Figured I'd combine these two questions into one post so yall can weigh in on my old man problems. I'm about to turn 43 and am in decent shape. NO high blood pressure or beer belly. Exercise somewhat regularly and have always been active.

Low T
I started doing testosterone injections in October of last year after blood work revealed my T number was like 175 which I guess is really low. Was trying to get my energy levels up but so far I haven't seen much of a difference except my weight has jumped from where it's been since college (185-188 lbs) to now 199-200. I don't feel like I look any different but 10-12 lbs gained in a few months is alarming. Nothing else has changed. I guess it's normal to put on a bit of water weight at first when taking the injections but I'm starting to have second thoughts about continuing. Has anyone had a similar experience with the weight gain problem?

Potential Sleep Apnea
I actually went and saw a sleep doc today because the wife says I've been snoring really badly for years and I never really feel all that rested regardless of how much sleep I get. Sounds like they may want to do an in-office sleep study. I'm willing to do whatever they suggest to fix the problem but has anyone had any luck with a device other than a C Pap machine?

Thanks! Old man, out.

TRT did give me some water weight initially, but not that much. Have you been working out? Any chance you put on some muscle mass?

I actually started a thread a while back about Low T.

https://texags.com/forums/48/topics/3224830

I couldn't stand my cpap and went the oral appliance route. This is a C/P from another thread talking about it.

Quote:

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Had an oral appliance for about a year. My sleep improved, but I fought the appliance every night in my sleep. My jaw muscles actually became noticeably bigger in that year. Got to the point that one day I yawned and felt something pop in my jaw. Couldn't chew for days. Shortly after that one morning my teeth would not realign no matter how long I left the bite thing in.

Long story short, had my tonsils and uvula removed. Also had my nose roto rooted. That was about a month ago and I can breath and get a good nights sleep for the first time in my life. Recovery from surgery was one of the worst things I have ever gone through.

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Hope some of this helps!

T did zero for my energy levels. It was the main benefit I was hoping to get.

(The other was weight loss, which it did zero for that as well.)

If you have a high probability of having apnea (do a STOP-BANG assessment), and don't have cardiac arrhythmias, significant pulmonary disease, Restless Leg Syndrome, or significant abnormal behavior during sleep, there is no good reason to do an in-lab study. Ask for a Home Sleep Test. It will be easier and cheaper.

The only reason I'm on board with doing the in-lab sleep test is we did an in-home sleep test in 2023 and it was inconclusive.

Thanks for the feedback. I feel like my muscle mass is maybe up a bit. I've been working out but not consistently. I'm rededicating myself to that at the moment in being more disciplined about working out and getting back on my mountain bike regularly.

Good to know about the oral appliance. Thanks.

ReloadAg said:

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The only reason I'm on board with doing the in-lab sleep test is we did an in-home sleep test in 2023 and it was inconclusive.

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My doc told me that around 90% of in-home sleep tests come back inconclusive and you just have to go back and do the in-lab one anyways.

I did an in-home test and it said I had sleep apnea. GF is a nurse practitioner, and I already knew i had it bad. She has video ( which finally convinced me.) I have the face mask and the nose-only "pillows" I stuck with the full mask (nose+mouth). I have a deviated septum and if there is any congestion, I have to mouth breathe.

I am on TRT as well. I haven't really noticed much of a difference. When I first started, I was hitting the weights HARD and saw some really quick gains in strength. Hit PRs in everything. But I haven't been doing weights as hard now, just maintenance. I don't notice a difference in energy levels at all.

Yeah I'd like to know the workout routine. Even if it seemingly stayed the same it's possible the higher testosterone is telling your body to build muscle. I say seemingly because you may be improving as a result of the muscle mass without really noticing. If you have been sitting on the couch all day before and after TRT with no change in activity then doubt it's muscle. Water retention certainly could be part of it. Personally I'd focus on fixing sleep before TRT. Good sleep alone might positively affect your testosterone and energy levels without needing TRT.

texasaggie2015 said:

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ReloadAg said:

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The only reason I'm on board with doing the in-lab sleep test is we did an in-home sleep test in 2023 and it was inconclusive.

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My doc told me that around 90% of in-home sleep tests come back inconclusive and you just have to go back and do the in-lab one anyways.

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To each his own, but I am Board Certified in Sleep Medicine and I would not agree with that assessment. The Home Sleep Test kits nowadays are highly accurate, sensitive, and specific. It's just that they track fewer variables than an in-lab study. I wonder if they're saying inconclusive but really mean borderline. I read tons of both in lab and home tests every week. In the OP's case, with a previous inconclusive result, there is certainly some benefit to doing one in-lab.

Sorry. Didn't mean to give bad info, just repeating what my doc told me

That said, my insurance wouldn't help cover either one because they weren't convinced I needed it at my age so I never got one done. Couldn't shell out the couple grand it would cost me.

I totally get it. After I posted, I was just about to make an edit to my post. Not at all disagreeing with you, just disagreeing with the information an M.D. gave you. Sometimes people LOVE to argue just for the sake of argument. Not trying to do that. Stifles open exchange of ideas.

I wonder if he was using hyperbole to convince me to go ahead and do an in-lab so prevent the headache of having to do both

texasaggie2015 said:

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Sorry. Didn't mean to give bad info, just repeating what my doc told me

That said, my insurance wouldn't help cover either one because they weren't convinced I needed it at my age so I never got one done. Couldn't shell out the couple grand it would cost me.

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Do a STOP-BANG questionnaire:
STOP-BANG
And do an Epworth Sleepiness Scale:
Epworth Sleepiness Scale
If either are elevated, tell your doctor. If they still refuse, tell them you almost killed a migrant family on the side of the road because you were drowsy while driving.

Haha. Will do.

I have plenty of energy during the day. We're trying to find the root cause of my hypertension.

Also, for OP, the CPAP isn't that bad. You get used to it. A better night's sleep will change your opinion on that. I usually fall asleep with it ~10 pm and may wake up in the middle of the night. If so and it's annoying me, I just take it off. At least it gives my GF a chunk of hours of sleep where I'm not snoring.

It's not very sexy, but you get to do a cool Darth Vader impression with it on.

Ha thanks. I called myself an old man in the post in jest. For the most part I do not feel almost 43.

Yes the previous in-home test I took said I was borderline for sleep apnea.

Stay away from the oral appliance route. They will f up your teeth, your bite, your jaw and then move on to your neck and shoulders. Took me over two years to recover from 9 or so months of use.

Good to know. Thanks!

Trazadone 100mg for my insomnia

CPAP machine for my severe obstructive sleep apnea. My wife says it's like a very quiet white noise machine. If I don't wear it then she kicks me out of bed.

My sleep doc said my snoring sounded like two bears ****ing.

I got my sleep study done at Fort Hood in a sleep lab overnight. Don't do in home.

Also, there is a device called Inspire Sleep. It is a surgically implanted device that treats obstructive sleep apnea (OSA). It's an FDA-approved alternative to continuous positive airway pressure (CPAP) machine

Aggie Therapist said:

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Trazadone 100mg for my insomnia

CPAP machine for my severe obstructive sleep apnea. My wife says it's like a very quiet white noise machine. If I don't wear it then she kicks me out of bed.

My sleep doc said my snoring sounded like two bears ****ing.

I got my sleep study done at Fort Hood in a sleep lab overnight. Don't do in home.

Also, there is a device called Inspire Sleep. It is a surgically implanted device that treats obstructive sleep apnea (OSA). It's an FDA-approved alternative to continuous positive airway pressure (CPAP) machine

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Inspire is only for failed CPAP and have to have BMI < 30. It is very costly so getting it covered is a pain (according to my FP).

I'm on nasal CPAP and got used to it very quickly. I have a big ole tongue and small posterior airway so Inspire likely wouldn't work for me anyway.

I've gained a lot of strength on T Gel and using Tonal 2-3x a week. Up 30% and still hitting PRs weekly, fantastic (but expensive) machine!

Any recommendations on CPAPs? One manufacturer or model better than others?

ResMed AirSense 10 is pretty great and what I use. I take it with me on the airplanes and extremely light when traveling.

Your sleep doc can adjust it from anywhere in the country because it's got a cellular chip in the device. Really quiet and faint white noise for my wife and I.

Recently found out I didn't snore or have sleep issues using a wedge to raise the head. Just purchased a smart adjustable bed to elevate in comfort. Waking up rested without a sore throat is nice.

I also lost 35 pounds in '23 before I tried the wedge. It might not have worked before the weight loss. No idea.

Your weight loss played a significant role

Been down both roads. APAP machine (airesense 11, using nasal pillow because of my beard) took a solid month to get used to, but in 6 hours I will feel more rested than 9 hours without it.

For trt weight gain - monitor your estradiol- if it gets high you will retain more water than you should, and anastrozole is the solution. Trt increases appetite too, so be careful on food volume - that's my #1 enemy.

For those saying trt doesn't add energy - look into pairing it with a vitamin B complex and make sure your vitamin D is in normal range.

This thread title needs some work

aggiesundevil4 said:

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Been down both roads. APAP machine (airesense 11, using nasal pillow because of my beard) took a solid month to get used to, but in 6 hours I will feel more rested than 9 hours without it.

For trt weight gain - monitor your estradiol- if it gets high you will retain more water than you should, and anastrozole is the solution. Trt increases appetite too, so be careful on food volume - that's my #1 enemy.

For those saying trt doesn't add energy - look into pairing it with a vitamin B complex and make sure your vitamin D is in normal range.

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Good points. Be careful with the anastrozole tho. You need some estrogen even as a male for normal function. A little goes a long way.

Correct - when I needed it, it was half a pill once a week

Granted it was gym bros on an online forum, but the consensus was don't take an estrogen blocker unless you have high labs and have adverse symptoms. I've read stories about guys that absolutely crashed with low estradiol.

My symptom like the OP was carrying a lot of extra water weight, didn't feel right. Over time I lowered the dosage of trt to balance out side affects and the anastrozole isn't really needed anymore

I'm gonna try the B complex and D supplements.

Getting vitamin into healthy range can literally take 2-4 months but it really will help with mood and baseline energy. My b complex pill really gives good energy that doesn't feel like caffeine jitters and feels like it last all day. Pee gets neon yellow so drink a lot of water.