First speed bump with my testosterone replacement therapy (TRT) regimen!

[Spunkey71]

First speed bump with my TRT regimen!

Well everyone has warned me and I experienced it first hand yesterday, the TRT crash is no joke!

I have been on TRT for four full weeks now and I always felt a little less than perfect on Mondays but yesterday it was extreme. Even though I did not feel 100% yesterday it was shoulder day and I hit the weights hard and I can not even begin to explain what happened. It was almost like an intense leg day, I wore myself out to the point that I threw up after my workout and almost needed help getting to my car afterwords.

Once getting to my car I sat there for 30 minutes before I was able to drive myself home, although it was only 7 miles to my house it felt like 70. I got home and completely crashed, I passed out on the couch and didn't wake up until 7:30 this morning (12 hours). I go in today for my injection and I am telling my doctor flat out that either he allows me to do bi-weekly injections or I am going to find another doctor.

 

[tiredguy]

Well everyone has warned me and I experienced it first hand yesterday, the TRT crash is no joke!

I have been on TRT for four full weeks now and I always felt a little less than perfect on Mondays but yesterday it was extreme. Even though I did not feel 100% yesterday it was shoulder day and I hit the weights hard and I can not even begin to explain what happened. It was almost like an intense leg day, I wore myself out to the point that I threw up after my workout and almost needed help getting to my car afterwords.

Once getting to my car I sat there for 30 minutes before I was able to drive myself home, although it was only 7 miles to my house it felt like 70. I got home and completely crashed, I passed out on the couch and didn't wake up until 7:30 this morning (12 hours). I go in today for my injection and I am telling my doctor flat out that either he allows me to do bi-weekly injections or I am going to find another doctor.

how often are you injecting now? 1 time / wk? crashing on the last day before injection?

 

[Spunkey71]

how often are you injecting now? 1 time / wk? crashing on the last day before injection?

Yes sir, I spoke with my doctor about it today and we also reviewd my labs....

He said my Estradiol is way too high, 37.3 on a range of 7.6-42.6, he said that he wants to get that in the low 20's before going to a twice a week injection schedule. We are going to try increasing my Aromatase inhibitor (AI) from .5mg a week to 1mg a week.


I am not completely happy with his answer but he is a good doctor and really has my interest at heart and wants to see me get my life back so I will go along for now.

 

[Megatron28]

Yes sir, I spoke with my doctor about it today and we also reviewd my labs....

He said my Estradiol is way too high, 37.3 on a range of 7.6-42.6, he said that he wants to get that in the low 20's before going to a twice a week injection schedule. We are going to try increasing my Aromatase inhibitor (AI) from .5mg a week to 1mg a week.

I am not completely happy with his answer but he is a good doctor and really has my interest at heart and wants to see me get my life back so I will go along for now.

I promise you this. If you keep everything the same except for injecting twice a week instead of once a week that your E2 will be lower. That is a far better choice than taking more AI.

And for what it is worth, E2 of 37 is not way too high. Most guys are happy in the 20-40 range.

I would push him on this.

 

[Spunkey71]

I promise you this. If you keep everything the same except for injecting twice a week instead of once a week that your E2 will be lower. That is a far better choice than taking more AI.

And for what it is worth, E2 of 37 is not way too high. Most guys are happy in the 20-40 range.

I would push him on this.

I plan too, he is very reluctant but did say that we could do it if I continue to have crashes, it just is not part of their treatment protocol. I did forget to mention that they increased my weekly dosage from 160mg to 180mg a week starting last week, the blood had been drawn prier to the injection, that is part of the reason for the increase from .5mg to 1mg of AI.

I had a question for you Megatron28, my SHBG came back at 17.5 on a scale of 16.5-55.9, that is right at the low end, is that something that I should be concerned with?

 

[cruiser1019]

Mega is correct. The more frequent the injections the less likely the need for an Aromatase inhibitor (AI). Also as Mega said that E2 is not really a big deal. In my protocol I inject 125mg/5days & dont need an AI.

Basically you want a lower SHBG so you have more test available for use in the body.

Test in the body is bound to SHBG. Only a very small fraction of about 1-2% is unbound, or "free," and thus biologically active and able to enter a cell and activate its receptor. SHBG inhibits the function of these hormones. Thus, bioavailability of sex hormones is influenced by the level of SHBG. (grabbed this from Wiki)

 

[Spunkey71]

Mega is correct. The more fequent the injections the less likely the need for an Aromatase inhibitor (AI). Also as Mega said that E2 is not really a big deal. In my protocol I inject 125mg/5days & dont need an AI.

Basically you want a lower SHBG so you have more test available for use in the body.

Test in the body is bound to SHBG. Only a very small fraction of about 1-2% is unbound, or "free," and thus biologically active and able to enter a cell and activate its receptor. SHBG inhibits the function of these hormones. Thus, bioavailability of sex hormones is influenced by the level of SHBG. (grabbed this from Wiki)

Thanks so what you are saying is that having a SHBG of 17.5 on a scale of 16.5-55.9 is a good thing, I beleive my Free T level was at 700 which was a big increase from when I started. My T Level is only 250 but that is up from 64 from three weeks prier when I started treatment.

I agree that twice a week is ideal, my doctor is a specialist (a Low T Clinic) and my insurance covers everything, I only pay a $10 co-pay every week so I am fearful of jumping ship so quickly. I have considered sourcing a vile of Test C and supplementing myself with a second injection of 40-50mg 3 1/2 days after the first just to keep my levels more consistent and avoiding the crash.

 

[300winmag]

I wouldn't say your E is way to high either. Typically they like to see 10-1 ratio of T to E or close to it. Its possible maybe you are crushing your E way to low. I was a 54 on that scale tried an Aromatase inhibitor (AI) and it crushed me. But like others have said 20-40 is optimal. I had the same problem as you I crashed on day 6, could start feeling it on day 5 late in the day. I went to every six days and am fine now.

Really you don't need the docs permission to do bi-weekly, go to walmart or online and buy extra needles he will never know the difference. Unless hes still injecting you, and after the first 1-2 times you shouldn't be going in for that anyways unless your to freaked out by it or the doctor is trying to garner more business.

 

[Spunkey71]

I wouldn't say your E is way to high either. Typically they like to see 10-1 ratio of T to E or close to it. Its possible maybe you are crushing your E way to low. I was a 54 on that scale tried an Aromatase inhibitor (AI) and it crushed me. But like others have said 20-40 is optimal. I had the same problem as you I crashed on day 6, could start feeling it on day 5 late in the day. I went to every six days and am fine now.

Really you don't need the docs permission to do bi-weekly, go to walmart or online and buy extra needles he will never know the difference. Unless hes still injecting you, and after the first 1-2 times you shouldn't be going in for that anyways unless your to freaked out by it or the doctor is trying to garner more business.

Yeah my doctor will only write a script for cream, but for the injections I have to go in to get them, that is why I have considered sourcing a vile of Test C and supplementing myself. I really like my doctor, very easy to talk to and the office is 2 miles from work so it is easy to pop in and get my injection, usually in and out in 15 minutes. I know I can try and find another doctor but I just am not at that point yet, sourcing a vile of Test C is just easier.

 

[fit2beking]

Yeah my doctor will only write a script for cream, but for the injections I have to go in to get them, that is why I have considered sourcing a vile of Test C and supplementing myself. I really like my doctor, very easy to talk to and the office is 2 miles from work so it is easy to pop in and get my injection, usually in and out in 15 minutes. I know I can try and find another doctor but I just am not at that point yet, sourcing a vile of Test C is just easier.

It is so much easier to wake up get my shower and let my wife pin me or pin myself. Since you are going to be sourcing a vial yourself you may as well pin it all yourself. Just my .02

 

[Spunkey71]

It is so much easier to wake up get my shower and let my wife pin me or pin myself. Since you are going to be sourcing a vial yourself you may as well pin it all yourself. Just my .02

You are probably right, I am a little scared to be honest, still trying to get my head around sourcing (one never knows exactly what they are going to get). I also have to admit I like that fact that labs and everything are done on a regular basis and that I have a doctor overseeing my treatment and that it only costs me $40 a month. I think I will stay with my doctor and just supplement, just need to get over my fear and source.

 

[fit2beking]

You are probably right, I am a little scared to be honest, still trying to get my head around sourcing (one never knows exactly what they are going to get). I also have to admit I like that fact that labs and everything are done on a regular basis and that I have a doctor overseeing my treatment and that it only costs me $40 a month. I think I will stay with my doctor and just supplement, just need to get over my fear and source.

There is always risk concerning the topic. I am sure there are some good people on this board that can point you in the right direction. If you seek you will find...I am fairly new here myself and I rarely post but I read this board and another board that I belong to religiously and you will find what you are looking for...Good luck bro! I can tell you that my health and psychy is so much better since I have been on HRT...I am just like you in that I am trying to get my numbers dialed in and find that sweet spot. We will get there!

 

[Megatron28]

Just tell him self injecting is REALLY important to you. A deal breaker at some point. And find out what needs to happen for you to self inject. Give him the diabetic self injecting analogy. Sounds like you will be fine once you clear that hurdlle.

 

[totalburnout]

Sounds like an estrogen issue.

Your dose and your frequency isn't what is causing the crash if you were at 160mg at 1injection per week. Will 2 injections help with estrogen management? Sure, but what you're describing wasn't an issue that your T dropped too low. After 4 weeks and based on the ester of the T, your T levels were probably at an all time high, during your "crash". I'd be willing to bet that your E2 level was at an all time high, as well, if you're not taking an AI.

As for the person that said E2 isn't a big deal - speak for yourself. Anything over 120mg T per week and I need to take a significant amount of Aromatase inhibitor (AI) to manage estrogen. Anything under 120mg T per week and I don't feel the positive effects of TRT.

Everyone differs, but I feel much, much better with about 160mg T (split into 2 injections) and a hefty dose of Aromatase inhibitor (AI) (2mg/week, split up into .5mg taken with hCG injection, .5mg taken with T injection - repeat twice per week).

 

[cruiser1019]

E2 at 37 is no big deal. I've seen guys in the 800's.

 

[totalburnout]

E2 at 37 is no big deal. I've seen guys in the 800's.

Again, it's all relative. For starters, we don't know what estradiol test was performed - whether it was the sensitive assay or the standard test. If it's the sensitive assay - he may have issues. Some of us perform well with super low estrogen, some of us perform better at higher estrogen. Its irresponsible to say that this couldn't possibly be an estrogen issue and that it's no big deal without having at least a starting point and having his most recent labs.

After reading some more - it looks like he actually is on an Aromatase inhibitor (AI) - which I originally thought he said he wasn't.

So lets take a look at what the variables in his protocol. The T isn't dropping - it's increasing over time until he reaches saturation. If he's maintaining a consistent dose of T and a consistent dose of Aromatase inhibitor (AI), then his estrogen won't be dropping. So then what's the most likely change that he experienced? You got it, his estrogen increasing and his T increasing. I'd start by looking there before I get into some fancy, over complicated issue.

On the flip side of the coin, if he changed something with his Aromatase inhibitor (AI), like taking it later in the week or increasing to more than he had previously used, he very well may be experiencing low E2 symptoms rather than high E2 symptoms.

We absolutely need more information, but pulling E2 off the table as the issue right now is foolish. 9 out of 10 times, I've found the issue does correlate directly back to estrogen.

 

[Spunkey71]

I think I am very sensative to Estrogen, my doctor tells me to take my Aromatase inhibitor (AI) dose two days after my injection however the directions on the prescription bottle says to take it the day of the injection. I split the difference and I take it 24 hours after my injection...

I don't now but after my first testosterone replacement therapy (TRT) injection I had pufffy and itchy nips, I mentioned this to my doctor and he prescribed me the Aromatase inhibitor (AI). I am still having major issues with bloating, it is really causing me issues!

 

[cruiser1019]

I'm very estro sensitive myself. I had issues with gyno ect... I was taking 1mg Adex the day after my inject of 125mg/5days & managed to tank my estro to 6. After months at this low level I suffered with joint pain & tendonitis. I do not take an Aromatase inhibitor (AI) at my testosterone replacement therapy (TRT) dose anymore.

 

[Megatron28]

I think I am very sensative to Estrogen, my doctor tells me to take my Aromatase inhibitor (AI) dose two days after my injection however the directions on the prescription bottle says to take it the day of the injection. I split the difference and I take it 24 hours after my injection...

I don't now but after my first testosterone replacement therapy (TRT) injection I had pufffy and itchy nips, I mentioned this to my doctor and he prescribed me the Aromatase inhibitor (AI). I am still having major issues with bloating, it is really causing me issues!

Based on the dose you are taking, I am going to assume you are using Arimidex (Anastrozole). It has a half life of about 48 hours. I would take it at the same time as you inject your T. You don't want the E2 to get a foot hold. And I can't remember, but if you are only taking Aromatase inhibitor (AI) once a week, you should split you dose and take it twice a week.

 

[Spunkey71]

Based on the dose you are taking, I am going to assume you are using Arimidex (Anastrozole). It has a half life of about 48 hours. I would take it at the same time as you inject your T. You don't want the E2 to get a foot hold. And I can't remember, but if you are only taking Aromatase inhibitor (AI) once a week, you should split you dose and take it twice a week.

As always thanks for the info Megatron!