TRT, Weakness, Low Energy, and Dopamine?

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Dasein88

Member
Sorry in advance for the long post. I want to be thorough.

I have been on TRT for 8 weeks through Defy. Defy says my recent follw-up labs are perfect.

I am experiencing no libido, poor sexual response, no drive or motivation, poor mood (apathy or emotional flatness), general weakness, and lack of energy; I am also experiencing cognitive impairments, such as difficulty concentrating, poor memory, difficulty reading, or performing simple tasks, such as creating this post.

Also, I put on about 10lbs of weight, mostly in my gut. I assume it is water weight and I realize that HCG is a likely culprit.

Defy says my levels are perfect. My problems arent hormonal. They offered no meaningful advice, they couldn't answer my questions, and they acted like they have never encountered anyone with my symptoms. Dr. Saya?

I am on zoloft, and have been for most of the last ten years. I fully know what to expect on zoloft. It can lower libido and sexual response, but I have never felt the way I do currently before trt. Zoloft never prevented me from crushing workouts, even if it made me somewhat tired at times.

Without stating that it is a dopamine issue, Defy says that I should consider changing to a different medication, such as wellbutrin, because wellbutrin affects dopamine, not serotonin, and is energizing, etc. Obviously, I don't know much about how TRT affects neurotransmitters, such as dopamine, which is why I am seeking help here.

I am caught between a rock and a hard place
I have spent close to $2000 on Defy, trt, and related stuff. I want to see the benefits of trt, but I am not seeing the proper results in my current state.

I am going to switch to wellbutrin asap, in a last ditch effort, even though I am reluctant to take a drug that has so many sides.

Also, I have Hashimoto's. I have had it for over 20 years and I believe my subpar testosterone levels are a direct result of Hashimoto's. I haven't encountered any information that tells me TRT won't work for men with Hashimoto's as long as their thyroid hormones are optimal. Plus, Defy is supposed to specialize in thyroid treatment and trt. If there is any kind of contraindication, they ought to know.

I should note that I have never experienced a euphoria from trt. I find it hard to believe that a trt-induced euphoria is even a thing, because I have at no point felt great on trt. Since dopamine is involved in motivation, among other things, it is a possible culprit. Even so, I don't understand why I am affected this way, and not others. I understand even less why Defy did not have any answers for me.

I am on 80mg test cypionate, 0.125mg adex, 500 ius HCG twice per week. I've decided to stop using HCG to see if that helps alleviate any of the symptoms.
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Defy Medical TRT clinic doctor
Every thing you said is related to Zoloft. TRT takes time to work. There is a list on this site that gives timeline to benefit. TRT may help you to the point you may not need Zoloft or like drugs.
 
So you’re labs do look pretty good, apart from your E2. I would say it’s way too low, based off of your SHBG. With you having a SHBG of 51, you have plenty of room for your E2 to go up. So I would 100% stop taking the ai. You could also try dropping the HCG as well, even just temporarily to see if you notice any differences, good or bad. But I would absolutely stop the ai.

I also agree with Captain, it could absolutely be related to the Zoloft. I understand you didn’t feel like this before TRT, so it seems like TRT would be the obvious thing to blame, but Zoloft messes with key mechanisms in your body/ brain, and TRT alters things as well. So it could be the combination of the two at the same time that’s causing you to feel the way you do. All I know though, is if I was on an SSRI, I would be looking for every way possible to get off of it. They definitely have their place, but me personally, I would hate putting that stuff in my body everyday, knowing the disregulation it’s doing in regards to neurotransmitter output, neurotransmitter receptors, and just overall how my body regulates serotonin. Anytime you alter the normal functions of the body, it’s never going to be good, and we don’t have any long term studies showing how these drugs effect us in the long run. Don’t want to scare you, just letting you know what I would do personally in your shoes. I’m a nurse, and worked in psych for 5 years, if that matters at all. But check out this psychiatrist named Kelly Brogan. She’s amazing. She’s really getting the word out about psych medications, and has turned her mission into helping people get off these medications and live great lives without them, instead of prescribing them. She has a Youtube channel called “kelly brogan”. She has a ton of testimonials on there about people that weaned off of their medications completely. I found out about her through the joe rogan podcast. Here’s a link to the podcast I’m referring to.

 
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So you’re labs do look pretty good, apart from your E2. I would say it’s way too low, based off of your SHBG. With you having a SHBG of 51, you have plenty of room for your E2 to go up. So I would 100% stop taking the ai. You. You could also try dropping the HCG as well, even just temporarily to see if you notice any differences, good or bad. But I would absolutely stop the ai.
You beat me to the punch.
 
I feel like death on anastrozole regardless of my E2 level. HCG may not agree with you and the belly bloat stands out as HCG induced since E2 looks fine.
 
Every thing you said is related to Zoloft. TRT takes time to work. There is a list on this site that gives timeline to benefit. TRT may help you to the point you may not need Zoloft or like drugs.

I think I know the timeline you are talking about, but that only addresses sexual and physical aspects, not cognitive aspects.

How do we explain the fact that I never had these problems before TRT? Something about my body chemistry is certainly "off." I've been on Zoloft for most of the past decade and my periods of greatest mental clarity have been on Zoloft. Does testosterone cypionate interact with Zoloft?

Ever since TRT, I have had constant cognitive difficulties. Some days are worse than others. Today happens to be worse than yesterday, which was worse than the day prior. My cognitive function is so poor, I will waste most of my day off being unproductive.

I never struggled in the gym on Zoloft. These days I take a large amount of preworkout just to have the motivation to complete a workout. While I may have put on some muscle, it is very hard when I don't have the muscle energy needed to push myself. I feel as though my ATP is not there.

In any case, there has to be a biochemical explanation for my muscle weakness, and I hope someone can answer that. Preworkouts before TRT gave me insane energy with a standard portion. On TRT they either barely work, or work moderately, even taking up to 1.5-2 times the portion size. I haven't abused preworkouts since 2012 and the only reason I use them since going on TRT is because I simply don't have the drive or motivation to go to the gym and push through a workout.

The most common responses I have received about my complaints are that I haven't been on TRT long enough, or that Zoloft is now causing all of these side effects it never had before. First thing tomorrow I will schedule an appointment so that I can switch to wellbutrin. What if I still don't see results? Are we going to blame wellbutrin?

I hope Dr. Saya comments.
 
Its the hormone cascade that gets disrupted from TRT. There are recent post about it. Some of these things are probably how you got where you are to start with. Backfilling the pathways is what you can search for to get an idea. SSRI drugs make me feel like I have a constant sinus infection or like you would after you get off a merry go round. Just feel run down and don't want to do anything but sit still.
 
Why Zoloft? Depression and or anxiety? Wellbutrin is not a good idea if you suffer from anxiety it can make you feel worse. Don’t change your medication without consulting your doc!
 
Again, another new person started with TRT, HCG and AI right out the gate. I don't understand why? I thought AI only if needed? (symptoms) and his E is on the low end of normal. I know its all about balance but starting with one thing at a time seems to make the most sense.
 
Some think your E will go up when you start. Some have sides at first that go away after they are on TRT longer. If you feel you want to wait before you start an AI you can say you want to wait. I don't think they will make you take it and if they try to well you know. They may offer it to you but you have to say you want it.
 
Some think your E will go up when you start. Some have sides at first that go away after they are on TRT longer. If you feel you want to wait before you start an AI you can say you want to wait. I don't think they will make you take it and if they try to well you know.

I thought we treat symptoms not numbers?? This seems to be a common occurrence.
 
I agree but they deal with this everyday. I was put on an AI with E2 at 15 with anticipation of it going up with a dose change. It didn't happen but I did agree to try it. You do have a choice you can say no.
 
I agree but they deal with this everyday. I was put on an AI with E2 at 15 with anticipation of it going up with a dose change. It didn't happen but I did agree to try it. You do have a choice you can say no.

I completely see the sense of offering it, to have in the event that you may need it. But it seems its not being presented that way. I could be wrong.
 
I can see E2 at 22 with top of range 35 then adding T to the mix may increase E. He is where you want him before T is added. I would wait and see but I am not a doctor and we don't know what was talked about with the doctor.
 
So you’re labs do look pretty good, apart from your E2. I would say it’s way too low, based off of your SHBG. With you having a SHBG of 51, you have plenty of room for your E2 to go up. So I would 100% stop taking the ai. You could also try dropping the HCG as well, even just temporarily to see if you notice any differences, good or bad. But I would absolutely stop the ai.

I also agree with Captain, it could absolutely be related to the Zoloft. I understand you didn’t feel like this before TRT, so it seems like TRT would be the obvious thing to blame, but Zoloft messes with key mechanisms in your body/ brain, and TRT alters things as well. So it could be the combination of the two at the same time that’s causing you to feel the way you do. All I know though, is if I was on an SSRI, I would be looking for every way possible to get off of it. They definitely have their place, but me personally, I would hate putting that stuff in my body everyday, knowing the disregulation it’s doing in regards to neurotransmitter output, neurotransmitter receptors, and just overall how my body regulates serotonin. Anytime you alter the normal functions of the body, it’s never going to be good, and we don’t have any long term studies showing how these drugs effect us in the long run. Don’t want to scare you, just letting you know what I would do personally in your shoes. I’m a nurse, and worked in psych for 5 years, if that matters at all. But check out this psychiatrist named Kelly Brogan. She’s amazing. She’s really getting the word out about psych medications, and has turned her mission into helping people get off these medications and live great lives without them, instead of prescribing them. She has a Youtube channel called “kelly brogan”. She has a ton of testimonials on there about people that weaned off of their medications completely. I found out about her through the joe rogan podcast. Here’s a link to the podcast I’m referring to.

Trt can cause the same disregulation to the body also. Your shutting down pathways by taking a hormone and nobody knows about that long term either. Yes testosterone has been around forever and some people live just fine taking it as do some people on ssri. This debate gets exhausting. Can’t we just agree that both of these games are dangerous. They work for some and not for others also a reason why forums like this exist. Trt isn’t even close to perfect science either. And some people like me actually had worse side effects mentally from messing with hormones vs nt drugs. I know I’m on a lot of threads saying this and I really do not have a ssri agenda I’m trying to push but the op clearly stated that he didn’t have these symptoms till trt and one guy above says it’s absolutly Zoloft. Doesn’t make sense.
 
He has been on Zoloft for 10 years and he is not happy. Then he has been put on TRT for 8 weeks and TRT is the blame. Doesn’t make sense.
 
I think I know the timeline you are talking about, but that only addresses sexual and physical aspects, not cognitive aspects.

How do we explain the fact that I never had these problems before TRT? Something about my body chemistry is certainly "off." I've been on Zoloft for most of the past decade and my periods of greatest mental clarity have been on Zoloft. Does testosterone cypionate interact with Zoloft?

Ever since TRT, I have had constant cognitive difficulties. Some days are worse than others. Today happens to be worse than yesterday, which was worse than the day prior. My cognitive function is so poor, I will waste most of my day off being unproductive.

I never struggled in the gym on Zoloft. These days I take a large amount of preworkout just to have the motivation to complete a workout. While I may have put on some muscle, it is very hard when I don't have the muscle energy needed to push myself. I feel as though my ATP is not there.

In any case, there has to be a biochemical explanation for my muscle weakness, and I hope someone can answer that. Preworkouts before TRT gave me insane energy with a standard portion. On TRT they either barely work, or work moderately, even taking up to 1.5-2 times the portion size. I haven't abused preworkouts since 2012 and the only reason I use them since going on TRT is because I simply don't have the drive or motivation to go to the gym and push through a workout.

The most common responses I have received about my complaints are that I haven't been on TRT long enough, or that Zoloft is now causing all of these side effects it never had before. First thing tomorrow I will schedule an appointment so that I can switch to wellbutrin. What if I still don't see results? Are we going to blame wellbutrin?

I hope Dr. Saya comments.
If it makes you feel any better low dose lexapro Gave me my life back after I screwed up my hormones by overtraining under eating. Read dr Mariano’s posts on the boards over the years he has some pretty insightful posts about why they can help.

I’ve had perfect labs on trt. I was a patient of. Dr johns for years. We tried every single combination of drugs on hrt. I mean we tried everything from clomid to triptorelin. Hc /t3 trt mono, hcg mono, trt with hcg ai, hcg mono and Ai mono. I’ve never felt right on any form of hrt. Last run with trt mono I was doing ok but I was only taking 60mg per week everyday shots. But I wasn’t really feeling anything at all. And my athletic performance has always suffered on trt. I’m not sure why this is the case and ssri isn’t fool proof either some times I think they might make me care a little less about things and a little short tempered but also might be me just getting older
 
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He has been on Zoloft for 10 years and he is not happy. Then he has been put on TRT for 8 weeks and TRT is the blame. Doesn’t make sense.
I’m not arguing with you at all but I think your missing his point he wasn’t saying Zoloft was a cure all. But he did say since going on trt he has felt way worse. And I can second that I’ve had the same experience. And for me I can’t tolerate trt at all without an ssri. Ssri actually made me able to tolerate trt long enough to say on and say it has little to no positive effect on me. That said if I was op I would at least try trt mono out of the gate. I know I can do ok on trt alone but hcg is awful for me
 
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