I have to wonder if prolactin is increasing your SHBG.
Can you get 0.5mg/week dostinex/cabergoline to see?
You need high T and lower E2 to decrease SHBG.
Can you do labs sooner than later to see where things are going?
You will need anastrozole and I suggest that you have a target of E2=16-18 for now.
When SHBG is high, T+SHBG is higher and TT is inflated. FT or bio-T then is a good measure of your T status and TT alone cannot be used as a therapeutic target! Some guys hyper-metabolize T and need 300mg T per week to get where others are at 100mg/week. A hyper-metabolizer has a shorter effective half-life for injected T and you should also be injecting EOD, then AI EOD will make sense too and that means many small doses and dissolving tablets in vodka 1mg/ml and dispensing by volume or by the drop provides suitable dosing. As you go through this and as SHBG gets [hopefully] driven down, FT or bio-T will increase and TT:FT should not remain as extreme. Please print this for your doc. I expect that 160mg T/week will simply not be enough to improve your status [but TT may look “good”]. Really high TT numbers need to be accepted as OK until SHBG becomes reasonable.
Thanks for your comments, KSman. Caber was definitely the route I was previously thinking, but at my last blood test a month ago, just before I started TRT and on only a multivitamin, Prolactin came back normal [6.6 (2.0-18.0)], which left me scratching my head, albeit happily. At that same blood sample, SHBG was still elevated [56.7 (16.5 - 55.9)].
On the interim initial blood test, I was expecting my E2 to have been higher due to the increased insomnia and anxiety, but it came back low-normal at 12.5 (8.0−35.0) using the sensitive assay. Perhaps this blood test was just done too early (after 4th pin @ 2/wk)?
I’ve been feeling a little better over the past week so I’m hoping this new dose with the eventual addition of HCG brings me in the right direction. As for SHBG, I’m now supplementing with Zinc, Magnesium and Liver Support and we will see what impact all of this has on the next round of blood tests. Tests for E2 and Prolactin will be included on the 5-week blood tests coming up in 2 weeks.
If it is the case that I will need to get to a much higher dosage to accomplish feeling better with a better FT level, then how worried do I need to be about side effects? Besides estrogen maintenance, won’t large doses lead to excess conversion to DHT leading to harsh effects with the prostate, balding, etc?
So I’ve been generally feeling better, more energy than pre-TRT, improved libido. Am going to retest next week to see where levels are at on this new dose.
Sleep - has been worse since starting TRT over a month ago. I don’t feel tired at night (but do in the morning), so I restlessly move around and/or end up having short and fractioned sleep almost every night. I do know that pre-TRT, my cortisol was on the higher end at night. It is not anxiety, per se, more like my mind has energy to just keep spinning the wheels. Mediation hasn’t really helped here like I thought it would.
I’ve tried melatonin which literally makes things worse for some reason.
I’ve heard that high E2 could also be the cause, but my last test showed that it was normal, and I’m not feeling any nipple sensitivity anymore. I think my body is becoming more normalized but we shall see when the next round of tests come back in a couple weeks.
Anyone else experience worse sleep after starting TRT, and any suggestions?
When I first started TRT, my body went into a shock, and I could tell my cortisol was high. Had kidney/adrenal (pain) when I would do something that would increase cortisol. Almost falling off my bike, felt the adrenaline/cortisol surge, and feel it in the kidneys/adrenals. Anyway, it made my sleep terrible at first, now im back to sleeping like a baby. It was causing me to wake up at 3-4 AM wide awake, could not fall back asleep.
Something that could be another cause is the fact that your body is use to your testosterone dropping at night, now your supplementing exogenous test, so your body doesn’t go into that testosterone lull at the end of the day anymore, your at a constant, high level. Would make sense that the body needs time to adjust.
Thanks for sharing your experience, it sounds similar. Do you remember how long it took before normalizing?
This could definitely be part of it, and don’t know of any way to counter this other than taking a lower dose of Test Cyp and allowing my body to normalize over time. I am currently taking a heftier dose (160mg) because of aforementioned high SHBG and low Free T. I feel like I have more mental energy than I ever have, but wish I could turn the chatter down a bit at 11pm…
All across these forums, I see story after story of these things being related to an out-of-whack E2 level or T:E ratio, so I’ve got that front in center. I’ve read that too low E2 can cause hypersomnia (sleeping too much), whereas high E2 can cause some insomnia. However, I feel like I don’t have many of the other often reported symptoms of High E2 other than perhaps increased anxiety. My E2 pre-TRT was around 18-22, which is perfect, on paper. 2 weeks into TRT, pinning 2/wk, I was experiencing some nipple sensitivity so I pulled labs for the big 3: Total T, Free T and E2, and here again my E2 (Sensitive): was 12.5 (8.0−35.0) without Arimidex.
So I’m hoping you are right and things will get better with time.
Give it time. I think it was about a month or so before I started to feel better. Also, im super sensitive to test. I only take 50 a week, split up into 2 doses, and even then my BP is still a little highish 132/75 and if I go higher on my test dose, my body does NOT like it at all. Bp spikes about 12-24 hours after injection too, so im still struggling with that. My body did normalize for a while not it seems to have gone back to being out of whack. Sometimes I think that being anxious over the issue prolongs the healing, or normalizing. I need to practice that actually, starting today. HA! Good luck bro.
Lowering Test dose back down to 120mg/wk (@ 60mg x2/wk) and adding low dose of hCG at 250mg/iu/wk (@ 125 x2/wk). Also adding in low dose Arimidex at .5mg/wk(@.25 x 2/wk).
I don’t want to have too much aromatizing occurring within testes and want to reduce affect of hCG sensitive breast tissue from increasing gyno.
Also adding in 60mg Raloxifene HCL (SERM) per day, which I had on hand (since I’m sensitive to gyno) to spot reduce gyno while I get E2 and Test into proper balance (E2 between 20-25).
Obviously, Total Test is a bit high. I will adjust Test Cyp down to 100mg/wk and retest in a couple weeks. Probably explains the back acne. And may partially explain some of the gyno…
From the labs, it’s clear that high estrogen and or prolactin is not the root cause of my gyno issues. On raloxifene and lower hCG dose (125iu x 2/wk instead of 250), gyno hasn’t progressed and has gotten better, almost back to pre-nodule development size. It is clear that for me, in the presence of high testosterone, hCG has a direct causal effect on gyno. Literally within a day of taking the hCG shot, the nodules enlarge, and my nipples itch, becoming extremely sensitive.