T Nation

One Week Into TRT, Is There an Adjustment Phase?

The first 3 days I felt a nervous energy about me. Like I had too much coffee. Nothing to complain about but I could feel something.

Also - first few days I was sleeping better. That was very much a welcomed effect since I normally do not sleep well. No increase in libido but I was waking up with morning wood. That honestly hasnt happened in 10 years. During the initial few days my appetite was voracious. I was eating non-stop.

The last 3 days I have been SUPER CRANKY. Like I was PMSing like crazy. I had zero patience. Inanimate objects would piss me off. I realize that makes no sense but thats what was going on … i was just irritable and pissy. Around these three days i went to the gym and lifted heavy. One day I went to a gym-in-a-box and did a HIIT workout. On all those days I was either very very sore the following few days - or I was so tired after the workout I needed to come home and take a 4 or 5 hour nap.

Today however I feel great. I am calm. I do not have the nervous energy and i am not frustrated for no reason. Today is day 8 i believe and I realize any change in hormones take time to level out, however, I wasn’t prepared for this kind of stuff right out of the gate. I would appreciate any info and advice from the forum. I have been told there are a lot of knowledge guys that post here

Background info - I have always been athletic and lean. Never prone to gyno and have laways been an athlete. That said, any time I have gone to doctor because I “just feel off” I have had a drug thrown at me without a second thought - SSRIs, Adderall, Ambien, etc etc. I hear this is common. I would try the drug but never took them for long - i always felt this was a band aid approach and i wanted to get at the root of the problem. Most docs would take one look and tell me I am fine and don’t need viagra because I am a healthy looking 30-something and “you’re fine” … regardless I have had energy and libido, sleep and focus issues most of my adult life. I am happy to be taking control of this issue and would appreciate feedback on my labs and what I am feeling.

6-0
185 lb
Currently 11% BF
Over the last few years my recovery and gains in gym have been declining …a month ago i had labs

Rx: 120 mg Test Cyp / Week … 750 HCG / Week (40Mg x3 & 250 x3 - both SubQ)

Testosterone, Tot ng/dL 264 - 916 122

Free T (Direct) pg/mL 6.8 - 21.5 6.7

Dihydrotestoseterone ng/dL 30 - 85 7.1

Thyroxin (T4) ng/dL 0.82 - 1.77 1.44

|DHEA-Sulfate ug/dL 102.6 - 416.3 418.3

TSH uIU/mL 0.450 - 4.500 1.19

Luteinizing Hormone (LH) mIU/mL 1.7 - 8.6 8.4

Prolactin ng/mL 4.0 - 15.2 10.9

PSA - Serum ng/mL 0.0 - 4.0 1.1

IGF-1 ng/mL 75 - 216 192

Reverse T3 - Serum ng/dL 9.2 - 24.1 20.3

Estradiol, Sensitive pg/mL 8.0 - 35.0 3.2

Thyrogobulin Antibody IU/mL 0.0 - 0.9 <1.0

Thyroid Peroxidase (TPO) IU/mL 0 - 34 9

Triiodothyronine (T3) - Free pg/mL 2.0 - 4.4 3

Sex Hormone Binding Globulin (SHBG) nmol/L 16.5 - 55.9 21.2

Glucose mg/dL 65 - 99 70

BUN mg/dL 6.0 - 24 24

Creatinine|mg/dL 0.76 - 1.27 1.5

eGFR mL/min/1.73 >59 57

BUN/Creatine Ratio (ratio) 9.0 - 20.0 16

Sodium mmol/L 134 - 144 145

It will take 6 weeks for levels to stabilize, until then you will have good days and bads days. If you make a course correction, it starts all over again and 6 more weeks.

Reverse T3 is a little elevated, dietary changes and working out you should be able decrease. Reverse T3 blocks the main free thyroid hormone (fT3) which is responsible for increasing body temperatures and therefore metabolism.

Doctors need to start digging deeper to find a cause for depression and anxiety because drugs only mask the symptoms instead of addressing the cause. Unfortunately treating the symptoms is more profitable than the cure, TRT will prevent disease.

TRT isn’t profitable for doctors, SSRIs are profitable and is why they are only interested in prescribing drugs. These frankenstein drugs, chemicals not natural to the body can cause low testosterone. Statins can also cause disease.

Doctors get paid to diagnose you with a disease, TRT will put a stop to it and now big pharma will be unable to profit from expensive new treatments and drugs down the road.

This is why TRT is difficult to get prescribed.

Some men do not tolerate HCG at all, it can cause water retention and mood issues.

Glad your feeling better. This is a marathon not a sprint as another member says. Jsut be patient. You know the root of your problem and now just stay focused and expect a roller coaster until it’s dialed in.

I spoke to a good doc yesterday and he said to me “you have to give it 4 months”. It won’t fully kick in until then… so yeah I thought 6 weeks or 2 months not 4!!! Regardless it’s all worth it for a life time of healthy happy awesomeness!!!

Welcome to the TRT club…

I also got off hcg. Felt like my head was going to pop and my labido was messed up. I was also depressed and had tons of anxiety. Removed it and it all dissapeared.

Thanks System -

Can you give me some more insight to what your real-world thoughts are on R T3?

I have an undergrad in pre med but honestly the more i dig into all this the more i realize how intended yet flawed our medical education system is … I never would have guessed I would have a thyroid issue and wasnt aware how many down-stream effects the thyroid controls.

Any info and suggested plan of action appreciated

There seems to be a big divide on the HCG thing. A lot of guys say you need it to keep test baseline up. Some say its garbage. Some say its needed for fertility and some say you can be on TRT solo and when you want to “turn on” fertility just add HCG at that time …

Not certain what to believe. I was in favor of it becasue it just felt right to keep my boys “turned on” and not let them atrophy. plus i want to have kids

It’s true that you don’t need HCG off the bat. When you need to be fertile you add hcg and it works. There are numerous men who were off hcg for a decadl and after starting hcg they had children. I trust them and it totally makes sense.

I have not heard of any trt doc (that is good) ever comment someone not being fertile once hcg is started. That’s started after not being in it for years. Never heard this.

I’m sure by now we would of been told about this issue and it would be public knowledge. Problem is there are docs to scared to not give clients hcg because your system totally shuts down. Including other hormones… it’s pure fear… not fact based science.

One should freeze sperm if they are that worried about this. Keep in mind that the cost for producing a child through frozen sperm is 10k or more from what I’ve read and it’s also not having a high rate of success.

Try it out. Jsut saying watch out for the sides. If you have issues it’s probably hcg. Remove it and be better.

awesome and thanks for the info

i did look into the freeze option and youre right - the storage isnt that much but the untilization of sperm on the back end is where it gets pricey

So what dose would you suggest to keep the boys afloat that would yield minimum side effects

i am on 750 a week now - should i drop to 500 or lower?

I am doing 100iu in Monday’s and the boys didn’t shrink and no side effects. You can do that to keep them working minimally or do 100iu twice a week e3d. Some take 200iu. When I took 200iu I still felt horrible and stopped.

I know someone who did 100iu three days in a row every couple weeks or maybe once a month and had kids. I’ll look for it.

@KSman

KS i was told to ask for your input. Care to look over these labs and tell me what you think? Thank you

I felt the same way the first couple days. I’m on week 4 right now. The swings have leveled off a little bit. I still have good days and bad but not as severe. Though toward the end of the week I start to drag a bit. I’m on 100mg of Depo a week right now and have my next round of blood tests in a couple days. I feel like the boys have gotten smaller but I’m done having kids so I’m not worried about fertility, mainly looks lol. I can’t say that I’ve noticed any difference in appetite or metabolism. But like everybody says, it’s a marathon. I’m hoping to start seeing some changes in the coming weeks. Plus my doc said that more than likely my dose will have to be increased to get up to where she wants me (800-1100). Though I will say my energy levels have come back up a bit and the brain fog has diminished quite a bit. That’s been my experience so far. Not sure if it helps or not.

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Read the stickies and research these boards. You’ll find you can avoid the end of week crash if you split it .

@Fat_ginger_ninja

appreciate the reply

yeah i know its a marathon … i was mainly curious why i had such crazy swings right out of the gate. Today i feel much better and i think i am going to keep my same schedule moving forward but drop the HCG down a bit.

@enackers - agreed and i realize that levels things out, thus my confusion. I am injecting 40 mg 3 times a week and the HCG 250 units three times a week … lot of good info here. appreciate the help

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@bmbrady77

appreciate the feedback - i didnt want to hijack someones thread but a lot of what you said in the other thread does make sense. Given that, what is your take on my labs below?

Man, again I am no dr, but what little I do understand is leading me to believe that you are definitely primary hypogonadism. I don’t see your FSH, but your LH is screaming at your testicles to make more T. I don’t know much about Thyroid but your numbers look pretty decent to me. Wonder why your BUN is so high? Do you eat very high protein? If not, it could (loosely take the could here) be an indicator of kidney issues.

I think you’re going to eventually wind up at around 100mg - 120mg split into at least 3 doses a week. Stay the course and adjust as necessary and you can laugh at me in a year if I’m wrong. It won’t bother me because I am very adept at being wrong! lol

The labs could be skewed as these were non-fasting and the whole month of January I was following the whole30 plan, not drinking alcohol, and ramping up my training (doing some HIIT or spin in the early morning a few days a week and Weights in the evening after work.) and in hindsight I think i was dehydrated I just didnt realize it … and that dehydration was probably more significant that initially thought

with that said i did see a Uro after these labs and he was more concerned about hormones than kidney function

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@bmbrady77

I have been reading up and studying some of the hormones and pathways i am unfamiliar with and a few guys on reddit to have found the sweet spot adding Progesterone, which helped their mood and sleep… id like to work on both of these. I dont see Progesterone listed in my labs - is that something I have to request outside of the panel I had done?

Whats your take on adding pregesterone?

Yes I think you would have to request that bloodwork separately.

As far as adding it you your protocol, just make sure that you don’t put the cart before the horse. Get dialed with Test only and get those levels stabilized for a few months. Sometimes, the T deficit can cause the other areas to just go haywire, and often the body can self correct those other levels when T gets in line. Give your body time to heal itself when you are able to sustain the proper amount of T.

If after you’re stable and the Free T is looking good for a good while (couple of months), and at that point there is STILL something else that is reading sub par, that’s when you start considering adding other things to your stack, or supplementing naturally.

One at a time brother. Take it slow. It’s been said a thousand times on here, it’s a marathon and not a sprint. That’s never more true than where you are at right now.

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So I am half way through week three (Day 17? or 18?) and I can tell a difference.

Week one - initially better sleep. The return of MW and I cant recall consistently waking up to that in over ten years

Week one-two … Around the end of week one I got SUPER moody and just down on myself. I was bitchy, irritated and sad. That lasted about 3 maybe 4 days. Sleep was not good during this stretch

Week two-three … so the majority of week two was Ok. No moodiness. No irritability. Sleep was kinda normal. One night of insomnia.

Today and Yesterday I feel like the sun has come out after a very long dreary rainy week. I am quick to smile, I feel like I have better focus, my libido has ticked up a notch yet it is nowhere close to where i want it but it was so low before anything is nice … I feel more patient and overall a more pleasant person to be around.

I have been keeping a log via Penzu where i jot down how things are going on that day… mostly subjective stuff (optimism, libido, motivation, focus, energy, procrastination) and list them out 1 - 10 so i can “track” my progress …might be dorky but i think it will show a steady increase as I rejoin the world of the living.

Its kind of funny to look back over the last 12 - 15 years and only now realize that I let myself drift into this state of overall unhappiness. I havent really had a strong libido in a decade and combine that with poor sleep and energy and it doesn’t paint a pretty picture of how i went about my day on a daily basis. I understand why doctors have tried to give me SSRis before as i know i wasnt a “happy” person … i wish they would have checked my hormone levels back then. This seems to be doing the trick

Just an update. Appreciate all the feedback from the forum

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Good news. I wish the majority of western civilization would have there hormones checked. It would stop the over dependence on medication. Including alcoholism and addiction. We’re masking our pain and it’s unhealthy.

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@studhammer @alldayeveryday - tagged you both. Appreciate the info in the other thread, but here is the one i started initially.

@alldayeveryday is there any info you need specifically?