T Nation

Experiences Starting TRT with OCD/Panic Disorder?

Looking for advice and other’s experience and opinions.
My total T has been anywhere between 253 and 325 for the past few years…SHBG around 21-23 consistently.

My doctor prescribed 100mg test cyp to start out, but left it up to me on how to split the dose and whether to pin IM or SubQ etc then follow up labs 8 weeks later and adjust as needed.

It’s been about 2 years and I’ve never taken the 1st shot, but he said I’m still free to start if/when I’m ready.

The ONLY reason I haven’t, is that I’ve had panic disorder (random panic attacks) throughout life (which I am medicated for). I have OCD also (more of just my mind constantly turning) I’m worried that the test shots could cause them to flare back up… Anyone else have any experience with this?

From age 17 through 29, I didn’t have a single panic attack, but plenty of them before and after…which 17-29 my T would have been highest, so I also wonder if that could be the reason itself?

I’m currently 39 years old
6’4" 260lbs
Muscular but definitely overweight ( years of lifting history)
Desk job
Low in D3 (low 30s)
Last labs had TT at 317
FT 2.3%
SHBG 23
E2 26
Everything else looked normal

Should I start? IM, SubQ? What dose frequency etc? I have 29g 1/2" pins and 30g 3/8"…both are .3cc
Should I not start, and focus on lifestyle changes?

Advice, opinions and recommendations greatly appreciated!

I have random panic attacks from nowhere. TRT has reduced this signifciantly for me.

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How long did it take to help? What doseage/frequency etc works for you?

This is a decision you are going to have to make for yourself whether or not to start TRT.

I have seen over the years men with anxiety disorders have issues with large infrequent injections and experience a worsening of symptoms, in this case frequent smaller injections minimizes or completely eliminates anxiety caused by these large hormonal peaks and troughs.

You say your medicated for OCD, some of these medicines for the treatment of anxiety/OCD can suppress testosterone.

I get more benefits on TRT when injecting daily or EOD, spacing the injections further out and the benefits start waning.

I take 100mg/week either once or twice a week split if I can be bothered to split.

Hard to say as I would have a random panic attacks about 6 times a year. I’ve been on TRT for 18 months and I have only had one on holiday, probably due to drinking too much!

Ive actually been on clonazepam .5 twice a day for the better part of 10 years… i’ve never had to up my dose for it to work, and have even weaned myself off of it twice (stayed off for 6 months or so each time, but just feel more “normal” while i’m on it, as my brain must just be wired a bit differently. I know people talk about the negatives of benzos, which im well aware of…but if it improves quality of life, then to me, it’s no different than taking any other medicine that you need to function best.

As for the question of TRT… i WANT to try it, but my OCD tells me that “what if” i do, get shut down and decide it’s not for me…or what if i do, get shut down and it makes things worse.

I’ve decided that if i do, then i’ll do small daily shots… i just dont know what daily dose to start with or if i should do SubQ or IM… if all things were equal, i’d prefer the simplicity of SubQ…and the lowest dose that makes me feel better (even if it is less than the 100 per week i’m prescribed). Being low SHBG, and having panic/ocd, i’m guessing i may work better on lower doses anyhow?

also, would i do better on something other, like clomid or enclomiphene instead of shots? I’m open to all ideas and suggestions.

My main symptoms are brain fog, an almost depersonalization feeling some days, lack of energy/motivation, no issue with erections but the desire is low, sleep isnt always great etc plus i do wonder if it could possibly FIX the ocd/panic stuff?

Considering your listed symptoms, I would be interested in getting a look at DHT. The higher my DHT is, the better I feel physically and mentally. To the point that taking DHT-derivatives (like anavar) produces a quality of life that is fantastic. Other guys have reported feelings of wellbeing and calm with Matseron. In any case, supplementing with Testosterone will increase DHT as well.

As for panic, a lot of men report that higher test levels increase confidence and motivation and decrease anxiety and depression. This has certainly been the case for me. @systemlord makes a good point, though, in that large doses can produce swings with concomitant bodily sensations that may provide a point of fixation for someone with panic and OCD. Think things like water bloat, restlessness if E2 is high, warmth, etc.

As for HPTA shutdown, yeah, that will happen. But you’re dealing with very low levels as it is. It’s not like you’re an 18 year old with a perfect endocrine system and decades to go before midlife. Anyway, there are many, many men that report full recovery even after years of steroid abuse. It’s not a guarantee, but there are PCT protocols that can provide a good kick start if you found TRT didn’t work out for you.

I’ll also add that 100mg weekly is not very much. It is technically a replacement dose, yes, but many don’t report symptom resolution below 150mg, and some not until 200mg.

100mg put me at the top of range. Start low and work up, not the other way round

Some suggest to start high and work down. The consensus seems to be that 150mg is probably the best starting point for most.

@breakerjump absolute utter crap.

@lukeandrews39 Listen to your doctors advice for dosage.

This argument has been made by all manner of rude and bitchy people dozens of times by now. But thanks for restarting it.

thanks for the well thought out reply…

Another thing i’ve been wondering (and i know that no one can answer, not even myself unless i actually DO it)…

about 6 years ago when i first tested my hormones, my total T was upper 500s…while still low, i was still about 15-20 lbs overweight and worked night shift, so my sleep and diet was awful…but i was lighter, lifted 3-4x per week, did sprints 3x per week, got plenty of sun and used the tanning bed regularly and felt pretty good overall

Now i’m about 40 - 45 lbs overweight and also low in Vitamin D… i have a desk job, havent lifted weights or exercised seriously since my daughter was born (two and a half years ago) and my sleep and diet are still crap…

I wonder if i lost the 45lbs, cleaned up the diet, started lifting and exercising seriously again, brought my D3 up to optimal levels and got my sleep pattern down the way it should be… how much could i get my #s up naturally? I know it “can” be done with lots of guys…and while some may say that those are too many variable to have to keep up with…ultimately, TRT or not, those things need to be in order…

Anyone care to throw out a guess (yes i know it is purely speculation as everyone is different) on if the above would work? Have any of you done so successfully and what were your #s before and after?

I have the 10ml vial of T in my cabinet…but i’m leaning heavily towards spending the next 6-9 months getting everything listed above in order and seeing how much better i feel and if i even need the TRT.

What are everyone’s thoughts and opinions on that?

Yeah, those things need to be in order. And if you start test while you’re that overweight then you may wind up aromatizing to more E2, which can be obnoxious.

If you want help dialing all that in, let me know. I would be happy to look over your gameplan with you.

Thanks, man! While no one sees me as “obese”, i’m 6’4-6’5" and about 260ish pounds… i have a lot of muscle from my previous years of heavy lifting and a large bone structure…but i’m also realistic and know my ideal weight right now would be about 215-220lbs.

As for diet, my “plan” is lots of fish (salmon, sardines, mackerel), grass fed red meat, whole eggs and greek yogurt (helps me avoid ice cream etc when trying to cut my weight)… and fruits/vegetables/potatoes/sweet potatoes…

A daily whole food multivitamin/mineral, daily D3 and daily magnesium glycinate. Not sure how much D3 or Magnesium to take, honestly… or if i need anything else not covered by the multi and diet…

Going to shoot for 7-8 hours of sleep…lift 3-4x per week and start out with walking and work my way up for the “cardio/exercise” part…

I know that lowering calories can also lower T in the short term, but once i reach my goal weight and then eat at maint. calories for a few weeks, i should be ok to re-test my labs, i’d think?

any other advice or suggestions are welcomed! And thanks again to everyone for the tips/opinions/thoughts etc

I would retest after you’ve dropped your weight and have eaten at maintenance for at least six weeks.

Unless your HDL is already perfect, add a few grams of fish oil.

If you’re serious about cutting then I would suggest considering eliminating red meat until you’re done with the cut. It’s very high in fat (even the “lean” cuts) and calorie-dense in general. May want to ditch the yogurt, too, if you can stand it. Whole eggs are great nutrition, but if you’re eating more than a few per week consider impact on LDL. For a natty, though, some cholesterol is needed for test production.

At your height, 45 lbs should fall off pretty quickly if you’re serious about it. Good luck and keep us posted.

I was on clonazepam 1mg 2x daily (30 years) since the age of 14 to treat my Tourette Syndrome and then I was diagnosed with low T years later after tapering off. It’s been shown clonazepam can increase growth hormone and luteinizing hormone (LH= testosterone production) and I believe the reason I was diagnosed with low-T after tapering off of clonazepam.

This study also shown a connection between low growth hormone and increased anxiety in male rats. I have always wondered if I went back on clonazepam would my testosterone increase.

Effects of Central and Peripheral Type Benzodiazepine Ligands on Growth Hormone and Gonadotropin Secretion in Male Rats

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so all things being equal, if i plan to remain on the clonazepam… it shouldnt factor into my T being low, as far as that part of things, correct? It was when you came off that you think it contributed to it?

I’ve heard a respectable doc mention that clonazepam has reduced testosterone in some of his patients, Dr Rob Kominiarek was on TRT Revolution a while back and was talking about it that clonazepam can screw with your sleep cycles and he said clonazepam induced sedation of the pituitary gland.

You can find the videos on YouTube where he talks about it. It does seem like there is conflicting data out there regarding some of these drugs and some people can have opposite reactions to drugs, ie less anxiety, more anxiety. You just never know how someone will react to any given drug.

Case in point, I came off clonazepam and my testosterone decrease, most cases see testosterone decrease while on the medicine. My libido was insane on the clonazepam, most see a reduction in libido.

Not directly, but I can relate the experiences of some patients. The etiology behind OCD, panic attacks and anxiety is complex and varies greatly from individual to individual, making it difficult to predict outcomes. However, there is no denying the impact hormones can have on emotional and physical well being and it is easy to make the leap.

Generally, hormone optimization is of significant benefit to these patients, both men and women, and it is not unusual to see dramatic results. These patients are not treated any differently than anyone else when it comes to dosing protocols, nor have I seen them respond differently. Almost all start with 150-200mg once weekly and like everyone else, only a few will need to make any adjustments.

Your level of 317 total testosterone is pretty low and the range reported over the past few years doesn’t make me think it will improve. Your SHBG level likely prevents you from feeling horrible.

Definitely worth looking into.

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