T Nation

Sleep Issues on TRT

Been having major sleep issues for the last two weeks (been on TRT for about 4 weeks now). Went to Defy Medical to get dialed in recently (my doc didn’t have much of a clue) and here are my most recent labs…

Total Test = 749
Free Test = 19.7
DHEA = 179.2
TSH = 1.720
IGF-1 = 249
Sensitive Estrodiol = 36.9
SGBG = 23.9

I am doing 30 mg Test Cyp and 420 iu of HCG EOD. The new doc also prescribed 0.1mg of Anastrozole twice a week, but the pharmacy has not shipped it yet (hope to have it by end of week). Only thing I can come up with is that my estrodiol is a bit high (target being 25) and it’s causing some side effect. Other than waking up every night at 3am and not being able to go back to sleep, I do feel a little bloated, sweaty, slightly sensitive nipples, and my feet feel slightly swollen. If i don’t do cardio 4-5 days a week, the symptoms are worse. I was feeling pretty good until these sleep issues started, and now I am a zombie. Any input is appreciated! Also, do you guys think the dosage of Anastrozole is appropriate (seems a little low)? Thanks again!

Your testosterone and estrogen levels reach a stable state at 6 weeks, so 2 you have more weeks until you reach a stable state. Some men don’t tolerate HCG well and it can increase estrogen, this is why I prefer to start TRT in isolation as it simplifies dialing in and if you add HCG months later and you start feeling bad, then you know HCG isn’t for you.

Your levels look great, although estrogen may be a bit high for you, your symptoms are classic sign of estrogen being high. Your body fat percentage can play a role in how much testosterone your convert to estrogen.

Staying metabolically actives helps, lifting heavy weights burns more than cardio alone for 2 days after a workout. You go to sleep and you’re still burning calories.

I don’t tolerate anastrozole at all and over-respond to it, aromasin is another story.

Thanks for the quick response! I do lift and do cardio 4-5 days a week (usually alternate). What do you think about the Anastrozole dosage? Maybe he went low to see if I would also over-react to it? Haven’t seen such a low dose recommendation anywhere on the forum.

It’s smart to start out low until you determine if you are an over-responder, you don’t want estrogen at zero, trust me. If it were me I would drop the HCG and not take the AI, that may solve your E2 problems.

When it’s time for kids, inject FSH.

Anastrozole is a powerful drug, and crashing estrogen is worse than high estrogen.

I agree with you that it seems pretty low, but I would stick to their protocol. You can bump up your AI later after you know how your body handles it.

If you start getting gyno, then for sure bump it up.

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Trying to maintain fertility, hence the increased HCG by the doc.

Just a comment on the HCG. If I was taking test c, and HCG twice per week, then 400-500 iu per shot would make sense.

Usually HCG is dosed at 250 iu, if on EOD shots (with also taking test).