My first 4 months - what next?

[TIS1978]

Hi all - just signed up today and happy to be here.

I’m 46 years old, in decent physical shape but for over 8 months had the classic low T symptoms (lethargy, anxiety, brain fog, poor sleep, low libido, poor workout recovery). An initial blood test confirmed this, so having signed up with Leger UK, I started 250mg Enanthate, 2 x 0.2ml sub-q per week. I improved my diet & supplements (zinc, magnesium, vit-d & maca) and increased cardio & weights. Have lost 1 stone and gained muscle.

All started well and after 3 weeks had significant impact on all symptoms. I felt really good.

My 1-month bloods showed increase in numbers, but I was advised to increase my dose to 0.22ml. 3 weeks after increasing (2.5 months after starting) I had a sudden increase in anxiety and my libido and energy dropped.

This has been up and down since and while my latest bloods show some further increase in total and T (neither are that high), my Estrogen has tripled and is now approaching the top of the range.

I’m considering either

1. Dropping back to 0.2 for a few weeks and monitoring symptoms
2. Increasing my dose to get my T up, but probably requesting an AI given how my E is increasing.
3. Switching to EOD injections

But I am new to this – what would you guys do?

(I do appreciate any advice & comments, all my other levels are in range btw)

 

[HSLD]

A couple of thoughts:

If you're not already aware of this, when you first start administering exogenous testosterone there is a dopamine boost. Most feel great in the first few weeks of beginning TRT, whether or not the dosage is correct for them. This is commonly referred to as the "honeymoon" phase.

A few weeks to a month in is a bit early to start tinkering with doses or even to draw labs. Some say to wait a minimum of 7 weeks after making a change and one knowledgeable member here advocates for waiting 12 weeks.

You mention the possibility of increasing your dose and adding an AI. In my opinion, adding more drugs to counteract the side effects of another drug is not the best approach right out of the gates.

3-4 weeks into a protocol change is one of the worst times to throw in the towel and make yet another change. In my experience, regardless of whether or not the change made was a step in the right direction, the period 3 to 4 weeks after making a change seems to be when things are truly in flux and I always feel kinda off. You can get into a pattern of making tweaks every few weeks if you start doing this.

If I were in your situation, I would continue with your current dose and injection schedule (.22ml 2x/week) for at least 4 more weeks (until you're at minimum at the 7 week mark or further along) and reevaluate at that point.

 

[TIS1978]

thank you for your response, I really appreciate it

my original post may have been a little unclear, so to clarify

- I was on the 2 x 0.2ml a week for 7 weeks
- I have been on the the 2 x 0.22ml for 10 weeks, with the increased symptoms for the last 7 weeks

does this change your view?

 

[HSLD]

Thank you for the clarification. That does change my view - in that case I would probably opt for returning to the lower dose. Which brings a question...if you were feeling good on your initial dose, why did the provider suggest increasing your dose? Was that suggestion based on lab numbers alone?

 

[Phil Goodman]

I try to steer away from giving people medical advice, but I can tell you what I’d do in that situation.


I would drop back down to my original dose and let my body adjust for 8-12 weeks. Your body seemed good to go there, so the adjustment may have been unnecessary. Whether it’s due to your doctor chasing numbers, trying to make up for lost endogenous production, or some other reason we don’t know. What we know is that it lead to issues. Dropping down allows you to get back to earlier levels which seemed more successful. It would also allow for starting to create a backstock of medication, which I feel is incredibly important. Pretty much everyone agrees this is a good idea for all medications(especially after somewhat recent supply chain issues) but when it comes to testosterone people may assume it’s being absurd when you state a desire to acquire more. If your doctor believes you’re on a dose higher than you are, then you are able to naturally build a supply of excess medication that can be used during times of supply issues or other circumstances.

Do note that your body has tried to adjust to a higher level, so initially the lower level may not feel optimal at first. But that is much preferred over adding even more medications(like AI) and is also simpler than increasing administration frequency.

I would start with option 1, not tell my provider, and begin working on my emergency supply. That’s just me though.

 

[TIS1978]

thanks again

yes, after my first bloods I was initially advised to increase to 0.25ml to get the total numbers higher. When I told them I was feeling good they revised this to 0.22ml, which is what I've been at since