T Nation

Insomnia Since Starting TRT


I was kinda expecting all my troubles to melt away once I started TRT, it was like the answer to all my problems. It isn’t, this is the hard truth. It’s so difficult to balance everything - I wasn’t told this before I started, I’m feeling really disappointed tbh.


The only thing that keeps me going is thinking a new protocol will help.


Same here mate, we need to keep going!


Long shot here but is there a chance you have an infection (I’m sure you’d know by now)? I get insomnia, rapid heart rate increase with any form of exercise, fatigue, high anxiety, trouble concentrating, irritability and depression when I have an infection. I’ve had so many ear infections over the past two years due to sinus issues and I’m very familiar with these symptoms coming on.

Another possibility which you may have ruled out earlier is thyroid. Have you checked it recently including reverse t3?


Hi, I’m pretty sure I don’t have an infection. I had my thyroid check around 6 months ago and all came back normal although reverse T3 wasnt checked


I’ve had extensive testing to see if there are physiological factors contributing to my insomnia. All my test results have returned normal, including thyroid (6 checks over the last year!), androgen levels (my Test, Free Test, SHBG and E2 are all in normal/optimal levels), auto-immune markers, AM cortisol, full blood count, etc.

PS - previous to some of these tests, I was convinced I had “adrenal fatigue” but my AM cortisol has always been in normal ranges (2 blood tests) as too were my catecholamines (24 urine test).

I’ve tried supplementation with a range of vitamins and minerals without much result (magnesium and zinc are the only supps I persist with).

I am now confronted with the possibility that perhaps I’m suffering from mild depression, which could explain all of my symptoms - fatigue, headaches, insomnia etc. I would have never accepted this diagnosis previous to all of these tests, and I’m still struggling to get my head around it. Perhaps it is something you may need to acknowledge as a possibility (even a remote one) and try and work on improving your life notwithstanding your health condition.

Since starting TRT I’ve gone to the gym 5 x a week (for 30 mins a session, cause that’s all I can handle) and do think it has improved my feelings of well-being. It has also resulted in some improvements to my physicality (people have commented on my increased muscle mass etc). I haven’t noticed an significant improvement to sleep, but the fact that I can attend the gym shows me that I can live a relatively normal and fulsome life notwithstanding insomnia: getting past this psychological barrier has been extremely important as it has lowered my health anxiety and allowed me to focus on other things in life apart from why I feel unwell/tired/anxious all of the time.

I’m not saying you should give up on investigating physiological causes, but while you do investigate, do your best to change your mindset: accept your current condition and make the most of life until the insomnia calms down. The body wants to be in a state of homeostasis and it may take some time for it to get there, so patience and acceptance are important qualities to exercise. If things become unbearable, there are other drugs you could try, such as gabapentin, which have been shown to be more effective for sleep than anti-depressants and without any significant side-effects.


I wanted to share with you what works for me to sleep and ask you a question.

Do you sleep alone or with someone?

My wife makes me die of heat exhaustion and causes incredible fatigue to my sleeping pattern. She wakes up 100 times a night if a cricket farts or her 1ml bladder fills up from the 2 gallons of water she drinks a day. Add the kid jumping in the bed to be with momma and you have permanent exhaustion. I fixed this by sleeping alone until I am better, this was a major improvement for me immediately. I found myself sleeping from the time I close my eyes until the alarm.

The supplements I take for sleeping are:

  1. Cerenity - 3 pills right at or slightly before bedtime.

  2. OptiMag 125 Magnesium - 6 pills right at or slightly before bedtime.

  3. Handful of Almonds as they literally knock me OUT.

Wash it down with some water.

I have found in the beginning TRT did give me some insomnia and it also would just “wake me up” in the middle of the night and boom. No more sleep. Exercising, letting my mind relax with mellow music and the above vitamins and almonds really helped me.

Hope that helps.


I’ve been having issues sleeping as well. 6 weeks in. I figure it was TRT. However I got rid of the blue light on my phone and used my phones built in feature… I actually slept in about 1 hour last night… finally… it was taking me 2-3 hours…

Looks like TRT amplified my pre trt bad habits.


Hi, thanks for your input. i have drawn my conclusions on what is happening with me. Since I have had every possible examination performed under the sun and everything comes back normal, I’m now thinking the problem is mental and not so much physical although it feels physical.

Ok, so back in September 2017 I weaned myself off an SNRI (Cymbalta) after 15 years of use, I was given an antidepressant in 2003 even though what I actually needed was TESTOSTERONE, anyway that’s a separate story… 2 months after quitting my SNRI extreme anxiety and insomnia started, along with exercise intolerance as in I would exercise and that night I would have severe insomnia, sometimes lasting 3 days - I would be wiped out during this time, this hasn’t improved. In this time frame I have developed aches and pains all over my body that I didn’t use to have. Because the symptoms were/are so physical I was convinced I had CFS / ME / Sleep apnea / MS / Diabetes and many other diseases, although every doctor I saw couldn’t find anything wrong with me.

So here’s the eureka moment for me and it came in the form of @roscoe88

@roscoe88 suggested it could be a serotonin issue as in a depletion issue. Over this last week I have made some astonishing findings:

  1. Exercise can deplete serotonin and if I’m already depleted after stopping my SNRI then I am running on empty, this is spiking my adrenaline which is keeping me awake at night - then the insomnia causes anxiety and round and round we go. I also believe exercise creates a fight or flight situation in me which ignites all the anxiety symtoms, pounding heart etc,…

  2. Serotonin makes Melatonin, the sleep chemical, being low in serotonin will mean low melatonin = insomnia

  3. Low serotonin has been linked to Fibromyalgia - aches and pains all over the body

  4. Low serotonin = anxiety & depresssion

I now believe I have found the answer - it’s all starting to make sense. I believe I am serotonin depleted.

Reluctant to go back on an SSRI/SNRI I have just started a newer kind of Antidepressant (NaSSA) called Remeron, this is given to people with anxiety/insomnia. Its early days yet but I am hoping this will re-balance my brain chemicals including serotonin and I hope to see improvements. So far I have been getting some sleep but feel like a zombie all next day, I have read the groggy feeling will go away in time.

I believe the TRT is quite stimulating also which is adding to the insomnia, I am working on this to get dialled in, I don’t want to use an AI so lower more regular dosing is my new protocol, hopefully once this balances out then things will only get better from there.

I am now at the beginning of my life journey to get my body balanced from all angles, this is going to take time but I am pretty confident my problem has been mental and not physical all along, this in itself is a weight off my shoulders.

I will keep everyone posted on here with my recovery.



Hey, actually after I have been on my phone all night, these are bad nights for me. I will check my phone for night time settings!


My wife actually sleeps in another bedroom with oujr new born baby, she knows I struggle with sleep so she opted to do this so she didn’t disturb me through the night.
Almonds! Wow never knew that!


Gonna try this tonight, the tryptophan in them makes sense. Magnesium, like you said, is also helpful.

Literally had an argument with my wife about this last night. She wants the fan off, I want it on because I’m a blast furnace at night. She also tosses and turns all night because she’s 7 months pregnant and uncomfortable. I’ve actually considered buying another bed.


Just clarifying: Are you waking up after sleeping for short periods of time or not getting to sleep at all?


Not getting to sleep at all, BUT if I do manage to drift off, I keep waking up with a racing heart, adrenaline pumping through my veins (well that’s what it feels like!)


Try having something slow-digesting close to your bedside, maybe some nuts, nut butter or protein of some sort. The waking up with adrenaline thing MIGHT be due to low blood sugar. I just read yesterday that the brain consumes tons of glucose and, as it feels levels dipping during sleep, it increases adrenaline to save what’s left.

Of course, this article seems to be aimed at diabetics, but it’s worth a shot.


Yeah, I started having peanut and honey on a slice of wholemeal bread before bedtime - I read the same thing. I’ve literally tried everything. I am going to get the brain chemicals balanced and see what happens


It’s a pain man, I feel you. Started having bad insomnia after withdrawing from TRT, but starting again only marginally helped. My nights are hit or miss, I hadn’t slept properly in days before last night.


I cannot think of anything worse than lack of sleep, it affects every aspect of your life.
I have very lonely nights, just sat for hours on end waiting for the morning to come to get up for work, then I have to be normal at work on the back of no sleep.
Its horrendous. I was always a good sleeper, not anymore. I actually worry about going to bed!


I do as well, in fact I’ve been thinking about it all morning since I finally had a good night. I’ve been doing some meditations about accepting insomnia and changing the relationship with sleep.

I’ve wanted to try a tryptophan supplement but I’m on an SSRI and fear serotonin syndrome. Guess I’ll just try tryptophan-rich foods instead, I don’t think they’ll contain enough to cause an issue. How was your SSRI withdrawal btw? I’m going to get off of mine eventually but heard coming off can be hell.


SSRI withdrawal was hell, I’m not going to lie to you. It took me 18 months of splitting capsules and reducing slowly, each time I reduced I felt it.

I have Tryptophan also but as you mentioned I am scared of doing too much at once, I have only just upped the dose of the mirtazapine so I need to let that bed in first before doing the tryptophan.
I did try the tryptophan a couple of days ago but believe it just added to the groggyness of the mirtazapine.

Around 8pm I start to worry about going to bed, worry if I will sleep or not once I get there, this triggers butterflies in my stomach and that’s all it takes for me to have a bad night!