TRT for 6 Weeks, Now Feeling Like Crap

Hello all, Here’s a little background about me. I am a 28 year old male. I’ve always been into health and fitness since I was in my early teens. Always had a decent amount of muscle and worked out quite often. I had to go on methadone to take control of my life because of some bad choices I made. I am currently doing well and have been clean for over a year and I am not looking back! Anyhoo, methadone kills your testosterone levels. Before starting the Testim cream, i came in at a whopping 137 ng/dl. After being on the Testim and still feeling crappy and not being able to lose weight or put on muscle, I got rechecked and the level was 181 after a full 24 hrs after application. I was on 1 tube a day.

I’ve been on injection TRT for about 6 weeks now. My urologist dosed me at 200 mg of test cyp every two weeks. However, I’ve been doing 100 every week due to the half life and I want to avoid the roller coaster ride. The first 5 weeks I felt great! 2 hours at the gym every day and I shed 10 pounds of body fat and my bench press raised about 40 lbs. Now, I’m starting to feel crappy. I’m losing that drive that I had in the beginning. I had my blood work checked one week after doing a 200 mg shot since the nurse told me that’s what they wanted. The level came back at 580 ng/dl. However, I suspect my E2 levels have risen. But heres the kicker… my urologist won’t check my E2 levels. He said that many men at his clinic don’t have it checked. They then said my insurance won’t cover it since I am not female.

What should I do? Should I go see my PCP and explain what’s happening? Is there a way I can get my E2 and some other values checked out of pocket? I just want to feel good again. I’m in my last year of school and want to have a good year and not feel crappy all the time. Thank you for your time!

Depends on where you live. In the states, you can find a lab and run virtually any lab work. Google Any Lab Test. They do a good panel for folks on TRT. It’s almost certainly high E2 that is making you feel like crap. If so, you’ll need an AI. Also should start injecting twice per week.

Get your own e2 tested using labcorp.com. If your e2 comes back high, research and print out implications of men having high e2. If he won’t stand to reason and treat your high e2 find a new Dr.

e2 can be lowered by increasing your test injection frequency, lowering your T dose (if possible), losing body fat and ensuring your liver is functioning optimally.

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I got an E2 test done today from LabCorp. Results should be in by tomorrow. I will post results once they’re in. I also made an appointment with my urologist on Thursday. I will bring him the E2 results. I’m kinda hoping it’s high E2 since that will be an easy fix. If he refuses to treat it, I can get Arimidex, but I would really prefer to be under Dr. care with it. If it’s not high estradiol, what else can it be? My testicles also have a dull ache now and have gotten smaller. I know that this is a normal side effect. I want to talk to him about HCG to possibly reverse this. I am 28 years old, and I still am possibly considering kids (25%). I will also inject more frequently too.
I’m just so disheartened since I was feeling so damn good. I was spending 2 hrs a day at the gym and still had energy. My confidence was high and I was walking about with a bop in my step. Now I just feel anxious and crappy. The workouts are done just to get them over with. Honestly, I just wanna cry. I felt so good and now I feel lethargic.

Also, my libido is down too. When the TRT was working, I was constantly thinking about sex and can go a couple times a day no prob. Now, it’s all the opposite. I haven’t been getting as many night time erections, although I got a couple last night but I also had to pee extremely bad.

All you can do is wait for the results. If it’s any comfort, sure sounds like high E2.

Sounds like typical E2 effects after a few weeks.

Endo’ can be idiots. Would be fun to show him that the testing labs have male reference ranges for E2 lab tests.

Please read these stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

You should be self injecting:

  • 50 mg T cyp/eth twice a week
  • 0.5mg anastrozole at time of injections
  • 250mg hCG SC EOD to preserve testes and fertility - very important at your age

Injecting T once a week or wider apart will increase E2.
You need frequent injections so levels are steady and labs actually represent something.

Many here have thyroid issues caused by not using iodized salt. Easy signs are sparse outer eyebrows and low body temperatures - feeling cold easier. You can eval overall thyroid function by checking oral body temperatures as per the thyroid basics sticky.

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Very interesting KSman. Lab values should be here tomorrow for E2. I called urologist today to see what my free test was last time I got bloods and the only thing they took was total test. Needless to say, I have a lot to go over on Thursday. If this is gonna be a lifelong thing, i wanna make sure I start off right.
*Quick update from earlier… I had access to Arimidex and took 0.5mg at 6 PM. Honestly, I feel a bit better already. The anxiety has diminished a bit. I’m really thinking it’s gonna be a high E2 value. At least this is easily fixable thru frequent injections and an AI.

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You need hCG to preserve your testes and potential fertility. If you get your e2 in check and you still feel off you’re probably over training. Two hours a day in the gym isn’t necessary to make progress and you should look to “trim the fat” from your program. You certainly can deplete your other systems and glands with undue stress. Rest days are needed for your CNS, hormones and immune system now that testosterone isn’t the limiting factor.

ok, so I got the E2 readings and they were below <5. I took the test on Monday. Before the test, I took .25 letrozole Friday and .25 Arimidex Sunday. There’s no way that would be enough to deplete my levels that much. I know I should have waited on taking the AI’s until I got blood work. I was just desperate to feel better since I was feeling awesome before. It was taken via Roche Elcia methodology if that means anything.

I went through an anti aging clinicfor my TRT. I start week 2 tomorrow. My E2 is low like yours. I have my AI but they said to wait 4 weeks for my E2 to rise. Ive been looking around and there really isnt much info on men with low E2. From what I gather symptoms from low E2 can rival those of low test. Im curious what others have to say, as I am in the low E2 boat as well.

Here I was I thought my E2 was high. But I don’t get how it can be so low. What would make me go from feeling awesome to crappy like that? I got tested just for Estradiol. Now I feel even more confused. I meet with the urologist on Thursday.

Letro is rather harsh in that its dose-response is often not very predictable. Anastrozole seems to be well behaved. Some are anastrozole over-responders who need to take 1/4th the expected doses. Do not know if those guys would over-react to letro. So you are back to square one, miserable and not knowing what to do. Take 5-6 days to wash out and maybe resume at 1/4mg anastrozole per week in divided doses.

Read those stickies!

KSman, I’m gonna take your advice and stray from the anastrozole for a week. I’ll retest on Monday next week and see where I stand. I’m gonna inject 50 mg test cyp tomorrow and again Sunday.

Everyone can learn a lesson from this. Don’t make any deviations to your protocol right before blood work, regardless of how much you crave relief.

After you stabilize, you’ll need to get blood work done again. If you still feel awful and all of your numbers look good (tt, ft, e2, tsh, ft3, ft4, rt3 etc), I would wager you’ve been training too hard. Take a week off or follow CT’s neural charge training exclusively for a couple of weeks. No heavy lifts, grinding or going to failure.

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I will be going to the urologist tomorrow to see what can be done. Besides TT, FT, E2, TSH, T3, T4, what are some imperative labs to have them check? I’m two days off arimidex and I am going to pay for a lab myself come Monday to re-check it.
As far as training goes, I’ve always exercised my whole life and was only really going hard for about a month (when I felt good). I’m doubting it’s the training since I haven’t trained heavily in the last week or so since I’ve felt crappy. I’ve done cardio, but that’s about it. My diet was very clean during that time too. Ate multiple smal meals with fruits, veggies, meats, and supplemented with whey and BCAA’s for gym recovery.
My drive and libido are the two main things that are gone. Is it posible for Adex to crash your E2 within a few days?

Yes, some are over responders to Adex.

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Yes its possible and of course you feel terrible right now. Men still need estrogen to function optimally and with an e2 of less than 5, many of your systems are struggling. The question that needed to be answered is why were you feeling terrible before the adex and letro. Was it low e2 then as well? Was it compounded/made worse by the adex or letro or was it a new problem altogether? Don’t make anymore changes until you stabilize and get more blood work done. Right now you certainly feel bad because of low e2. Our brains and cardiovascular systems need estrogen.

I’m GUESSING (this was a lesson learned, don’t do anything until you get blood work!) that my E2 went too high and I crashed it with Letro and Adex. Rational as follows:
Was on injection 200 mg/2 weeks prescribed, started doing 100 mg/week. Felt AWESOME for a month or so. Went downhill pretty quick. Took Letrozole last friday at about .25 mg and again saturday at .25 mg. It was hard to gauge since the pills were 2.5 mg so I broke about an 8th or 9th of the pill off. Took Adex .25 mg on Sunday. Had bloods Monday. So I may have crashed my E2. I eat very healthy, lots of fiber, vitamins, so maybe my body was able to take out the estogen that was there before, and since the AI’s prevented anymore from forming, I may have hit bottom. Is the half life of E2 a little more than a day?
I went to the gym last night and had more energy and was able to push myself through a good cardio session. 60 minutes broken down -10 minute slow warmup (HR 110-130), medium cardio for 30 (hr 145-155), and then there was some HIIT thrown in there (135-175) and a 5 minute cool down. This morning I am actually feeling a bit better. I WANT to go to school and I had a few night time woods last night. Some were fully erect, as opposed to half. I could probably achieve orgasm right now if I wanted to. Still not 100% but noticed improvement.
I will be taking an E2 blood test Monday again. It’s been 3 days since last Adex (0.5 mg) dosage, and I injected 50 mL Test Cyp Tuesday. I want to see what the urologist says about the testicular atrophy and if he will run bloods today. If he chooses to brush me off, i will run my own bloods and possibly look for another Dr.
Thanks guys!

So the doctor examined my testicles and said everything feels normal. I talked to him about the E2 issue and he said that my health insurance will not cover that test, according to the medical coder and biller. I told him that I am going to run my own bloods for that on Monday. The medical coder said that an E2 test would run me about $300, when walkinlab.com has an E2 test for $44. I’m thinking about making an appointment with my PCP to get another full blood lab done. My CBC from 8/9/2016 came back all within range. Cholesterol was good (160’s), LDL 92, HDL 40, Trigs 73. I’m taking fish and flax to improve my HDL. H&H 16.2 and 49.5%. Todays blood pressure was 130/68. I felt a bit anxious at the doctor so I will recheck before sleep. I’m gonna bet that my systolic is ten points lower.

Update on physiologic and psychological S/S: Feeling much better today. Had energy and confidence. Very little anxiety. Was able to get rock hard and have an orgasm. Still a bit “tired” in the head though. The thought of a nap is pleasant. I have not consumed any caffeine today. I will be going to the gym later on to do some light weight/higher reps and some cardio.
I want to see what I’ll feel like tomorrow. If I am feeling better, my hypothesis is that I crashed my E2 with the Letro and Adex. I went from high E2 to literally no E2.
Any thoughts guys? Would that hypothesis make sense?