T Nation

Trouble Sleeping After Months on TRT. WTF is Happening?

Wanted to get your guys thoughts on this. I’m on 200mg/ml of Cyp weekly dived up with EOD injections. Been injecting for 4 months. Three times now I have gone to bed and could not sleep, heart pounding, skin flush, overly excited, eyes wide open. The first time it happened I “slept” for 4 hours in a 48 hour period. Last night I finally drifted off at 4am or so. I have no history of anxiety, restlessness, sleep apnea, nothing…I’m asleep normally before I hit the pillow. How can this be linked with TRT? I haven’t been able to find anything really concrete on the topic?

It might not be linked to TRT.

Do you have more stress at your job?

Are you working out harder?

Taking a pre-workout?

@mnben87 Literally everything is the same. And I’m not taking pre-workout.

Do you have any recent blood work? E2 can cause anxiety, but that should be determined with blood work.

Is your test 200 mg/mL?

@mnben87 Yes 200mg/ml…I’ll have my blood work done today.

Okay, post your blood work once you get it. My guess is that you will have high test, high free test and likely high E2. Some do fine with all of them high, some do not.

What time of day do you inject? I had a similar issue when I was injecting in the morning. The timing of when test must have peaked in my body must have aligned with bed time and I was energetic and awake when I should have been tired. I switched to injecting at night before bed and it’s all good now.

Have you done a cortisol test?

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That’s interesting. Yeah I inject in the morning…My thought was injecting at night would cause the issue i’m dealing with lol No I haven’t had a cortisol test. That’s a saliva test right?

Cortisol and acth test

When you describe dosing in ml and I am no closer to knowing your dosage, dosing is in milligrams which represents the strength of testosterone.

Levels that are too high can cause your issues, even levels that are low can cause these symptoms. At the minimum you need total testosterone, free testosterone and estrogen to gain insight as to what is going on.

It sounds like to me that your symptoms may be linked to your levels being too high. I’ve seen guys start out on TRT and do well, then their protocol eventually produces levels that are higher without so much as a dosage change.

You will not always need the same dosage, you will have to make minor course corrections every so often. Also TRT suppresses LH and can see the decline in other hormones that are precursors to LH, pregnenolone is one, allopregnanolone stimulates Gaba which also stimulates the sleeping hormone in the brain.

If you’ve burnt out your 5-alpha reductase enzyme which allows for the conversion of progesterone and allopregnanolone, then you would experience insomnia.

Holy shit this is complicated.

How do I come to know this information? How do I recover?

It can be, but it doesn’t need to be.

Do a complete review of your nutrition, training, lifestyle, TRT protocol, etc. surrounding the times you’ve had issues. Has anything been different? Different foods (calories/macros/quality)? Different workout time or new routine? Different responsibilities at work? New argument with your significant other? Different injection site, dose, timing, etc.? Changes to your HCG or AI?

I know you said “literally everything is the same”, but the body typically doesn’t produce spontaneous side effects for zero reason unless there’s a major underlying problem on the horizon.

You said it’s happened three times. Is that three separate times in the last four months? Three times this past week? What? Bottomline is that there are countless reasons why someone could suffer from insomnia. It’s not necessarily related to your medication.

Too complicated not only for the average doctor, but only the doctors leading the field of TRT check for these 35 hormones that are declining do to TRT suppressing LH. Your above average doctor isn’t checking for any of these hormones and is operating in the dark.

Let’s start with the basics, run some labs and we’ll go from there, but this guessing what wrong with you on symptoms alone isn’t going to lead to an action plan.

I keep up with the leaders in the field of TRT, Mark Gordon treats vets with traumatic brain injuries and is seeing all kinds of brain hormone deficiencies as a results of TBI and TRT suppressing other hormones.

YouTube is where you can learn from the experts rather than some random guy on the internet who has no credentials. You need to verify what your being told is correct because wrong advice can lead to consequences.

Is it happening at the peak of any particular shot? Like between 35 and 45 hours after an injection?

I know you’ve been on the dose a while, but these are the symptoms I get when I inject too much T. Have you switched syringes (different size/shape/manufacturer) lately?

You should start with a full blood workup. In addition to the standard T/E hormone check, also check for DHEA and Pregnenolone. Include a full Thyroid panel. TRT can cause anxiety and restlessness. After 4 months, your body might be telling you something. You may need to add some of the downstream hormones, you may need to lower your T dose… There’s a lot of maybes. Many of which are valid but best to just start with bloods. My 2 cents on the subject is that 200mg/week is too high of a dose. Its very rare to see someone on that dose and not be supraphysiologic. After a few months, you hit a wall because your body has been flooded with androgens. Have you been using any nutritional supplements over the past 4 months? Deficiencies in minerals or vitamins can be compouned by adding T into an already strained system.

Wouldnt hcg solve this? I’m also suffering from issues I believe are due to hpa shut down from trt, keeping my adrenaline in overdrive.

Before you try anything too drastic try 400-600mg of magnesium glycinate 30 mins before bed. Its cheap and effective and may solve your issue. You may want to give 5-HTP 30 mins before bed too. It works in the creation of melatonin which is important for sleep signaling.

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I have the exact same problem, I definitely know the eyes wide open feeling.
It’s like your body suddenly decides to release high amount of adrenaline, and instead of sleeping you feel on edge.

Haven’t been able to determine what is the cause.

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I have the same exact problem… In my case and i think in most cases it’s about how trt effects cortisol. You really need to do 4 point cortisol saliva and thyroid test. I would describe it as TRT reveals your problems with other hormones or deficiencies… It makes them more pronounced.

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