T Nation

Anxiety and Irritability Getting Worse on TRT

My levels aren’t great, but are better than they were before. Writing this from my phone but TT was around 720 a couple weeks ago, FT close to 30, and E2 just under 30. Injecting 150mg week, ED.

I’m getting these sudden panics, and my girlfriend and I have both noticed that I’ve become a lot more angry, to the point it’s going to get me locked up if this worsens more. I’m getting worried. I’ve also developed a light tremor, some weight gain issues, intermittent appetite, and probably some other things I’m forgetting.

Just had my 3 month labs for Dr Saya, and TSH was noticeably high at 3.25. It’s been creeping up since before I started TRT.

I wasn’t on HCG but am giving it another shot at 300iu week to start, to see if that helps.

I do take magnesium normally too. 200mg of citrate at bedtime. Glycinate gives me insomnia. Thinking of going back up to my old dose of 400mg day.

I had lowered my D3 dose months ago to 1000iu day. Going to have that tested, but it is summer so I’d be surprised if that’s low.

Any other ideas? I’m wondering if it’s thyroid related. In other ways I’m feeling better on TRT so hoping I don’t have to give it up.

I was getting anxiety. I stopped my AI and it went down. Are you on AIs? I am not claiming causation here, but the correlation was pretty strong (quit the AI few days later anxiety and depression are noticeably better).

So you’ve been on 150mg/week ED for 3 months and you’re just now getting anxiety and panic attacks?

Seems weird it would take this long for these sort of symptoms to manifest.


No AI anymore. Dropped that well over a month ago

It’s been creeping up the whole time but lately I’d say it’s hitting a breaking point. Instead of feeling more capable of handling it too, it feels the opposite.

Part of me wonders if it’s the loss of other hormones from not using HCG.

How is stress at work? How about home? Money?
Those things are big things that should not be ignored. It is really easy to blame stuff on meds (and it might be your TRT regimen), but everything else can’t be ignored either.

They’ve been tough lately. I’ve given that a lot of thought though and I feel I used to handle those things better at times.

Couple things have made me really anxious lately that were never an issue. Like flying recently I kept thinking we were going to crash or get hijacked. I love flying, I used to want to be a pilot!

Just seems like it’s getting irrational. Noticeable increase in that general feeling of unease I’ve had my entire life that vanished when I started TRT too. And it wasn’t the overconfident high of the honeymoon I don’t think. Just the constant worry I’ve always had slipped away. Now it’s back with a vengeance.

I’ve also noticed an increase in the amount of mumbling and complaining and talking to myself in public when something frustrates me. Like person steps in front of you. I’ve always done that jokingly around friends but lately it’s start to feel a little too serious and like I’m going nuts.

TRT is known to increase the T4 to T3 conversion by up to 30%, ie your levels of the active thyroid hormone might have increased significantly.
Maybe the dose you are taking is too high for you.
I am on 3x25mg subq which results in about 550 ng/dl. I tried to increase to 3x35mg but could not tolerate due to insomnia and irritability. Back on 3x25mg and i feel good again.

Hmm that’s interesting. Didn’t know that.

I do feel better overall on 150 a week versus 100 a week.

Dr Saya just ordered a full thyroid panel that I did earlier so if one is jacked up hopefully we’ll see that.

Is that a TRT only thing or does it also apply to higher natural levels?

I do think my insomnia has improved though while on TRT. I’ve also gained weight.

I think its the sudden change in hormone levels that you feel upon starting TRT. Maybe your system finds equilibrium again and it will ease out in a couple off weeks.

Also I would guess an increase in T3 or T4 would lower TSH. It’s been going up

Your estrogen is high and the only way to lower it is lower your dosage, FT levels are excessive and nowe you have a reason for E2 sides.

E2 of 30 is barely high IMO…

Are we going by the symptoms or the numbers and are going to ignore symptoms? Who cares about the numbers, the numbers based on how you feel are telling me these numbers are bad and also you are sensitive to estrogen and may require it closer to 20 pg/mL.

If you continue to fixate on lab numbers in making protocol decisions, you won’t be on TRT for much longer.

If I feel good, have insane erections and a strong libido, I don’t care where my numbers are.

Why do you say it’s definitely estrogen?

I believe high normal TT levels are not for you, you need something closer to 450-500 ng/dL. I feel exactly as you described when I scored a TT of 698 ng/dL and FT at 29 pg/mL.

I was angry, bitchy and on edge. Your FT levels are unnaturally very high, no one has these levels naturally. Men need not fear midrange or slightly lower levels, I believe this is why you are struggling.

You’re aiming to high and having estrogen sides and I believe high testosterone sides, remember testosterone makes men appropriately aggressive, in your case you are overly aggressive because you have too much testosterone.

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What are you at now? Sucks because my libido and all that has seen marked improvements. As have confidence and energy levels.

Personally I would recommend giving yourself more time for your body to work out the kinks. It could be that you are similar to me in that it just takes longer than others for your body to reach a steady state where things are all working how they are supposed to. Especially when you add life stress on top of it.

You chose a protocol so stick with it.


Recently scored 97-119 ng/dL, FT 3 ng/dL and have erections, libido and ok energy. My erections are insane at only 417 ng/dL, FT 14.9 pg/mL (6.8-21.5). I have low SHBG 14-22.

My problem was iron deficiency while on TRT so every time my levels stabilized, iron dropped low and lost energy and erections/libido benefits on TRT.

I never had anxiety pre-TRT, even now I have none yet high testosterone brought out anxiety.

Imagine your anxiety wasn’t even related to TRT and you changed everything after waiting 3 months because someone read a paragraph you posted and knows exactly what you need to do from that.