One Year on TRT, Muscle Pain/Fatigue/Tingling

I’ve been on trt for one year now, currently taking 150ml of test c injected once per week. (.75cc is what the dose comes out to.) Right now I’m having a lot of muscle pain and weakness. When I do simple stuff like work on my vehicles or do basic tasks at work I get tingly sensations in my hands that doesn’t stop for hours. I’m tired basically all the time. My doctor doesn’t seem to think my platlet count being in the upper 500s is an issue.(570) my hemoglobin is normal. He also says testing my estrogen levels isn’t helpful while taking testosterone… I have an appointment with another doctor this week because we all know thats bs. But I’m concerned about the pain. I haven’t read about people experiencing this muscle pain. It’s all over/random. Could be my arms or legs or both. Could be my abs, my back, the front of my shins or my calf’s. I don’t work out, I’ve tried to start but prior to starting trt I was at 140-170 nl which was one reason I just had no energy and depression was kicking my ass. Now my t is higher but I feel worse than I did before. Sure, sex is great, but so is being able to walk without a limping and being able to pick up a wrench without dropping it because my grip is so weak from my arms being sore.

I’ve also experienced migraines. I went and had an mri and had no other issues. I’ve since started taking a med for that and it’s gotten the migraines under control.

Last month my doctor had me go three weeks without a shot to test my levels and see if the pain subsided, my t dropped, as expected, to 65. The pain was going away, sadly taking with it any sense of sanity I had left. The sudden drop was hell on my psyche.

I resumed the dose of 150 mg once a week and after three days my t was 913, four days the pain was intense, one week it was 848. I took another dose at seven days and two days after that the pain again was intense. I guess I’m a glutton for punishment. I’m going to see a local doctor who’s better known in the area for treating low testosterone. So I’m hoping to get this sorted out soon. I’m not willing to go through life this low, I’m only 32 and at 30 was testing under 150nl/dL…

What are you taking for the migraines? What else are you regularly taking? Have you had your iron or ferritin checked?

I’m taking 50 mg a day of topiramate for the migraines. I haven’t had a full CBC done in a long time, before starting trt. I will get in to the lab on Tuesday to get a full work up done again. I Don’t know if ferritin levels were included in that.

How could your doctor think testing your E2 was not important?? You are on exogenous Testosterone. You need to advocate for yourself man and insist you get your estrogen checked. Each time I get labs done I want TT, FT, E2, SHBG CBC done. At minimum, you need to do the same. If he will not do this for you, you might wanna look for a new MD. Also your platelet count being high could very well be causing this problem.

This is BS, he is only saying this because the guidelines say nothing about testing estrogen, so if he has to look at the guidelines, well it means he doesn’t know how to play this TRT game. If he had experience he wouldn’t need to look at the guidelines everytime action was needed.

The doctors inside managed healthcare tend to be the most clueless, they didn’t ever think before becoming a doctor that they would ever be prescribing steroids, so they are completely unprepared for it.

Testosterone converts to estrogen and even DHT, they are relevant. I notice you are only talking about TT, no mention of SHBG or FT, the free portion of testosterone matters and some doctors don’t test it because the guidelines focus primarily on the portion of testosterone that is bound to SHBG and is not bioavailable.

A 150 TT suggests SHBG might be on the lower end and therefore 1x weekly dosing may be entirely inappropriate, the doctors you have access to may be unable to manage you on TRT.

You need a doctor that prescribes TRT on a daily basis, not one who prescribes TRT on occasion because these doctors will mostly likely be the reason why men having problems on TRT quit. If your doctor isn’t checking mineral and vitamin status pre-TRT and during the course of treatment, you are lost.

There are few doctors that know how to troubleshoot men on TRT. Men who are older tend to have more mineral and vitamin deficiencies, having optimal testosterone will demand more for resources. Pre-TRT my potassium was on the higher end of the ranges, after TRT was initiated potassium dropped considerably and eventually became abnormally low, I see this happened to other men as well.

I became vitamin C deficient very early on which lead to other deficiencies. The muscle pain, fatigue and tingling sounds like high hematocrit or levels that are too high. I want to just throw this out there, I have found high vitamin C levels to cause numbness and tingling in my extremities.

My PCP doesn’t test E either. He doesn’t know what to do with it. I don’t get my shit from him btw.

The E can cause water retention which can raise blood pressure which can cause tingling in the limbs.

And his doctor doesn’t believe is testing estrogen, the standard of care for TRT is in its infancy.

I’m not trying to hijack this thread but I’m about to for a quick second. Apologies, Heathen.

Dude, I cannot take you seriously after finding out you’re so drastically lacking in your own personal care. Especially after being on this site for so long. You relentlessly attack doctors capabilities while at the same time neglecting the most basic exercise and nutrition aspects for yourself.

Being 30+% bodyfat is not due to vitamin/mineral deficiencies. It just isn’t. Bodybuilders get ripped all the time while being deficient in key micronutrients. The average person can absolutely get into basic “healthy” shape while at the same time addressing micronutrients.

It’s intellectually dishonest, borderline hypocritical, to be so overtly anti-doctor while at the same time having a glaring blindspot in your own personal health care.

One of the biggest issues I see throughout the TRT forum is guys being overfocused on dialing in their TRT protocols, debating injection frequency, considering AIs or HCG while paying minimal, if any, attention to something as simple as proper diet and exercise. Putting TRT into an unhealthy and out of shape body is building a house on sand, plain and simple.

It’s not even a chicken-egg issue when guys try to say, “I have no energy so I can’t workout, that’s why I need TRT.” No. You have no energy, which is why you clean up your diet and start a super-basic training plan first… because those will improve health and body comp… which will improve bloodwork… which will change the TRT plan.

As I said in the other thread, it would be a great example if you started some kind of training log or thread to let the experts on the site offer advice to get you into a more healthy state of being. There’s literally no reason for you not to.


That it’s so spread out is, almost, a good thing in that it would rule out any kind of localized nerve issue. So the underlying cause is more than just, like, a bad injection hitting the wrong spot.

I’m seeing a ‘one and one makes two’ situation here. Fortunately, it’s not like dosing is an all-or-nothing thing. Have you and your doc tried a lower weekly dose?

High platelets have also been associated with joint pain and muscle weakness, so that would certainly make sense too.

Yes he’s only testing total testosterone. I’ve asked him several times but I haven’t been very assertive with him about it. Last week when I started the shots and got my blood tests (the 913 and 848) I specified that I wanted total, free, and estrogen levels, and I was told “it wouldn’t do any good to test your estrogen levels while on testosterone replacement, you would need to stop taking it again to test you estrogen levels”… I told the doctor in the most polite way that I could that I heard what he was saying, but to please amuse me, and do it anyway. He assured me that the last blood we drew could still be tested for estrogen and he would call that in. At this point, my confidence in him calling in the correct labs for a male estrogen test isn’t very high. I’ve been concerned obviously, but I’ve pretty much blindly trusted my doctor Until a few months ago. I do have an appointment with a doctor who specializes in trt on Thursday, 6 days from now. In the meantime, I’ll get in to the lab and get my own work up and be sure to include the above mentioned tests. Thank you guys for helping me out. It’s much appreciated.

I started TRT 4 months ago, 3x per week 25mg Tcyp subq. Worked out great and at about 6 weeks into TRT had a blood draw. T came back 530 and E2 in the low 20s.
By month 3 i felt increasingly overstimulated, started to have sleep issues and interestingly also developed intense muscle pain and leg cramps. Tested T which came back at 720 trough and E2 at 50. Apparently my T still kept raising after 6 weeks. I reduced the dose to 3x 20mg and feel better. Interestingly also the muscle pain and leg cramps vanished. Never had joint pain though.

Long story short, have you considered reducing your dose and injecting maybe 2x or 3x per week?

Tingling in the hands while doing mechanic’s work on a vehicle is - and I’m waiting for the pot shots for saying this - going to be most likely a combination of two things. First, water retention from elevated E2, combined with, secondly, a lot of activated androgen receptors in the chest and shoulders that are not activated when your T is low. This produces pressure in the area and cause some mild blood-flow issues to the arms and possibly mild nerve impingement.
As for the random pain, you need to know your minerals. It could be a basic common deficiency from diet, coupled with using things up faster while in TRT. Your metabolism is a lot higher when your test levels are good.

The tingling in your hands and feet is almost certainly the topiramate. Thats one of the main side effects of it. I’ve taken it at your dose and higher & my feet tingled the whole time I was on it and probably for 2 years after I stopped. I wouldnt be surprised if the muscle pain is a version of that thats just presenting weird. If you have coordination issues or are dropping things, this is considered a serious side effect of topiramate and you need to talk to the doc right away.

The tingling could very well be a side effect. This did start after i began taking topiramate.

The muscle pain was before I started taking this.

I started taking 100 a week and ran that for about 6 weeks before talking to my doctor and him suggesting I take the three week break I mentioned in the original post. The pain was less. Still there, but not as intense. I would like to try two injections a week. I brought it up to him, and he made it sound like I was being ridiculous and that wasn’t a reasonable solution. I have had issues with highs and lows but he made it sound like that was just going to be the way it was… Now, I understand that while not exceeding his prescribed dose per week, I could in good consciousness, take it upon myself to break my dose down into two shots and do my own blood work to track my levels and how I’m feeling. And I’m likely to do that if I can trace down the root of the pain. I would typically rather err on the side of trusting my physician however, a better safe than sorry kinda deal.

I got some test results back that I went and had pulled on my own. These are the first tests that I’ve gone to the lab on my own for, and I probably wasted money and got some that weren’t exactly necessary at the moment. But here’s the results for those.

Do you have a cold or some sort of infection?

Your testosterone and all that looks good. How are you feeling? What is your current protocol and how long have you been on it?

I do not have a cold. My wbc has been that high for a year now, my platlets seem to be climbing the lymph’s and monocytes have also been high.

I haven’t had a spleen for 22 years. That’s one thing I need to keep in mind when it comes to wbc. The rest I’m not sure about. I’m pretty nervous now after these results. I’m going to see a endocrinologist as suggested by my pcp.

From my limited knowledge it looks like your body is fighting something. I’m sure an endo will know. I had similar results when I got bloods done while getting over being sick.

No spleen definitely complicates you. As I understand it, that means you can’t really fight new infections well (A friend had hers out, but oddly enough she grew another one). Tingling (neuropathy) has a lot of causes, B12 deficiency being a big one.