question from a user
I’m new to TRT. I’m 47 yrs old. Did bloodwork and was put on 200ml/week in Oct of 2023.l. felt great, sex drive was good, even had “morning wood” most days of the week. Even before trt I was very active. Worked out everyday of the week and had my diet dialed in. The past month tho, everything seems to have switched. Super tired and lethargic during the day. Coffee/energy drinks do nothing. Sex drive way down. Just did blood work and everything came back fine. I’ve changed nothing in my diet nor workout, I actually started taking sat/Sundays off from gym. I average 6-6.5 hours of sleep during the week, weekends are closer to 8 hours. He also prescribed me 200mg of progesterone that I take each night. Just looking for some thoughts/advice.
AlphaMD's Answer
Well, I think I have your answer. The average man produces 10-20mg of progesterone daily. If you are really taking 200mg daily, you are overdosing.
Progesterone can be converted into other neuroesteroids (dihidroprogesterone and allopregnanolone) which are sedating and positive allosteric GABA modulators even stronger than benzodiazepenes like Xanax or Ativan.
You should talk to your doctor, but personally, I would cut out the progesterone completely and let it wash out and see if your extreme fatigue resolves.
I'd say first you should switch to a twice weekly injection routine and break that 200mg up into two 100mg doses. Due to the half life of most Testosterone medications, once a week is going to cause a high spike in Testosterone which your body may react to with SHBG or Estrogen conversion, then also the last half of the week you're going to be much lower on Testosterone because half of that dose is already gone.
The up/down nature of those extremes isn't something that your body will love, especially at 200mgs. Before looking to add anything else to the mix, we'd make that change first and see how it feels doing it for a fair number of weeks. Then maybe review to check out those other two markers from above if that doesn't help.
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