T Nation

On a TRT Roller Coaster

I am on a roller coaster from hell. I went to a TRT clinic and they started me off on her 140 mg per week of testosterone cypionate. I started feeling really good after a few weeks and things were real good for a few weeks. Six weeks and they did my blood work and my levels came back in the 700s and my free testosterone was 22.

For some unknown reason they said I could go higher and bumped me up to 200 mg a week and I started feeling like crap with no libido. For the last couple months they have jumped me back down to 140 for a couple weeks up to 160 for a couple weeks and back up to 200 a week for the last three weeks and I feel like crap. The worst is my libido coming and going .

I am thinking about Doing self injections at home with my regular family doctor but all he is willing to prescribe to start is 100 mg per week. What should I do?

Welcome kilowatt86,

You should post all pre-TRT or most recent labs including Total T, Free T SHBG (very important) and estrogen.

This clinics isn’t doing you any favors, clearly inexperienced at this TRT game. Consider Defy Medical because you need a doctor that has experienced with TRT or you’ll have to count on yourself to figure everything out all by yourself.

Weekly injections isn’t optimal for everyone, especially myself and inject 24mg EOD do to lower SHBG, spend some time on these forums and you’ll see everyone is different. There are a lot of guys who complain feeling off 4-5 days after an injection, increasing injection frequencies fixes this little problem.

Note everytime you change dosages, levels will become unstable (hormonal roller coaster) and 6 weeks is needed until levels are stable again provided dosages remain the same. Do not expect to feel good at all times within 6 weeks of changing dosages, only after 6 weeks, but the true measure of a protocol is at 8 weeks.

The only labs they did were
Total 770
Free was 22
Estradiol 19
Thank you for your reply. Should I stick with this 200 mg a week for a few more weeks… Or quit the clinic and start doing 100 mg split in two shots a week myself ?

That would put your SHBG about mid range which is ideal, those are good numbers if your levels remain there 24/7 and not just a few days out of the week, when were these labs taken in relation to your injection?

If these labs were taken hours before your next injection, I would have left well enough alone. If labs were taken 3 days after an injection, levels may be lower by the end of the week.

Note TRT can take months to reach maximum benefit and can be a slow process.

Onset of effects of testosterone treatment and time span until maximum effects are achieved

These were taken mid week after injection. 4 days later

Those levels are perfection, I would have considered your TRT protocol a success and left it alone.

Next time do labs right before your injection to see your lowest point or trough, this is the true measure of a protocol. You don’t want to be in the below 500 the last few days of the week.

Yea ! I felt great and they upped my dose and now feel horrible. Should I stay and let them keep me at 200 a week or make them lower me again… or quit and do 50 mg every 3.5 days myself? They want me to stay on 200 a few more weeks until blood work. I just can’t stand my libido problems. I know by switching doses so much it’s making things worse. Is 200 a week a lot?

You may feel better on 50mg twice weekly, levels will be steadier with less fluctuations. It’s up to you but sounds like you were doing well on weekly dosing. This is a game of trial and error, figure out what works best for you.

Should I skip a dose this week to let things lower or just start the 50 mg the day I usually would take the 200?

It depends on how bad thing are for you right now, it won’t kill you to skip a dosage, you have plenty of Test built up in your system.

Then again if you start at 50mg instead of the 200mg, your testosterone peak 48 hours later will be smaller and have less impact on you.

If things are bad right now just skip the dosage, you’ll be fine.

Thanks for your time.

Sure your welcome.

Do you know your estradiol level? You felt worse with 200mg, really good with 140. Perhaps E2 elevates past your comfort level with the higher test dose, which was nearly a 50% increase?

The desires and needs of the patient are part of good patient care. It is perfectly reasonable to ask, whenever there is a change in treatment suggested, why. I would also question why, as you sound very happy with results, there was a need to try something different. If it isn’t broken…


Don’t skip a dose. Adjust your dose. Skipping one is asking for a swing and skewed everything. The best option would be just go back to 140 and ride it out for a couple of weeks until you level back out. Going 200 to 0 to 50…How about go back to where you liked it. You’ll probably be just fine in a couple of weeks. Now you know, the higher dose doesn’t agree with you.


Do you think I should try splitting my dose into two shots a week also or once a week?

I think you should go back to what worked and level out before you tweak anything. If you want to try twice a week or whatever, level out for a few weeks first.

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Two is rule of thumb with most docs now a days. Or once if you were fine on once. But stick with this dose for the long run .


What dose are you saying to stick with?

I would go for the one that worked.split twice a week or daily.

I’m gonna try 120 mg a week into two doses every 3.5 days…so .3 every Wednesday evening and . 3 every Sunday morning. I read that if you switch to twice a week you don’t need as much as once a week.(140) I’m gonna try this for a month and see how it goes. Thanks guys! If anyone thinks this is a bad choice please tell me.