T Nation

Insane Anxiety and Side Effects Following First Testosterone Injection

I recently got prescribed trt through defy. The last time I tried it, I ended up having to quit due to heart palpitations and anxiety (ended up getting afib for a brief time and had to go to the hospital, may have been from hcg?). Since that time, I have had almost everything I can checked out by doctors. I have had full thyroid labs and free t3 and free t4 are in the upper 3/4 of the range, with a low reverse t3. TSH was a 1.6. I was also evaluated for pheochromocytoma with a CT scan of my abdomen, which showed nothing. I had an ecg and ultrasound of my heart and everything was perfect. After having all these results, I felt comfortable enough to begin TRT again.

After doing my first injection of 70mg T Cypionate (in grapeseed oil), I began having issues again. Within about 6 hours I could feel an uncomfortable chest tightness that radiates into my neck (feels like something is swollen in my neck, or like a muscle pain that I can’t stretch). Along with this, my pulse rate elevated along with my blood pressure, from 70-91 and from 120/69 to 138/88. I took my anastrozole 24 hours after the injection. However, the worst side effect of all, besides the strange feeling in my chest is the INSANE anxiety I have been feeling. I have had it in the past but not even benzodiazepenes are really helping. It feels like someone is squeezing my heart/neck, which is triggering a very large amount of anxiety.

Could this be some sort of allergy to the carrier oil? Or maybe something that could be mediated by doing smaller doses subQ instead of IM? I am really trying to make this work, as I have been getting fatter regardless of how much I work out and my body composition has changed drastically in the past two years. I went from being that “jacked” dude at the gym to the skinny-fat guy who can only stay about 45 minutes. In addition to this, my testicles ache almost all of the time, and my scrotum doesn’t really hang loose anymore. Really everything down there has kind of shrunk. I have glucose intolerance as well.

Any advice on how to proceed from here would be greatly appreciated, as I really need to make this work somehow. Having low testosterone has impacted my life in a very negative way and I am desperate to fix it. I am convinced that my ongoing depression and anxiety that has resulted from it led to the end of my relationship a few weeks ago as well. I just need to figure out how to administer this without feeling crazy in the head. I am currently returning my test cypionate to defy to swap it out for enanthate in sesame or cottonseed oil to see if this resolves the issue (I did one cycle when I was about 21 of 500mg test e a week and barely noticed anything until the third week when I was suddenly very horny and strong. There was no anxiety at all that I can remember. I am 25 now) Thanks

I would recommend smaller more frequent doses, it would help to know your other pre-TRT lab values, like SHBG and estrogen. I’ve had a little bit of anxiety on just about every protocol I’ve been on except one, when I was doing a 10mg daily protocol I didn’t have any anxiety.

That has to do with the fact that being on a daily protocol the peaks and troughs are tiny, the larger peaks and troughs may be what’s causing your anxiety. TRT could also be depleting pregnenolone and or magnesium, deficient in either one of these could cause anxiety.

Benzodiazepines, I know them all too well and was on them for 30 years and is why I need TRT for life.

Did you recently just stopped a benzodiazepine? I did a 10 months slow taper and at the end I needed TRT where before my testosterone was perfectly fine.

It could also be that you over responded to the anastrozole which would explain the anxiety and muscle pain that you did not experience years earlier.

You have the advantage for the fact that you’re working with Defy Medical, I’m a patient as well.

I am not a doctor but here is my experience that might help you.

  1. 100mg single shot - thought I was going to die. Heart was insane, worst headache of my life.
  2. Had HCG .35ml 3 times a week.
  3. Enormous painful lumps at injection sites. Sizes of golf balls or larger 6 weeks after starting.
  4. Huge crashes near end of week just prior to next injection. Total exhaustion and anxiety.

Changed to SubQ, more frequent injections and a cypionate with no special oils to suspend in. Much better in all departments. Tried massages, heating up test, etc. etc. Nothing worked to solve it except getting away from test suspended in fancy oils. Just keep in mind that when I injected in muscles, I felt it immediately. When I changed to SubQ, it took like 2 weeks for it to finally catch up and kick in but seems to sustain better for me. Seems more controlled in release.

Yes, you could be having an allergic reaction like I did. I tried 3 different types and had the same effect. Only stopped when I changed to a CVS brand that has nothing in it but test cyp.

I can’t see why trying a higher frequency would do any harm. Just don’t take more test than you’re prescribed and split it up however you want (2 or 3 times a week). 2 times would be like monday morning and thursday evening. 3 times would be like Monday morning, Wednesday morning and Friday morning.

Your experience might vary (probably will). This is a safe way to try to control estrogen and keep yourself balanced.

Hi touchindeez, Sorry to hear about the anxiety I struggly with that as well.
It sure sounds like your body is metabolizing your testosterone really fast.

I will go out on a limb and guess you have really low SHGB. You can’t fix the dose you just took but if you do metabolize fast it will be thru your system quick. You really should consider lowering your weekly dose to about 60mg just until your body gets use to this extra T. You might even consider dividing your shots up to make the doses smaller.

Say M/W/F take 20mg (.10ml on your syringe) and see if that helps. Also consider subQ injections in your lovehandles. Pullup a wad of skin either side and poke the needle in. Keep the skin pulled out so the needle does not touch the muscle. You can even use a smaller needle like a 27ga 1/2"

Some guys don’t do well with HCG if you think it is giving you issues stop it for now. I am just the opposite with out HCG in have more anxiety attacks.

I find whiskey, video games, & music all help me thru my anxiety attack. If I can stop thinking about how anxious I am and distract my mind doing other tasks it almost always works. I will only take a benzo when nothing else works.

I had similar symptoms when on a large weekly dose. Chest tightness and pain, pounding heartbeat throughout my body, aching neck. My body metabolises the T very quickly and I just can’t handle big doses.

I’m now on 22.5mg EOD subq - pretty much like what hrdlvn suggested - and all those symptoms have gone.

Just a side thought. Though I do agree that you would fair way better by splitting your injections throughout the week, are you SURE that you aspirated properly? The immediate effects that you describe sure sound a lot like some of the things that I have read about guys feeling if they accidentally had a partial vein injection.

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This is my first reply on the site so I apologize if I’m doing it incorrectly. Estradiol sensitive was a little high at 41 and shbg was 35. I also use a pregnenolone cream a few times a week along with around 500mg of magnesium citrate per day.

I have not recently come off of a benzodiazepine, I have taken them as needed for a couple years and make sure to take several days off in between doses. I will look into the daily injections as I still have not tried subQ. Hopefully this method also leads to the testosterone not being metabolized as quickly. Thank you for the input

Thank you for the advice, what is the testosterone suspended in if not in an oil?

SHBG was around 35, could I still be metabolizing too fast at this level? And yeah I hate having to use the benzodiazepines as well, for me it seems to be more of a physical sensation that causes my anxiety rather than vice versa (the chest/neck tightness causes me to panic). Thank you for the help

What was your shbg when you had these symptoms? My value before my first injection was 35.

I pulled back slightly but now that you mention it it may not have been enough to get the plunger to move… I didn’t see any blood shoot into the syringe at the very least. The injection was done in my quad. May be trying sub q when I receive my replacement vial of test to avoid something like that happening in the future

I forgot to mention I am not currently taking hcg as I wanted to rule that out as an issue.

I would definitely have problems at an E2 of 41, I feel good closer to 30. I metabolize testosterone quickly and is one of the reasons why I see little benefit from TRT injecting two large doses per week, it seems the higher the frequency of injections, the better and more stable I feel.

SHBG does have a part to play in Free T and Free E2, an SHBG of 35 is going to bind some of those free hormones and is an ideal level to have. You may find you don’t need benzo’s any longer once you dial in your TRT protocol and find that perfect testosterone to estrogen ratio, TRT calms me more than benzo’s ever have all without feeling sedated.

All of the pros and none of the cons.

This morning I knew I hit a nerve in my quad, when I pulled the string out there was blood, it happens sometimes and is of no concern.

My SHBG is high, 126 at it’s highest, currently at about 80. I don’t think it necessarily matters that much though. I don’t need much T to get high levels despite having high SHBG. This was my peak test when I was on 100mg per week. My body’s weird…

the worst symptoms were when I was on 175mg per week at the beginning. God knows what my peak levels were then

My understanding is that Testosterone Cypionate is in itself oil soluble and typically suspended in oils like Sesame Seed, Cotton Seed, Grapeseed and sometimes rarely Olive oil. Any of these types of combinations give me issues.

My Cypionate isn’t suspended in any of those to my knowledge (at least it doesn’t say that on the bottle or prescription). What it does say is that it uses Benzyl Alcohol as a preservative. This version absolutely gives me no bumps or issues.