Need help with sleep management on TRT

[cigpk]

Hey there - been back on trt for about 3-4 months. Currently on the following protocol:
40 mg test-c 2x weekly
360 iu hcg 3x weekly
.0625 anastrazole 2x weekly - I was on .125 anastrazole 2x weekly but my e2 was at 24.5 and I was still having joint pain so I decided to cut the dose in half to try and get e2 up to ~30

I feel great all around besides joint pain (improving) but most of all - my sleep sucks.

I fall asleep around 10-1030 but almost always wake up around 12-1 am and I am HOT as shit, can’t cool down and can’t fall back asleep till 3 or so and my sleep the rest of the night is very light. It’s wearing me down. No matter what I do, I can’t get solid sleep.

I am taking ZMA currently but it hasn’t helped - if anything, it makes me even hotter at night.

No caffeine after noon, no unhealthy sleep behaviors.
This problem only ever happens on trt.
Should I increase my anastrazole dose back to .125? Maybe it’s e2 related...

 

[Vince Carter]

No SHBG or E2 labs? Post your lab results.

 

[cigpk]

Right - sorry.
I’ll have to check shbg but it was elevated last lab work, over 60 I think (15-55). I’ll have to post full labs when I have more time.

On no ai, my e2 sensitive was 35 (8-35)
On .125 2x weekly it was 24.5
I recently cut it down to .0625 hoping to hit about 30 e2.

 

[James]

cigpk - I had the same challenge you have. After starting TRT, my sleep would suffer. I fall asleep easy but wake up a couple hours later, and stay awake 2 - 3 hours before crashing hard for 3 hours when I have to wake-up. I'm a "low dose everything" kind of guy. I just seem to get my ideal results when using a low dose (and I suspect with the low dose Test and IA that you take, you may be the same way). DHEA helped with sleep, but even with only 6 mg of ultra micronized DHEA daily, it caused too many sides. Since I fall asleep quickly, I put a low dose melatonin (.75 mg), on my nightstand and take it when I wake up. It knocks me out pretty quickly and it's such a low dose that I don't feel groggy in the morning.

What are you doing to get your AI down to .0625 mg? The compounding pharmacy I use can only go as low as .125 mg.

 

[cigpk]

cigpk - I had the same challenge you have. After starting TRT, my sleep would suffer. I fall asleep easy but wake up a couple hours later, and stay awake 2 - 3 hours before crashing hard for 3 hours when I have to wake-up. I'm a "low dose everything" kind of guy. I just seem to get my ideal results when using a low dose (and I suspect with the low dose Test and IA that you take, you may be the same way). DHEA helped with sleep, but even with only 6 mg of ultra micronized DHEA daily, it caused too many sides. Since I fall asleep quickly, I put a low dose melatonin (.75 mg), on my nightstand and take it when I wake up. It knocks me out pretty quickly and it's such a low dose that I don't feel groggy in the morning.

What are you doing to get your AI down to .0625 mg? The compounding pharmacy I use can only go as low as .125 mg.

That’s a good idea.

What brand of melatonin do you use?

I literally pour half of the capsule into another empty one. Kind of a pain in the ass but worth it for me

 

[Trents]

You can get 1 mg melatonin tabs on amazon. I take 5 mg nightly.

 

[James]

That’s a good idea.

What brand of melatonin do you use?

I literally pour half of the capsule into another empty one. Kind of a pain in the ass but worth it for me

The brand I take is Natrol.

 

[Gman86]

Why are you using an ai? An E2 of 35 is pretty much perfect. Some doctors would even say that it’s too low, not too high. Especially considering your SHBG is around 60. Did you have unwanted symptoms at 35? I would personally ditch the ai.

To help with sleep, I would take magnesium glycinate. The ZMA has magnesium in it, but probably not enough, and probably not bound to glycinate.

Also, make sure to get sunlight in your eyes for about 20 minutes when you wake up. This will reset your circadian rhythm, and will tell your body to wake up, and more importantly later in the day it will know to start making melatonin so that you can sleep. Make sure to avoid blue and green light from screens and fluorescent light about 3-4 hours prior to sleeping. If not, the lights will inhibit your melatonin production, and make it very difficult to get a good night’s sleep. If avoiding screens is impossible before bed, you can get a pair of blue/green light blocking glasses. I just picked up a pair from blublox.com. I feel like it makes a difference in my sleep.

 

[James]

I cut the 3 mg in half twice to get .75 mg. You can get it in different mg obviously. Based on what you've shared above, start with a low dose and work up if needed. Like with most things, be patient.

 

[James]

You can get 1 mg melatonin tabs on amazon. I take 5 mg nightly.

My first experience with Melatonin was 5 mg, had a deep 12 hour sleep and felt groggy the next day.

.5 -.75 mg fills that gap I get when I wake up in middle of the night.

 

[James]

I thought it was a cortisol issue, but after testing, I was wrong.

 

[Trents]

That’s a good idea.

What brand of melatonin do you use?

I literally pour half of the capsule into another empty one. Kind of a pain in the ass but worth it for me

Nature’s bounty makes 1 mg tabs. Not sure why anyone would need less
Than that it barely does anything at 1 mg

 

[Vince Carter]

Ive been cutting a 3mg in half and doing OK with that, I tend to change it up every night in some kind of combo...1.5mg Melatonin with a Tylenol PM, or a Bendryl.

Staying asleep thru the 0200-0300hrs is really my complaint overnight, I can get to sleep easily, but awake around those hrs and back to sleep but its lite and not really rest full sleep and I'm up for work at 0400.

 

[Trents]

Ive been cutting a 3mg in half and doing OK with that, I tend to change it up every night in some kind of combo...1.5mg Melatonin with a Tylenol PM, or a Bendryl.

Staying asleep thru the 0200-0300hrs is really my complaint overnight, I can get to sleep easily, but awake around those hrs and back to sleep but its lite and not really rest full sleep and I'm up for work at 0400.

Vince
Sleep hygiene is very important- stop using screens an hour before bed. Also your bedroom should not have tv in it; only use bed for sleep and sex.

Additionally, a time release melatonin is available on Amazon. I personally need to use sleeping pills and am
Groggy in the morning, but coffee or 300 mg caffeine pill gets me moving for morning workout.

 

[Nelson Vergel]

Hey there - been back on trt for about 3-4 months. Currently on the following protocol:
40 mg test-c 2x weekly
360 iu hcg 3x weekly
.0625 anastrazole 2x weekly - I was on .125 anastrazole 2x weekly but my e2 was at 24.5 and I was still having joint pain so I decided to cut the dose in half to try and get e2 up to ~30

I feel great all around besides joint pain (improving) but most of all - my sleep sucks.

I fall asleep around 10-1030 but almost always wake up around 12-1 am and I am HOT as shit, can’t cool down and can’t fall back asleep till 3 or so and my sleep the rest of the night is very light. It’s wearing me down. No matter what I do, I can’t get solid sleep.

I am taking ZMA currently but it hasn’t helped - if anything, it makes me even hotter at night.

No caffeine after noon, no unhealthy sleep behaviors.
This problem only ever happens on trt.
Should I increase my anastrazole dose back to .125? Maybe it’s e2 related...

Low Estradiol May Cause Hot Flashes and Night Sweats in Men
Stop the anastrozole.

Take 3 mg of melatonin before 10 am. If you wake up in the middle of the night, take one cc of this liquid melatonin: Liquid Melatonin

 

[cigpk]

Low Estradiol May Cause Hot Flashes and Night Sweats in Men
Stop the anastrozole.

Take 3 mg of melatonin before 10 am. If you wake up in the middle of the night, take one cc of this liquid melatonin: Liquid Melatonin

Thanks for the response.

Everyone has been super helpful here.

I just cut the dose in half last week so I am going to wait about 2 weeks before making another change. on no AI, i had even worse insomnia so I want to see if a low dose ai will do the job. plus i have some labs coming up in the next month so if the low dose ai + increased zinc from zma has my e2 on the low end (<30 or so?) I'll prob cut out the ai all together.

Why are you using an ai? An E2 of 35 is pretty much perfect. Some doctors would even say that it’s too low, not too high. Especially considering your SHBG is around 60. Did you have unwanted symptoms at 35? I would personally ditch the ai.

To help with sleep, I would take magnesium glycinate. The ZMA has magnesium in it, but probably not enough, and probably not bound to glycinate.

Also, make sure to get sunlight in your eyes for about 20 minutes when you wake up. This will reset your circadian rhythm, and will tell your body to wake up, and more importantly later in the day it will know to start making melatonin so that you can sleep. Make sure to avoid blue and green light from screens and fluorescent light about 3-4 hours prior to sleeping. If not, the lights will inhibit your melatonin production, and make it very difficult to get a good night’s sleep. If avoiding screens is impossible before bed, you can get a pair of blue/green light blocking glasses. I just picked up a pair from blublox.com. I feel like it makes a difference in my sleep.

Interesting. Yeah my end game is to reduce ai to zero and go from there. BUT, I just made this change last week so I'm going to give it a few weeks and see if I have any improvement in sleep.

On no ai, I was having pretty bad insomnia and anxiety. Dr. Saya had me introduce anastrazole at .125 mg twice weekly and then split my HCG dosage into 3x per week.

Just last week, I decided to cut my ai in half after seeing my e2 was in mid twenties. I also added in the ZMA (450 mg mag aspartate) so I'm going to see if those two changes take care of my problems. I'm having my labs drawn again in about 3 weeks so I will see where I'm at. If I'm still not seeing improvement I will prob cut out the ai and try some melatonin or something.

How does the relationship between shbg and e2 work? I know that high shbg = low free t often but is there a relationship between e2 and shbg too?

 

[Gman86]

Thanks for the response.

Everyone has been super helpful here.

I just cut the dose in half last week so I am going to wait about 2 weeks before making another change. on no AI, i had even worse insomnia so I want to see if a low dose ai will do the job. plus i have some labs coming up in the next month so if the low dose ai + increased zinc from zma has my e2 on the low end (<30 or so?) I'll prob cut out the ai all together.

Interesting. Yeah my end game is to reduce ai to zero and go from there. BUT, I just made this change last week so I'm going to give it a few weeks and see if I have any improvement in sleep.

On no ai, I was having pretty bad insomnia and anxiety. Dr. Saya had me introduce anastrazole at .125 mg twice weekly and then split my HCG dosage into 3x per week.

Just last week, I decided to cut my ai in half after seeing my e2 was in mid twenties. I also added in the ZMA (450 mg mag aspartate) so I'm going to see if those two changes take care of my problems. I'm having my labs drawn again in about 3 weeks so I will see where I'm at. If I'm still not seeing improvement I will prob cut out the ai and try some melatonin or something.

How does the relationship between shbg and e2 work? I know that high shbg = low free t often but is there a relationship between e2 and shbg too?

Ya the relationship is basically the same. High SHBG equals lower free E2. So say one person has a very high SHBG, and another guy has a very low SHBG, and they both have a total E2 of 30. The high SHBG guy might feel like he has low E2, due to having low free E2. The low SHBG guy might feel like he has high E2, due to a lot of the E2 being inbound and free in his blood stream.

I’m extremely surprised Dr Saya prescribed you an ai with an E2 of 35, with a SHBG around 60. I wish I could hear his rationale and thought process in regards to why he thinks it would be a good idea to lower your E2 when your free E2 is most likely already on the low side. If I had to guess, I would say raising your E2 would more likely alleviate your sleep issues than lowering your E2.

 

[Vince Carter]

I can't take anything for when I might wake up around 0200 and be sleep disturbed...I have to be up by 4 for work so there's no room there for anything to ease me back to sleep.

 

[Vince Carter]

I wish I could hear his rationale and thought process in regards to why he thinks it would be a good idea to lower your E2

Well it's right there in his post, he felt worse on no AI; insomnia. You're not looking thru the numbers here.

 

[Dansk]

Why are you using an ai? An E2 of 35 is pretty much perfect. Some doctors would even say that it’s too low, not too high. Especially considering your SHBG is around 60. Did you have unwanted symptoms at 35? I would personally ditch the ai.

To help with sleep, I would take magnesium glycinate. The ZMA has magnesium in it, but probably not enough, and probably not bound to glycinate.

Also, make sure to get sunlight in your eyes for about 20 minutes when you wake up. This will reset your circadian rhythm, and will tell your body to wake up, and more importantly later in the day it will know to start making melatonin so that you can sleep. Make sure to avoid blue and green light from screens and fluorescent light about 3-4 hours prior to sleeping. If not, the lights will inhibit your melatonin production, and make it very difficult to get a good night’s sleep. If avoiding screens is impossible before bed, you can get a pair of blue/green light blocking glasses. I just picked up a pair from blublox.com. I feel like it makes a difference in my sleep.

I have helped several people with the very same suggestions about getting as much sun in the eyes and on the body in the morning up to noon time if needed, and then blue blockers after the sun goes down. I have gotten several reports back that it has helped.

I use these blue blockers
https://www.amazon.com/Uvex-Blockin...YXW9H8QXMHR&psc=1&refRID=X4ETDENWAYXW9H8QXMHR