Start up bad side effects... ?

[Systemlord]

So 5 weeks in on 18mg MWF(54mg) and the last week have felt like rubbish. Tired, achy no energy and zero motivation. The strange thing is my Test levels are now higher than before i started TRT? so i thought i would feel better. Strangley my libido is slightly higher than before starting.

Do i wait this out? or bump up my dose?

I would increase the dosage.

 

[JayD]

I would increase the dosage.

How much do you think I should increase the dosage, if I wanted to aim for a trough of say 600

 

[Vince]

How much do you think I should increase the dosage, if I wanted to aim for a trough of say 600

That would be a good level to reach for. I wonder what would happen if you added in low dose nandrolone?

 

[JayD]

That would be a good level to reach for. I wonder what would happen if you added in low dose nandrolone?

Is the tired, achy part just a transient part of getting dialed in?

 

[Vince]

Is the tired, achy part just a transient part of getting dialed in?

Personally, I never had any issues with starting TRT or changing protocols. But as you know, when it comes to TRT one size does not fit all.

 

[Systemlord]

Is the tired, achy part just a transient part of getting dialed in?

It is for some and the length of time you’re in flux depends upon the half-life. On Jatenzo the half-life is 8 hours, so the time you spend with unsteady levels (7 days) is far shorter that say cypionate which has a 5-7 day half-life and 42 days to a steady state.

 

[Systemlord]

How much do you think I should increase the dosage, if I wanted to aim for a trough of say 600

I think 22 mg daily should get you there.

 

[JayD]

Thanks for the replies everyone appreciate it. Trying to navigate this on my own is not easy.

I will up the dose for another 5-6 weeks then do bloods and report back.

Will also add in some P5P and vit E to see if I can move those prolactin numbers

I'm guessing my E2 was fine as no one mentioned it

 

[Cataceous]

Personally I think you should have tackled the elevated prolactin before starting TRT. It might have been reducing your natural testosterone production and directly affecting libido. I wouldn't mess around with the supplements. A trial with micro-doses of cabergoline would allow you to lower prolactin in a controlled manner to see if it's been contributing to your problems. In some cases even levels over ~210 mIU/L have been known to cause problems, so I would target 150-200.

 

[Systemlord]

I'm guessing my E2 was fine as no one mentioned it

The estrogen is on the low side, but is irrelevant because you’re going to be increasing the dosage.

 

[JayD]

Personally I think you should have tackled the elevated prolactin before starting TRT. It might have been reducing your natural testosterone production and directly affecting libido. I wouldn't mess around with the supplements. A trial with micro-doses of cabergoline would allow you to lower prolactin in a controlled manner to see if it's been contributing to your problems. In some cases even levels over ~210 mIU/L have been known to cause problems, so I would target 150-200.

I had a head scan prior to starting but they found nothing. I asked my doc for something to lower it before it almost doubled on TRT, but she didn't think it was high enough to warrant intervention. Now that I have this high number on latest test, I will go back and ask again for caber.

 

[JmarkH]

The estrogen is on the low side, but is irrelevant because you’re going to be increasing the dosage.

 

[JayD]

So i emailed my Trt Doctor and he emailed back instructing me to start IM injections.

Zero mention of the high Prolactin.

"Because of your feedback below, I would have to say that you do need to be on intramuscular injections from now on. This can be given either in the upper thigh or the deltoid muscle upper arm"

I dont want to 2nd guess my Dr but im feeling conflicted

 

[JayD]

So i got another response from Doc

"Unfortunately it is not really just a matter of prescribing a pill as it would be using it for an off label use which is more strict requirements and consent process.
If I direct you to the Medsafe data sheet attached URL, read through thoroughly and you will see that there has to be a number of investigations to eliminate particular disorders that may be there undetected which could be aggravated by a fibrotic process.
And you would be likely have it for relatively long term increasing that risk.
Even though you would give consent, in the medicolegal sense I am totally responsible if we did not go through the preassessment process.
Yes, I know that around the world people get them online or by them from various pharmacies are just take them and they are probably fine.
Because I already have 2 vexatious complaints against me (not from patients obviously) to medical Council related to assisting people with Covid, my prescription habits are closely monitored.
Perhaps an endocrinologist might assist, though I have my doubts.
Other than that keeping your doses relatively frequent and low, reducing aromatisation through to oestriol and reviewing your prolactin every 2 or 3 months, is the more workable solution."

Man my Country sucks but i guess i have to be thankful we even get testosterone