Total exhaustion after 10 wks of TRT

[dobe1000]

Hi guys:

You've probably heard my type of complaints many times before but I'm totally confused.

I'm 54. My TT was 58. My FT was 9.6. I have no other medical conditions.

The only reason my Dr. tested me was because of my decreasing bone density (osteoporosis in one site in the hip); a mass under my right breast and total sexual dysfunction + low libido. My mood was fine. I lift weights and there wasn't much of a difference in energy or muscle mass in the last 20 years.

I started on 4/4 with one 200 mg injection bi/wkly. After 3 injections I felt no effects so he increased the 4th injection to 300 mg. That created high anxiety, acne and my heart pounded for hours after I worked out. After about 3-4 days the mood leveled off and I was fine until about 3 days before my next injection when I crashed. I felt total exhaustion and brain fog.

He decreased my last injection (2 wks ago) to 200 mg. I had the same initial anxiety which leveled off. He switched me to Androgel 1% - 5 mg per day applied to upper arms/shoulders and sides of the stomach. I started on Sunday hoping to avoid the crash. I crashed today.

He won't test Estradiol. He says it's a waste of time.

The only benefit I have is an extremely strong libido and easy to get erections which were non existent before. In fact in the morning while sleeping I worry about the 4 hour warning that they advertise with certain products! I don't take any of those but the TRT effect seems the same but with a strongly increased libido.

I'm going on a 12 day trip starting Saturday. I don't want to be exhausted during the trip. I've read that stopping TRT can make the exhaustion/anxiety/brain fog much worse and last for weeks!

Any suggestions? The TRT must be working because the breast mass has disappeared and the sexual functioning makes me feel like I'm 18 again but OH the exhaustion -- which I never had before!?

But why am I totally exhausted when that wasn't a problem before TRT? Any help is appreciated. Thanks.

[kelkel]

Welcome Dobe. Your doc does not understand the half-life of Testosterone, which is app. 5-7 days. Meaning after a week you crash to a low level, hence a roller-coaster effect. Plus the amount is not unheard of but normally NOT a starting dose. Avg starting dose is around 100mg per week, check Blood work after 6 weeks and adjust.

Basically your wasting time with doc. He won't test E as it's a waste of time? Wow. You need to run from this guy and seek proper medical care before he hurts you. The agel will be in your system within a few days and hopefully you will feel more normal and be able to have a good get away. It is a huge dosage difference between the two T's.

Did your doc even tell you why your T was that low and do you have initial BW you can post with ranges for us to look at? Is it due to a pituitary issue or testical issue? Lots of questions that your doc should have answered for you, but then again he's lost and won't admit it. When back from your trip find another doctor asap. Read the stickies above this forum and begin to educate yourself. Sometimes we have to educate our doctors ourselves when they are willing to work with us. In your case, move on.

Welcome to the forum! Don't panic, it takes time to get dialed in on TRT. Plenty of good people to help you here but you are your number one advocate, so again, read up and educate yourself. Also go to www.allthingsmale.com and read everything. It is Dr. Crislers site and he is one of the leading TRT physicians in the country. You will see how "off base" your doctor is.

[Brohim]

Get a new doc that using an AI. Read the stickies on this forum.

And a test level of 58 is crazy low. Did you rule out pituitary tumor?

And 5mg of gel is not enough. I think most use 8-10mg. I would perhaps bump up the dose during your vacation so you don't crash.

As for exhaustion I have no answer's. usually T give you energy. Your estrogen is probably high with large (300mg) injection's, that could have something to do with it. I would get some bloodwork to see where you at.

[dobe1000]

Thanks for the responses. It helps to know others are out there who can help.

I'm frustrated with my Dr. but I'm in an HMO and he's been my Dr for about 8 yrs. I doubt any other dr. in this HMO knows any more. I understand most Dr's aren't very knowledgeable about TRT and that Endocrinologists aren't any better. Is there a specialist type I should be referred to?

This guy didn't know why it was so low.

My psa is 1.8. My liver, kidney and CBC count was normal. Glucose is normal. The only abnormality in my blood work was "White Blood cell Differential" where Lymphocytes % was 48% (normal per lab is 44%) and "Neutrophils auto count" was 1.8% (normal low is 2.1 per lab). He said these results were due to low T. No other tests were done.

Is there any harm in increasing my dosage from 5 g (4 pumps) to 7.5 g (6 pumps). The literature on Androgel says 5 g per day is equal to 5mg being absorbed per day? I would need to take 2 bottles on my trip but if it avoids the exhaustion/brain fog it's worth the hassle. I just don't want to make it worse.

Thanks again.

[Squirrel88]

To me Androgel and Axiron is worthless. I have taken both, been on shots where they gave them to me once a week and once every two weeks. I would crash pretty hard when taking those shots. Especially once every two weeks. I have finally found the correct dosage for me is a half cc shot (100mg) every 3 days. Keeps my levels elevated and keeps me from crashing. It also keeps me from swinging one way of being pissed off at everyone then 4 days later feeling like crap.

[kelkel]

I did pretty well on agel 1.62% for a period of time. Only harm in increasing dosage is running out ahead of time and being left with none. I think you will be fine for your trip. A little trick you can use is to put on moisturizer or sunscreen over top of the agel about an hour or so after application. It improves absorption nicely. Read the actual package insert. It's right in there. When home search for an A4M Certified doctor. See if the Finding a TRT Physician Sticky helps. Have a good trip. Let us know how you make out on this thread.

And like both myself and Brohim said, you should probably have an MRI to rule in/out pituitary issues when possible.

[steroid.com 1]

Tell this guy he doesn't really understand what he's doing and more importantly what he's doing to your health!

"Is there a specialist type I should be referred to?"

Yes!

Ask him if he'd be willing to consult with a specialist, that you will pay for, to have him learn and put you on the right protocol.

If he's opened minded and wants to learn and help you...you both will win.

If not, run from this quack as fast as you can as you are being harmed and it can get a lot worse...trust me.

You should NEVER feel like you do! This man took an Oath and he's violating it.

There are a number of excellent TRT Doc's that will consult with your Physician for a very small fee to put you under the right care.

If you need a referral or two just IM me and I will help.

[dobe1000]

Thanks for the advice.

I can't find anything in the insert about applying lotion an hour after the gel to increase absorption but it makes sense. I would think it should also help to keep the skin from drying out. Apparently healthy skin is important for the gel to work correctly.

The insert does say directly squirting the gel on the sites "may prevent loss of product that may occur during transfer from the palm of the hand onto the application sites". I'll try the direct squirt. I apply to the biceps, shoulders and sides of the stomach -- one squirt each.

Any other suggestions for maximum absorption?

I feel less exhausted today. Now I just feel tired but it's manageable. I've had this trip with friends planned for a year and I don't want to negatively affect their vacation with my mood changes or tiredness. If the exhaustion doesn't re-occur before Saturday, I think I may stick with the 5g's per day until I get back. I still don't understand why I feel tired now but didn't before starting on the TRT? Would increasing to 7.5 g's most likely increase or decrease the tiredness?

I will talk to my dr. when I return about additional testing. If you guys have any further suggestions, I would appreciate hearing it. Thanks again.

[kelkel]

Here it is from the 1.62% insert. I pasted it over from a previous post:

"Effect of sunscreen or moisturizing lotion on absorption of testosterone
In a randomized, 3-way (3 treatment periods without washout period) crossover study in 18 hypogonadal males, the effect of applying a moisturizing lotion or a sunscreen on the absorption of testosterone was evaluated with the upper arms/shoulders as application sites. For 7 days, moisturizing lotion or sunscreen (SPF 50) was applied daily to the AndroGel 1.62% application site 1 hour after the application of AndroGel 1.62% 40.5 mg. Application of moisturizing lotion increased mean testosterone Cavg and Cmax by 14% and 17%, respectively, compared to AndroGel 1.62% administered alone. Application of sunscreen increased mean testosterone Cavg and Cmax by 8% and 13%, respectively, compared to AndroGel 1.62% applied alone"

[Brazensol]

I know what you mean about being exhausted. I started on Androgel 1% (5 grams) and it promptly cut my testosterone in half! I went from being fatigued in the afternoon and wanting a nap to having to sleep a couple of hours to make it through the rest of the day. I just started with a 7.5 gram dose, at least until I can get injections. The gel just doesn't seem to work well for me. My mornings are somewhat better (apply gel ~7 am) but around noon it quickly goes down hill. I did start doubling up on the 5 gram packets (one am and one pm) after my last labs and have not noticed much difference yet. I am not holding out much hope for the 7.5 gram pump.

[HRTstudent]

If I was going to give someone advice on how to get the quickest positive response from TRT I would tell them to do bi-weekly shots starting at 100mg per week.

You would then titrate as needed in 4 weeks and then again in another 6-8 weeks.

Going on gels there are simply more variables. If it works for you then GREAT! But for me and many others, it's heartache, pain, frustration, and not a good experience. Injections are simple... we know how it is going to effect people pharmacologically with rare exceptions.

Quite frankly, when you did shots you had predictable side effects given your poor protocol (get a new doctor ASAP, seriously!). You took too high a dose! That is frequently associated with the anxiety you mentioned. And I mean frequent... just hang around here and you will see a similar story to yours soon enough.

Not only was the dose too high, but the frequency was too long. Your doctor doesn't know anything about male TRT nor testosterone's half life in a meaningful way. Otherwise, he would not have done what he did.

My best advice is to get a new doctor that specifically specializes in male HRT.

Also, my personal opinion is if you want the most rapid positive results then go on weekly injections or bi-weekly if you prefer. Drop the dose to around 100mg as well and titrate up or down on your follow up.

[dobe1000]

kelkel: Thanks. For some reason that info is not in the 1.00 insert. I will give it a try.

Brazensol: How long has it been since you doubled the 5g to 10 g? No difference from 5 to 10g packets? Now you're going to the 7.5 gel pump? How long have you been using the pump? Any good or bad differences from the packets? Thanks

[dobe1000]

HRTstudent: So you're suggesting 100 mg injections per week, instead of the 200 mg that I got (except one at 300mg) every 2 weeks. The problem -- for me -- is that I live 35 mins from the place where I would get the injections.

Do you you injection yourself? I'm not sure how that would work in my situation or if my dr. would even allow that. I know people need to be taught to give themselves daily insulin injections. I didn't think about the dr. letting people give themselves T shots.

For the next 2 week (my trip) period I need to decide on whether 5g or 7.5g daily gel is the best to relieve the tiredness and irritability. Thanks

[Brazensol]

Brazensol: How long has it been since you doubled the 5g to 10 g? No difference from 5 to 10g packets? Now you're going to the 7.5 gel pump? How long have you been using the pump? Any good or bad differences from the packets? Thanks

Yesterday was 6 days I believe, maybe 7. I picked up my 7.5 pump today and will start using it tomorrow. Question now is do I just go with the 6 pumps of the 7.5 and wait for the blood tests and doctor appointment on 9 Jul or maybe go with 6 pumps in the a.m. and a 5 gram packet in the pm...? I started with one 5 gram packet and my total testosterone went from 231 to 108 and my free went from 40.1 to 16.2. And yeah, I feel worse, which I didn't think was possible. lol. Although I only doubled up for a short time I can't say as I noticed any difference at all. Some people can feel the test. pretty quick and others it takes time. I just don't think I am absorbing the gel very effectively and it just won't work for me. Which would be fine since I wanted injections anyway!

[HRTstudent]

HRTstudent: So you're suggesting 100 mg injections per week, instead of the 200 mg that I got (except one at 300mg) every 2 weeks. The problem -- for me -- is that I live 35 mins from the place where I would get the injections.

Do you you injection yourself? I'm not sure how that would work in my situation or if my dr. would even allow that. I know people need to be taught to give themselves daily insulin injections. I didn't think about the dr. letting people give themselves T shots.

For the next 2 week (my trip) period I need to decide on whether 5g or 7.5g daily gel is the best to relieve the tiredness and irritability. Thanks

Injecting on your own at home is simple and easy to do. They could teach you how to do it, but you could also just pull up something online. There's probably a million videos on youtube. I recommend the glutes for minimal pain and it's the "safest" area.

I would expect far better results from 100mg per week rather than 200mg every 2 weeks.

Keep in mind, TRT is more of a slower thing than it's led on to a lot of people. Most people, I would argue, do not wake up one day and say, "I'm a new man!" Rather, they slowly improve over months and months.

[steroid.com 1]

If I was going to give someone advice on how to get the quickest positive response from TRT I would tell them to do bi-weekly shots starting at 100mg per week.

Also, my personal opinion is if you want the most rapid positive results then go on weekly injections or bi-weekly if you prefer. Drop the dose to around 100mg as well and titrate up or down on your follow up.

HRT - I believe you mean "twice weekly" and not "bi-weekly" which is once every two weeks.

OP - It's very common for men to self inject...hell, I was taught how to do it over the phone by my Doc years ago!

Also, did you have a Cortisol panel run on your last BW? I suspect it may be low...

[kelkel]

Op: visit spot injections .com (had to spread it out due to site filter)

[dobe1000]

Thanks for the responses.

My dr's on vacation so I can't ask about increasing the dose from 5g to 7.5 but I'm going to do it anyway for my trip. My problem with the 200 mg injections was that I had anxiety for the 1st 3 days but then felt fine for the rest of the 2 weeks -- except 3 days prior to the the next injection when I crashed.

To me that means that the amount of T in my body during the middle of the injection cycle was the correct amount. The 1st 3 days too much T. The last 3 days too little T. The insert say 5g's per day gel means 5mg is absorbed, so that's, at most, 35mg per week. I don't know how much T I was getting after the 1st 3 days but before the last 3 days of my injection cycle but I bet it was way more than 35mg per day.

The 7.5 mg will increase absorbed T to 7.5 mg per day or 52.5 per week. That's probably still less than the middle period of my injection cycle when I felt fine but it's better than only 5 mg per day.

There's probably some faulty logic in what I just said but I still think I won't feel worse using 7.5g per day.

Does anyone see any problems with my analysis?

Also, do most people have problems talking their non TRT expert dr's into letting themselves self inject?

You guys have been a big help and I will have a serious talk with my Dr. when I return. I want Estradiol checked/Cortisol panel. Plus I need my T checked again. I started the TRT on 4/4 and there's been no T level follow-up.

[Brohim]

I would try 7.5mg-10mg on your vacation and see if that works. Obviously, 5mg is not enough for you.

As far as injections you needed 100mg per week, not 200-300mg every 2 weeks. The half life of test C is 7 day's so many guy's split their dose and inject every 3.5 day's. You were injecting every 14 day's hence the crash and syptoms. (brain fog, fatigue, etc.)

Sorry your doc is uneducated on what he is treat you for!

[dobe1000]

Hey guys:

I returned from my trip and took your advice and got a new Dr. My reg Dr. was willing to refer me to the Chief of Endocrinology in my HMO. The info he gave me was consistent with the info I've gotten from this site.

I've remained on 7.5 gel. On a scale from 1-10, the sexual functioning has gone from zero before the TRT to 10 while on the injections to 2-3 while on the 7.5 gel. My mood is about the same as before TRT. But there's no peaks and crashes as there was while on the 200-300 bi/wkly injections.

I'm convinced after reading this forum that I would be best off with weekly injections of around 100 mg w/adjustments as needed. The Dr. is willing to let me self inject which I'm not looking forward to but I assume I can get over my uneasiness around needles. After-all it's so much easier than going to a nurse once a week. Do most people get over that uneasiness and the size of the needle. I would think it would be easier than finding vein .. but I don't know. Thw alternative is to go up to 10g Andro which apparently I'm absorbing okay but I don't like the daily hassle.

He doesn't think there's a Pituitary problem but is willing to do an MRI if I want to be sure. He's convinced there's nothing wrong with the testes. That still leaves the question as to why this is happening but I'm not sure what else to do.

He's willing to go up to 10g per day with Andro or 100 + per/wk injections. If anyone has further suggestions, I'd appreciate it. You've been a big help. Thanks.

Here are my test results. The normal ranges are in parenthesis. He said the low FSH and LH are because I've been on treatment for 4 months.

Polactin 18 (2 - 18)

FSH 1.1 (1.4 - 18.1)

LH <1.0 (1.0 - 12.0)


Estradiol <50 (< 50)

TSH 2.89 (0.10 - 5.50)

Free T4 1.0 (0.8 - 1.7)

Cortisol morning 20.8 (8.0 - 25.0)

Testosterone, TOTAL 402 (> 180)

[steroid.com 1]

A couple of things:

1. First, thank you for using your original thread to update...so important for us to respond even after the time that has gone by.
2. CONGRATS! The forum has helped you find the right Doctor to care for you!!! Now, make sure to inform your previous Doc so he can learn.
3. Get the MRI.

Bloodwork:

Polactin 18 (2 - 18)
This is high, albeit at the top of the reference range better at mid or lower.

FSH 1.1 (1.4 - 18.1)
This assay is a waste of time when a man is on a TRT protocol. It shows that a Testosterone Replacement actually causes a Secondary Hypogonadal state.

LH <1.0 (1.0 - 12.0)
Same as FSH.


Estradiol <50 (< 50)
Don't know what this means...

TSH 2.89 (0.10 - 5.50)
Your TSH is elevated and is better well below 2 pg/ml. Try adding in Kelp and Selenium along with Iodizied salt to your supplements and diet.

Free T4 1.0 (0.8 - 1.7)
Really low and suggests possible Hypothyroidism when tied to your elevated TSH. Need to see FT3 and RT3. Ask your Doc about possible Hypothyroidism.

Cortisol morning 20.8 (8.0 - 25.0)
High but who knows why...

Testosterone , TOTAL 402 (> 180)
I need to know the bottom and top reference range here. Seems confusing...

A few more things to figure out but you are in the right hands.

Get the MRI and discuss Hypothyroidism with your Doc.

Nice work man, very happy for you!!!

[kelkel]

Everything GD said. Only thing I could add is that the more modern standard range for TSH is .3 - 3.0. So you see why GD is concerned about it. Strongly concur on getting the MRI.

[dobe1000]

Thanks for the response.

According to the lab they use, my Estradiol should be less than 50 pg/mL and it is. They don't give a specific # for my results and they don't give a ratio between the TT and the E2. I don't now if that's important or not?

I just clarified and Per the lab the TT should be between 350 and 750 ng/dl. Mine is now 402.

I will ask him about Hypothyroidism.

Am I correct in saying that most guys in my situation get better results from 1 injection per week (around 100mg) rather than 10 mg Andro per/day?

Thanks

[bodyrokk]

Man i feel for you! i was on cyp injections 100mg a week for a few years ,been having problems with anxiety and even started going into Afib..never had it before i started on test..My endo wouldnt check estro levels or anything else so i switched to new dr .He put me on Androgel and since i feel like shit exhausted foggy headaches ,no energy at all ..so im switching bad to cyp and thinking of maybe trying shots every 4 days at 50 mgs see if this keeps anxiety away..

[APIs]

Am I correct in saying that most guys in my situation get better results from 1 injection per week (around 100mg) rather than 10 mg Andro per/day?

For what it's worth, it seems the majority of people who start on Gel end up switching to self injections at some point. Do youself a favor, save time & just do it since your Doc is willing. Don't worry, you'll get over the fear of needles. The rewards you'll experience down the road are worth it...

[startingnew]

I break my injections down to two a week.For me,60-70mg on monday and another on thursday.It does take time to see how you're doing at a certain dose.For me it's about 4-5wks to tell the difference and if I need to increase/decrease the amount.No rollercoaster rides and feel great pretty much everyday.Forty nine yrs old here,well....in 19 days.Hope you get yours worked out,it just takes some time.

[dobe1000]

For what it's worth, it seems the majority of people who start on Gel end up switching to self injections at some point. Do youself a favor, save time & just do it since your Doc is willing. Don't worry, you'll get over the fear of needles. The rewards you'll experience down the road are worth it...

The more I read the more I think you're 100% correct. I talked to my Dr. today. I pick-up my T and injection supplies on Friday. My Dr. is going to have someone in the ID staff call me and set up a "teaching appt". I think I'm lucky that he trusts me with the self injections.

Man i feel for you! i was on cyp injections 100mg a week for a few years ,been having problems with anxiety and even started going into Afib..never had it before i started on test..My endo wouldnt check estro levels or anything else so i switched to new dr .He put me on Androgel and since i feel like shit exhausted foggy headaches ,no energy at all ..so im switching bad to cyp and thinking of maybe trying shots every 4 days at 50 mgs see if this keeps anxiety away..

Except for the peak/crash, I felt best in the middle of the bi/wkly injection cycle. With the gel I have more of an everyday tired feeling. I don't have the anxiety anymore. Who knows why. The foggy brain is also a problem since I started using the gel. I'm hoping the 100-120 mg per/wk will work but the nice thing is I think I'll have the ability to adjust to twice a week if needed. I'll just keep my Dr. informed.

I break my injections down to two a week.For me, 60-70mg on monday and another on thursday.It does take time to see how you're doing at a certain dose.For me it's about 4-5wks to tell the difference and if I need to increase/decrease the amount.No rollercoaster rides and feel great pretty much everyday. Forty nine yrs old here,well....in 19 days.Hope you get yours worked out,it just takes some time.

Good info. I'm going to try and take all these experiences into account when I'm deciding how to proceed. At the moment I really glad I joined this forum. As a result, I got some needed testing and I'm going to have more control over my replacement therapy. I need to avoid the "rollercoaster rides" and I would like to feel great (at least good) everyday.

Thanks.

[dobe1000]

One other thing I forgot to mention. Prior to TRT my sexual functioning was Zero on a scale of 1-10. After 7 weeks on the bi/wkly injections it skyrocketed to 10. Now that I'm on the gel, it's at about a 2.

I'm hoping the weeking injections will get me back to about an 8! I don't now why the big drop off with the gel?

[lovbyts]

No you did mention it in post #20 but that was a while ago.
Good to hear you are getting things worked out and the doctor is working with you. Hopefully you can get back to normal.

[xtitan1]

Just so we're clear:

Semi-weekly = twice per week
Bi-weekly = once every two weeks

[dobe1000]

I wanted to ask a question of you guys who self inject.

[dobe1000]

Hey Guys:

I have a few questions I need to ask before I talk to my Dr. You guys have been very helpful with your input. To summarize, my TT was 58, FT 9.6 -- 6 mos ago. I started with bi-weekly injections of 200 mg. After the 3rd injection the Dr switched to 300 and then went back to 200 -- because I started having an initial 2 day jolt (intense anxiety) and the last 2 day crash.

He then switched me to the Gel. He then referred me to an Endocrinologist. The Endo ordered a # of tests which I detailed earlier.

Since I last posted, he ordered an MRI. My Pituitary was normal. He examined my testicles -- which my reg Dr didn't do. The Endo said they were normal. So we don't know why my numbers were so low. I asked about Hypothyroidism and he said that isn't a problem given my test results.

My last TT on 7/26 was 402. He has allowed me to self inject which I've been doing (a bit over 1/2 ml [100 mg]) each week since 8/02.

My problem is I'm still getting the crash a day or so before my next wkly injection, although thankfully I'm not getting the initial jolt of intense anxiety -- although I still have mild daily anxiety.

I'm guessing you guys would suggest 50-60 mg's every 4 days? The problem is my drawing needles (90 day supply) are 3 ML and the injecting needles are 1.5 inches. It would be difficult to draw .3 or .25 ml given the drawing syringe size and I don't want to inject myself twice a week with such big needles.

What size drawing and injecting needles do you guys suggest if I'm going to try 50-60 mg every 4 days?

Any other suggestions for eliminating this crash?

The strange thing is my TT was checked because of sexual dysfunction and a mass under one breast. I never had the tiredness or other problems I now have. I even have more difficulty sleeping since starting TRT. I thought you were supposed to sleep better? I also don't have the sense of well-being that some said I would get.

So the only improvement I've gotten is sexually. The rest of the effects are all negative. I don't how unusual my experience is under the circumstances.

Thanks for any input.

[kelkel]

Hey Guys:

I have a few questions I need to ask before I talk to my Dr. You guys have been very helpful with your input. To summarize, my TT was 58, FT 9.6 -- 6 mos ago. I started with bi-weekly injections of 200 mg. After the 3rd injection the Dr switched to 300 and then went back to 200 -- because I started having an initial 2 day jolt (intense anxiety) and the last 2 day crash. Every other week injection caused that issue which you now know. Idiot doctor.

He then switched me to the Gel. He then referred me to an Endocrinologist. The Endo ordered a # of tests which I detailed earlier. Absolutely guessing as he's clueless

Since I last posted, he ordered an MRI. My Pituitary was normal. He examined my testicles -- which my reg Dr didn't do. The Endo said they were normal. So we don't know why my numbers were so low. I asked about Hypothyroidism and he said that isn't a problem given my test results. Refer to GD's comments above

My last TT on 7/26 was 402. He has allowed me to self inject which I've been doing (a bit over 1/2 ml [100 mg]) each week since 8/02. 402 on weekly injections or bi-weekly? If weekly I'd like to see it higher. Need to see free T to evaluate further though.

My problem is I'm still getting the crash a day or so before my next wkly injection, although thankfully I'm not getting the initial jolt of intense anxiety -- although I still have mild daily anxiety. Possible hyper-metabolizer?

I'm guessing you guys would suggest 50-60 mg's every 4 days? The problem is my drawing needles (90 day supply) are 3 ML and the injecting needles are 1.5 inches. It would be difficult to draw .3 or .25 ml given the drawing syringe size and I don't want to inject myself twice a week with such big needles.Just go on line and order syringes or use the site sponsor. 1.5 is too long for my taste. I use 3ml, 25 ga, 1". Drawing 50 or 60 mg with 3ml is really no issue. We all do it. Order extra needles also (tips only,) maybe 18-20 ga just for loading purposes. Then change it to 25 ga to inject. You'll only forget to change it once btw! Correct on every 3.5 day injection cycle

What size drawing and injecting needles do you guys suggest if I'm going to try 50-60 mg every 4 days? above

Any other suggestions for eliminating this crash? Add hcg. Read GD's sticky

The strange thing is my TT was checked because of sexual dysfunction and a mass under one breast. I never had the tiredness or other problems I now have. I even have more difficulty sleeping since starting TRT. I thought you were supposed to sleep better? I also don't have the sense of well-being that some said I would get.

So the only improvement I've gotten is sexually. The rest of the effects are all negative. I don't how unusual my experience is under the circumstances.

Thanks for any input.

Answers in bold. Patience. It takes time. Some longer than others but still very well worth it.

kel

[dobe1000]

Thanks for the response. Do you guys think it's important to monitor the ratio between Estradiol and TT. The Endo ordered a test for Estradiol but the result was <50. So I have no idea what the specific # is and no way to know if it's rising.

I've read that it's important for the Dr. to specify that it's male estradiol? Do you agree and should there be a specific # and what should the ratio be between E2 and TT.

If I question my Endo I want to be informed.

Thanks.

[HRTstudent]

Thanks for the response. Do you guys think it's important to monitor the ratio between Estradiol and TT. The Endo ordered a test for Estradiol but the result was <50. So I have no idea what the specific # is and no way to know if it's rising.

I've read that it's important for the Dr. to specify that it's male estradiol? Do you agree and should there be a specific # and what should the ratio be between E2 and TT.

If I question my Endo I want to be informed.

Thanks.

The estradiol test you got is, unfortunately, worthless. You need to specifically order an estradiol sensitive test, or ultrasensitive from Quest.

The ratio of T to E2 is, imo, a worthless calculation. It's generally going to fall in the same area but that's just because we all aim for similar ranges when it comes to both T and E2. What's important to me is getting the T to 650+'ish and making sure e2 is in range and not too low.

[dobe1000]

Sorry to bother you guys but I'm confused.

I inject .6 ml (120 mg) on Tuesdays at noon. By Saturday I'm feeling tired/irritable/foggy. By Sunday I'm exhausted. I had my TT tested yesterday while I was feeling all the above.

My Endo just emailed me and said my TT is 720 and that I shouldn't increase my dose. I feel like I've crashed which I thought meant my TT would be much lower.

I felt much much better when my TT was 58 and my FT was 9.6! I don't understand! The only improvement I've noticed is better performance in the sack. The rest of the results are negative -- starting on the 4th day after injection.

The only reason they tested my TT was because of poor functioning (it won't let me use the word); mass under my right breast and early bone loss in my hip. The mass is gone.

My energy; sleeping and feeling of well being was fine before TRT. Now I have a difficult time pushing myself to the gym; I don't sleep well and I'm exhausted/anxious starting on the 4th day after injection.

Does anyone have a good guess as to what's going on? There was a complete panel which I reported earlier in the thread. The Endo thought everything looked normal. The MRI was also normal.

Thank you.

[juice2012]

If you are feeling tired 4 days after your injection, I would definitely switch to injecting half the dose, twice a week. The same thing happened to me so I switched.