T Nation

Newbie on TRT, Feeling Lightheaded and Foggy After Injection


#1

I’m a 49 yr old male (turn 50 in Sept). Played a ton of sports growing up, always kept in very good/good shape/diet always good…could be better. I may have a couple alcohol drinks a week at the most. No real ailments over the years although I do have hemochromatosis and donate blood every couple months to keep iron levels normal. About 2 months ago, I had some pain in my prostate and urologist put me on antibiotic and alfuzosin 10 mg (muscle relaxer for prostate). been just below avg levels of T the last 10+ years but really didn’t nothing about it and my primary physicians have never addressed it. Over last 8 months, my 5 yr old son (4 at the time) was diagnosed with cancer and has been on chemo since Oct. That along with other factors (buying a franchise and we’re building the store soon with opening around Labor Day, stresses/anxiety of life, tough marriage, challenging stepkids) had me going to my primary dr to hopefully “feel better”. I definitely have many of not all of the low T symptoms (lack of energy, lack of sex drive (but certainly don’t have ED), irritable/mood swings, insomnia (been on Ambien/melatonin/Kirkland sleep aid since Sept), etc. primary dr said “you have anxiety and maybe depressed, let’s get you on Zoloft”. I told her I want a 2nd opinion (which kinda turned her off but I don’t care). I then looked at my old labs from Sept 2016 and my T levels were:

Total T : 337 ng/dl (normal range 348-1197)
FT: 6.3 pg/mL (normal range 6.8-21.5).

So I started researching and went to a urologist last week to check levels again. Here are my T levels last week (test was done around 11am)

Total T: 2.72 (1.75-7.81)
FT: .05 (.043-.213)

They prescribed .7 mL of test cyp (200 mg/ml) every 10 days and I injected in my left check (actually had wife do it) last Friday morning at 10:30 am but injected .75 ml (which I believe would be 150 mg). Injection went fine…we even watched YouTube.

Here is the issue: later that day (last Friday) I started feeling foggy, light-headed, the best way to describe it is if you’ve had you’re bell rung in football…also had rubbery legs and just feel tired…it would be hard for me to workout right now due to these feelings. Feel like my anxiety has elevated as well (not too bad). On Saturday, I was at the pool sitting in a chair with feet in the water and got up an hour later and had the strongest headrush I’d ever experienced. Almost feel down and it was a chore to walk 10 steps before sitting down again.

I find that the mornings are worse and afternoon (and especially evenings) I’m much better. Thought I was over it last night, but clearly have symptoms described this morning. I called urologist office yesterday and he said “initial dose may have been too high for you and to take .5ml with next injection (again, I’m suppose to take injections every 10 days).

I feel like I need to go to LabCorp today and get checked for various things including E2 as well as T levels, thyroid level, CBC, AST/ALT, hematocrit, PSA. Anything else I should check? M


#2

Get the labs but since you started injections already inject 50mg 2x a week for a total of 100 a week. You appear to have experienced a rush from the high dose. You will be more stable injecting every 3.5 days.

I pray for your son.

Labs
Total t
Free t
Shbg
TSH
Free t3
Free t4
Reverse t3 if u can
Prolactin
Cortisol
LH and FSH if u never took before
CMP
CBC
Lipid panel
Estradiol sensitive
PSA


#3

Charlie - thanks so much for the response. I am seeing Urologist tomorrow and will also have more tests run. Hopefully they can test everything you have listed and I can post these to the forum. Surprised i’m still feeling the way I am since I injected Friday at 10:30am. Is 150mg of cyp a lot? I definitely will talk to Urologist but sounds like we’ll move to 50mg twice a week. I’m guessing this 150mg just shocked my system/brain and it’s going haywire right now.


#4

Your testosterone was low. Injecting 150 at once will cause a huge spike in testosterone and estrogen which you body is not used to.
The 200 mg every 2 weeks is a protocol that is very old and does not work.
If your doctor is not knowledgeable about trt they will not know what works. You may need to shop for another doctor.

Please check About the T Replacement Category

It has info on protocols, labs, and finding a dr


#5

Charlie - the doctor prescribed .7 mL (140 mg) every 10 days and made it sound like 140 mg every 10 days was a nice place to start and then see what are levels are at in a couple months. With the little i know, it does sound like I spiked my T and estrogen and thus my brain is foggy/lightheaded. I’m a little surprised I wouldn’t see more posts like mine.

I will see him tomorrow but spoke to him briefly yesterday and he was very open to a much smaller dosage. I’ll get some tests run and post results within this thread. I’ll also plan to take 50mg twice a week after this initial 10 days is up.

Thanks for the prayers on my son (his name is Alex).

Take care!


#6

You need to self-inject 50mg twice a week and better if you inject subq over legs or belly fat with #29 1/2" 0.5ml insulin syringes. “25” is 0.25ml and that would be 50mg of 200mg/ml. Injecting IM in your butt is a bad idea, too many major nerves and blood vessels. With subq as described you can do that easily yourself and can see what you are doing and avoid surface veins if you can see them.

You need to do a lot of reading. Your doctor is a typical idiot when it comes to TRT and you need to know what you need and why. Passive with TRT does not work.

You will probably need to manage E2 with anastrozole. And 250iu hCG subq EOD will prevent shrinkage/atrophy of your testes if you and/or wife care about such things.

Your history of stress puts you at risk of adrenal fatigue. That creates or amplifies low thyroid function. If you have not been using iodized salt, you are deficient. See “oral body temperatures” below and post BOTH sets of temperatures.

When thyroid function is poor, energy can be low as metabolic rate slows down, and you get fat and depressed, low-T certainly contributes as well. Then starting TRT increases/restores metabolic rate/demands and if your body cannot sustain that because thyroid function is low, you can feel as you describe.

So T and thyroid are major players in you vitality and mood. Cortisol is also very important. With stress, cortisol increases but adrenals can fatigue from that then cortisol can drop later on. You need to do lab work for “AM Cortisol” and do that at 8AM or 1 hour after waking up. Do not do later on.

If Ambien is dragging on the next day, it could make you a zombie and could amplify depression. Ask to try Trazodone 150mg and these are scored to break at 50 or 75mg. Try 50mg. $40 per year [360x150mg] at Walmart. After a 30 pill trial, get script for 360 tablets and pay the $40 cash price out of pocket.

Melatonin should be 5-6mg time release, look for it. Fast release melatonin wears off in ~4-5 hours and dropping melatonin is exactly the mechanism of waking up.


Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.


#7

As long as you have the testosterone injections you can inject when you want.
My Endocrinologist told me 200 mg every two weeks. I asked if I can to weekly and he reluctantly agreed but he didn’t I was doing it anyway.
Then I did 50 two times a week and felt better. He doesn’t know I do that and it didn’t event ask since he reluctantly agreed to 1x a week.

Good bless Alex!

This will be even tougher for you going through this great stress with your hormonal imbalance.
One thing at a time.
Where do you live?


#8

Charlie - great info! We live in North Atlanta and have some great doctors and nurses for him! We hope to be done with chemo treatments in October.

I’m fairly good at “blocking things out” (for the most part) but if anything, this injection on Friday has really made me lethargic/very “cloudy” in the head. Just struggling to focus and run my business.

Are you taking anything to keep your E2 in check or don’t have any issues with E2? Have you taken HCG? Curious to know what supplements you take? I’m just taking a multi-vitamin but will be doing more and more research on this site. It’s somewhat info overload so at times, it’s overwhelming.

Where do you live? How long have you been on TRT?


#9

Am 41. Live in NYC area.
I tried HCG and did not like how I felt. Appeared to have high e2 symptoms.

I used an AI a few times and all time I crashed my e2. Some are over responders. I have not taken an ai for several weeks. My e2 is currently in the low 30s and appear to have no symptoms for high e2. But low 30s is high normal anyway. I take a zinc supplement, vit D, and a multi. Also Cialis daily (3mg) to make sure I can get it up when I want without worrying if am perfectly dialed in.
Zinc and cruciferous veggies suppose to help e2.

Everyone is different.

It would have been good to get complete labs before you started trt. Now that you introduced outside testosterone your bOdy will stop producing it on its own. So you may have a couple of weeks of not feeling right before you get better.
I started trt in December. Other guys on here have been doing it much longer and will hopefully chime in.

But keep reading when you can.


#10

thanks KSman - tons of great info that I need to read over a few times and do my research to full understand everything. I’ll definitely read the stickies. I certainly don’t want to burden the forum nor be lazy! I clearly went about this ENTIRELY the wrong way and now not 100% on what I should do. I could only see the urologist at 2:20 tomorrow - wondering if I should hold off on any lab tests until another morning?

Will try trazadone as well as 5-6 mg time release melatonin.

My mother has battled hyperactive thyroid issues so I’ll discuss this with my doctor tomorrow.

I may not be getting my dietary requirements …especially in the morning. Today I had oatmeal and some egg whites…and still haven’t eaten lunch (it’s 3:22pm…I’m an idiot).

Part of me is saying: just stop the injections for now with everything else going on in my life. I only did one injection last Friday but I don’t think this is the way to go…I’d like to get my T levels at normal levels while keeping other variables intact (E2, etc).

Curious what you would test tomorrow if you were me? And again, would it be ok to test around 2:30-3pm tomorrow?

Thanks!


#11

Injecting 70 mg every 10 days is stupid and so is your doctor, we see this kind of crap all the time. You have to know what your SHBG level is in order to design a protocol, you can’t just blindly inject testosterone.

Everyone is different, those with low SHBG inject small micro doses every other day, mid-range SHBG guys twice a week and High SHBG guys once a week. Your doctor clearly doesn’t know how that TRT game is played, most don’t.

Insurance doctors don’t have the same set of tool boxes that private practice doctors have like prescribing estrogen blockers and HCG to keep the testicles alive and functioning maintaining fertility.

Mention and estrogen blocker or HCG to your current doctor and he look at you like a confused idiot. Doctor will likely refuse to even test your estrogen, a critical component to successful treatment.

This is why most of us pay out-of-pocket for proper care, insurance doctors are too heavily restricted from doing what’s necessary, like and estrogen blocker and HCG.


#12

I went to Urologist Wednesday and had blood tests. Hope to get back early next week. Still feel light-headed/foggy, rubbery legs but definitely feel better than last weekend/early this week. I’m able to at least concentrate at work since Wednesday which I was not able to do Monday/Tuesday.

I will order the #29 insulin syringes/.5 mL syringes. I just want to make sure I order the right thing. I went to pharmacist yesterday and asked for #29 insurance needles and he was like “that’s too thin and will be difficult to push out the T”…I don’t think this guy knows what he’s talking about. He didn’t have #29 but did have #27 so i got a few needles. I’ll try WalMart later today - can someone clarify: so i need: a) #29 insulin needles, b) .5mL syringe? Do I need the thicker needle for drawing the T from the vial?

Thanks!


#13

There are a bunch of diff ways you can do it and it really comes down to personal preference based on comfort, time, etc.

FWIW here is my protocol:

  1. Draw T with 18g 1.5" luer lock needle with 3ml syringe.
  2. Switch out 18g 1.5" for 30g .5" luer lock needle for subQ injection.

Its all relatively inexpensive at Westend Medical Supplies online.

Edit: I think KSman suggests the smaller barreled syringes because they are easier to push the plunger down.


#14

The pharmacist was correct, with needles that thin it is harder to push out, but that is ok. I use #29 with a 1 ml syringe. Drawing the test into the syringe takes a minute or two with a thin needle like that, but the needle goes into the skin easily with little or no pain most of the time. With a .5 ml or 1 ml syringe, you have to press strongly to get the test out, but nothing too bad. Just don’t go with bigger syringe than 1ml…I could never get the test out unless I heated the oil when I did that.


#15

Thank you for the great tips


#16

I don’t think links are allowed here so you need to google it.
Easy Touch 27ga 1/2" 12 buck per 100. Googlr youtube for subQ injections around the naval.
Simple and no pain.
If you inject 100mg/wk or less there is a very good chance you will not need and AI

This foggyness and pain for days after makes me wonder if you are having an allergic reaction to the oil. You can buy T cyp in 3 different oils I prefer grapeseed.


#17

Great help! Took first Test cyp (150mg) last Friday morning and I haven’t felt good ever since. I would think if I was allergic, I would have hives or breakout from the allergic reaction. Strangely my brain has felt “swollen”, my body has felt super weak, still dizzy/light-headed, rubbery legs. Maybe I’m allergic and this is how I’m reacting. Some have responded that maybe the 150mg dose was too high. I plan to do 50mg sq this Monday. Surprised I don’t feel better by now. Also wondering if my body has shutdown my natural T production and my T levels are back to low a week later. I am getting my lab numbers from Wednesday’s test next week and will post here.


#18

And just to clarify, I haven’t felt pain (from the injection or really any body pains)…mainly my head/brain just feels very swollen…I would equate it to the feeling post concussion (like I got my bell rung when I played football). Monday and Tuesday was simply terrible…off and on felt a little better the last few days but not much better. I basically feel like I’ve had a bad hangover all week.

I’ve read a few posts from folks who were allergic to test cyp and it sounded like their reactions were different from mine (skin rash and other reactions)


#19

I have a feeling this dosage is going to be too high for you given your Total T and Free T. One week is nothing as your pituitary is either shutting down or will within 3 weeks.

Remember everytime you change dosage or start injecting more frequently you reset the clock and it takes 6 weeks for blood levels to stabilize. This is when you start to feel good consistently unless your levels are high/Low.

Keep making changes every week and your suffering will never come to an end as you’ll never reach a stable state.

If you were having an allergic reaction it would be at the injection site.


#20

SystemLord: I agree with you. The doc prescribed .7 mL (200 mg/mL test cyp) every 10 days and I injected . .75 mL (150mg) and it’s like it’s fried my brain.

I plan to do 50mg twice a week and will talk to doc about getting hcg and Arimidex. Do u think this is too much test cyp?

Lab results should be back next week and will post.