomplishing simple daily tasks, experiencing weakness, lack of energy and motivation, and I struggle horribly in the gym.

I push myself through workouts and it takes a lot out of me. I feel weaker than prior to trt, even though I may have put on some muscle. Many people apparently think I look bigger. It helps that test makes me more vascular than I already am.

Defy’s lackluster response certainly didnt instill confidence in me. They got the protocol right. Besides that, they dont strike me as the experts people make them out to be. They couldnt give me any kind of clear answer about any my symptoms, my water retension.

During my consult, I was told that men never complain about feeling worse on trt. This wouldnt be the first time, nor the last, that I am treated as an aberration.

[systemlord]

Wow those are amazing labs, it must be some other factor for why you feel the way you do. My money is on the HCG causing the problems, HCG can cause water retention which can affect blood pressure and mood.

It definitely wouldn’t be the first time a guy cut out the HCG and started to feel good. There are some cases where TRT can deplete magnesium and or pregnenolone. A magnesium RBC test is the one you want because serum magnesium can look normal and cell magnesium can be depleted.

Do you have any muscle spasms or twitching?

[hrdlvn]

Hi Dasein,
I am also a defy patient have been for 4 years now.
You blood test is spot on. Those defy docs know their stuff when it comes to looking at pre TRT bloods and working up a protocol.

About feeling better. 8 weeks is not very long. Yes your T cyp has reached steady state but your body has just begining to heal. Your whole endocrine system is flipping out. It is trying to rebalance everything from this new found source of T. You really do need to give your protocol more time.

That said there is nothing wrong with stopping the HCG cold turkey. It will be out of your system in less than a week. Note HCG raises your bodies total E2 and your E2 is borderline low IMO.
If you cut the HCG out cut your anastrozole dose by 50%. Then give everything another 2 weeks to settle and see how you feel.

Now about the zoloft:
Zoloft is a SSRI medication used to treat several conditions. Have you ever googled ssri induced sexual dysfunction. It’s pretty scary and you never know if or when it might hit you.
Some reports say if you get it it might never go away even if you stop.

I’d suggest you drop the HCG/cut the AI in half and see what that does. While you are doing that start researching other drugs to help your mood.

[NH_Watts]

@dasein

My problem is that week after week, I dont feel any better.

8 weeks dude. This takes time and sometimes longer for some individuals.

[highpull]

@dasein

I am on 80 mg test cypionate, 0.125 mg adex, and 500 ius hcg twice per week.

Why did they give you hCG? Unless you are actively trying to conceive, there is no reason to use it starting TRT. If you are concerned with testicular atrophy, some do not experience any or much, you could, even should, take a wait and see approach.

Some need higher doses to obtain desirable results. You want to treat symptoms, not numbers on a lab report. We criticize the mentality of thinking the lower in range levels are normal. Perhaps the higher in range levels won’t cut it for you?

I would look into the possibility of increasing test to 200mg/week and d/c the AI and hCG.

[hrdlvn]

@highpull

Why did they give you hCG? Unless you are actively trying to conceive, there is no reason to use it starting TRT. If you are concerned with testicular atrophy, some do not experience any or much, you could, even should, take a wait and see approach.

For some of us HCG is wonderful. I’m 65 and have been cut since 1985. My pcp had me on T mono and in 3 months my nuts pulled up against my body. I experienced dull aches and short sharp pains. Defy put me on 800iu/wk HCG and in 5 weeks all my issues were gone. I will never go off HCG. My boys are back where they belong swingly freely. I never noticed any size difference on or off.

[highpull]

@hrdlvn

My pcp had me on T mono and in 3 months my nuts pulled up against my body. I experienced dull aches and short sharp pains.

@hrdlvn

My boys are back where they belong swingly freely. I never noticed any size difference on or off.

So, no size difference, but scrotal changes and symptoms? To me, that is justification for trying hCG.

I’m not opposed to it and have used it as well. Some report hCG helps lean them out, probably the increased test.

[dasein]

@systemlord

Do you have any muscle spasms or twitching?

I dont have muscle spasms but I will look into a possible magnesium deficiency. I skipped hcg in my pin last night and I will see if that helps in the coming weeks.

[dasein]

@highpull

Why did they give you hCG?

I am not currently trying to conceive but I want to maintain fertility and size. I know that a lot of guys dont get why I worry about shrinkage but it bothers me. Even with hcg I feel like there is still some atrophy from the HPTA shutdown. Hcg only stimulates the leydig cells, not the sertoli cells, right?

I asked Defy about using clomid in place of hcg, but they say clomid is strictly used for hpta restart.

@highpull

Some need higher doses to obtain desirable results. … We criticize the mentality of thinking the lower in range levels are normal. Perhaps the higher in range levels won’t cut it for you?

I would look into the possibility of increasing test to 200mg/week and d/c the AI and hCG.

Why increase test to 200mg/week? Seems like a high dose. That would put me in the supraphysiologic range, which would be fine as long as I feel good.

[highpull]

@dasein

I want to maintain fertility and size.

Nothing wrong with that.

@dasein

Why increase test to 200mg/week? Seems like a high dose. That would put me in the supraphysiologic range, which would be fine as long as I feel good.

You’re making my point. You were not happy and feeling well in the low physiological range. Why would the high physiological range be OK if you are not happy and feeling well? It’s just a number. Some go as high as 250-300mg per week to get there.

They have a total test of 1500. I take 200mg per week, TT usually around 900, FT around 200. Regardless, I think you should feel something by now, maybe not max results yet, but something. I felt better in two weeks. We’re all different, but if nothing changes you’ll have to change something. Good luck.

[dasein]

@hrdlvn

Note HCG raises your bodies total E2 and your E2 is borderline low IMO.

If you cut the HCG out cut your anastrozole dose by 50%. The give everything another 2 weeks to settle and see how you feel.

I agree that the e2 is borderline low. If possible, I would like to cut out the AI altogether, so that I have less drugs in my system and less side effects to worry about. In order to do that I think I would have to lower my dose of test.

@hrdlvn

Now about the zoloft:
Zoloft is a SSRI medication used to treat several conditions. Have you ever googled ssri induced sexual dysfunction. It’s pretty scary and you never know if or when it might hit you.
Some reports say if you get it it might never go away even if you stop.

I havent googled it, but I will. My current problem has less to do with sexual response than mood, energy, and libido. I just feel apathetic and I have no interest in sex. I assume by sexual dysfunction you mean ED?

[highpull]

@hrdlvn

Now about the zoloft:
Zoloft is a SSRI medication used to treat several conditions. Have you ever googled ssri induced sexual dysfunction. It’s pretty scary and you never know if or when it might hit you.
Some reports say if you get it it might never go away even if you stop.

With some patients on SSRIs, TRT just can’t overcome the SSRI med.

[hrdlvn]

@dasein

I havent googled it, but I will. My current problem has less to do with sexual response than mood, energy, and libido. I just feel apathetic and I have no interest in sex. I assume by sexual dysfunction you mean ED?

No as I understand it you lose penile sensitivity and the ability to climax. Now that would be something to be depressed about.
Post-SSRI Sexual Dysfunction
Close to 100% of people who take antidepressants experience some form of sexual side effects.

Most people who take a selective serotonin reuptake inhibitor (SSRI), a serotonin-norepinephrine reuptake inhibitor (SNRI), and some tricyclic antidepressants (clomipramine and imipramine) will feel some degree of genital numbing, often within 30 minutes of taking the first dose.

Commonly used SSRIs include paroxetine (Paxil, Seroxat), fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro), and vortioxetine (Trintellix).

Common SNRIs include venlafaxine (Effexor), desvenlafaxine (Pristiq) and duloxetine (Cymbalta).
The whole article Post-SSRI Sexual Dysfunction - RxISK

[stepbystep]

Dasien, I have been on various forms of TRT/HRT for about 14 months now. I’ve been with Defy since August.

At the end of December I decided to get off of TRT as I share many of the same problems that you do. TRT has made me feel worse. ED is worse, low libido, fatigue, and what I would describe as emotional flatness. Thousands of dollars gone, and I’m worse off than when I started. Currently on Clomid for a restart, then I’ll do some tests, possibly stay on Clomid if I feel good. But the plan is to go back to baseline for several months and pull extremely comprehensive labs and get a better look at what’s going on.

Please keep this thread alive and be sure to check in from time to time.

There are nurotransmitter tests available by the way, although I believe they only check for the metabolites and there’s little consensus on what the results really mean.

[enackers]

I’ll share my experience. I cut out HCG 6 days or so ago. I was thinking the same thing. I’ve been on this for 5-6 weeks and my numbers were perfect. 1280 total, 27 free t and 27 e2… something has to give. Then I was told to drop hcg and see how I feel… 4 or 5 days after dropping hcg I started getting erections again, nipple sensitivity isn’t as pronounced, and I feel much better…

It makes sense to try one medication at a time. Otherwise shooting in the dark missing the target.

[dasein]

@stepbystep

I share many of the same problems that you do. TRT has made me feel worse. ED is worse, low libido, fatigue, and what I would describe as emotional flatness

I feel for you. That is my predicament. I am so bummed I am considering doing a restart, but it seems like most people say I havent been on it long enough, or hcg or adex are giving me sides, or, as Defy says, zoloft is to blame. Were you on any antidepressants?

It is hard to feel lousy day after day. I pinned last night and feel worse today than before I pinned yesterday. I dont feel like working out but I will force myself to go and take a shitload of preworkout, not that it helps much.