T Nation

Lower Dosage or Inject More Frequently?

I started TRT in early June with 200mg of Testosterone Cypionate every 8 days. I split that into 100mg every 4 days.

Everything was great until September. Then I started a roller coaster of anger and crazy emotions that cycle on every three to four weeks. I’ll be totally fine, then one day the anger and depression come on and sit on me like an anvil for 5 or 6 days. Then I go back to feeling fine. This cycle has repeated itself in September, October and November.

I had blood drawn each time and early on I thought E2 was the culprit. The first time was on October 11th. My T was in the low 800’s and E2 was 58. The doc gave me Anastrazole and I figured that would help.

4 weeks later BAM! Another vicious round of anger and emotionality. I had blood drawn again on November 8th so I could see what was going on. My T level was 991, Free Test was 265, and the Anastrazole had pushed my E2 down to 5. I figured that explained the mood swings and emotionality. It was a hellish week but I figured I was onto something with that E2 level.

On Nov 16th I felt normal again, so I got blood drawn just so I could see what ‘normal’ looks like. My E2 was below 5 ( I think the last of the Anastrazole was still working it’s way through my system). Here I thought that the actual swing in E2 must be the really bad thing, and that once it stabilizes things kind of start feeling normal again…this is just me guessing based on the limited data I had.

On November 20th I dropped my dosage from 200mg a week, to 160. I simply had to find a way to stop this nasty cycle. My marriage can not last through much more of this, it’s that bad.

So on November 29 I had blood drawn again (4 days after an 80mg shot). My T level was 604 (down from the upper 800 and lower 900 range when I had it checked 5 days after my old 100mg shot), and my E2 level was 20. So E2 was moving up and was back in a normal range.

Two weeks later, on December 10th I started another cycle of anger and emotionality. I had blood drawn again, and my E2 level was 31. That surprised me. I thought it would be quite high or quite low…not right in the middle of the range.

At this point I don’t know if E2 has anything to do with this emotional roller coaster I’m on. I’m supposed to take another shot today but quite frankly I’m concerned. I don’t know if I should drop the dosage again, if I should inject every other day to keep the same 160mg a week level, or if I should just quit this altogether and go back to Clomid for a while.

Any thoughts on this roller coaster I’m on? It’s literally killing me.

SHBG? TSA? Vit D? Other meds? Are you off the AI at this point?

No other meds. I’m off the AI. I don’t know what the other numbers were. The doc did tell me a few months ago I was low on Vitamin D but I didn’t do anything about it. I’ve got the vitamin supplements but totally forgot about them.

Can you correlate the mood swings with the shot protocol in anyway?

Well it’s a small sample size since it’s only happened four times, but in each case it began either the day after a shot, or the day I was due for a shot.

And then the T hits and brings you back to normal. I think you might need to increase your shot frequency. It couldn’t hurt.

I think it was a mistake you started high dosage.

Back to the basics. 50 mg e 3.5 days for 6-8 weeks. Then adjust dose if necessary.

Your levels are fluctuating to much.
Ai made everything worse
Your free t I did not see range but it looks like it was way above range. That is a shock to the system. If trt should be in mid to upper range

The answer to your question is both lower the dosage and inject more frequently.

It’s clear your doctor isn’t managing your TRT protocol very well at all, first he should have lowered the dosage and increase the injection frequencies to lower estrogen and maintain more stable T levels since it sounds like your levels are swinging.

When I was on a 50mg every 3.5 days, in the beginning everything was fine, but as time went on I began to notice my mood was swinging out of control, started an EOD protocol and the swinging stopped. Once weekly was even worse for me.

We have a lot of anastrozole over-responders here, myself included who need very small doses only available through compounding pharmacies, they go as low as 0.050.

Typically the majority do well on injections every 3.5 days and increasing the frequency for those with estrogen issues. Some guys feel better on an EOD and even daily protocols.

SHBG is a big piece of the puzzle and if really low, more frequent injections may be necessary.

Your biggest challenge is finding a competent doctor.

When you switched to EOD did, did you keep the weekly dosage the same?

I did keep the dosage the same and my levels went too high, when you inject more frequent, you prevents your testosterone from dropping as much as before, so you actually need slightly less testosterone to achieve similar levels as before.

The longer you go without an injection, the lower your levels decrease.

if you had hypogonadism symptoms for long, initial start of TRT, you will notice tremendous benefits of mood, libido, physical activity, etc…for initial 6 - 8months.

this happens becoz the receptors for testo were deprived of testosterone for long.

after few months the receptors develop tolerance, so beneficial effects are not as much when compared with intial start of treatment… but they tend to stabalize to normal with time.

my adivce is …keep yourself busy and occupied. continue with 200 or 160.
also do some workout .

if you are on 200mg better maintain good physique. so that you dont gain weight.
increase in weight also causes high e2

if you can not workout, better to go with lower dose.

higher dose of TRT needs more discipline and monitoring.