Years in on TRT and now feel awful, no sleep etc, is it SHBG?

Pharma / TRT
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Next month will be 4 years on TRT. Started at 140mg split 3 times a week and moved to 40mg eod test c (averages 140mg a week), this year I’ve felt more uneasy, and between different brands (padagis, then really Crappy crystallized Wilshire, followed by Alvogen now for 8-9 weeks). I went to daily injections last Monday, 20mg a day with 28g 1/2 in VG the way I’ve done it for years. I’m Sure sometimes it’s poorly absorbed and sometimes it’s right in the muscle. It’s hard because I’m getting bruises and lumpy tissue pretty quickly now.

My SHBG has gone down from 20’s, to 20, to 17.7 to 16.xx to 15.7 over time.

For weeks now I am having severe myclonus, sleep jolts when dozing off. I thought initially it was systemic effect of dexamethasone in some eye drops I was having to take on high dose, but it was coinciding with being on the Alvogen for 5 weeks at that point . I can get to the point where I’m sleeping 1-4 hours of completely broken Up sleep for days, and nothing will take me out but trazadone. Trazadone in of itself, much like being severely sleep deprived for weeks makes me flat mood and suicidal, so I can’t rely on it. Melatonin makee me jolt worse and feel like complete garbage the next day, so does Benadryl etc. magnesium theronate at night seems to cause anxiety, so have been trying to use magnesium Taurate in the AM instead.

I was able to fall asleep two Nights in a row naturally, but can’t tonight once again, and I was completely mopped when I got home from work and tried to sleep an hour on couch and body was jolting and fighting then. Now I can’t even come close to sleeping and my life is falling apart.

Recent bloods on 5/27/25, doing my typical 40mg eod on day of injection but before injecting are posted. This is as low as I can get hematocrit, about 27 days post donation and hydrated to the gills. Ferritin was still way down there after donating.

Previous results back in Feb were total Test 608( 264-920’s) free t 24.99, e2 sensitive 25.9, SHBG was 16.xx, back in feb it was 774 total, free t 30.34, e2 was 35.1.

Not sure if more free floating androgens with shbg continuing down over time is the issue or what, but I feel fucking awful. Random bouts of anxiety that cause tense traps, back, legs, when that happens there is nothing you can do.

I’ve had way higher test levels than this and was fine. I am at a loss and driving all of My close ones away, because I’m Losing my mind at all hours. I don’t do drugs, don’t drink, have massively turned down the Gym in the last few weeks because I can’t take it, I barely do caffeine but had to on Thursday/Friday last week (a Mountain Dew one day and and an RC the next day), no pre workout bullshit. I do Take tadalafil and it seems to play a role, but can’t figure it out because of the long half life.

I’m not new to TRT, my body just doesn’t seem to handle testosterone at this point. Being unable to hold eyes open and function, while simultaneously being unable to doze off for hours and hours, across weeks is pure torture. I am close to ending it, at least my mom would get some money. I refuse to live like this. I am losing interest in EVERYTHING.

TRT eliminated mild core anxiety for me originally, but has given me a litany of side effects over the years, and this is too fucking much. I don’t have the reserves in my sleep life to keep dealing with this, and need to be able to function at work. I dozed off and on for hours driving back 470
Miles from a meeting week before last, and don’t remember how I got home
Through most of it.

I should be getting up in less than two
Hours but haven’t gone to sleep. My day is ruined again and the anxiety when I try to doze off is killing me. Breathing techniques and meditation are making it worse.

Could just be this brand of test,
Or maybe tadalafil is giving me issues. I added it back for first time in days yesterday

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How do you know that it’s TRT-related insomnia? Could be a ton of different factors, correct?

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I had exactly the same symptoms you are reporting. The only way I was able to resolve this problem was to completely stop using testosterone.

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This isn’t regular insomnia. It’s pure torture and agony. I mean, cannot hold
Eyes open, but cannot doze off, and after days and days of getting barely any sleep, I still can’t fall out. Was up 40 something hours a couple of weeks ago, and could not go down for the count. Insomnia is people
Not getting tired and therefor being unable to sleep, I am TIRED AND READY TO DROP

I switched to daily injections Monday of last week, stopped doing them after Monday of this week, took two days off (so coming off of 20mg being last injection vs 40mg when doing EOD, so smaller peak and quicker fall off) and was able to sleep more easily. Injected 35mg on Thursday as daily is most certainly not going to work at probably any dose for me, and figured I’ll just adjust my overall weekly dose down from 140mg to 122mg, and by last night, unable to sleep, violent jerks and jolting, brain runs wide open suddenly when trying to sleep.

Went to bed at 4 something AM finally (this will NOT work during the week) and woke right back up a little after 7 unable to sleep, body just keeps revving up as I try to doze off no matter how tired I am, and it’s a weird gross anxiety feeling.

I can’t handle any testosterone right now, so either it’s the Alvogen brand, or I just can’t handle anything. Not sure why 15.7 SHBG would be so much worse than 17.7, but it certainly seems like it is.

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But how long were you on? A lot of people have this I. Their first 6 months or year, this has been 4 years.

I don’t think coming off is going to be easy. I still felt like e2 was taking longer to come down than test levels when I stopped taking daily injections for a couple of days. Can’t imagine what would happen if I just stayed off.

If something doesn’t change, I can’t stay on. I am calling all kinds of friends and family at all hours, in hopes that will keep me from killing myself. Gets worse after multiple
Days of it in a row.

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I understand you. I injected it for two years and five months.

At first I had episodes of night sweats and a little restlessness when sleeping, but nothing significant. Sometimes sleep apnea. But in the end I was having exactly the symptoms you describe.

There were days when I didn’t sleep even a minute during the night. And this was accompanied by horrible anxiety. I couldn’t identify exactly what was causing this side effect. But I have some clues.

  • Every time I tried to use AI, I immediately had horrible episodes of insomnia. So desperate that I felt like killing myself to make it stop.

  • I tried using Proviron for a while. At first I felt many positive effects, but after a while I started having these episodes of insomnia too.

  • I noticed that a 1x/w protocol, whether with Cyp, Sus or E, made me have strong anxiety attacks, shortness of breath and my blood pressure and hematocrit went up a lot.

  • So I imagine it may have something to do with E2, but I couldn’t identify it exactly.

The protocol that worked best for me was 125mg/w divided into two injections, Monday and Thursday

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In the end I was using prop, 100mg/w eod. Funny thing is, it was like an instant anxiety injection. Hours after injecting I started having symptoms of anxiety and shortness of breath.

Added to this terrible insomnia, I decided to stop using T completely to see if my life would return to normal. No benefit that TRT provides compensates for this side effect of insomnia. Sleep makes a huge difference in a person’s life. At work, in relationships, everything. It’s destructive.

What I can tell you is that stopping was not as bad as I imagined. And weeks after stopping I already started to notice improvements. It got to the point where it was time to sleep and I was very happy and thought “now I’m going to go to sleep because I can!”. I imagine you understand the seriousness of this…

I currently use ZMA and it seems to have a positive effect on sleep, but it seems to make it harder to wake up.

I recommend that if nothing works, do the test. You can always go back to TRT if you don’t like it.

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Just sitting two days out of the new ED injection pattern had me feeling a lot better, but unable to orgasm when blowing a load by the second day.

What was your SHBG over time?

Also, I actually went on TRT because my sleep was really bad. What I mean by that is, I had a home study in 2019, completely fragmented sleep, no deep sleep at all. Paid out of pocket for in lab study in 2021, zero n3 sleep, neurologist didn’t have an answer. I knew my test levels were declining because of bad sleep, but e2 and free t were single digits and I had enough. Sleep was the only thing I was never able to fix, so I went on t to have more energy, actually stop stalling in the gym, get my edge back at work (outside sales b2b) etc.

The problem is TRT has done zero to improve my sleep, and when I am having these types of episodes out of nowhere, I am completely fucked, because it’s even worse than it ever was. Wrote a suicide letter to all friends and family last week, and stared at my Sig in my hand way too long during one of these.

I know it doesn’t translate through text how fucked up somebody is, but I am not in a good place. I am not sure I could handle the roller coaster of coming off, COMBINED with loss of size/muscle, libido for a long period of time. But I can’t exactly handle what’s happening now

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I think that if you already had problems with insomnia before starting TRT, then maybe the use of T is not really the cause of the insomnia. But I can certainly say that the use of T makes anxiety worse. So you try to sleep, you can’t, you have a horrible day and when it’s time to sleep you start to get anxious because you think you won’t be able to. And this ends up snowballing.

If you don’t intend to stop injecting, then you would have to find out the real cause of the insomnia and treat it. I imagine it has to do with anxiety.

I’ve ended up in the emergency room more than once thinking I was having a heart attack. After tests, it was proven that it was anxiety. It’s something very serious.

I don’t usually reply to posts here, I only read. English is not my native language. But I thought it was very important to reply to you because I’ve been in your shoes before. No one deserves to go through that.

I wish you a speedy recovery.

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I didn’t have insomnia then, I have no restorative state of sleep.

I don’t truly have insomnia now. If you’re actually physically dozing off, it’s technically the opposite of insomnia.

Thanks, it’s a nightmare, but the anxiety is coming from lack of sleep, and gets worse as the sleep deficit gets deeper

I’m glad you were able to get rid of the anxiety!

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Have you tried taking a sleeping pill? Or a benzo?

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That’s not a fix. Won’t do benzos. They are awful.

Trazadone for two days, then nothing, then for a couple of days. Massive fatigue next day and felt grey and flat each time. I’m keeping it on hand for emergencies, but it’s not sustainable. I took it in the 90’s too and it fucked me up

What’s crazy is I can’t tolerate like ANY testosterone right now. Starting to wonder if it’s the brand. Has happened before

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Benzodiazepines are a medicine that is to be used for symptoms like acute heavy bouts of anxiety or insomnia for no longer than 2 weeks. If used properly and not abused they can be extremely helpful.

I wouldn’t limit my options like that if I was in your case and became suicidal due to lack of no sleep.

Also, in your shoes, I would likely just quit the TRT and live with my natural production while getting some sleep.

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I went on TRT because sleep is the only
Thing I have not been able to really fix. T, free t and e2 just kept going down for years, I had no energy, barely a sex drive, no edge, lifting sucked for years but it just kept
Going with it etc.

The problem is TRT has made my sleep worse outside of this no sleep issue,
And of course these types of issues where I can’t sleep are the worst I’ve ever felt in my life.

Benzos and opioids have killed plenty of friends and family members, not an ideal
Choice for me. Also, once I was having a similar issue, unable to
Stay awake or sleep for days and days, I tried an Ativan, it could only put me down for 3 hours. So it was rather useless.

What I find interesting is I stopped injecting again on Thursday (did 35mg in hopes of
Going back to EOD and lowering weekly dose but was trashed again by Friday nihtn)
and while I have been oily and hot, and run down, gym felt great earlier once I finally had energy to leave the house, and orgasm still insanely powerful.

Not sure what this tells me yet. Daily injections of 20mg sucked after a few days,'took 2 days off, felt good, went back to 35mg, felt awful within 38-40 hours, skipped 3 days and feel better.

Not sure what that tells me I should do

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Here I am giving my opinion on your post again. But the fact is that I am really concerned about your situation and I want to be able to help you.

Every time I tried to sleep it was like I had a spasm in my entire body. Each time this happened I would be in a state of alert. This would repeat itself throughout the night.

I would spend the days tired, and when it was time to sleep it would happen again.

I did some research on this and most of what I found points to anxiety. Testosterone is a CNS stimulant, so it certainly aggravates anxiety in those who are predisposed to it.

Now you are saying that you feel great after going a few days without injecting, and you feel terrible after injecting, and you don’t know what that means? I think we all know what that means…

I think that before you started injecting T, the problems you report were due to your lack of quality sleep. This could be affecting your T levels, not the other way around.

TRT can only alleviate the problems that are being caused by low testosterone. If you started injecting and didn’t solve the initial cause of the problem, now you have two problems…

After I stopped injecting, I lost a lot of weight, lost strength in weight training, and noticed a low libido, for sure. But it wasn’t the end of the world. I stopped “cold turkey” and it wasn’t as bad as I thought it would be. And the sleep problem didn’t take long to go away. Now, after 5 months, my T levels are in the 360s, LH and FSH are working well, even without doing PCT. Everything is fine, life is normal.

None of these benefits that TRT can bring you are more valuable than your life.

I really hope you can solve your problem and get better.

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Obviously cannot pin point your issue, but might be able to provide some insight.

Tadalafil definitely lowers my estrogen, and i saw that you said Tadalafil seems to correlate. Maybe you are dropping your e2 too low? Low e2 can cause daytime sleepiness/lethargy. What other supplements are you taking? Any high dose vitamin D? Melatonin regularly? Chamomile tea? All of those lowered my e2.

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I don’t think that’s the case because it’s the outright inability to doze off, like enter dream while half awake but never cross the line to to sleep, followed by a very sharp jolt and body jump to awakening, followed by instant heart rate spike and wave of anxiety. After days of this you can just doze off anywhere.

Last e2 trough was 34.3 on senstive test (8-35).

It’s been higher and it’s been lower with higher total t.

I think e2 is flying up and down because SHBG has left the building and the tadalafil
Being a weak AI is adding to the fluctuation

19

Agreed

In the short term they are totally fine barring maybe Xanax just because it’s so widely abused (and for the life of me I can’t understand why!!!)

In the long term… really should be limited to peoole with schizoaffective disorders and the likes

If op wants a less habit forming short term alternative zopiclone or suvorexant coukd work

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Hi friend, I’ve been on TRT now for just about 5 years 120mg/wk eod dosing and my numbers look similar. May I recommend pregnilonone 25-50mg, trazodone 50mg at bedtime with magnesium glycenate. It works like magic. No benzos no leg jerks or twitching and much calmer.