Does TRT increase tendonitis?

[CKO]

I've been on TRT for 3 years now and I'm starting to wonder if TRT may be related to me having numerous tendonitis issues over the past few years. Prior to TRT I don't think I ever had tendonitis. I've been an active functional lifter for years and probably used to over train routinely (typical of CrossFit style workouts). But within the last two years I've had tendonitis is both knees, left shoulder, elbows and my wrist.

Another factor is that I drink a lot more than I used to. Probably two to three glasses of wine every night. This may also be the main culprit. I'm 42 now, so maybe my age is just catching up with me . Any thoughts?

Protocol: T Cup 40mg x 3/week, Nandrolone 25mg x 3/week, HCG 400iu x 2/week, anastrozole . 125mg x 3-4/week.

 

[Systemlord]

But within the last two years I've had tendonitis is both knees, left shoulder, elbows and my wrist.

anastrozole . 125mg x 3-4/week.

The drinking a lot more water comment got me thinking, lower E2 causes you to hold onto less water. Higher E2 and you’re holding more water.

Where does your E2 sit?

 

[madman]

I've been on TRT for 3 years now and I'm starting to wonder if TRT may be related to me having numerous tendonitis issues over the past few years. Prior to TRT I don't think I ever had tendonitis. I've been an active functional lifter for years and probably used to over train routinely (typical of CrossFit style workouts). But within the last two years I've had tendonitis is both knees, left shoulder, elbows and my wrist.

Another factor is that I drink a lot more than I used to. Probably two to three glasses of wine every night. This may also be the main culprit. I'm 42 now, so maybe my age is just catching up with me . Any thoughts?

Protocol: T Cup 40mg x 3/week, Nandrolone 25mg x 3/week, HCG 400iu x 2/week, anastrozole . 125mg x 3-4/week.

No.

If you are one who relies on an aromatase inhibitors to control your e2 and you drive it too low than that can definitely have a negative impact on the tendons, bone health.

Deca (nandrolone) for joint pain

Hi all, I've been on TRT for 1.5 years now and absolutely love it. Mood, energy levels, libido, are all improved. In the case of libido, my wife says it is TOO improved but that's another story. I'm 48 years old and have been doing BJJ for 6 years. BJJ is really hard on the joints (as is age)...

www.excelmale.com

Tendonitis and TRT

I’ve read that using exogenous testosterone, and in particular having high TT/FT levels, can cause some “stiffening” of tendons. I’m experiencing extremely painful, chronic tennis elbow. It didn’t occur in isolation - it is an overuse injury. But one that simply will not heal. It’s not as if...

www.excelmale.com

 

[CKO]

Estradiol sensitive runs 17-29 pg/mL for the past 1.5 years.

SHBG 21-30 nmol/L on average.
Free T Direct: 33 pg/mL
Total test: 1100-1300 ng/dL

 

[bixt]

I've been on TRT for 3 years now and I'm starting to wonder if TRT may be related to me having numerous tendonitis issues over the past few years. Prior to TRT I don't think I ever had tendonitis.

Indeed TRT could be the root cause of tendonitis in my experience if either:

1.E2 has been driven too low by an AI
2. You are skinny, don't aromatise well, use a high dose of Test and have driven the T/E2 ratio very high
3. Are converting heavily to DHT
4. TRT made your muscles very strong very quickly and allowed you to lift far heavier weights than normal with ease, but putting strain on your tendons which didn't catch up on their ability to handle the heavier weights.

In your case number 1 is the most likely, cut the AI out completely.

 

[madman]

I've been on TRT for 3 years now and I'm starting to wonder if TRT may be related to me having numerous tendonitis issues over the past few years. Prior to TRT I don't think I ever had tendonitis. I've been an active functional lifter for years and probably used to over train routinely (typical of CrossFit style workouts). But within the last two years I've had tendonitis is both knees, left shoulder, elbows and my wrist.

Another factor is that I drink a lot more than I used to. Probably two to three glasses of wine every night. This may also be the main culprit. I'm 42 now, so maybe my age is just catching up with me . Any thoughts?

Protocol: T Cup 40mg x 3/week, Nandrolone 25mg x 3/week, HCG 400iu x 2/week, anastrozole . 125mg x 3-4/week.

Tendon: Principles of Healing and Repair

Tendon: Principles of Healing and Repair (2022) Christian Chartier, MD, Hassan ElHawary, MD, MSc Aslan Baradaran, MD, MSc Joshua Vorstenbosch, MD, PhD, FRCSC Liqin Xu, MD, MSc, FRCSC Johnny Ionut Efanov, MD, PhD, FRCSC Abstract Tendon stores, releases, and dissipates energy to efficiently...

www.excelmale.com

 

[madman]

I've been on TRT for 3 years now and I'm starting to wonder if TRT may be related to me having numerous tendonitis issues over the past few years. Prior to TRT I don't think I ever had tendonitis. I've been an active functional lifter for years and probably used to over train routinely (typical of CrossFit style workouts). But within the last two years I've had tendonitis is both knees, left shoulder, elbows and my wrist.

Another factor is that I drink a lot more than I used to. Probably two to three glasses of wine every night. This may also be the main culprit. I'm 42 now, so maybe my age is just catching up with me . Any thoughts?

Protocol: T Cup 40mg x 3/week, Nandrolone 25mg x 3/week, HCG 400iu x 2/week, anastrozole . 125mg x 3-4/week.

Trust me when I tell you its not your therapeutic dose of T!

 

[CKO]

I respect your opinion. Thank you.

 

[Nelson Vergel]

Estradiol sensitive runs 17-29 pg/mL for the past 1.5 years.

SHBG 21-30 nmol/L on average.
Free T Direct: 33 pg/mL
Total test: 1100-1300 ng/dL

Are you on anastrozole ? I would stop
It. Estradiol is key for tendon health.

The effect of estrogen on tendon and ligament metabolism and function

Another possible positive benefit for e2? The effect of estrogen on tendon and ligament metabolism and function - ScienceDirect Abstract Tendons and ligaments are crucial structures inside the musculoskeletal system. Still many issues in the treatment of tendon diseases and injuries have...

www.excelmale.com

 

[Cataceous]

If lack of estradiol is a contributing factor then it's another indicator that running top-of-range testosterone is going to be problematic for some. Essentially you're choosing between high absolute estradiol or low relative estradiol. The OP has chosen the latter, with estradiol running somewhere around 0.13% to 0.26% of testosterone. Normal is more like 0.3% to 0.6%. There can definitely be negative consequences to this.

Dropping the AI may lead to high absolute estradiol, which can cause other issues. Why not just put overall health ahead of athleticism and lower testosterone to a level that's probably closer to peak natural levels? This would mean reducing to 60-70% of the current dose.

 

[madman]

Are you on anastrozole ? I would stop
It. Estradiol is key for tendon health.

The effect of estrogen on tendon and ligament metabolism and function

Another possible positive benefit for e2? The effect of estrogen on tendon and ligament metabolism and function - ScienceDirect Abstract Tendons and ligaments are crucial structures inside the musculoskeletal system. Still many issues in the treatment of tendon diseases and injuries have...

www.excelmale.com

He sure is!

If his labs are at true trough (72 hrs post-injection) than his trough FT level would be very high.

Look at where his TT and estradiol sit.


Protocol: T Cup 40mg x 3/week, Nandrolone 25mg x 3/week, HCG 400iu x 2/week, anastrozole . 125mg x 3-4/week.


Estradiol sensitive runs 17-29 pg/mL for the past 1.5 years.

SHBG 21-30 nmol/L on average.
Free T Direct: 33 pg/mL
Total test: 1100-1300 ng/dL

 

[Vince]

I had pretty bad tendonitis in my Achilles tendon. I actually have a thread on it. I did therapy, acupuncture I went to a chiropractor. Nothing helped. Until I tried creatine I didn't think it would help but it did heal 90% of it. I can now again walk all day. I can even jog. I'm on my feet all day at work and I have no pain. It's unbelievable. I'm sure it wouldn't work for everybody. For some reason it worked for me. I taking 5g daily.

Results from my ultrasound of right Achilles tendon.

If anyone has dealt with this or has information on healing, it. I would appreciate it. IMPRESSION: Findings suggestive of chronic tendinosis with subtle partial tearing involving the deep tendon fibers of the mid Achilles tendon, as above. Narrative ULTRASOUND RIGHT ACHILLES TENDON DATED...

www.excelmale.com

 

[HSLD]

I had chronic issues with my achilles tendon on my left ankle. Dealt with it for years before beginning TRT. Interestingly enough, TRT effectively cured it. It still pops and cracks immediately after getting out of bed, but no longer causes pain/interferes with daily activities like it used to.

My E2 runs high on TRT and I do not use AIs.

 

[CKO]

Thank you for the replies. I think this probably has a lot to do with keeping my e2 too low. I will reduce my testosterone dosage and cut out anastrozole. We will see where it ends up. I'm taking small doses of creatine and it has helped my mood significantly. It seems reasonable that an increased dose could help with joints.

For reference my labs are 48hrs post injection, so not a true trough. I wouldn't have thought 120mg test/week is a lot, but then again my shbg is pretty low

 

[Nelson Vergel]

Until I try creatine I didn't think it would help but it did heal 90% of it.

Interesting! Glad you got relief.

From an AI:

There is some evidence to suggest that creatine supplementation may have a positive effect on tendons. One study found that combining creatine supplementation with specific therapy can accelerate the recovery of injured tendons[2]. Another study found that creatine supplementation did not have a negative effect on the tensile strength of tendons[3]. Additionally, oral creatine may reduce the frequency of injuries to tendons, muscles, bones, ligaments, and nerves[1][6]. However, it is important to note that no formal research has indicated that creatine supplementation may increase the risk of muscle tears or tendon strains[5].

Citations:
[1] Creatine
[2] Creatine Supplementation Supports the Rehabilitation of Adolescent Fin Swimmers in Tendon Overuse Injury Cases
[3] https://www.jstor.org/stable/4608544
[4] https://www.researchgate.net/public...t_Fin_Swimmers_in_Tendon_Overuse_Injury_Cases
[5] Creatine and the Muscle Injury Myth - AST Sports Science
[6] Creatine | Beacon Health System

The effects of creatine supplementation can vary from person to person, but generally, it may take some time to see noticeable effects. Here is a timeline of what to expect:

1. Initial period (first several days): During the first few days of creatine supplementation, it is common to experience water retention[4]. This can lead to a slight increase in body weight.

2. Muscle saturation (around 1 week): It takes time for your muscles to become fully saturated with creatine[3]. This means that the creatine levels in your muscles gradually increase over the course of about a week.

3. Performance benefits (after muscle saturation): Once your muscles are fully saturated with creatine, you may start to experience the performance benefits. These benefits can include improved strength and power during high-intensity, short-duration exercises like weightlifting[1].

It's important to note that individual responses to creatine supplementation can vary. Some people may experience the benefits sooner, while others may take longer to see noticeable effects. Additionally, the dosage and duration of creatine supplementation can also influence the timeline of results.

Overall, it is recommended to give creatine supplementation at least a few weeks to see its full effects. Consistency and adherence to a proper dosage are key factors in maximizing the benefits of creatine supplementation.

Citations:
[1] Creatine Information | Mount Sinai - New York
[2] Timing of Creatine Supplementation around Exercise: A Real Concern?
[3] Creatine Before And After: Discover What Happens When You Take It For 30 Days
[4] Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? - Journal of the International Society of Sports Nutrition
[5] Creatine
[6] CREATINE: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

 

[Nelson Vergel]

Another interesting discussion:

BPC-157/TB-500 Dosing

Due to a nagging knee injury, I am about to treat myself with a BPC-157/TB-500 blend (5mg/5mg). Would anyone know the dosing regimen for this combination? Provide links if you have them. The BPC-157/TB-500 blend is a combination of peptides that have shown potential benefits in wound healing...

www.excelmale.com

 

[Larry B]

I've been on TRT for 3 years now and I'm starting to wonder if TRT may be related to me having numerous tendonitis issues over the past few years. Prior to TRT I don't think I ever had tendonitis. I've been an active functional lifter for years and probably used to over train routinely (typical of CrossFit style workouts). But within the last two years I've had tendonitis is both knees, left shoulder, elbows and my wrist.

Another factor is that I drink a lot more than I used to. Probably two to three glasses of wine every night. This may also be the main culprit. I'm 42 now, so maybe my age is just catching up with me . Any thoughts?

Protocol: T Cup 40mg x 3/week, Nandrolone 25mg x 3/week, HCG 400iu x 2/week, anastrozole . 125mg x 3-4/week.

I've been told that if one reduces their estradiol too low that can cause tendinitis.

 

[aneuman]

I've been told that if one reduces their estradiol too low that can cause tendinitis.

What I've read appears to contradict that.

Estrogen has a dramatic effect on musculoskeletal function. Beyond the known relationship between estrogen and bone, it directly affects the structure and function of other musculoskeletal tissues such as muscle, tendon, and ligament. In these other musculoskeletal tissues, estrogen improves muscle mass and strength, and increases the collagen content of connective tissues. However, unlike bone and muscle where estrogen improves function, in tendons and ligaments estrogen decreases stiffness, and this directly affects performance and injury rates. High estrogen levels can decrease power and performance and make women more prone for catastrophic ligament injury. The goal of the current work is to review the research that forms the basis of our understanding how estrogen affects muscle, tendon, and ligament and how hormonal manipulation can be used to optimize performance and promote female participation in an active lifestyle at any age.

Effect of Estrogen on Musculoskeletal Performance and Injury Risk​

I've suffered much more tendonitis after I started using Enclomiphene/HCG and my estrogen started going above the normal levels of "healthy young lean men" (22-35 pg/ml) although it has never been too high (never above 50 pg/ml). I also never had tendonitis before (but I was never 60 yo before either)

 

[Larry B]

What I've read appears to contradict that.

Effect of Estrogen on Musculoskeletal Performance and Injury Risk​

I've suffered much more tendonitis after I started using Enclomiphene/HCG and my estrogen started going above the normal levels of "healthy young lean men" (22-35 pg/ml) although it has never been too high (never above 50 pg/ml). I also never had tendonitis before (but I was never 60 yo before either)

I suppose science doesn't have a definitive answer. I was told this by Defy Clinic which many here are familiar with. I did notice when I allowed my estradiol to increase a little the tendinitis went away for the most part.

 

[FunkOdyssey]

I've suffered much more tendonitis after I started using Enclomiphene/HCG and my estrogen started going above the normal levels of "healthy young lean men" (22-35 pg/ml) although it has never been too high (never above 50 pg/ml). I also never had tendonitis before (but I was never 60 yo before either)

The presence of the medications is a confounding variable here. To eliminate that, you would need to elevate your E2 to the same range without enclomiphene and hCG and observe effects on tendonitis. It is possible, for example, that tendonitis is a side effect of enclomiphene, either through its estrogen receptor antagonism (inducing a local state of "low E2"), by its well-documented reduction of IGF-1 level, or some other mechanism.

The review below explores the links between estrogen and tendon health and the balance of evidence presented suggests estrogen is protective of tendons and deficiency is detrimental in various ways. They note that high levels of estrogen are apparently detrimental to tendon health only in young women, where the opposite is true in older women. Postmenopausal women have more tendon pathology than premenopausal women and this change is attributed to estrogen deficiency.

Impact of oestrogen deficiency and aging on tendon: concise review

The knowledge about tendons and tenocyte biological behaviour during aging and, especially, oestrogen deficiency is limited. Women differ from men with regard to muscle and tendon, most likely due to differences in sex hormones activity and tissue response. ...

www.ncbi.nlm.nih.gov

Some discussion of related complaints from enclomiphene users:

https://www.reddit.com/r/sarmssourcetalk/comments/py0zc8

https://www.reddit.com/r/sarmssourcetalk/comments/wvttug

https://www.reddit.com/r/Testosterone/comments/12ibxkv