New to TRT: Need Some Urgent Help

[tww11]

Hello,

I really need some help trying to figure this out! I'm sorry if this is long. I just recently started testosterone replacement therapy (TRT) after having low testosterone for years. I finally reached a breaking point when my work schedule had me working 10hr days and I wasn't able to recover from the long work days and my workout schedule along with all the stress from having a family etc.. I decided to get some tests for testosterone and the first one came back at 138 ng/dl. The second test came back at 260 ng/dl and that was after three days of rest. I got so weak I couldn't hardly do anything. I started testosterone replacement therapy (TRT) about a month ago starting at 100mg/wk taken in two weekly IM injections of 50mg. The first shot seemed to work wonders. I started to have more energy, but by the second shot things were going down hill quickly. I was feeling terrible with brain fog, rapid heart rate, anxiety etc.. Every shot brought the same symptoms. I didn't really understand what was going on because I had my E2 tested with the sensitive test and it came back at 8 pg/ml which I thought was low and didn't need attention. I went through this for a week or so and then I had to drop my dosages way down almost to nothing and I really thought I was going to lose my mind with all of this.

What happened is that no matter what dosage I took, whether it was 50mg or 5mg, I had this terrible reaction within minutes I had severe brain fog, my legs felt heavy like I'm carrying around weights on my legs, puffy nips, and I just felt incredibly bad mentally. This was not in my head. This was a true reaction to the shot. I decided one day to take an Aromatase inhibitor (AI) when these symptoms started. I took .5mg of anastrozole and the symptoms mostly disappeared within 30 minutes! I couldn't believe it. I had my E2 tested again and again it said 8pg/ml. So, I decided to get it tested another time when I started to have these symptoms and when I got my results back my E2 had risen to 10 pg/ml. I took some anastrozole after the blood test and immediately felt better.

I'm slowly ramping back up to the 100mg and taking some anastrozole immediately after each shot to stop this reaction. What the hell is going on inside my body? I never thought E2 could spike that fast and hard and have that bad of an effect on my body and mind. I'd love to hear some of your thoughts on what's going on. Is it that my T/E ratio is just bad right now? Is 10 pg/ml a high E2? Other people seem to have this problem weeks into treatment, not with the first couple of shots. I've run many tests on all my other hormones etc.. and everything is within a normal range. Please help.

 

[Megatron28]

What kind of test are you taking? Is it doctor prescribed? Are you getting from a pharmacy? Where do you live?

Same with the anastrozole? Prescribed and from a pharmacy?

Can you post all your labs with the reference ranges?

 

[tww11]

What kind of test are you taking? Is it doctor prescribed? Are you getting from a pharmacy? Where do you live?

Same with the anastrozole? Prescribed and from a pharmacy?

Can you post all your labs with the reference ranges?

Sure no problem. Thanks for the reply. This has been the worst experience I've ever been through and I've had some rough times in my life
1.Test Cypionate
2.Yes, both the test and the anastrozole are doctor prescribed. Mailed from a pharmacy.
3.I live in South Carolina

I'll post what I have for blood work. I know some people have a list a mile long. Mine is not that elaborate. I did also get a CBC panel done and everything came back normal. If I need to add something else that is critical let me know.

Testosterone, Serum 691 ng/dl (348-1197)
Testosterone, Free 16.866 ng/dl (5.00-21.00)
% Free Testosterone 2.44 (1.50-4.20)
Estradiol, Sensitive 10 pg/ml (3-70)
SHBG, Serum 28.1 nmol/L (16.5-55.9)
ACTH, Plasma 16.0 pg/ml (7.2-63.3)

 

[Megatron28]

When was this blood work taken? Before testosterone replacement therapy (TRT)? After? If after, how long after you started? And when relative yo your last injection?

 

[tww11]

When was this blood work taken? Before testosterone replacement therapy (TRT)? After? If after, how long after you started? And when relative yo your last injection?

Stats:
Age:33
Weight:196
Height:5'11"
Bodyfat%: about 17%

This is after starting TRT. Most of it was taken on the 9/20/13. The only thing that is a bit out of date is the testosterone reading. It was taken on 9/11/13, but I know it dropped a lot between then and now because of these side effects I was having. I just recently started ramping the dose back up. Here is my dosing schedule since I started. I know it's all over the place. I was trying to figure out what was going on and it took some time to make the E2 connection.

Aug.30th-50mg-Felt pretty good
Sept.2nd-50mg-Started to feel really horrible
Sept.4th-21mg-took this because I thought I was crashing for some reason or still had low T when in fact my E2 was probably rising. Felt horrible.
Sept.6th-33mg-again felt like maybe I was low on T so I took another shot, but my symptoms didn't get better
Sept.10th-5.25mg-Felt horrible after shot
Sept.13th-5.25mg-Felt horrible after shot
Sept.15th-5.25mg-Felt horrible, but took .5mg arimidex and started to feel better almost immediately
Sept.17th-5.25mg-Felt ok, pretty close to normal
Sept.19th-10.5-Felt horrible after shot
Sept.20th-7mg- took a shot to try and spike E2 and get blood tested. Results came back at 10 for E2 which was a little higher than the 8 result I had previously
Sept.22nd-20mg-Took shot felt horrible until taking about .125mg anastrozole
Sept.24nd-20mg-Felt horrible until taking about .125mg anastrozole.

So far I do feel better overall, but it's been an uphill battle. I just don't understand why I get an E2 spike so fast. I'd like to work up to just doing something like one shot a week, down some anastrozole and feel good the rest of the week. I'm just very worn down from going through this daily/EOD torture routine. I know the smaller shots are supposed to create smaller E2 spikes, but i'm miserable at any dosage so it's almost like I should just go through it once a week instead of EOD.

 

[Megatron28]

I know I am asking you a lot of questions without answering anything. It is just that some of the info you are providing makes me question things. The reason I asked about the type of test is because there are different esters. Cypionate is a long estered test. That means it slowly gets absorbed into your blood stream when injected intramuscularly. The only effect you are feeling immediately after an injection is psychological. The very first injection for example typically does nothing. It takes 3-8 weeks before you generally start feeling the effects of test cyp injections. Also keep in mind that in the beginning, you natural production of test is being shut down as you replace it with exogenous test.

I asked about where you are getting your test to see if it is pharma grade or not. I thought that if you were buying it off the street that you could be having an adverse reaction to impurities in it. But that is highly unlikely with pharma grade. Still, you could ask the pharmacy to give u a different brand or different ester (e.g, ethanate) to see if that helps.

So now to you dose. I don't see how it is even possible to inject 5.25mg. That would equate to just injecting a drop if yours is 200mg/ml as is common. Are you getting a 10ml vial of test that is labeled 200mg/ml? Just to be clear, let us know what your test is labeled as and how you are measuring a dose for injection.

Stop changing how much you take with every injection. You need things to be consistent. Otherwise you will have no idea what is going on with you.

There is no way you E2 is impacted that quickly after and injection. There is no way that adex takes effect immediately either. Again, you are either having an allergic reaction or it is psychological.

I know I am not telling you what you want to hear. But with all the fucking around you have done with your doses there is no way yo tell what is going on with you. And I am really questioning the amounts of test you claim to be injecting. So let's focus on how you are measuring you dose first. I want to help you, but I am going to have o ask you a lot of questions. And you have to stop fucking around with things and give it time to work.

 

[tww11]

I know I am asking you a lot of questions without answering anything. It is just that some of the info you are providing makes me question things. The reason I asked about the type of test is because there are different esters. Cypionate is a long estered test. That means it slowly gets absorbed into your blood stream when injected intramuscularly. The only effect you are feeling immediately after an injection is psychological. The very first injection for example typically does nothing. It takes 3-8 weeks before you generally start feeling the effects of test cyp injections. Also keep in mind that in the beginning, you natural production of test is being shut down as you replace it with exogenous test.

I asked about where you are getting your test to see if it is pharma grade or not. I thought that if you were buying it off the street that you could be having an adverse reaction to impurities in it. But that is highly unlikely with pharma grade. Still, you could ask the pharmacy to give u a different brand or different ester (e.g, ethanate) to see if that helps.

So now to you dose. I don't see how it is even possible to inject 5.25mg. That would equate to just injecting a drop if yours is 200mg/ml as is common. Are you getting a 10ml vial of test that is labeled 200mg/ml? Just to be clear, let us know what your test is labeled as and how you are measuring a dose for injection.

Stop changing how much you take with every injection. You need things to be consistent. Otherwise you will have no idea what is going on with you.

There is no way you E2 is impacted that quickly after and injection. There is no way that adex takes effect immediately either. Again, you are either having an allergic reaction or it is psychological.

I know I am not telling you what you want to hear. But with all the fucking around you have done with your doses there is no way yo tell what is going on with you. And I am really questioning the amounts of test you claim to be injecting. So let's focus on how you are measuring you dose first. I want to help you, but I am going to have o ask you a lot of questions. And you have to stop fucking around with things and give it time to work.

I don't mind you asking me any questions as I'm in a very desperate situation to begin with and I just need to get it under control. I know that the cypionate slowly gets absorbed. I really had no problem with the first injection, but after the second I had a horrible time. I know this sounds crazy, but I've had anxiety before and this is not psychological. The brain fog comes on strong, my libido is dead, my nipples point out, my heart races, and I can feel the water retention in my legs. And, I kid you not that within an hour of taking the anastrozole I feel pretty close to normal. Not totally normal, but close. If I don't take the anastrozole then these symptoms don't go away even with Xanax! Yes, it's a 10ml vial dosed at 210mg. I know the dose seems low. Keep in mind two things. Number one I was scared to death to inject much more after these reactions. Number two, I was literally not in my right mind when the E2 was spiking. The brain fog and confusion was terrible. I was drawing up to the first line on the syringe. Not even the .1ml, but the very first line you see. I do agree with you that the crazy dosing doesn't help and that's why I've decided that I have narrowed this down to one problem and it has to be the E2. So I will keep my dosage at one or two injections a week from now on and adjust the Aromatase inhibitor (AI) as needed. I've just never read about someone having this bad of a time right after the injection. It could be an allergy, but then it's strange how the Aromatase inhibitor (AI) seems to help the symptoms.

 

[Megatron28]

Here's what I would do if I were you. Keep taking 50mg of test cyp every 3.5 days. Injecting twice a week vs. Once a week helps lower your aromatization.

At the same time as your injection take .25mg of arimidex (anastrozole).

Get blood work in about 3 weeks at your trough. So ideally right before you would put in your next injection. You can use Private MD - Buy Lab Tests Online if you don't want to go through your doc for labs. You typically get your results within 24 hours. You can get the Female Hormone Panel (it is for men too). It costs about $50 with the coupon code. Panel includes CBC, Metabolic Panel, TT, E2, LH and FSH.

Keep us ted on how you are doing and we can make adjustments if needed. Ideally though, you need to stop making all these changes though and give things time to level off. In the beginning of testosterone replacement therapy (TRT) you are on a bit of a rollercoaster ride until things level off.

Have you been watching your hematocrit? Exogenous test raises it. You need to donate blood regularly to keep it in check.

 

[tww11]

Here's what I would do if I were you. Keep taking 50mg of test cyp every 3.5 days. Injecting twice a week vs. Once a week helps lower your aromatization.

At the same time as your injection take .25mg of arimidex (anastrozole).

Get blood work in about 3 weeks at your trough. So ideally right before you would put in your next injection. You can use Private MD - Buy Lab Tests Online if you don't want to go through your doc for labs. You typically get your results within 24 hours. You can get the Female Hormone Panel (it is for men too). It costs about $50 with the coupon code. Panel includes CBC, Metabolic Panel, TT, E2, LH and FSH.

Keep us ted on how you are doing and we can make adjustments if needed. Ideally though, you need to stop making all these changes though and give things time to level off. In the beginning of testosterone replacement therapy (TRT) you are on a bit of a rollercoaster ride until things level off.

Have you been watching your hematocrit? Exogenous test raises it. You need to donate blood regularly to keep it in check.

Thanks for the help. I feel pretty good today. Just a bit nervous about everything because of what I've been through, but my head is clear and I don't feel and water retention. I'm going to stick with your suggestion and do the 50mg every 3.5 days and take the Aromatase inhibitor (AI) at that time to stop any potential spikes and I know it must sound nuts to have a spike that fast, but the only thing I can think of is that I'm just very sensitive to any quick rise in E2 and the fact that my E2 was probably already out of whack when I started TRT. Thinking back I know I had the signs of excessive E2 before, but when my testosterone got too low it became more pronounced and with each injection it was creating a spike.

Thanks for the tips on the blood work! It sounds like a much better deal than what I'm getting now. I'll definitely let you know how it's going. I haven't checked my Hematocrit level, but I have read about giving blood if it gets too high and I don't mind doing that. Hopefully things will level off here and I'll be able to get on track soon.

 

[Megatron28]

Just so you know, I think your E2 is too low. You are sitting around 10 right now. Most guys like being in the 20's or 30's. Around 10, many guys experience joint pain, fatigue and ED. Over the long term, having your E2 that low can cause bone density issues and fat gains among other things. You need sufficient E2 to be healthy.

 

[bigben66]

Good luck OP... your log is very helpful for others and you are getting some amazing advice from Megatron along the way...
Please keep posting - there are many many other people learning from your log

 

[tww11]

Thanks for the responses and I do appreciate any and all advice. I hope that others can learn from it and save themselves the hell I went through. I'm mentally strong, but this experience was pushing my limits. I really felt alone in this situation even though I know that's far from the truth. I've read that an E2 of 10 is low and I expect it to rise and I'm ok with it rising in a controlled way in relation to my T levels. The only thing I can't handle is the bad brain fog and confusion, irritability etc.. I'm no expert, but I thought that maybe with low T levels an E2 of 10 could actually be high for me. As my T levels rise maybe I could tolerate my E2 at a more acceptable level without a problem. I'm hopeful that things will stabilize and level out in the next few weeks.

 

[IMT staff]

As my T levels rise maybe I could tolerate my E2 at a more acceptable level without a problem. I'm hopeful that things will stabilize and level out in the next few weeks.

Yes that will help. The ratio is often more important than the actual levels.

Are you on testosterone replacement therapy (TRT) with us? Just curious, I didn't think so cause you have so many questions and we would have walked you through it, I just want to make sure if you are with us to call us so we can help

 

[tww11]

Yes that will help. The ratio is often more important than the actual levels.

Are you on testosterone replacement therapy (TRT) with us? Just curious, I didn't think so cause you have so many questions and we would have walked you through it, I just want to make sure if you are with us to call us so we can help

Thanks for the response. I'm not with you, but you sound like you're more hands on with your clients. I also wanted to give an update. I was having some anxiety, weird feelings, and just feeling tired today. I haven't really felt normal for a while now, but it's slowly improving. I had to get away from my desk today at work and take a small break. During that break I thought of a few things. First, I wish I had understood how these shots were going to make me react before taking them, but at least I believe that I have some knowledge about how they affect my body chemistry. I don't know why the reaction is so fast, but it's there.

Second, I realize that all the screwing around with my dosages probably did nothing more than shut me down and give me a T level lower than what I had before testosterone replacement therapy (TRT) because I started high, went low, and now I'm trying to climb back up again. This is probably why I've also felt a little more anxious and I also realize that this will take weeks to get the full effect. I also realize that my E2 is lower than it should be and that might be making me feel bad also until it comes up a little in relation to my T levels. Lastly, I have HCG, but I haven't used it yet. I'm just wondering if the Human Chorionic Gonadotropin (HCG) would help me to feel a little more balanced since it will be stimulating my own production. Of course I know this will spike E2 also so I'll be proceeding with caution when I start.

All of this is a tough balancing act. I don't mind feeling tired or whatever. What is really uncomfortable for me is the mental/mood swings and weird feelings that come with all of this. I know it's just the hormones, but I have an active work life and family and I can't afford to be up and down all the time. I'm going to give this more time to work and see how it goes.

 

[IMT staff]

Well if you want to switch we would walk you through it, there is no need for you to be going up and down like you are. All of your concerns can mitigated with little effort.

 

[juced_porkchop]

Hello,

I really need some help trying to figure this out! I'm sorry if this is long. I just recently started testosterone replacement therapy (TRT) after having low testosterone for years. I finally reached a breaking point when my work schedule had me working 10hr days and I wasn't able to recover from the long work days and my workout schedule along with all the stress from having a family etc.. I decided to get some tests for testosterone and the first one came back at 138 ng/dl. The second test came back at 260 ng/dl and that was after three days of rest. I got so weak I couldn't hardly do anything. I started testosterone replacement therapy (TRT) about a month ago starting at 100mg/wk taken in two weekly IM injections of 50mg. The first shot seemed to work wonders. I started to have more energy, but by the second shot things were going down hill quickly. I was feeling terrible with brain fog, rapid heart rate, anxiety etc.. Every shot brought the same symptoms. I didn't really understand what was going on because I had my E2 tested with the sensitive test and it came back at 8 pg/ml which I thought was low and didn't need attention. I went through this for a week or so and then I had to drop my dosages way down almost to nothing and I really thought I was going to lose my mind with all of this.

What happened is that no matter what dosage I took, whether it was 50mg or 5mg, I had this terrible reaction within minutes I had severe brain fog, my legs felt heavy like I'm carrying around weights on my legs, puffy nips, and I just felt incredibly bad mentally. This was not in my head. This was a true reaction to the shot. I decided one day to take an Aromatase inhibitor (AI) when these symptoms started. I took .5mg of anastrozole and the symptoms mostly disappeared within 30 minutes! I couldn't believe it. I had my E2 tested again and again it said 8pg/ml. So, I decided to get it tested another time when I started to have these symptoms and when I got my results back my E2 had risen to 10 pg/ml. I took some anastrozole after the blood test and immediately felt better.

I'm slowly ramping back up to the 100mg and taking some anastrozole immediately after each shot to stop this reaction. What the hell is going on inside my body? I never thought E2 could spike that fast and hard and have that bad of an effect on my body and mind. I'd love to hear some of your thoughts on what's going on. Is it that my T/E ratio is just bad right now? Is 10 pg/ml a high E2? Other people seem to have this problem weeks into treatment, not with the first couple of shots. I've run many tests on all my other hormones etc.. and everything is within a normal range. Please help.

allergy or its in your head... imo

 

[tww11]

Could be an allergy, but I'm not so sure. Unfortunately, these symptoms are not in my head. They don't subside and they don't go away with anything but anastrozole from what I've experienced. I know my body very well. I wish I could just say it's anxiety, but when I took some Xanax I had these same symptoms and felt like a slug at the same time. It didn't help anything. It didn't happen right away with the first shot. It took a few shots for these symptoms to start happening. It was like a slow build up and then it got to where every injection was giving me some kind of "spike". Even when I started tapering down my T dosage I would get these symptoms after every shot until I decided to try some Aromatase inhibitor (AI) and it knocked it out for the most part. Tomorrow I take a full 50mg shot again. I really have no idea how it's going to go. All I know is that the anastrozole seems to counter it's negative effects. If it goes bad and the anastrozole doesn't work then I'm switching to something else to give that a try. I can't go through this with every shot.

One thing I do want to ask is if Labcorp's E2 sensitive tests are accurate. I had read where they were making some errors, but got it straightened out. I don't know if that is still the case, but I do wonder.

 

[tww11]

Well if you want to switch we would walk you through it, there is no need for you to be going up and down like you are. All of your concerns can mitigated with little effort.

Thanks. We'd probably have to speak outside this thread, but I'm open to all options.

 

[Megatron28]

The only thing you will notice with the injection immediately are psychological effects. It will take you weeks to build up your TT and E2 levels again.

 

[tww11]

The only thing you will notice with the injection immediately are psychological effects. It will take you weeks to build up your TT and E2 levels again.

Yeah, I believe that to be true based on science etc... I'm not really sure why I react the way I do. That's why I'm just searching around to see if anyone else can relate to my experience. I just took my 50mg shot about 25 minutes ago. I'm not taking any Aromatase inhibitor (AI) at the moment. I need an objective experience until I really feel I need to change something. I'm trying to watch myself to see how I react since there should be no surprises this time. I'll be monitoring my mental state, feelings of fluid retention, and chest area for signs of puffyness etc. I'll report back as time goes on. I've felt pretty ok the last couple of days. Not entirely like myself, but better than before.