T Nation

TRT for 4 Months, Significant Drop in T. Why?

I’ve been on 120 mg/wk of cypionate for four months. In January my T was 865. My bloodwork last week showed a T of 585. I am rather new to TRT, but isn’t that a big change?

My diet has been the same, but my workouts have changed. In January I worked out often, but in February developed bursitis and so have been taking it easy. Could that be the cause of the drop in T?

By the way, my estradiol was less than 25 pg/mL both times, and hematrocrit was 45 & 47%, respectively – so basically the same.

Thanks for any advice.

I have seen similar experiences in myself and others, they start out TRT on a particular dosage and months down the road the body decides it’s no longer enough. You will find yourself changing dosages every now and again.

One way to mitigate this little problem is to inject more frequently keeping steadier levels so when levels do decline, it’s by a smaller amount since your levels are fluctuating less between injections. I would expect to see a greater reduction in levels in someone injecting less frequently.

How much less than 25 pg/mL? Low E2 can lead to joint issues/pain/damage.

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Good call.

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I am glad to hear that my situation is not that unusual. More frequent injections sounds like a good idea. Thank you.

My lab work literally says <25 pg/mL So, I don’t know what the actual number is for my estradiol. The range from the bloodwork says my estradiol should be between 27.1 and 52.2

I had no idea that this could lead to my shoulder pain issues. I’ll have to bring this up to my doctor. Thank you so much!

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Are you taking an AI?

Yes, I am taking 0.5 mg of anastrozole a week.

You mention inflamed joints (bursitis), anastrozole can inflame joints if estrogen is suppressed too low, why are you taking anastrozole?

If you are not obese and never demonstrated a need for lowering estrogen, you should never have been prescribed an AI.

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Am taking anastrozole because my TRT doctor prescribed it, and I don’t know much about this science. I am not obese. This is good to know…

That’s a bad sign and sounds like a cookie cutter approach to managing men on TRT, do you have pre-TRT labs you could provide?

This idea to start out on an AI is borrowed from the bodybuilding world where they are running very high testosterone levels and need an AI to manage estrogen excess, most men on TRT don’t need AI’s unless obese or just high converters.

You are likely causing harm to bone mineral density and joints by keeping estrogen <25, women who see estrogen very low after menopause see a diagnosis of osteoporosis years later.