T Nation

Dropped My Dosage and Now Feeling Like Crap

Hey everyone. So I was accidentally taking 120mg a week instead of 66mg. I was feeling pretty good but noticed I was running out of testosterone too fast (test E). After discussing with the urologist we discover my error. So I skipped one week and then started my 66mg a week protocol. I’ve only been on this new dosage for just under a week.

Thing is, now I’m feeling like crap. Super tired, terrible sleeps, nauseous, losing weight, and lots of anxiety. My question is, is this a normal thing to experience when dropping your dose by half? And if so how long do you think it will take for my body to adjust?

I also take Effexor for anxiety which I started 2 months ago, but my anxiety was more or less under control until I adjust my test, which is why I’m thinking that’s the culprit.

What do you think?

You never should have agreed to a protocol of 66mg/week. The dose is too low, it will crash your normal production and most likely not even replace what you had before TRT. In other words, your testosterone is probably worse than when you started.

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We will find out in a few weeks when I do blood work. Can’t see how he benefits from giving me a protocol that will make my situation worse. I’m all for the lowest dose possible to get my levels to mid/high normal. I was on this protocol before (but injecting every three weeks 200mg) and my levels shut up to higher than normal levels at 10 days post injection. I’ve decided to inject weekly instead to curb the crashes.

Yeah, you skipped a week of shots, and a week later you feel like crap. Makes sense. You’re kinda starting fresh with the low dose now

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First off, 66mg/week is a very low dose. I did 82 mg for 6 weeks once while doing a dos-response experiment and definitely felt the return of low T symptoms. I was still much improved over pre-TRT, but nowhere near optimized. I can’t imagine going any lower.

Secondly, in my experience, 120mg/week is close to where I feel abatement of most of my low T symptoms. You just happened onto it by mistake, but I would take this information back to your Urologist and discuss optimizing your dose.

See the graph below for a dose-response experiment that I did to optimize my dose. I suggest you ask your doc if you can do an abridged version of this. Also, I suggest that you use Free T (as I did) rather than Total T. Free T is what you need to feel ‘normal’ because SHBG bound T will not pass through the blood-brain barrier where you need it. There are interactions between androgens and SHBG production, the more T you use, the less SHBG that will be produced and the more Free T you will get per dose of T. So, bottom line is that Free T is a better predictor to how you will feel.

For me, I started feeling my best around in terms of symptom abatement at about 120 mg per week with slight improvements up to about 140 mg per week. After that, the improvements were all physical due to better recovery from gym workouts. It’s a contraversial subject in this forum, but I consider the latter to be anabolic steroid use and not TRT I have since targeted 125 mg per week as my optimal dose. This also happens to put my Free T at about the upper 100 percentile of a 20-29 year old male, which I consider the upper bound of normal physiological levels for an adult male.

Regarding the need for anxiety meds, I would use that as evidence for your doc that you need a higher dose of T to prevent low T symptoms and minimize (or eliminate) the need for meds to control low T symptoms. Anxiety was a HUGE symptom for me too.

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Thanks for the info and the response. I agree I felt pretty good at 120mg, but I was retaining a lot of water. I gained 15lbs in 6 weeks also erections were way out of control, and sometimes uncomfortable, although I assume that side effect would likely calm down after a while… or not. 120 may be a bit high for me tbh, but I think somewhere up in that range may be ideal. I did find that when I was on 120 my anxiety was much better, but I just assumed it was the Effexor. Now I’m not so sure.

My test level is actually in the mid range, my bio is low. It will be interesting to see what my levels are at on this dose now that my body has likely stopped producing test on its own.

You went down a bad road. Get up to 100mg a week. Your MD is a jackass.

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Or I can wait to get my blood work and adjust my doses accordingly. I resent the implication that my MD is somehow less smart than randoms on these sites. This is what he does for a living, and he will get nothing from giving me treatments that don’t work, why would he? Any smart MD will start with a low dose and work you up to the optimal dose… for ME… which may be different than YOUR optimal dose. I wouldn’t trust a doctor who just sends me home with bodybuilding level doses or doses that we both know shoot my levels through the roof. Plus, what do you know about my personal situation? Fact is we need to watch my PSA levels too because I’m high risk prostate cancer. In all honesty, every time I post a question here I get a bunch of comments like these, always calling my doctors morons and how my protocol sucks.

That being said, I’ll give you the benefit of the doubt. I’d love to see your credentials and the sources of your information.

Curious about the details. What’s in your medial history that puts you at risk for prostate cancer?

I too gained a lot of water during the first 6 months. I’ve read numerous posts from guys with similar experience. I have no idea what’s going on endocrinologically to cause this. Probably something to do with an alteration in mineralicorticods (e.g., aldosterone). May have something to do with increased IGF-1 production too. Whatever the cause, it seems to be common and stabilizes to a new norm after about 6 months.

Regarding erections, most guys would kill for that side-effect, but I do understand. When I layered in 5 mg/day Cialis to help treat BPH, I started getting crazy hard nocturnal erections. They often wake me in the middle of the night at least twice per night and I have the feeling I need to pee, but peeing with a full erection is somewhat difficult and messy. Laugh if you will, it’s a real annoyance. I choose to put up with it. It’s far better than the alternative.

Regarding bioavailable T, it’s a good lab that can be used in place of Free T to optimize your T levels. I find that the two labs parallel each other quite well.

Both father and grandfather on my father’s side had it, so they’ve got to keep a close eye on my PSA levels. It’s not a guarantee that I’ll get it, but it’s def a red flag when it comes to my TRT. I have to start getting prostate exams regularly now… comes with the TRT territory in my case. Not looking forward to it, but it is what it is.

No way man, like ya I’m happy to finally be pitching tents in the middle of the night and morning wood is a great sign that things are working properly, but I was getting them while taking naps on the couch and during car rides. And you know we’re all just wearing track pants all the time these days.

And ya, peeing with an erection isn’t nice. Mine would last so long I’d get worried. Sounds dumb, but it’s true. Like I’d be hard all night long, and I have a 7 month old that’s a big time night feeder, so it’s not like I can use it when ever I have it.

Again, where’s the evidence that trt, at any dose, causes prostate cancer?

Where’s the evidence for this?

Don’t you think it makes sense to start at a more “mid range” dose, so yo can be adjusted either up or down?

66 mg per week is probably too low for most men.

Yes, at 200mg every three weeks I was off the charts high by 10 days post injection. The evidence is in my blood work. I’m trying the same dosage with weekly injections to see where my levels are at after a few weeks.

I don’t think anyone is saying it causes prostate cancer. I think the idea is that if you have prostate cancer already TRT can possibly make it grow faster. Tbh, I’m okay with airing on the side of caution.

That’s been debunk and was a myth created out of a “belief” based on a 1941 report which included 99% of men who had their testes surgically removed which placed them in a completely different risk category.

Prostate cancer takes 20-30 years to become detectable. Some of us are dealing with docs operating on old information and need to re-educate, but until then many men with be kept suboptimal and symptomatic as a result.

There is no study that proves TRT causes prostate cancer. Your doc may not be up to date in current medical knowledge.

Testosterone Therapy in Men With Prostate Cancer

The use of testosterone therapy in men with prostate cancer was previously contraindicated, although recent data challenge this axiom. Over the past 2 decades, there has been a dramatic paradigm shift in beliefs, attitude, and treatment of testosterone deficiency in men with prostate cancer.

Testosterone Replacement Therapy Following the Diagnosis of Prostate Cancer: Outcomes and Utilization Trends

In this population‐based observational study of testosterone replacement therapy in men with a history of prostate cancer, treatment was not associated with increased overall or cancer‐specific mortality. These findings suggest testosterone replacement therapy may be considered in men with a history of prostate cancer, but confirmatory prospective studies are needed.

66mg a week is a joke for the vast majority of people. It simply isn’t enough (as you’ve no doubt already found out). The fact that he had you on 1 injection per THREE weeks at one point makes it clear he doesn’t know what he’s doing when it comes to TRT. Resent that fact all you want, it doesn’t change the facts. Ask him to show you what levels do after 7-8 days… after that point you’ll be lower than you started. Look up studies with actual daily blood work after a 200mg injection of T and you’ll see what I’m talking about.

I don’t understand starting at less than 100mg/week. If it were up to me I’d start you at 125’ish per week and adjust up or down from there based on symptoms as much as blood work. But, it’s not up to me, obviously.

If your doc is really going to work with you and adjust up to resolve symptoms then it might be worth continuing to work with him. Maybe.

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I went through a similar thing not too long ago. Endo flipped out at my levels, I took a few days off (I inject daily), and then started again. This mistake cost me several thousand dollars in horrible stock trading (insane anxiety and couldn’t think straight) and triggered a drinking relapse for me (after a successful 4 months sober). I’ll never drop my dose like that again - ever.

It’s not surprise you feel like crap from it. 66mg is way too low unless you’re one of the very rare people who are fine on that.

If I were you, I’d call Defy or another reputable provider, get everything started with them, and then divide up the test E you have left to hold you over until you get prescribed a more common starting dose. Or talk to your urologist and tell him you’d really prefer to stay on 120mg until you get bloodwork if at all possible. I’m sure there are prescribing guides online you could show to him for the name brand test that would prove 66mg/week is way too little too.

Also, I tried dropping to 100mg/week twice and neither time was successful, fwiw. I personally seem to do best at 150mg/week, maybe a little more. Pretty standard dose.

As for the every 3 week injections, my urologist here in NYC initially prescribed me individual 200mg bottles, one for each week. That right there should tell you every 3 weeks is pretty weird.

Take it from a guy with a pituitary tumor who’s done the rounds of doctors in a major city…a lot of them are not very familiar with how TRT works. One even told me men don’t need estrogen at all! Just because they’re a doctor it doesn’t mean they know everything - doesn’t make them a bad person.

What do I know about your personal situation? I know that youre having side effects due to a lack of androgens and need help from randoms online, otherwise you wouldnt be here seeking out help. My credentials are as good as your MDs, worthless. 120mg of Test is not Bodybuilder doses, so dont kid yourself, and being paranoid of cancer due to TRT has no merit. Ill be straight with you. You sound whiny, and only want to hear what you want to hear. If you fear cancer, eat the right foods, and have a healthy amount of androgens running through your system, without interruption. Your doc is simply running an experiment and making changes as he guesses with the best of them. You were doing fine with the exception of water retention and teenage boners. All of those things will pass once your body self regulates and knows how to work with higher doses of T/E. PSA can be checked anytime during that process and you can always back off a bit. But to cut your dose down to half is harsh, and foolish. You should be questioning his credentials not mine. I didnt fuck you over.

120-125 a week does same for me. Right there at very top of free t range on trough.