T Nation

Help with Blood Tests Results. Have Not Been Feeling Good

T Replacement
#1

Hi, I started TRT on March 8th with 250mg per week of Sustanon 250 split into two doses per week. For the first 2 weeks or so i didn’t feel anything by the 3rd week i started to have elevated resting heart rate and bouts of anxiety and panic attacks so I lowered my dose to 150mg Sustanon per week on March 25th. I took some blood tests on 3/31 and just got them back yesterday. They’re pretty abnormal so I lowered my dose to 100mg per week starting yesterday and switched to Test Enthanate. Im still feeling pretty shitty overall with crazy anxiety.

Should I take an AI for a short amount of time to get my Estradiol in check or just ride it out at this lower dose?

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#2

You’ve made too many changes in a short period of time and this is why things aren’t going well for you.

You started out on too high a dosage which really isn’t TRT and had you made it to a stable state, your levels would have been even higher.

Now you are coming down from very high levels and your body is having to cope with all these changes.

The goal should be the minimum affective dosage that relieves symptoms of low-T. No AI is warranted as you haven’t even attempted to dial in your protocol yet.

If I were you I would do 50mg twice weekly as it will give you more consistent levels throughout the week.

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#3

You may win for the highest e2 I’ve seen on here. PRL is very high too.

Take P5P for the prolactin, and I’d take one dose of anastrozole .25-.5mg while your new dose settles in.

As said before, lots of changes over a short period of time.

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#4

Thanks for the input. Im learning as much as I can but I am by no means an expert at all so I appreciate all the feedback I can get.

The high estradiol is my concern as well as I have never seen anyones this high and i’ve been lurking for a solid 6 months before i even attempted TRT. I know most are against an AI and I certainly don’t want to be on one long term but I believe a couple doses to get the estradiol down may be needed.

However, I do want to be in the higher Testosterone range near where my blood tests show and cutting my dose by more than half just to appease my Estradiol levels may bring me back to the lower ranges. How would I manage a high testosterone level while maintaining reasonable Estradiol levels?

#5

By not using sustanon incorrectly. Since you’ve switched to E it’s academic now. You need to do the following things in the following order: get on a stable schedule at the 100mg/w dose, split; wait six weeks and redraw blood at your trough day; assess where you are from there. I’m not crazy about AIs, but man you legit need one at this point. Take a tiny dose once and see if that helps. If it doesn’t take another tiny dose. After that don’t take anymore until you’ve gotten another round of blood work confirming that your e2 is either still too high or is in a more reasonable range.

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#6

Thanks. I just took .25mg of arimidex. I guess ill see how it goes from here. Im pretty much a walking panic attack right now so I don’t see how an AI would hurt.

#7

The affect will only be temporary, once the AI is ceased estrogen will rebound.

Estrogen is nothing to fear, you seem to have high estrogen which tells me it’s high naturally. You can lower it by losing weight, something more testosterone can only help.

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#8

I’m on TRT and my estrogen is 62, and I just increased my T dosage by 20mg which means my estrogen is going to be even higher in 6 weeks and I’m not at all concerned.

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#9

I would not only fire your doctor I would punch him in the face for Fing you up so badly. Or you could sue him for medical incompetence.

#10

I forgot to comment on the high prolactin and low SHBG, the former could be linked to underactive thyroid and high estrogen can also increase prolactin in some individuals.

The TRT will lower SHBG in just about everyone with me as the exception since mine is being suppressed by diabetes in which TRT treats therefore increasing SHBG.

Your estrogen levels have got to be the highest I have even seen of anyone on TRT to date and since Free T-> converts to estrogen via aromatase (in fat tissue), lowering your dosage should have a meaningful impact on estrogen levels and might even lower the prolactin.

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#11

That is high E, I would want to get retested in case the lab made a mistake, which they will not admit to if that is the scenario. A retest should confirm this. You already took an AI so it should be lowering your aromatase no matter what. Enanthate is a good choice for continuing since it gets into the bloodstream faster than Test C even though they are both long esthers. Stick to the program and I would want to retest just to see where your E sits in a few weeks. Try to see things from a different view now, you made some drastic changes for the better. It should help your anxiety subside.

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#12

As someone who deals with anxiety, it is hard to mentally wait 6 weeks and stay the course when you want relief NOW. when i started my protocol 5 weeks ago i was dead set on no ai, but was prescribed one. I made it 6 days and took .5mg, and then another round the following week. The anxiety got better, but I’m not ruling out placebo as the reason why. Nevertheless it got better.

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#13

Thanks for all the replies. I have a doctors appointment in a couple weeks where im getting a full hormone panel plus a myriad of other tests done so I should get a better understanding of where im at by then.

#14

Haha thats the truth. I, unfortunately have been dealing with chronic anxiety/panic disorder for the better part of 5 years now so I can kind of see through the BS tricks my own brain trys to play on me.

I finally caved in and got on an SNRI about 18 months ago and it was a life changer. Completely eradicated my anxiety/ panic attacks so it was surprising to see how hard it came back with starting TRT.

#15

I had my thyroid checked before TRT and everything came back fine so that leads my to believe the high estrogen led to increased prolactin.

#16

SSRI and SNRI can increase prolactin.

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#17

Over the years I’ve tried a number of SSRI’S. Prosaic, lexepro, effexor, wellbutrin, and trintelex. I would say trintelex was the only one where I saw any benefit, but not enough to continue use. I’m glad to hear that you have found relief from panic attacks. My biggest reason for starting trt was to help eliminate dizziness, light headedness and brain fog, but am hoping for a little anxiety relief.

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#18

Yea, I’ve been reading up on prolactin all morning. I think SNRI + high Estradiol = High prolactin in my case.

Im on Cymbalta now. I love it but I obviously don’t want to be on it forever. I hope TRT can be a good start on helping out with anxiety.

#19

So high prolactin can cause anxiety/panic attacks? Mine is in the upper limits of the normal range. Could this be an issue?

#20

Im by no means an expert but from this science experiment im doing on myself it seems either high Estrogen or high Prolactin cause anxiety. Before TRT, my SNRI had suppressed my anxiety to pretty much nothing. About 3 weeks after i started TRT (when the Testosterone kicked in) my anxiety has been through the roof and my resting heart rate has went from 60bpm to 80bpm.

The correlating blood tests show I have high Estradiol and high Prolactin so im definitely attributing my side effects to those elevated levels.