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Does TRT Make You Retain Water?

Are you feeling like you are retaining water? Maybe you are feeling a little swollen and asking the question, does TRT make you retain water or cause fluid retention?  In this video, we will look at this specific topic, the causes of fluid retention, and what you can do about it.  We will also look at how to track fluid retention so that you can really pin it down and get your fluid retention under control. 

If you want to understand the variables involved with TRT and fluid retention, keep reading. 

Does TRT Make You Retain Water?

Yes it does.  Testosterone replacement therapy also known as TRT can make you retain water if you are producing a lot of estradiol or estrogens in general.  The main estrogen that does this is estradiol.  Fluid retention can also occur with higher testosterone levels and corresponding increase in cortisol levels.   Both of these hormones can increase from testosterone replacement therapy.  However just because you are taking testosterone replacement therapy does not mean that you are going to have this issue. 

Both estrogen and cortisol (mainly estradiol but estrogens in general to a certain extent) increase the amount of sodium reabsorption in the kidneys.  When sodium is being excreted through your urine these hormones increase the reabsorption and prevent sodium from being excreted in your urine.   Water follows sodium.  The increased sodium and water retention in the kidneys causes the puffiness and fluid retention in your tissues.  So what can you do? 


First you have to find out if this is indeed your problem because it does not happen to everyone.  To do this, you want to check your estradiol levels from a few different angles .  This will ensure to you are actually capturing the real effect in your body.   You want to look at the estradiol on different days.  Which days depends on how often you are injecting.  You might want to do it on the third day after injecting, if you inject every seven days.  It also makes sense to check it the day after and the day before you inject.  You just want to get readings at different intervals.  You definitely don't want to only check at the end of the week.  This is when it's probably going to be lowest. 

The other thing to note is the type of test being used.  There are different tests for estradiol.   Some of them are less sensitive than others.  You want to use the most sensitive.  The most sensitive estradiol test uses mass spectrometry and liquid chromatography technology.   This test will capture the true nature of the issue.   You can also do a total estrogen test which will capture some of the other estrogens other than estradiol.   These can also contribute to the problem. 

In some cases increasing your testosterone levels can cause elevated cortisol.  So this is also important to test when you are wondering if TRT is making you retain water.  Testing for cortisol is pretty straightforward but it can change quickly too.  You want to make sure you get it earlier enough in the day, if you are doing a blood test.   You could also do a twenty four hour cortisol as well.  The twenty four hour will capture the whole day.  Usually when cortisol is high, it is high in the morning.  So the am cortisol capture most of the issues with cortisol.  There are also salivary cortisol tests which I don't use as much.   The twenty four hour cortisol or am cortisol earlier in the day are both options to capture the cortisol issue. 

Along with these test you may also want to track your electrolyte levels and your osmolality.  This can also give you hints about your sodium intake and retention in relation to cortisol, estradiol, and you testosterone dosing.  If  it is really high or higher than it was before, that tells you something about your fluid retention. 

That should answer the question, does TRT make you retain water or increase fluid retention.  If you have questions about the content or around fluid retention related to TRT drop it in the comment section below. 

If you want a customized plan on how to reduce your fluid retention, click in the link below to get started. 

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