T Nation

5 Days After Second Injection, Feeling Horrible. Normal "Valley"?

T Replacement
#1

Hey ya’ll. Would like some input on what I’m experiencing and wondering how normal this is at this stage of my TRT cycle. A couple weeks ago, I saw a Dr regarding low T and he prescribed a regimen of 200mg every 2 weeks, for 6 weeks. First week I felt awesome, energy through the roof. Second week, started waning a bit, but ok. Come second shot, I felt ok the next day, and for the next couple days. Then, by the 4th day I started feeling tired, fatigued again. Today - 5th day - feel absolutely horrible. No energy, fatigued, can’t concentrate. How long does this go on for?

I know I’ve been reading threads on here about these endocronologists not knowing what they’re doing, etc., etc., but figured I’d still give him a shot.

Wants to take a blood test 5 days after the last shot to check levels, then have an appt the following week. This seems legit in terms of the body “dialing-in”, doesn’t it? Won’t it take 5 days after the last shot to see where the body is?

Thank you for your responses!

#2

You are on a path that leads to misery and your doctor is clueless, these 200mg every 2 week protocols do not workout for the majority of men. The sick care system doesn’t have a doctor that specilizes in TRT and these outdated guideline do not help matters.

You will either go private and locate a knowledgeable TRT specialist or continue to have problems while you figure out everything on your own without the help from your doctor. Testosterone cypionate has half life of 7-8 days, so this idea of injecting every 2 weeks is a bad idea because it means you will be on a hormonal roller coaster and as your testosterone declines 5-6 days after an injection and estrogen peaks at this time, you are now estrogen dominate like a female and is why you feel so unwell.

A clinical study came out in 2005 which shows your testosterone levels low by day 6, since your doctor doesn’t specialize in this area of medicine, he doesn’t know or care to be informed in TRT as the medical system turned away from TRT 70 years ago do to false prostate cancer studies and is frown upon in the medical community.

Your injection frequency will need to increase to two or more injections per week, SHBG is as great biomarker for selecting an injection frequency, lower SHBG men feel better on multiple injection per week. I felt little on once or twice weekly and things didn’t start happening until I started injecting 25mg EOD.

My SHBG is low 16-22.

Skip to Figure 1 graph B
Hormone profiles after intramuscular injection of 200mg testosterone enanthate every 2 weeks in patients with hypogonadism

1 Like
#3

Your shot has a half life of 7-8 days. This means that it’s at half strength by day 7 or 8. So you are spending one week with it working, and then the second week with less test than you started with because your natural production stops when you are getting shots. So, the minimum is once a week dosage, 100 mg every week is a million times better than 200 mg every 2 weeks. Two shots a week, or 50 mg per shot, would give you a more even level than once a week. There are technical reasons for other shot protocols, but generally once or twice a week gets it. Your levels stabilise around 6 weeks, so bloods are generally going to be 6 weeks from starting and 6 weeks from any protocol adjustment. Bloods are taken at trough, which is to say at your lowest point, which is shot day but before the shot.

#4

Thank you. But, shouldn’t I feel better after I inject? At least for a week?

The first time I injected, I felt great all week, and almost up to the second shot. Then when I took my second shot like 4/5 days ago, I feel like crap today.

Why doesn’t it work as long or as well as the first time I shot?

#5

Your natural production is falling off. Your shot isn’t going as far, this can be affected by several things, but mostly by your individual metabolism of testosterone.

#6

Thank you for your response.

So, how would I know what I should bump the shots up to? How do I determine whether it’s:

  1. not enough T,
  2. Injections too far spread from each other, or
  3. whether I need to pair T up with any other injectables (hcg, ai, etc.)

Thanks in advance.

#7

For certain the shots are too far apart, so first step is to move to 100 mg once a week and see how that goes, or 50 mg twice a week would probably work better in your case. Give that like 6 weeks and check your T, free T and E2. If you still don’t feel “right”, the numbers will give you an idea of how much to go up.

#8

Thanks. Very much appreciate your responses.

If I ask my doctor for more T (going from 200mg every 2 weeks, to 200mg every week) will they get suspicious? I don’t want to get into the area where they think this is more so for drug use vs medical use (like with opiates, etc.).

#9

Maybe. It’s better to just ask him to split the existing dose into weekly, and mention the half-life. They will be open to change it from there, and 200 mg a week is likely too much anyway.

#10

You can ask for 100mg weekly and inject 50mg twice weekly and see how you feel. You will have to buy insulin syringes online if you plan on taking control of your protocol, which in this case you should do anyways because your doctor is useless.

Your doctor is only good for prescribing testosterone, beyond that you are on your own. Your doctor will refuse AI’s and HCG in conjunction with TRT, AI’s and HCG is off label use for men on TRT so doctors are forbidden from combining them with TRT.

Show your doctor the study I provided, see what he says.

You need some labs to help determine a good TRT protocol, pre-TRT SHBG and estrogen being important. If total testosterone was below midrange and estrogen high, weekly injections will only increase estrogen higher causing severe mood problems, erectile issues and low libido. I’m willing to bet your doctor only ordered total testosterone.

#11

So if that’s the case, then where do I get AIs and HCG? What are those used for anyway? How common is it that people need AIs and HCG?

#12

I think he’s gone off his meds a little. HCG is non-prescription in some States, so you can order it online. Your doctor very well might provide them, there are plenty that give them automatically without any actual reason. AI’s are good to have on-hand until you know how you do with things. You probably don’t need any.

#13

I did a little bit of reading, but not too clear on HCG.

From what I understand, it’s used to spark your body’s production of testosterone and sperm, correct? So, does the injection of HCG allow your body to create more T? Or is it just for sperm production? If for sperm production, is it enough to re-produce?

Thanks again man, sorry to bother with all the questions. You guys have been awesome.

#14

HCG is used for fertility while on TRT since TRT suppresses sperm production , AI’s are used to control high estrogen side effects. If you want these, by prepared to pay out of pocket for your TRT, which is probably not bad idea.

FSH when added to HCG can increase sperm production to a greater degree if having trouble on TRT and HCG only. Clomid is used to restart the HTPA and get testosterone production going again, but if the cause of low testosterone is not addressed or do to normal/abnormal aging, your levels will decline again to pre-TRT levels.

#15

It is mimics LH (luteinizing hormone) in your body. This hormone inspires your testicles to produce more, which means test, estrogen and sperm.

#16

Now, what about Clomid? Does that replace anything?

#17

Clomid binds estrogen receptors and fools your body into thinking that your E2 is low. In response the pituitary cranks up the LH and tells your balls to get to work.

#18

I asked my first Dr about HCG. And he had no idea what i was talking about. I think he though it was hgh or something. When explained he said oh you dont need that. TRT doesnt shut you down. Didnt even bother with the AI talk i just found a new Dr

#19

So what’s the difference between that (Clomid) and HCG? Which works better?

#20

The tele clinics, what do they usually start you at if you’re a new patient? Do they usually schedule you out 6 weeks after your first round? Thank you