HCG Causing Anxiety

Hello im new here but had a quick question. I have just had my 2nd HCG injection (500iu E3.5D). I am 46 year old male 140 lbs. I was on the low end of the normal range for testosterone, TT 514 ng/dl (250-1100 range)
FT 62.5 pg/ml (46-224 range)
Bioavailable T 134 ng/dl (110-575 range)
SHBG 37 nmol/l (10-50 range)
Estradiol 27 pg/ml
My question is that i seem to feel great the day of the injection but 20-24 hours after i have terrible anxiety … verging on panic attack. It has lasted +/- 45 minutes each time and is horrible! It is enough to make me stop … i know its only the second injection but its bad enough to give up before even giving it a try. Is this normal for just starting out on HCG monotherapy or is something else wrong. Thank you for any help!!!

Some men just don’t tolerate HCG well do to deteriorating mood and anxiety, some feel nothing and other feel great on it. Add to that anastrozole can’t affect estrogen production inside the testicles, therefore you must reduce HCG therefore reducing testosterone in order to control estrogen, now you know why HCG monotherapy isn’t popular.

Men on TRT don’t have those limitations, on TRT you can have your cake and eat it to. You can have high testosterone all while controlling estrogen.

systemlord thank you for the reply.
The clinic said they were going to put me on HCG Monotherapy because my T numbers were not very low and wanted to see it this would help with the symptoms.
I originally went to my regular Dr. and they told me everything from T levels to thyroid levels were in the normal range. They then sold me some supplements, that i assume they endorse, and told me to call back if i needed anything. Are my T levels good enough? Are my symptoms (no energy/drive, gaining fat around stomach area, tired ALL the time, always seem to be in a bad mood) from just getting old? Sorry i am new to all this. I have never taken steroids or anything else. The extent of my supplementation is a multivitamin (anavite which i love). I do not lift much but am an avid runner. I have never in my life gained fat…anywhere… from running i guess. Now it takes all i got to get going and im getting fat around my middle (love handles). I have not been on my same running regiment for the last 7-8 months due to lack of drive as well as time restraints but have been making a real effort to get back where i was. It will not hurt my feelings or anything I just need to know…am i just looking for something to blame this on? Is this how its going to be due to ageing? Do i just have to somehow find the drive and quit looking for an excuse? Thanks to anyone who can shed some light on things.

Regardless of the numbers, you feel terrible and your symptoms are right in the TRT wheelhouse. Given what you do have (it would be nice to get LH, FSH, prolactin, thyroid, IGF-1, VitD, LFT, etc.) you are certainly a candidate for TRT. I do not think hCG monotherapy is a long term solution.

Your free test is at 1.2%, 2-3% is thought to be ideal. Triple that free test level and you will be a lot happier. TRT can do that.

For now, it looks as though you are stuck with hCG. I would try 300IU three times a week. Maybe that would help level out your E2, which I am guessing is causing your problems. If that bumps up your test, and you feel better, you’d have a good case for TRT, not that I don’t think you already do. I doubt hCG monotherapy is a long term option because of E2 management. Maybe not, but you may be sensitive to higher E2.

Short of switching to testosterone injections, I would try that and see how it goes. Good luck.

Your problem is you went to a regular doctor for hormone testing, there are no doctors that specialize in sex hormones within mainstream medicine, so often doctors get it wrong. Your numbers aren’t in the normal range for Free T, normal is having Free T in the 2-3 percent range. SHBG wasn’t looked at closely enough to determine your circulating bioavailable testosterone percentage.

Diagnosing a testosterone deficiency is something the majority of doctors often get wrong because they overly focus on just total testosterone being in range and never consider bioavailable testosterone, in other words they have no idea what they are doing.

Total testosterone is bound to SHBG and therefore isn’t bioavailable. free testosterone is the hormones that is bioavailable. In ranges means nothing if you are naturally on the higher end of the range and now you’re at the bottom.

Endocrinology is complicated and it’s not as simple as in range you’re normal and out of ranges you’re not normal, the numbers do not tell the whole story.

Thanks again for the replies. I have other blood test numbers but i do not see that LH and FSH were tested. Prolactin was 7.8 ng/ml (2-18 range)

Thyroid: TSH 0.76 mIU/l (0.4-4.5 range) T4 total 7.9 mcg/dl (4.9-10.5 range) T4 Free 1.4 (0.8-1.8 range) T3 total 120 ng/dl (76-181 range) T3 Free 3.5 pg/ml (2.3-4.2 range) T3 reverse 15 ng/dl (8-25 range)

Red blood cell count 5.13 Million/ul (4.2-5.8 range) Hemoglobin 16.2 g/dl (13.2-17.1 range) Hematocrit 46.2% (38.5-50 range)

Vitamin B12 1232 pg/ml (200-1100 range) Vitamin D 44ng/ml (30-100 range)

DHEA 213 mcg/dl (70-495 range)

Sorry I think that’s it. I should have listed all i had from the beginning.
So is your advise to continue on the HCG and tough out the day after? I had the +/- 45 minute terrible feeling (i guess panic attack…racing heart, feel my heart beat in my head, really dizzy, sight closing in feeling like i would faint, thoughts that i was about to die, shaking…it was terrible) then i felt “off” the rest of the day. Zero energy and weak! Today I feel pretty good though…its strange. If that feeling is going to happen every time i do the HCG i don’t want to continue. I do seem to feel a little better but its not worth it. The day after feels like it takes such a toll on my body!
I brought my test to a T clinic and they didn’t bat an eye at them just said they could help. I don’t know that they wouldn’t try me on a low dose of T if i asked. Will the T give me the same feeling the next day? I guess i am asking yalls opinion on if i should start T with the numbers i have. I realize its a life long deal and not to be take lightly. I do not feel that “bad” so to speak just a lot different then i am used to. What prompted me to try the T clinic was my kids (9 and 12 year olds). They are super involved in sports and always want my help…well i found myself not even wanting to do that and i LOVE doing that and spending time with them.

Sorry i have nowhere else to go for advise. If yall think i should push harder and fight through with nothing I will! If you think a low dose of T is needed and still fight through i will ask the clinic. I have never taken meds so i am very apprehensive to jump into anything. I guess that’s why i have waited so long, I just can’t stand the fact that im loosing time with my kids.

Thanks again!!!

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The first 6 weeks after starting TRT can be difficult as there is an adjustment period that we all go through, but if the alternative is going back to feeling like death I would tough it out because in the end you will come out of it.

Going to a TRT clinic, you are asking for trouble as the majority are quite bad, these places give TRT a bad name. Sure there must be a few really good ones, but I’m not a gambling man when it comes to my health.

I will only go somewhere that has a reputation or where people’s personal experiences are favorable.

Thyroid levels look really good.

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Thanks for the reply Systemlord. Its good to know that about the T Clinics. I figured that they were good because that’s what they specialize in. How do I go about finding the right Dr? I work a lot and I’m on 24 hr call so it is hard to get away even for Dr visits. It would be difficult to do trial an error visits with a lot of different Dr until i found one willing to help.

What can be expected on the first 6 weeks of TRT? What is the difficult part of it? Is it the same type reaction and the HCg? I am supposed to go in for another 500iu HCg injection today…would yall suggest just stopping it now and moving on?

I have the perfect solution, Defy Medical is a telemedicine anti-aging clinic staffed by real doctors who have been trained in TRT, Dr Saya (my doctor) has been doing TRT for more than 20 years. I love the fact that consults are done over the phone, medicines are mailed to me and labs are drawn the usual way at Labcorp.

Telemedicine is the future of medicine, no more going to the doctors office. The experience is vastly different when compared with a sick care doctor who is trained to ignore symptoms and treat the reference ranges to determine health status.

When I started paying for my own treatment I notice the doctors started paying attention to all of my symptoms and told me reference ranges don’t always tell the entire story.

I had to do this because none of my endo’s could help even though I have excellent insurance, they just don’t specialize in TRT.

I would go to 300IU three times a week right now.

If you do not feel your current doctor is an ongoing option, try to find a local doctor. Ask around, ask anyone who may be, or may know, anyone on TRT. A personal physical exam is best and a doctor who knows you is as well.

If you go with telemedicine, make sure the doctor is licensed in the state in which you reside. Regarding telemedicine, almost every state requires the doctor to have a license to practice medicine in the state in which the patient resides. Most states require a face to face office visit/consultation prior to going to telemedicine.

Thanks for the information highpull. Today was good until this evening and the bad feeling came back. Not anything like yesterday though. I called the clinic and told them I wouldn’t be going in and what was happening. They said they have quite a few patients on HCG monotherapy and never had one with this reaction. They said I could try a small dose of T and see how I react to it. They didn’t specify the size dose just that they would start small. What do y’all suggest? I might just give up and try and power through… I really don’t like this feeling the HCG is giving me! Will T do the same or is it less likely to mess me up so bad? Thank y’all again for your help!!!

I would have rather seen you start with testosterone over hCG. So, I’d be all for it, provided the dose at least 100mg a week.

Sorry, overlooked this question. Very few describe the problems you have experienced, but the only way to know for sure is to try.

HCG Monotherapy is BS. Clinic out me on that first (500iu 3x week) for 3 months after being 3 months testosterone 100mg per week. My Total T went from 757 (3 months of 100mg test per week) all the way down to 345(after switching to HCG Mono and staying on it 3 months)

I had anxiety also. The worst thing was everything felt like it deteriorated or halted: muscle/strength gained from TRT,mood, sleep, women lol

Oh yeah make sure you stick that HCG needle straight in, won’t be afraid of it and side stick it
Beneath your skin . That could’ve also caused lower T but my LH went up a lot which means HCG was still working.

I’m just letting you know in case you think something is the right , that it isn’t and just that hcg is inferior to Test.

Generally I agree, especially long term. It does work for some people.

I tried to tough out hcg for about 2 years on my trt protocol out of fear of testicular atrophy. There appears to be more of a link to it spiking cortisol through a specific mechanism and also leading indirectly to increasing e2 after aromatization due to the slight T increase. I even tried as low as 50 ius everyday to no avail. Within 2 hours post hcg injection I would begin to retain water in my face and body, headaches, agitation, tension, difficulty sleeping etc. When I stopped it took 1-2 weeks to get back to normal.

Stop taking it asap. What were your pre hcg labs? I saw your thyroid, hct etc, but not T, ft, e2, shbg etc…

Not sure what i will do. I am not excited to try the T because of how i reacted to the HCG. Is it possible that just the 2 injections of HCG raised my E2 level enough to give me that reaction, or is it all in my head? I am just trying to understand so i can make a decision on trying the T. I understand its a process and takes some time to get dialed in but if its anything like what i experienced with the two injections of HCG im not sure i want to try. The only reason I am still considering it is that there were a couple days in the last week that i did feel great…not even close to enough to justify the bad reaction but something, and for my kids. I just really want be back to my old self and be begging my kids to come outside so i can teach them stuff instead of them begging me. Anyway I absolutely appreciate everyone’s input and advise. I have no ones else to ask for advise and what to expect. I have read everything i can find about it but I really do appreciate hearing from people with first hand experience.

Hostile the other lab numbers are in the very first post…sorry i should have put them all together.

TRT is nothing like hcg. I know how awful it makes others and myself feel. Two hcg injections may raise your e2 slightly but not enough to cause the reaction you’re experiencing. What you’re describing with hcg is not uncommon.

"HCG and testosterone affect an enzyme that clears cortisol from the body. This can cause water retention. Some men seem to be more susceptible to this enzyme inhibition than others. It has absolutely nothing to do with estradiol.

Lowering the dose of HCG may help but may not be enough to maintain fertility or testicular size. I am exploring the use of a drug mentioned in this link.

This study was pointed out in a previous article written by Patrick Arnold.

"There is an enzyme that is localized primarily in the kidneys whose function is to protect the kidneys from circulating cortisol. The kidneys have receptors called mineralcorticoid receptors (MR’s) which are meant to bind to specific adrenal hormones (called mineralcorticoids) in the body such as aldosterone. The result of this binding is a signal to increase sodium and water retention in the body, while stimulating the excretion of potassium. This is an important mechanism to maintain fluid and electrolyte balance in the body.

A problem exists though in that cortisol can also bind activate these receptors. Cortisol is a widely circulating hormone and serves a multitude of functions throughout the body. However its intended biological functions do not include mineralcorticoid action in the kidneys, so to prevent this from happening the kidneys are rich in the enzyme 11b-hydroxysteroid dehydrogenase 2 (11b-HSD2). This enzyme deactivates cortisol by converting it into cortisone before it can bind to the renal MRs."

11 beta HSD 2.jpg

Testosterone and anabolic steroids have been shown to inhibit 11b-HSD2.

Here’s how it works: throughout the course of the day, the adrenal gland releases the hormone cortisol, either due to normal circadian (daily) and ultradian (hourly) rhythms or in reaction to stress. Cortisol is an important stress hormone, but many of its effects, while good in a fight-or-flight scenario, are bad over time in terms of diabetes and obesity: cortisol increases glucose production and release in the liver; increases appetite in anticipation of any necessary reaction to the stress-causing situation; and alters metabolic processing such that fat is preferentially stored in the central abdominal region. So, for diabetics, this means stored glucose directly increases blood sugar, new calories are ingested and increase both blood sugar and weight, and, to top it all off, the new weight tends to be the “bad,” visceral, disease-causing weight.

There are a couple of therapeutically important pit-stops for cortisol throughout this process, though; the active hormone cortisol can be converted in the kidney, colon, and some other tissues into the inactive molecule cortisone. The enzyme 11 beta-HSD2 aids this conversion, and allows cortisol to be stored out of the bloodstream.

Inhibiting 11b-HSD 2 can cause glucocorticoid-mediated MR activation, potassium excretion, sodium and water retention, and increased blood pressure. "

Full Paper: http://toxsci.oxfordjournals.org/content/126/2/353.long

So if this is what is causing the anxiety/panic attack/whatever it is, wouldn’t taking T cause the same reaction?