I am in my mid sixties and have been severely compromised by low back pain and osteoarthritis. Seven physicians, spine surgeons, rehab, accupuncture, two spinal ablations this summer, blocks, PRP, weight loss, have all led to one thing, nothing. I have also had both hips replaced and the onset of OA in lower back started 25 years ago and ended in surgery to help 'clean' it up. I was also very involved in athletics since I could walk and it paid my way through college. I'm certain this all contributed along with some bad genetics. I also helped developed long acting opioids with deterrents for abuse so I'm familiar with how they work, dangers etc.. In the end, it was the same, wake up exhausted and wake up at 2 or 3 EVERY NIGHT, TAKE A PAIN PILL and wait for it to work and then return to try and sleep. I'm also an a fib patient so NSAIDS ARE OUT OF THE QUESTION DUE TO RISK OF BLEEDING given I'm on blood thinners. My blood tests always resulted in same thing. First reading (8AM fasting) always low, 125 or so. The second, seemed to go up but only to 300 or so and my endocrinologist was reluctant to prescribe. Finally, after noticing I was having issue with my short term memory about 6 months ago, I needed to revisit TRT. Forget no energy, no libido. Now I was very concerned. I approached my physicians, cardiologists and endocrinoligists with yet another request. This time the results were very low the first time 120 and borderline the second time 260 but also complimented with low LH, FSH and estradiol and free testosterone.
I have only been on TRT for 3 weeks (200mg every 2 weeks) and have seen fleeting signs of encouragement. Energy seems to be improving but it's hard to quantify. Not much improvement if at all in libido and hence sexual dysfunction and hard to say about short term memory. But, here is why I am posting. After 2-3 years of waking every night, I have now had 6 days of uninterrupted sleep for 6-7 hours a night which has not happened in years and I know the only change in my routine has been TRT. Not only am I encouraged, but elated. I believe other benefits will follow shortly. But for someone like me, who has not had a sound night's sleep consistenly for more than a day over the last +2-3 years, you can imagine how I feel. I haven't been able to determine if the anti-inflammatory properties are reducing the back pain because it remains but primarily when on my feet a few hours or even sitting legs not up.
Sleep is often not talked about with TRT or at least in most of my research. I hope this helps anyone who may be encountering similar issues that I have.
I have only been on TRT for 3 weeks (200mg every 2 weeks) and have seen fleeting signs of encouragement. Energy seems to be improving but it's hard to quantify. Not much improvement if at all in libido and hence sexual dysfunction and hard to say about short term memory. But, here is why I am posting. After 2-3 years of waking every night, I have now had 6 days of uninterrupted sleep for 6-7 hours a night which has not happened in years and I know the only change in my routine has been TRT. Not only am I encouraged, but elated. I believe other benefits will follow shortly.
Glad to hear you are feeling somewhat better jumping on trt but unfortunately you are going to miss out on many of the beneficial effects of having healthy testosterone levels due to the piss poor protocol you were started on.
Keep in mind that the metabolites
estradiol and DHT are needed in healthy amounts to experience the full spectrum of testosterones beneficial effects on (cardiovascular health, brain health, libido, erectile function, bone health, tendon health, immune system, lipids, and body composition).
*Natural testosterone is viewed as the best androgen for substitution in hypogonadal men. The reason behind the selection is that testosterone can be converted to DHT and E2, thus developing the full spectrum of testosterone activities in long-term substitution
200 mg T every 2 weeks is a protocol prescribed by those with a neanderthal mindset.
Such dose let alone injection frequency will have your TT, FT, and estradiol levels sky-high post-injection (8-12 hrs)/during the first few days only to be followed by lower levels come weekend end let alone back to being hypogonadal before your next injection (2-week mark) due to the half-life (TC/TE).
Most men on trt are injecting 100-200 mg T/week whether injected once weekly or split into twice weekly (every 3.5 days), M/W/F, EOD, or daily.
Even then most men would never need the higher-end trt dose of 200 mg/week to achieve a healthy let alone high trough FT.
Most men can easily achieve a high end let alone very high and in some cases absurdly high FT level injecting 100-150 mg T/week split into twice weekly (every 3.5 days), M/W/F, EOD let alone daily.
FT 5-10 ng/dl would be considered low.
FT 16-31 ng/dL (high-end) is healthy.
Most men will do well with FT 20-30 ng/dL.
Some may CHOOSE to run higher levels.
Notice I stated choose as it is highly unlikely most would NEED a
trough FT >31 ng/dL.
Critical to have healthy thyroid/adrenals as any dysfunction will have a negative impact on the outcome of trt.
If anything you need to be injecting once weekly and to be honest most would fair better injecting twice-weekly (every 3.5 days).
The downfall of injecting higher doses of T once weekly is there will be a significant difference in the peak--->trough and blood levels will not be as stable throughout the week as T levels will be very high post-injection (8-12 hrs)/during the first few days only to be followed by lower levels come weeks end which can have a negative effect on mood, energy, libido, erectile function, recovery.
The main advantage of injecting more frequently is you will be clipping the peak--->trough and blood levels will be more stable throughout the week which will have a beneficial effect on symptom relief/overall well-being.
Keep in mind that although TT is important FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.
Critical to know where your SHBG level sits as it will have a significant impact on TT/FT level achieved and can also dictate what injection frequency may suit you best.
Most men with lowish/low SHBG tend to do better injecting more frequently EOD/daily.
Comes down to the individual and what injection frequency suits you best.
The best piece of advice is to start low and go slow on a T-only protocol (100mg T/week) whether once weekly or split into twice-weekly injections (50 mg every 3.5 days) as we want to see how your body reacts to testosterone and where said protocol (dose of T/injection frequency) will have you trough TT, FT, estradiol let alone other important blood markers such as RBCs/hemoglobin/hematocrit 6 weeks in.
You have barely gotten your feet wet as you are only 3 weeks in let alone on a piss-poor protocol of 200 mg T every 2 weeks.
You are basically shooting your T levels through the roof post-injection/during the first few days only to be followed by much lower levels come weeks end (most likely still fairly high due to the whopping dose of 200 mg T) but more importantly, 7 days in and your T levels will continue to plummet only to be absurdly low (hypogonadal) by day 14.
A rollercoaster ride anyone!
I would strongly consider changing your protocol to 100 mg T once weekly and even then splitting your dose into twice-weekly injections (50 mg T every 3.5 days) would most likely have you better off.
Forget the 3 weeks you have wasted and start over.
Keep in mind that due to the half-life of the ester used (TC/TE) it will take 4-6 weeks for your blood levels to stabilize then blood work will be done as we want to see where your trough TT, FT, estradiol, and RBCs/hemoglobin/hematocrit sit
The first 6 weeks can be very misleading and it is common for many to experience ups/downs during the transition as hormones are in FLUX and the body is trying to adjust.
Even then once blood levels have stabilized it will take time for the body to fully adapt to the new set-point and this is the critical time period when one should gauge how they truly feel overall regarding relief/improvement of low-t symptoms/overall well-being.
Every protocol should be given a fair chance (12 weeks) to claim whether it was truly a success or failure.
Do not expect everything to be fine and dandy 6 weeks in and your dose of T should not be increased 6 weeks in unless your trough FT level is too low (highly doubtful).
Patience is key!
My blood tests always resulted in same thing. First reading (8AM fasting) always low, 125 or so. The second, seemed to go up but only to 300 or so and my endocrinologist was reluctant to prescribe. Finally, after noticing I was having issue with my short term memory about 6 months ago, I needed to revisit TRT. Forget no energy, no libido. Now I was very concerned. I approached my physicians, cardiologists and endocrinoligists with yet another request. This time the results were very low the first time 120 and borderline the second time 260 but also complimented with low LH, FSH and estradiol and free testosterone.
This is pathetic and typical of many endos/GPs!
Clear as day that TT 120 ng/dL is horribly low let alone 260-300 ng/dL would have anyone feeling the death grip of piss poor T levels.
FT would be in the gutter.
. 
