T Nation

First Week In - Thoughts and Concerns

T Replacement
#1

Hi All,

After flip flopping on the decision to begin TRT for a few months, last week I decided to take the plunge. That being said, I am beginning to have second thoughts and am very confused as to how to move forward. Being a long time lurker on this forum, I have seen a few people do exactly this, and I was quick to judge them for not being 100% committed before starting, but here I am…

Little background- just turned 32 this month.

I am 5’10 157 lbs. I have been working out fairly consistently for the past 5 years, going 3-5 days per week. My diet has been great, have been consuming apr 2500-3000 calories a day with plenty of protein.

I have had a very tough time getting over 160 lbs, despite consistently working out and eating a lot. I will add that I was on Wellbutrin xl 150 for 4 years, but successfully got off them a month ago. Maybe that contributed to the difficult in gaining weight, I’m not sure.

Overall Id say I’m relatively asymptotic with low t symptoms, however I may have just become used to feeling this way. Haven’t had morning erections in years, however libido is ok and no issues with maintaining an erection. My energy levels are ok too, however I’ve been lacking energy in the gym.

My recent labs are as follows:

Thyroid Function

TSH 1.91 Range: 0.32-5.04 mU/L

Pituitary Function

Follicle Stimulating Hormone (FSH) 2.6 Range: <9.5 IU/L

Luteinizing Hormone (LH) 2.0 Range: 1.1-8.8 IU/L

Prolactin 8.0 Range: 3.8-20.6 ug/L

Reproductive and Gonada

Estradiol 107 Range <157 pmol/L

Testosterone 12.4 Range 8.4-28.8 nmol/L

Bioavailable Testosterone was cancelled

because MSP criteria for SHBG testing were

not met.

I was prescribed 100mg/ week.

I did my first shot (50mg) last Wednesday and another 50mg on Saturday. Here’s where my concerns come in- Wednesday I felt ok, Thursday I had a major spike in anxiety and my emotions were pretty out of whack. Same thing happened Sunday, I felt like crying all day which is very bizarre.

I know things can take time to settle, but this reaction straight out of the gate scares me.

I know the ultimate decision comes down to me, but I am so on the fence at this stage. My symptoms were not terrible to begin with, and the last thing I want to do is make my life more difficult mentally, after finally coming off an anti depressant.

My labs did not test for SHBG, however my estradiol is relatively high, would this indicate a high SHBG? Is my free t probably low? And would this possibly explain my reaction to the first 2 shots? Also, if I were to back out at this stage, would I be shut down in any way?

I know these questions are a little annoying, but any input would be greatly appreciated as I am currently at a loss as to how to move on.

Thanks very much.

#2

This doesn’t sound like a T problem, it sounds like you’re not eating enough calories.

Trt, at the proper dose, will likely improve this area in your life dramatically. This will also be one of the first benefits you notice.

Likely placebo. Give it some more time and know that you can always go off of TRT and get your normal levels back, especially if only on the drug for less than a year.

Probably the opposite. SHBG binds both estrogen and testosterone (and DHT). High SHBG would indicate lower free T and lower E2.

No, it takes several weeks to completely shut down. And if you were shut down there are ways to bring your levels back up to pre TRT. The less time you’ve been on TRT the higher the success rate with that.

#3

Your testosterone is closer to the bottom of the ranges and your estrogen is almost at the top of the ranges, that’s estrogen dominance and now you are injecting 50mg, a moderate dosage and I’ll bet you are over aromatizing creating lots of estrogen.

The path forward is clear, you need small injections to minimize aromatization which is causing your anxiety and mood problems. This is an easy fix. You have secondary hypogonadism, you can choose to not treat it and go back to no morning erections or you can fine tune your TRT protocol and move closer to recovering your lost erections.

#4

It’s far too early for you to be feeling much of anything. Besides, you need a larger dose, at least 150mg/week.

#6

Thanks for the input! I have a feeling I’ll have to eventually up it from 100, but for now what would be the best way to increase frequency? EOD? Kinda tough to break that dose up accurately.

#7

It’s not difficult if using an insulin syringe with 10 units of measure per .1ml. I would try EOD and probably lower the dosage a little if you run into similar issues after 6-8 weeks after making the change.

There is a lot going on during the first 6 weeks, you have your body trying to adapt to these higher hormones, then you have your natural production (HPTA) is being suppressed and natural production shutdown.

You will have your hormones fluctuating for the first 6 weeks at which time levels become stable and things should calm down by then.

Things could get a little hairy by 4-5 weeks and stay the course because things usually resolve by 6-8 weeks.

#8

@systemlord so I got some blood work done going into the 6th week and was wondering if I can get your opinion. I tried to get SHBG and free test, but apparently they won’t do that through Lifelabs. Anyways:

Estrodial 157 range <159
Testosterone 28.6 range 8.4-28.8

My question is - I feel worst on the day of the shot and the day after (bad mood, increased anxiety, headache). Would this likely be attributed to the higher estrogen ?

I am hesitant to take my next shot as I don’t want to go through 2 days of feeling like absolutely crap mentally. Any thoughts?