T Nation

New to TRT, 10 Weeks In. Side Effect Questions

I am 35, 215lbs used to work out. Take 50mg of Zoloft for anxiety for 28 years, and 10 mg of Adderall a day for 15 years. I dont’ abuse adderral, but since starting trt I feel like I need to double up to function. It started the beginning of this year tired everyday, can’t get motivated to do stuff I used to do, like work out. I also feel like I can’t remember anything new or recall anything unless something triggers the memory. I thought I was just get older and wore down with kids, but about 5 months ago started getting what felt like a lump and a lot of tenderness in my left nipple. My wife finally got me to go to the dr, and after lots of blood work and mri’s he diagnosed me with low T and gyno. Here or my results.

Low LH 1.5
Low free test 8.1
low test 232

He started me on cypionate 200mg/ml 1ML every 2 weeks. I take the shot on Monday, and while I really don’t feel any energy or better sleep, I feel that for the first few days caffeine and Adderall have a better affect on my ability to have energy and think. After about 5-7 days, it feels like its completely gone and I am just extremely tired and can only function if I am taking in caffeine all day long. As for sex drive, it doesn’t increase until about sunday and last till about Wednesday. (days 7-10) After day 10 the thought doesn’t even cross my mind and I just feel depressed, tired, and just dumb. I feel like I can’t think at all, and want to avoid conversations.

I just went to my dr today and told him what was going on, and that I still have gyno and he broke the 1ml/200mg shot up from every two weeks to 1 .5ml/200mg weekly. Same dose just broke up.

I had mri’s on my head and no tumors or anything, and the dr is unsure of what is causing it. He has set me up with an endo, but I can’t get in until March.

My questions are should I be feeling better as far as brain function and tiredness? Is there anything I can do to increase the effectiveness of it? Does my dose seem good?

Anyone with advice to a newbie would be greatly appreciated. Thank you

Could you provide all of the lab results available?

Every two week dosing is not going to work very often. I would not waste time even trying it. At least now you’re doing something reasonable. Whether or not it is best for remains to be determined.

Post complete labs and you’ll likely get a lot of ideas here.

Labs ranges please.

An every 2 week protocol is no good and 200mg weekly is too much testosterone for the majority of men. You need to locate a doctor who can read your blood biomarkers to determine the correct dosing and injection frequency. The majority of endocrinologists and urologists are TRT ignorant and won’t even know the basics on how to do TRT, most don’t even know what tests to run as they have zero training.

A TRT protocol should be based off pre-TRT estrogen levels and SHBG levels, because a protocol for a low SHBG man versus a high SHBG man can differ greatly. You put a lower SHBG guy on once weekly injections and his levels will fluctuate throughout the week and he may feel as they he needs a dosage increase when what is happening is your body can’t reach a balance do to levels fluctuating wildly.

I scored a similar ratio of Total T and Free T to yours which suggested SHBG is on the lower end near 20, you need to inject at least twice weekly, inject using 29 gauge insulin syringes and inject in quads and shoulders and get rid of those 18 gauge harpoons I almost certain your doctor has provided.

I recommended 50mg twice weekly or 20-25mg EOD. It will take 6 weeks for testosterone and estrogen to reach a stable state, then you will start to feel better if levels are in a range good for you.

Zoloft and Adderall will negatively affect the way you feel on TRT and you were likely put on these drugs because of low testosterone, anxiety and depression is common among men who have lower than normal testosterone. These drugs, SSRI cause low testosterone as they rewire the brain.

Just think of an elderly cranky old man and think low testosterone.