Unusual problem with TRT or is it?

Maybe someone can help me figure this out. I'm 55. I started with TT of 58 and FT of 9.6. MRI and physical exam were normal. No explanation for the low T.

I started with biweekly injections which caused a spike/crash cycle. We switched to gel which didn't work well. I was referred to an Endo who suggested .6 ml (120 mg) weekly.

I started self injecting .6 ml (120mg) on Monday's in early Aug. I was feeling tired/irritable/foggy by Friday night. I had a TT test on 9/16 and my TT was 716.

I dropped the dose to .5 ml (100mg) in Sept because the crash I experienced was lessening and the TT was in range. However, I still feel irritable/anxious for the 1st few days after the .5 ml injection BUT I no longer have tiredness/crash before my next injection.

In fact my body doesn't "feel" like it needs the T, whereas before I craved the next injection. I had my T tested on Friday and it was 820!

Yesterday, I dropped my dose to .4 ml (80mg) and I still felt anxious/irritable all day yesterday. It's a little better today. I couldn't sleep last night because my heart was was beating too fast and I was anxious. That's never happened before.

Is it possible my TT is now too high even though I'm only using .5 ml per week and only used .4 yesterday? If so I don't know what to do? I have early osteoporosis and HAD performance functioning problems.

It seems like .5 should be the minimum dose and that .4 is too low to fix the problems I experienced from the initial low T. Maybe I should go back to the gel?

The Dr by email said I should retest in a month to make sure the TT does not continue to rise.

Does anyone have any theories or suggestions? This seems unusal from what I've read.

Thanks for your time.

Have you considered a more frequent injection pattern? Twice a week IM injections, or even eod subq injections? It's possible that could fix your problem. It very well could be other things like E2, but without complete blood work we can't exactly tell.

Yes, I considered 2x's a week but what dose would I use? The .4 ml dose I used yesterday was too much. I still have the anxiety from that dose.

Would I use .25 ml (50mg) 2x's per week? That seems like a really small amount per dose.

Isn't it unusual to go from 58 TT to 820 -- in 5 months -- when a person is only dosing at 100 mg per week?

Also the morning (4am to waking) "wood" is crazy intense and makes my balls ache! Urinating helps but it comes back after about 15mins ... I think my TT is too high but going below 100 mg per week seems wrong.

My blood tests are all normal. The Hematocrit jumped from 42 to 48 but it's still normal. My HMO doesn't use the correct Estradiol test.

Any other thoughts.

Thanks.

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Originally Posted by dobe1000

Yes, I considered 2x's a week but what dose would I use? The .4 ml dose I used yesterday was too much. I still have the anxiety from that dose.

Would I use .25 ml (50mg) 2x's per week? That seems like a really small amount per dose.
Many of the top docs are starting their patients out around 40-60mg per week. It's not the amount, it's the result that matters. I agree with splitting your current dosage and injecting every 3.5 days. The spikes may be causing your anxiety.

Isn't it unusual to go from 58 TT to 820 -- in 5 months -- when a person is only dosing at 100 mg per week?
Not at all. I was pretty much exactly where you were at one point with my T level. Read the sticky above on what to expect when beginning TRT. We all respond differently. Some need more, some less. Many factors influence this

Also the morning (4am to waking) "wood" is crazy intense and makes my balls ache! Urinating helps but it comes back after about 15mins ... I think my TT is too high but going below 100 mg per week seems wrong.
Wood's a good thing but it will calm down. Dopamine response. Again, it's in the referenced sticky! Don't get hooked on having to inject a certain number.

My blood tests are all normal. The Hematocrit jumped from 42 to 48 but it's still normal. My HMO doesn't use the correct Estradiol test.
Well, do your research and demand the correct sensitive assay. If it's labcorp I can give you the correct codes. It's imperative you control your E. You also need to consider HCG as part of your protocol for a myriad of reasons. Consider giving blood on a regular basis. It's a healthy thing to do and will help control your Hemo and Hema. See Stickies!

Any other thoughts.

Thanks.

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Above in bold.....and would love to see your pre-trt BW to try and see why you dropped like a rock.

just a minor point: if you can get testosterone at 100mg/ml, it might help with the fine adjustments.

All good stuff above...BUT...what's your Cortisol, SHBG and E2 levels look like...might find what you're looking for in one of those.

Me: I bet SHBG is tanked...but that's just me;)

You could easily do .2 ml twice a week, giving you 80 mg total a week. After blood work or see how you feel adjust. But like others have said, would be nice to see the numbers and what is going on.

small injections are no problem when using an insulin pin or allergy pin.