Poor sleep / Reaching end of my rope

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I am at 60mg testosterone Cypionate and started at 100mg 3 years ago. I have had sleep issues for years. I never noticed any change in my issues at the various testosterone levels. I use Unisom at 11pm bedtime and my first awake cycle at 2am. I also use a herbal formulation at bedtime and Relaxamag magnesium. I can not sleep without Unisom.
 
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Maybe a case for scrotal Test cream? Once daily?
Like many on here, I struggled on standalone cream. But there have been couple of threads about idea of using cyp/enan injectable as steady base and then adding dab of cream in morning to spike T earlier in the day (similar to adding propionate). I have always been intrigued by this protocol and need to give it a shot. On paper it seems to make sense
 
I track it every day with iPhone and sleep app. Deep sleep is usually between five and 15 minutes per night. Not to mention the way that I used to sleep before TRT and now after TRT.
I would definitely post your score. Just do a screenshot and post it here. It would make it easier for everyone to help you.
 
Try a lower dose testosterone. Some people do 50mg/week. The insomnia side effect tends to decrease with dosing.

If that doesn't help, you could try a sleep benzo: 15-30mg temazepam, although benzos are also immunomodulators and the temazepam is in the ummunosuppressive group - the research on that is skimpy. Temazepam is a very gentle drug, after you develop tolerance to it in a few days. It makes you slightly sleepy but it is up to you - if you want you may decide not to sleep. Ambien is like a date rape drug compared to Temazepam.
What about lunesta and immunomodulation/suppression/etc?
 
TRT has also affected my sleep since starting it 15 years ago. I've settled on lower dose and still have some negative effect on sleep but it's manageable. I still regularly think about trying to come off TRT to see if there is a net benefit, but I haven't taken a leap. I've found a reasonable place where I feel pretty good and struck a decent balance between the pros/cons.

When I tried doing my cypionate shot 1x/week, sleep would be better the 1-2 days before the next shot as my levels were lower. So cognition/mood/anxiety would be better largely because sleep was better.

So I lowered the dose over time until I found a reasonable compromise at 30mg cypionate 2x/week (along with danazol to control SHBG from t3-only thyroid replacement, and HCG 250 iu 2x/week to get E2 up and maintain fertility). I do my T shots Weds AM and Saturday AM because it seems doing the shot in the PM strongly correlated with worse sleep that night. Not a major difference vs AM but there's a signal there.

Tried daily low dose as well at some point in the past, but I think the dose was still a bit too high so never really got restful sleep. I like allowing androgen levels to go through a bit higher period and bit lower period every few days.

I'm considering lowering the dose even further from 60mg/week to 55 or 50, to see if I feel even better. This probably seems crazy to some, and one might argue I should just come off because that dose is so low. However, the 60mg/week with danazol and HCG has me at 1100-1200 total T at peak, around 700 at the low point, and ~35pg/ml free (direct, labcorp), with e2 (sensitive) ~ 25.

I'm planning to get a zMax from Hypnodyne to see if I can get a better sense of actual Deep and REM sleep patterns as it relates to various changes in my regimen, such as T levels, Free T levels, and numerous other factors. My Oura ring and Whoop are of course unreliable when it comes to measuring actual sleep stages.
 
What about lunesta and immunomodulation/suppression/etc?

All benzodiazepines and z-drugs are suspected to suppress the immune system because the immune system has benzo receptors, not only the nervous system. Diazepam is proven to be immunosuppressive in mice studies.

Another side effect of benzos and z-drugs is that they relax the muscles, in particular the esophageal sphincter, which may cause or exacerbate a gastric reflux, leading to aspiration and lung infections from the intestinal content (bacteria).

Read the discussion section here:

On the other hand, I've see articles that triazole benzodiazepines like xanax are either neutral or immuno boosting:

 
All benzodiazepines and z-drugs are suspected to suppress the immune system because the immune system has benzo receptors, not only the nervous system. Diazepam is proven to be immunosuppressive in mice studies.

Another side effect of benzos and z-drugs is that they relax the muscles, in particular the esophageal sphincter, which may cause or exacerbate a gastric reflux, leading to aspiration and lung infections from the intestinal content (bacteria).

Read the discussion section here:

On the other hand, I've see articles that triazole benzodiazepines like xanax are either neutral or immuno boosting:

Well, I suppose if it was enough immunosuppression to matter, this last round of covid would've been far worse while taking it, correct?
 
Yes correct and there are observational studies showing chronic use of benzos (z-drugs work on the same receptors) is correlated with a higher risk for hospitalization amongst COVID patients, but not mortality. However, observational/correlational studies are the lowest level of evidence in medicine and do not prove causation.

If melatonin works for you, it is immunostimulating.

 
Yes correct and there are observational studies showing chronic use of benzos (z-drugs work on the same receptors) is correlated with a higher risk for hospitalization amongst COVID patients, but not mortality. However, observational/correlational studies are the lowest level of evidence in medicine and do not prove causation.

If melatonin works for you, it is immunostimulating.

Well, after being on lunesta for like 5 months and then getting covid again which was a breeze, I'm not worried about it. Thanks for the info.
 
TRT has also affected my sleep since starting it 15 years ago. I've settled on lower dose and still have some negative effect on sleep but it's manageable. I still regularly think about trying to come off TRT to see if there is a net benefit, but I haven't taken a leap. I've found a reasonable place where I feel pretty good and struck a decent balance between the pros/cons.

When I tried doing my cypionate shot 1x/week, sleep would be better the 1-2 days before the next shot as my levels were lower. So cognition/mood/anxiety would be better largely because sleep was better.

So I lowered the dose over time until I found a reasonable compromise at 30mg cypionate 2x/week (along with danazol to control SHBG from t3-only thyroid replacement, and HCG 250 iu 2x/week to get E2 up and maintain fertility). I do my T shots Weds AM and Saturday AM because it seems doing the shot in the PM strongly correlated with worse sleep that night. Not a major difference vs AM but there's a signal there.

Tried daily low dose as well at some point in the past, but I think the dose was still a bit too high so never really got restful sleep. I like allowing androgen levels to go through a bit higher period and bit lower period every few days.

I'm considering lowering the dose even further from 60mg/week to 55 or 50, to see if I feel even better. This probably seems crazy to some, and one might argue I should just come off because that dose is so low. However, the 60mg/week with danazol and HCG has me at 1100-1200 total T at peak, around 700 at the low point, and ~35pg/ml free (direct, labcorp), with e2 (sensitive) ~ 25.

I'm planning to get a zMax from Hypnodyne to see if I can get a better sense of actual Deep and REM sleep patterns as it relates to various changes in my regimen, such as T levels, Free T levels, and numerous other factors. My Oura ring and Whoop are of course unreliable when it comes to measuring actual sleep stages.
I really feel like I have to come down even further with my dose. I’m going to skip and injection or two and see if I notice better sleep because I cannot continue like this. I’m tired most of the time and push through but it’s becoming unsustainable. Im going to drop to 70 mg per week and stay at that for 6 weeks and get bloods and see how I feel. Please keep me posted on your progress. It sounds like we exactly alike.
 
go to your doctor for a sleep study, you may have sleep apnea. I said fuck off for years to my doctor who suggested it, used pills, liquor, anything to allow me good sleep. Well I succumbed a few months ago, did a sleep study which showed I had apnea and now sleep with a machine. it may sound horrifying, but it really is not, and my sleep is awesome now, does not affect my love life at all as I only use it at home and only after my partner has gone to sleep. it really has improved my life.
 
I go to the gym 7 days a week and am a cyclist and avid hiker. Been doing this for 30+ years. Exercise has been and always will be a priority for me especially after my back fusion.
 
You said it yourself these activities you’ve been doing your body already knows how to handle you’ve been doing it for 30+ years. Shock your body by doing the activities I mentioned earlier and see if you hit REM if so then you’ll know you may need to change up your exercise routine introducing new methods.
 
I go to the gym 7 days a week and am a cyclist and avid hiker. Been doing this for 30+ years. Exercise has been and always will be a priority for me especially after my back fusion.
Any chance of overtaxing ur nervous system with all that exercise? Gym 7 days a week, on top of cycling and hiking sounds like quite a bit, especially when done on a consistent basis for 30+ years

As u get older the body just isn’t able to recover as well. And that includes the nervous system. I’m assuming ur probably 50 years old+. Even if ur body could handle all of this when u were younger, ur body might not be able to handle it as well now, and it could possibly be effecting ur sleep. I’m 37 and I’ve been lifting weights and going to the gym since I was 14. But I currently only go to the gym 3 days per week. and I give my body a day off inbetween to recover. I try to go Monday, Wednesday, Friday. No issues with sleep
 
Any chance of overtaxing ur nervous system with all that exercise? Gym 7 days a week, on top of cycling and hiking sounds like quite a bit, especially when done on a consistent basis for 30+ years

As u get older the body just isn’t able to recover as well. And that includes the nervous system. I’m assuming ur probably 50 years old+. Even if ur body could handle all of this when u were younger, ur body might not be able to handle it as well now, and it could possibly be effecting ur sleep. I’m 37 and I’ve been lifting weights and going to the gym since I was 14. But I currently only go to the gym 3 days per week. and I give my body a day off inbetween to recover. I try to go Monday, Wednesday, Friday. No issues with sleep
Possibly. My routine is consistent where I do one body part per session and then 30 minutes of cardio. I only try to spend 1 hour in the gym. It is possible that is causing something but this all started after TRT.
 
Possibly. My routine is consistent where I do one body part per session and then 30 minutes of cardio. I only try to spend 1 hour in the gym. It is possible that is causing something but this all started after TRT.
That sounds reasonable. And u would think HRT would improve ur recovery. But HRT can also ramp up the nervous system a bit. HRT can also deplete nutrients in the body a bit more, due to the body working at a higher level. So it could be possible that between HRT and ur active lifestyle, it may just be a bit too much for ur system atm.

I would definitely try taking a couple days off from the gym per week. But if u have a nice system going where u work one body part per day, that might suck having to alter ur routine like that.

If I were u, I personally would focus more on giving ur body the nutrients it needs to handle everything ur throwing at it better. I feel like that’s the biggest key to my personal success. If u look at every individual vitamin, mineral, amino acid, etc, u can always find a host of positive things they do in/ for the body. Now imagine the benefits when getting an adequate amount of all of them at the same time. Imo, most people DRASTICALLY underestimate the power of nutrition, and how much getting in all of the nutrients the body needs can affect the way their body functions. Again, imo, most people have no idea how powerful simply getting in enough micronutrients can be, in regards to their body functioning properly, and issues they’re having either completely resolving, or at least improving to the point where it doesn’t effect them negatively anymore day to day. U’d be shocked how drastically something as simple as not getting enough B12 in ur diet can affect a host of things within the body and mind. And that’s simply one vitamin. Now imagine not getting enough of multiple vitamins and minerals. U wouldn’t believe how something as simple as not getting enough micronutrients per day, on an ongoing basis, can cause serious issues overtime

I know people like to focus on HRT itself, as the problem, when issues occur immediately after starting it, but it’s completely possible that HRT could be the catalyst that resulted in the problem being present, but is still not the underlying cause of the issue. The underlying issue could still be simply needing to be more strict with diet and lifestyle factors, and getting the body in an overall healthier state, to be able to tolerate the HRT better

If I were u I would simply just try to get in as much fatty red meat in ur diet per day as possible. Red meat contains all the micronutrients our bodies need to function properly. And on top of that I would try to get in a decent amount of pastured egg yolks per day. Between those two things, in abundant amounts per day, u should cover ur bases enough to see improvements in ur sleep overtime. This is assuming ur at least eating at maintenance calories, and not in a calorie deficit each day

And since sleep is ur issue, I would also highly recommend supplementing with as much high quality magnesium as u can, without causing loose bowels. I personally take magnesium chloride liquid. The brand Remag, to be specific. And I would also start taking vitamin D3 if u aren’t already. An adequate vit D level can definitely improve sleep patterns
 
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Any chance of overtaxing ur nervous system with all that exercise? Gym 7 days a week.
I have encountered an overtaxed CNS working out, 7 days a week. If I lift too heavy for too long, I feel mentally off and lightheaded which takes hours to resolve.

If I were natty, I couldn’t get away with it. Being on TRT, I’m immune to testosterone suppression.
 
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That sounds reasonable. And u would think HRT would improve ur recovery. But HRT can also ramp up the nervous system a bit. HRT can also deplete nutrients in the body a bit more, due to the body working at a higher level. So it could be possible that between HRT and ur active lifestyle, it may just be a bit too much for ur system atm.

I would definitely try taking a couple days off from the gym per week. But if u have a nice system going where u work one body part per day, that might suck having to alter ur routine like that.

If I were u, I personally would focus more on giving ur body the nutrients it needs to handle everything ur throwing at it better. I feel like that’s the biggest key to my personal success. If u look at every individual vitamin, mineral, amino acid, etc, u can always find a host of positive things they do in/ for the body. Now imagine the benefits when getting an adequate amount of all of them at the same time. Imo, most people DRASTICALLY underestimate the power of nutrition, and how much getting in all of the nutrients the body needs can affect the way their body functions. Again, imo, most people have no idea how powerful simply getting in enough micronutrients can be, in regards to their body functioning properly, and issues they’re having either completely resolving, or at least improving to the point where it doesn’t effect them negatively anymore day to day. U’d be shocked how drastically something as simple as not getting enough B12 in ur diet can affect a host of things within the body and mind. And that’s simply one vitamin. Now imagine not getting enough of multiple vitamins and minerals. U wouldn’t believe how something as simple as not getting enough micronutrients per day, on an ongoing basis, can cause serious issues overtime

I know people like to focus on HRT itself, as the problem, when issues occur immediately after starting it, but it’s completely possible that HRT could be the catalyst that resulted in the problem being present, but is still not the underlying cause of the issue. The underlying issue could still be simply needing to be more strict with diet and lifestyle factors, and getting the body in an overall healthier state, to be able to tolerate the HRT better

If I were u I would simply just try to get in as much fatty red meat in ur diet per day as possible. Red meat contains all the micronutrients our bodies need to function properly. And on top of that I would try to get in a decent amount of pastured egg yolks per day. Between those two things, in abundant amounts per day, u should cover ur bases enough to see improvements in ur sleep overtime. This is assuming ur at least eating at maintenance calories, and not in a calorie deficit each day

And since sleep is ur issue, I would also highly recommend supplementing with as much high quality magnesium as u can, without causing loose bowels. I personally take magnesium chloride liquid. The brand Remag, to be specific. And I would also start taking vitamin D3 if u aren’t already. An adequate vit D level can definitely improve sleep patterns
Firstly, thank you for taking the time to write such a detailed and thoughtful response. I did have my doctor run some vitamin tests (iron, B12,D etc.) and of course being from New England, I was well below on the Vitamin D scale so I started that a few months back. I eat fairly well but certainly could be doing better. Incorporating the eggs could be an addition that I should add and will do so. I do take some Mag before bed and have been also taking some fiber as well. I just turned 50 in July and have always been very active and I do agree that I could be overtraining on some weeks but I am also very concerned about taking my foot off the gas pedal because that has kept me out of further back surgery up until now. My surgeons from 20 years ago were amazed at my physical condition after the type of surgery that I had so I tend to go overboard sometimes. You have given me lots to think about. Thank you.
 
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