MCT TRT issue anyone? Possible side effects?

[Sandz]

Hi team.

Been on a TRT journey for a year. One of the biggest takeaways I've learned here is to stay the coarse, try not to change dosage and timing often, things will stabilize. But, in doing so I am feeling off, constantly...its been going on for 6 months. After months of trial and error, 2x to 3x weekly and then back, I finally got my numbers to a good place 800s total T, Good free T, e2 is around 40 and SHBG is around the same. No dim, no AI. But in the fall I started feeling OFF. After means, after a long day at work, and every day im out of gas at 5pm. Sleep is terrible. The one variable I can point to is changing carrier oils back in October when it all started. I was trying to stay away from seed oils so I switched to MCT form grapeseed but still same dose. I don't know if I am having a constant low grade inflammatory response but I don't know what else to do. Went to mind clinic to check autonomic disorders, had my thyroid checked and an taking t3/t4, increased my DHEA which was in the tank but now improved, etc. I just switched to IM thinking maybe sub Q was an issue and just reordered grapeseed TRT hoping this helps. Any thoughts could all the fatigue and wired but tired be related? I'm out of options, and afraid to stop the TRT cause when I feel good its great but those days are very few.

 

[Nelson Vergel]

Good post, and you've done a lot of the right detective work already. Let me share a few thoughts:


The MCT oil carrier switch is a legitimate variable. MCT (medium-chain triglycerides) absorbs and releases testosterone at a different rate than grapeseed oil. MCT tends to produce a faster release after injection, which can mean higher peaks and steeper troughs compared to longer-chain oils like grapeseed or sesame. Some men who are sensitive to that peak-trough swing will notice it in their mood, energy, and sleep even when trough bloodwork looks "fine." Your instinct to switch back to grapeseed is solid. Give it 6-8 weeks on grapeseed before drawing conclusions.


Your "wired but tired" pattern points to cortisol dysregulation, not just testosterone. This is one of the most underdiagnosed pieces of the TRT puzzle. A 4-point salivary cortisol test (morning, noon, afternoon, evening) is the right next step. An inverted or flattened cortisol curve is very common in men on TRT who are under chronic stress, sleeping poorly, or whose HPA axis has been disrupted. Afternoon crashes around 5pm are a textbook sign.


Being on T3/T4 doesn't mean your thyroid is optimized. Post the actual numbers if you have them. Many men feel best with Free T3 in the upper third of the reference range. Reverse T3 can also be a problem if you're under metabolic stress. This is worth revisiting with your prescribing doctor.


A few labs worth checking if you haven't recently:

• Fasting insulin and glucose (post-meal crashes can be reactive hypoglycemia)
• Ferritin (ideally 80-100+)
• Vitamin D (25-OH)
• Free T3, Free T4, Reverse T3
• Sensitive estradiol (if you've only run standard E2)

Sleep apnea is underdiagnosed on TRT. If you snore or have gained any weight, a home sleep study is worth ruling out. TRT can worsen apnea, and apnea produces exactly the fatigue pattern you're describing.


Your hormone numbers actually look reasonable on paper. This reads more like an HPA/thyroid/sleep quality issue compounded by the MCT carrier variable. The good news is you have real leads to chase. Post your thyroid labs and cortisol results when you have them and we can dig in further.

 

[Sandz]

@Nelson Vergel thank you for replying. I heard you on a podcast and was amazed at your story, cool to see you chime in on my post, thank you!

Let me hit on a few markers you mentioned because I have been chasing this thing for a year and feel like I have tested everything

• Fasting insulin and glucose (post-meal crashes can be reactive hypoglycemia)
  • When I tested glucose last it was around 100 but since 2023 I have tested it 10 times btwn 90 and 105. For fun, a few weeks ago, I worse a GCM for 2 weeks and it was btwn 85-115 consistently and it was fairly steady.
• Ferritin (ideally 80-100+)
  • tested Ferritin 2x in 2024, was 182 and then 124.
• Vitamin D (25-OH)
  • Tested 3x in 2025 and ranged from 35 to 70
• Free T3, Free T4, Reverse T3
  • FT3 - hovers btwn 2.3-2.8. Now treating it and it was 3.2, will test again shortly.
  • FT4 - hovers btwn 1.05 and since been dropping to .74. Now treating and its .96, will test again shortly
  • RT3 was 9.4, and recently along with the improved numbers above 12.6, will test again shortly
• Sensitive estradiol (if you've only run standard E2)
  • Has been as low as 22 but that was a while ago, to hovering around 40 now, sensitive. I think I feel better a little higher than lower. Was using DIM but stopped because I think it was affecting my SHBG. I stopped and let my body do its thing. SHBG 36 down from high 60s to 71.

The MCT oil carrier switch is a legitimate variable. - been 2 sub q shots since getting my GSO TRT and I do feel different, my body is adjusting, it'll be interesting to see where this goes. I wonder if I had a minor but drawn out systemic reaction and I just never thought of this until I dug into my journey and thought of any of all variables! I was on 3x weekly but It didn't help either so went back to 2x. Maybe if this is smoother it'll be less peak/trough but I don't remember the surge and dip being rough, nothing seemed that different. I think my numbers look better on 2x per week, I think I may need the peak/trough....who knows but Im trying!

Your "wired but tired" pattern points to cortisol dysregulation, not just testosterone. - fasted regular cortisol was 13.4, but I have never done the 4-point, thats worth considering. I have a stressful job, and I sleep like $hit so this is super valid. But, if this shows to be true, what would I do to support it..... because Ive tried ashwagandha and Glycine, and also now taking an adrenal supplement, which may be helping, a little....maybe.

Being on T3/T4 doesn't mean your thyroid is optimized. - recent lab improved, awaiting another draw soon but on just t4 it increased and i upped that to 1.5 the dose 3 days a week and added a low dose of T3 so hoping for optimal levels soon. Don't feel that much different related to the post postprandial headaches after eating or early crashing, yet.

Sleep apnea is underdiagnosed on TRT. - 160s depending on my calories. Been this weight for years after losing 75-80lbs 25 years ago. I wear a Ringconn smart ring, I don't seem to have a lot of evening wakeups and my Spo2 seems good but I added breath right strips for more o2 just in case!

The whole point of my TRT (and peptide) journey at 49 is to optimize, trying to be the best version of myself beating last years version. My total T wasnt terribly low before starting (500ish) but my free T was always under optimized. I am getting stronger in the gym without question, the T is working there, but all the other optimization points are lacking and seemingly a setback.

Wow that's a lot of into I just laid out! If you feel like offering more insight, Id love to hear!

 

[FunkOdyssey]

Sleep is terrible

Focus on this, because it can explain everything else. Some guys can't handle high levels overnight, and need to either reduce their dose further, or switch to daily administration of something shorter acting (prop, cream, oral T) with an overnight trough.

 

[Sandz]

Focus on this, because it can explain everything else. Some guys can't handle high levels overnight, and need to either reduce their dose further, or switch to daily administration of something shorter acting (prop, cream, oral T) with an overnight trough.

Thanks for the input. I've lowered my doser since I started from 120mg weekly to 100mg to 90mg to now 80mg total. I've been on 3x per week and 2 x per week, no reportable difference. I was not experiencing what I am now even through the high T dose and numbers at the beginning. It started 6 months into my journey. The change around that time was the carrier oil which I ignored thinking theres no way that's a contributor. It's been 8 days without MCT, 2 shots of GSO test, now sure yet it's better ...I do feel different but not necessarily better, yet. Ill give it time.

I also added back in pregnenolone and dhea cause both were in the tank a few months ago. On paper the DHEA is recovering but last time, progesterone numbers still didn't change. But, since I'm supporting those, and things aren't really that different, I'm rulling that out.

 

[FunkOdyssey]

It started 6 months into my journey. The change around that time was the carrier oil which I ignored thinking theres no way that's a contributor. It's been 8 days without MCT, 2 shots of GSO test, now sure yet it's better ...I do feel different but not necessarily better, yet. Ill give it time.

I tend to agree with your initial view that there's no way it could be the carrier oil, but, stranger things have happened.

Do you have a gadget to accurately track sleep parameters? If not, you should pick one up: oura ring, whoop strap, something along these lines. Sleep apnea can be triggered by or exaggerated by TRT, and can take time to manifest, so you'll need to rule this out with SpO2 measurements.

You have no hope of feeling dialed-in, or halfway decent, or like a functional human being when your sleep is terrible, and that's why this becomes your north star until it's resolved (or it should IMO).

You wouldn't be consuming any caffeine would you? Doesn't play well with TRT in many guys. Higher estradiol actually slows the metabolism of caffeine by reducing CYP1A2 activity, allowing it to persist longer in the body.

 

[Sandz]

I tend to agree with your initial view that there's no way it could be the carrier oil, but, stranger things have happened.

Do you have a gadget to accurately track sleep parameters? If not, you should pick one up: oura ring, whoop strap, something along these lines. Sleep apnea can be triggered by or exaggerated by TRT, and can take time to manifest, so you'll need to rule this out with SpO2 measurements.

You have no hope of feeling dialed-in, or halfway decent, or like a functional human being when your sleep is terrible, and that's why this becomes your north star until it's resolved (or it should IMO).

You wouldn't be consuming any caffeine would you? Doesn't play well with TRT in many guys. Higher estradiol actually slows the metabolism of caffeine by reducing CYP1A2 activity, allowing it to persist longer in the body.

@FunkOdyssey Thanks for the reply......

I hope this is the 1 occurrence where "stranger things did happen!"

I say I don't sleep well, sometimes I have a 4am wake-ups or don't "feel" like it was a good sleep...but again just my feeling. I do use a Ringconn ring seems to think my sleep is decent. 7+, decent REM not too much awake time, but I dont know that I totally trust it!

Agree, without sleep, I am dead in the water. I have tried everythingggggg. Glycine, Magnesium, Theanine, THC gummies/drinks, etc. It's probably not as bad as I am making it out to be, but not as good as it can be.

Caffeine, ya. I have a coffee when I wake up and one more after breakfast, espresso so less caffeine. I can try to cut out or go to decaf.

Remember this all started within a few weeks of changing carrier oils (GSO to MCT, now back on GSO), but I was also playing with peptides at that time SS31 specifically. I stopped that, Reta, and CJC/IPA too. Just trying to eliminate all variables. Maybe I am just not cut out for TRT? But the dose so low, and my T isnt that high.

Im gonna keep trying though!

 

[FunkOdyssey]

Maybe I am just not cut out for TRT?

No, the only thing you might end up concluding, after you've exhausted all possibilities for improvement, is that you aren't cut out for moderate or higher doses of cypionate. First, the experiment of removing caffeine should be conducted, and there's a good chance this fixes your sleep, which fixes everything else.

Worst case scenario, you still have several different TRT options left to try, and at least one of them will work.

 

[Sandz]

No, the only thing you might end up concluding, after you've exhausted all possibilities for improvement, is that you aren't cut out for moderate or higher doses of cypionate. First, the experiment of removing caffeine should be conducted, and there's a good chance this fixes your sleep, which fixes everything else.

Worst case scenario, you still have several different TRT options left to try, and at least one of them will work.

I love my coffee.........but ill go decaf for a few days! Thanks!

 

[FunkOdyssey]

I love my coffee.........but ill go decaf for a few days! Thanks!

The caffeine withdrawal is going to make you feel like shit for awhile, so don't be discouraged by that or blame your TRT.

 

[Sandz]

The caffeine withdrawal is going to make you feel like shit for awhile, so don't be discouraged by that or blame your TRT.

I won't, honestly I've gone without and its not a huge deal, its more ritual than the caffeine. Its prob 50-60mg per shot and I do that 2x a day, NBD. Decaf starts tomorrow!!!!

 

[TornCallus29]

Я месяцами следовала различным протоколам, прежде чем поняла, что качество сна вредит всему больше, чем показатели гормонов. Когда плохой сон длится достаточно долго, всё начинает давать сбой, независимо от результатов анализов.

 

[FunkOdyssey]

Я месяцами следовала различным протоколам, прежде чем поняла, что качество сна вредит всему больше, чем показатели гормонов. Когда плохой сон длится достаточно долго, всё начинает давать сбой, независимо от результатов анализов.

He says in Russian, "I spent months following various protocols before I realized that sleep quality harms everything more than hormone levels do. When poor sleep lasts long enough, everything starts to break down, regardless of lab results."

100%

 

[TornCallus29]

He says in Russian, "I spent months following various protocols before I realized that sleep quality harms everything more than hormone levels do. When poor sleep lasts long enough, everything starts to break down, regardless of lab results."

100%

Sometimes my auto translate just does its own thing LOL. Either way the point and my experience are still the same. My bad guys, appreciate you translating it

 

[Sandz]

Wanted to update some labs I just got back -

Blood - all elevated aside TIBC and Ferritin
Hemoglobin 18.5
Hematocrit - 53.7
MCH -33.3
Iron TIBC - 306
UIBC - 106
Iron - 200
Iron Saturation - 65%
Ferratin - 82

DHEA - improved -110 to 148
Progesterone - went down to .3 when supplementing. Nothing moves the needle much, so I may stop the pregnenolone.

Thyroid - oddly things went down when I added a low dose of T3 and increased the dose starting dose of levo/t4 .05mcg
T3 - 3.2 now 2.7
T4 - .94 now .92
RT3 - was 12.6 - waiting on results
TSH - 1.42 now .871
Thinking just to go back to t4 only and call it a day and wherever it lands is as good as itll get.

Question is do I donate, am I starting a vicious cycle? Will my ferratin drop too low? Guessing iron was high cause I had some red meat recently before the draw, best guess.

Also, thoughts on dropping my dose a little from 80mg weekly to like 76 or 72mg just to lower the temperature of the lightheadedness and androgenic load without losing most of the benifit?