T Nation

TRT & Tendon Pain (Low E2)?


I’m on TRT - I dose about 1/2cc cypionate every 3 days (theoretically). Age is 34 y.o. Went on TRT after test results came back around 230 18 months ago. This is the only thing I take. I eat a clean diet and other than a multivitamin on occasion, take nothing else, including AIs, hcg, or other scripts.

About 6 weeks ago my tendons in my knees, ankles and wrists hurt when I get up and especially when I workout. Usually after a good warmup of 3-4 sets the pain subsides but sometimes I can’t even get through the warmup because of the tendon stiffness so I never get to the point where the adrenalin kicks in and I can power through it.

So I was thinking maybe it’s the way I was dosing the cyp. Granted I’m not too fond of sticking myself every 3 days so sometimes it would go 4-6 days between pins even though I kept the dose between 1/2 - 3/5 cc. I got to thinking this inconsitency may cause some of the other hormone levels to zig-zag, resulting in some side-effects. Sure enough after googling around some I saw that low E2 can cause tendon pain so I went to get some labs done last week the third day after my last dose. Results were:

Test 479
LH 0.1
FSH 0.2
Estradiol 16.2 (Roche ECLIA methodology)

Running low on my script, I put a call in to my MD to discuss those and re-up. Now I’ve never been too fond of MDs anyway and this was no exception. The MD said that since I wasn’t on any AIs my E2 levels were fine. When I inquired about the tendon pain, I was told it “could be anything, probably old age.” Thanks! :smiley: While I’m not 21 anymore I’m not 80 either and I think it’s pretty rare for there to be a sudden onset of tendon pain at only 34.

In a way I’m fortunate because I don’t take anything other than test so I the process-of-elimination is easy in this case. As of today I’m beginning to be more disciplined in 1/2cc E3D (instead of E4-6D) in hopes that the tendon pain will go away. However, I wanted to post this here to gather anyone else’s thoughts on this.



1/2ml of 100mg/ml or 200mg/ml?

ALWAYS discuss doses in mg or iu, never volumes.

Please post pre-TRT lab results with ranges.
LH/FSH should have been done then.
Any loss of width of peripheral vision?

On TRT, LH/FSH --> zero, do not test again. What is doctor thinking [?]

You need to double T dose. This will increase E2.

Is T cyp pharmaceutical or from a compounding pharmacy. If compounded, talk to them and ask if they added an aromatase inhibitor [anastrozole] to it.

With TRT, if one gets into training, there can be problems with muscle strength/forces increasing rapidly when connective tissue takes a year or more.

Current labs: Please post all lab work and must have ranges. You need to have FT testes or at least SHBG if FT not available.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.