T Nation

Insomnia Since Starting TRT


#1

Hi fella’s

I’m hoping I can get some sound advice before I quit TRT altogether.

As the title suggests, I am suffering with terrible insomnia since starting TRT. I am currently 3 months in to treatment and I am no where near being dialled in.

Since starting TRT I can no longer sleep, I manage 2,3,4 hours a night at best. I just cannot switch off, I feel really wired and my eyes are like dinner plates, I also have hot flushes.

Protocol from the start:

Sustanon 250 - 125mg 1 shot per week:
Results after 1 month:

Oestradiol 140 41 - 159 pmol/L
Testosterone 25.00 8.64 - 29 nmol/L
SHBG 30 18.3 - 54.1 nmol/L
Free-Testosterone(Calculated) 0.603 0.2 - 0.62 nmol/L
Prolactin 287 86 - 324 mU/L

Sustanon 250 - 75mg Every 5 Days
Results after 2 months:

Oestradiol H 206 41 - 159 pmol/L
Testosterone H 37.50 8.64 - 29 nmol/L
SHBG 40 18.3 - 54.1 nmol/L
Free-Testosterone(Calculated) H 0.842 0.2 - 0.62 nmol/L
Prolactin H 394 86 - 324 mU/L

As you can see my E2 was at the higher end one month in and very high after 2 months.
A few long term members advised me to split my dose and take more regularly, so as of 2 weeks ago I started taking 50mg every 3.5 days. I have Arimidex on hand but was advised to let the new dose settle (4-6 weeks) before I make any decisions about an AI. I have also heard lots of bad stuff about the AI’s which scares me to death!

The problem here is I cannot have another 4-6 weeks of insomnia, I am literally a zombie and my quality of life is very poor. I am on the verge of quitting TRT completely.

My GP (not TRT doc) wants me to take an antidepressant for anxiety. Although I do have severe anxiety, I know that it is caused by the TRT and insomnia so I don’t want to go down this road.

Please guys, can anyone advise me what to do, as I mentioned I cannot wait 4-6 weeks to stabilise. I need to sleep, if I could just get some sleep I know things would improve. If this cannot be resolved then I am going to throw the towel in, I simply cannot cope anymore and depression is creeping in.

Thank you in advance!


#2

You can try melatonin. Magnesium. Was you IGF-1 measured?


#3

… no it wasn’t unfortunately, to be honest with you I don’t even know what that is!
Our health system is so behind the times here in the UK


#4

I know you said in one of your other posts that you still didn’t have enough energy to start exercising. I’m taking it that you have a fairly sedate lifestyle.

I’m thinking that getting yourself into an exercise program would do wonders for you. I know you don’t feel like you have the energy, but get some C4 pre-workout and take it about 30 minutes before you go to the gym. It has a ton of B6 (which is known to have the affect of lowering E2), some caffeine (which will give you a slight burst of energy to do the workout), and Beta Alanine. You don’t have to go full balls to the wall here. Force yourself to do a different muscle group every day for a couple of weeks and then it will start getting easier and you’ll start sleeping better. You don’t have to tear your body completely down while working out at first. Just get in there and start lifting. Go for a 10-12 rep range that doesn’t push you quite to failure at first.

Also, keep cardio to minimum at first. You definitely do not need to raise your cortisol levels any more at the moment.

I would put good money on it that you would stabilize in every way if you add this one thing to your lifestyle and don’t change your TRT protocol.

Keep in mind that “balance” means EVERYTHING. Our bodies are designed for labor, and the world we live in now is not very physically challenging for most people.

It takes EFFORT to balance every aspect of our lives. The more aspects of your life that you can bring into balance, the better your body will react and the better you will feel brother.


#5

Insulin like Growth Factor 1, an assessment of your growth hormone status. Not relevant considering where you live. Look into sleep remedies, @bmbrady77 gave you great advice. Hang in there.


#6

Hey, thank you so much for the detailed positive response, what you are saying is absolutely true, I think you hit the nail on the head with a couple of points.

One of the reasons I had to stop exercising was because it would absolutely wire me, leading to insomnia which fuelled anxiety which fuelled insomnia. this started around 18 months ago and cannot work out why this happens.

Last week I decided now was the time to get back into something so yesterday I had a pre work out shake and went swimming, I did as much as I could manage, around 15 lengths of the pool, this tired me out and I thought it would help me sleep… nope, I was absolutely wired at night!

So, you are absolutely correct, I need to limit cardio and start lifting some weights.
The insomnia only usually happened after exercise but now its happening even when I’m not doing anything at all, I find the TRT quite stimulating, but yes, cardio makes things 10 times worse… any idea why this would be? It seems to give me too much adrenanline.

Ok, so tomorrow (sleep depending tonight), I am going to go and lift some weights, limit cardio and not touch my new TRT protocol.

Thanks again mate, I can’t tell you how grateful I am for everyone’s help!


#7

First and foremost, it’s my pleasure friend. I have received so much help from this forum, so if there is any way I can contribute to helping someone else I am happy to do it.

I can’t say for sure, but my theory is that cardio (running / swimming) is a natural reaction to the “flight” response in our body and increases stress levels. When you lift weights, it’s more labor intensive in a slower, more methodical and controlled way. This is more associated with productive labor (building things / gathering of food) and stimulates the more calming and self worth sensations.

The only thing I know of scientifically is that cardio raises cortisol levels, which in turn increases stress.

Best guess lol.


#8

…I’m also hoping the more frequent shots at a reduced dose will bring my E2 down, I am sure the high E2 isn’t helping matters (I have symptoms), I will give this a few weeks and see where I am with the addition of exercise…


#9

I have read some of the guys in here had to cut out any supplements that contain vitamin B6 due to it contributing to crashing their E2. If you get the C4 supplement I talked about, it contains a lot B6 so you may be able to use that effect to your advantage.


#10

… I will see if I can get hold of any here in the UK, if not should I just supplement with B6 ?
I have been looking at DIM but I’m not going to make any rash decisions until I get my next labs


#11

That would be a good idea. If C4 isn’t available, you can make your own concoction.

500mcg B6
35mcg B12
1g creatine
1.6g Beta Alanine
1g L Arganine
150mg caffeine


#12

I’ve found some on Amazon !!
I have some labs arriving this week, these were taken before my new protocol 10 days ago… would you mind looking over them for me when they arrive please?


#13

Glad to hear man. Post up your labs when you get them. I’m not the best to be interpreting labs, but I’ll chime in on what I can help with. Some of the other guys here are way more knowledgeable than I am, and can fill in the blanks.


#14

You likely have a serotonin inbalance causing an issue with your body’s own manufacturing of melatonin. Remember, serotonin makes melatonin.

Try appx. 500mg of tryptophan right before bed, preferably on an empty stomach. I would do this over taking melatonin itself. Let your body make it’s own and use it like normal as opposed to taking mega doses of melatonin.

Also look into trazodone. It’s a great sleep aid that has been working wonders for me, along with the tryptophan. I’ve been getting some of the best sleep ever recently due to these. I actually dream now. It’s so better that my personality is a bit changed too. Likely due from just better sleep.


#15

Hi, thanks for the reply. I was on an SSRI for 15 years which I stopped taking at the end of 2017, a lot of problems started around this time, including the exercise induced insomnia.

A few months ago the doctor gave me Remeron, I started taking 15mg which helped for a couple of weeks with sleep but now has worn off, it no longer touches the insomnia.
I was considering upping the dose to 30mg to see if this has an effect, I only haven’t done this yet as I am disappointed in myself having to take drugs again after it took me 2 years to come off the SSRI.

I could up the dose or keep it at 15mg and add tryptophan (not sure of any interactions), but yes I am sure I have some brain chemical imbalances and the TRT is just fuelling the fire.

I think I tried trazodone before but I didn’t like it which is why the doc gave me Remeron.
Would you up the dose of Remeron or simply add tryptophan to my existing 15mg dose Remeron?

I am going to follow the advice of @bmbrady77 with the exercise but yes, I need to get my night time medication sorted one way or another.

Thanks


#16

I would probably just add some tryptophan right now.

Something I’ve read: your body uses a lot of serotonin during exercise, which can leave you depleted. This could mean your body doesn’t produce much melatonin at night.

Yes, we get a lot of tryptophan through diet, and of course, whey protein. But the thing is is that it has a hard time being utilized as it competes with other aminos for absorption. So taking it on it’s own at bed time may help.

I’m assuming you’ve corrected all the obvious things first, like staying off phone at night, dark room, etc. Also, some wake up in the middle of the night due to low blood sugar. Maybe a little slow digesting carb right before bed would be beneficial too.

As for the remeron, I can’t give you an answer. I would like to know though, how did it affect you sexually? Like any side effects, either good or bad?

The trazodone took a couple days to get used to. There was certainly a day or two at the start where I thought I felt hung over in the morning. This went away fast though. 50mg.


#17

I try to keep good sleep hygiene but lately I have been on these forums until late at night which could wire my brain a little. I also keep a pot of raw honey at the side of my bed just in case I wake up during the night, I thought at first it was some kind of hypoglycaemia I was experiencing. It’s interesting you say about serotonin and exercise, I may have been low on serotonin from stopping the SSRIs, exercised and then suffered the consequences, kinda makes sense!

Ok, so Remeron is touted for having zero sexual side effects which is why I chose this, I took remeron years ago and it never affected me sexually. Only side effects are that it makes you really sleepy to start with this wears off, people also say they gained weight because it makes you hungry, to be honest it has never affected me this way. Funnily enough, when I stopped the SSRI last year after years of use, I developed a bit of PE - I believe serotonin controls this too!

No doubt coming off the SSRI was a massive shock to the system, I may still be paying the consequences?

I tried Melatonin, GABA and 5HTP, they all made me feel really weird so I discontinued taking each of them which is why I am a little reluctant to try the tryptophan, I may just up the dose of Remeron until I feel a bit better.


#18

copied and pasted…

Mirtazapine is a newer antidepressant that exhibits both noradrenergic and serotonergic activity. It is at least as effective as the older antidepressants for treating mild to severe depression. … It is particularly useful in patients who experience sexual side effects from other antidepressants .


#19

I’ve researched remeron and it’s interaction on the various serotonin receptors.

But wanted to know specially how it affected you.


#20

I have tolerated it very well, at first I was experimenting with 3.75mg and 7.5mg doses which was a bad idea, bizarrely the less you take the more sedating they are and not in a good way. I am now on 15mg but feel this is doing nothing for me, I may need a higher dose but as I mentioned earlier, absolutely no sexual side effects