T Nation

Josht9210's TRT Log - Depersonalization, Panic Disorder, Agoraphobia, Etc

Just wanted to keep a log of my progress on TRT.
Pre trt stats:
Age: 27
Weight: 180
Height: 5’9
Testicles: Huge
Former smoker
Small recreational drug use history, no anabolic abuse
Lift 4-6x a week, cardio 3-5x HIIT
Medical History: Panic Disorder, Agoraphobia(no longer), Depersonalization, Depression (due to ssri, and just over quality of life thanks to anxiety)
Medications: Paxil 10mg(10 years), xanax 0.5 (only taken when needed), Cialis 5-20mg(when needed, may start daily)
Side effects from medication: ED, weak erections, fatigue, brain fog, lack of emotion, weak orgasms, lack of emotion, no interest or motivation in anything, over sleep, can over eat easily, easy to become addicted to anything that makes me feel anything(thus i stay away from addicting things)
Reasons for getting on trt: see side effects ^

Pre-trt Anxiety: 2-4/10, very low anxiety on paxil, almost careless

Pre-trt labs: I will post full picture of them later.
424ng/dl TT range 264-864
110pg/dl FT range 55-220
Shbg 21
E2/fsh/lh/etc not tested due to doctors ignorance

Post trt labs will be attached:
I kept changing my dosage/frequency on my protocol due to high levels of anxiety, heart palpitations and just all sorts of concerns my anxious brain would feed me.
My labs were taken 4 days post injection 50mg ( I was supposed to be injecting every other day but kept getting really bad anxiety)

Current changes: Increased muscle mass, morning and night erections every day or so, week 3 I fealt more real, music sounded crisper, things just fealt real again, then came the anxiety, like a dark cloud following me everywhere. Still lingers but I’ve been distracting myself very hard.

Current protocol: 25mg Test Cyp ED, 5mg Masteron ED
Been consistent on this protocol now for 1.5 weeks, anxiety is at a 5/10, whereas injecting eod, 3.5d it was 6-8/10

I began my journey 8 weeks ago using UGL and decided to invest in defy for proper guidance and testing. Currently waiting on my telephone appointment with the defy doc.

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These medicines lower testosterone, this is what causes the side effects. I was on benzos for 30 years (14-45 yrs) and when I withdrew the medicine, testosterone plummeted. I went through puberty on this stuff and so my body can’t function without it as far as testosterone is concerned.

The daily injections produces minimal spikes in testosterone and very little fluctuations and this is ideal for those with panic and anxiety disorders. It will take 6 weeks for your levels to stabilize, until then levels will be in flux.

I would use 27-29 gauge insulin syringes and you can inject in the quads and shoulders.

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I’ve alternated both subq and im. Sticking to im with 25g 1 inch for glutes, 25g 5/8 delts. Daily 25mg 5mg mast. Waiting for defy docs to give me my official protocol etc though.

Idm pinning daily but this lingering anxiety is really annoying.

How do the rest of my panels look jw? My ldl/hdl/trigs?
I went to the cardiologyst had a 48 hr holter, ekg etc, he said it was all good and not worth echo.

Also, I’ve only taken about 10-15 total benzos in my 10 years of this disorder. The 10 year usage of ssris is my issue.

Mighty brave of you, not many willing to stick themselves daily with a 25 gauge 1" inch syringe.

I took clonazepam for Tourettes Syndrome which I was diagnosed at 7 yrs old, I no longer had any symptoms which is what prompted me to stop the medicine. I feel amazing at 7mg daily, definitely not common around here.

Most men experience this to varying degrees, I feel aggressive during a dosage adjustment if the dosage is excessive. I’m lucky that I can feel optimal at 400 ng/dL, FT at 15 pg/mL (range 6.8-21.5), but when I push higher the aggressiveness can come out to play and experience burning nipples which subside after 6 weeks.

TRT will decrease your glucose levels by driving it into muscle tissue, hoping TRT will not increase IGF-1, TRT might even decrease it. fT3 looks ok, you want it 50-80% of the range. Some people do well at this fT3 levels, other not so much.

You should want FT between 20-26 pg/mL, this is the optimal range for men <30. More testosterone “might” aggravate the anxiety, lowering the dosage slightly should do the trick if it comes to it after the 6 weeks. Estrogen is a powerful hormone, I would argue more powerful than testosterone and its effects on mood.

Getting rid of extra body fat should go a long way towards minimizing T->E2 conversion.

You may or may not need to increase the anti-anxiety meds until levels are stable, it’s always an option until you are stable, then go right back to your normal dosage. I hear Xanax is more difficult to taper off, the half life is shorter and withdrawal effects come on more quickly and worse versus Klonopin/Clonazepam longer half life.

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As I’ve said, 20 xanax pills in 10 years.
No clue what happened to my glucose.
No clue why my igf1 is high.
Also dunno if my cholesterol is bad or not, but I will be working on it regardless.

I’ve actually raised my t dosage since this test, once defy gives me new orders I’ll adjust… But until then I’m just gonna use up my ugl.

Your TSH value is shit (even though it is within your reference range).

You should do a full thyroid panel blood work to see if you have hypothyroidism (which I do believe you have) since anxiety, panic disorders and etc can be a clear sign of hypothyroidism.

You should also do a 4 point saliva cortisol test to see how your adrenals are working.

I developed severe anxiety and panic attacks from nowhere which was resolved once I found out that I had hypothyroidism and that my adrenals wasn’t working properly due to the hypothyroidism, and started treating myself for it.

I will look into this, my last panel included t4, tsh, no t3, no rt3, but the numbers were lower within range.

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What did you use to treat it?

3 things.

  1. Helminthic therapy for my immune system (early in the treatment but has so far been amazing, especially with my anxiety and mood).

  2. T3 and T4 for my hypothyroidism.

  3. CT3M for my adrenal fatigue (and before I started the CT3M, I started hydrocortisone to make sure my body would be able to do the CT3M).

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Why do I read everywhere about adrenal fatigue being like the problem to everything? Its always pushed by naturopaths and chiropractors too…

I just read helminthic therapy… You’re infesting yourself with worms…? Bruh, I’d rather have anxiety than an itchy asshole. (Not really my anxiety sucks, but what the heck dude lol)

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@josht9210
What does a problem to everything mean?

Everytime I somehow land on a chiro, or nd’s youtube I end up somehow hearing about adrenal fatigue. Not once has a real doctor mentioned it to me.

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Anyways how does one go about testing cortisol? Where can I buy a test? Which doc specialises in it? I wanna look into this adrenal fatigue you all boast about and see how my thyroid is even though I’m within range.

I have an endo appointment next week, so any concerns on my labs here I will bring up to them. Please advise.

Here are more of my pre trt bloods, mind you I cut down on my b complex after seeing my b12.
My tsh has gone up on trt, im sure that resulted in t3 and t4 going up as well


Glucose levels were non fasted, so no issues involving that. I also got my a1c 3 month tested, i was good to go
Anxiety is still high on my protocol. Life is bareable thanks to cbt, however the “wanting to crawl out of my skin” feeling is annoying. Makes me not want to do things outside of my comfort zone.

Saliva cortisol test or if you want to get real fancy the Dutch Test

Your TSH increased on TRT because metabolic demand increased, your pituitary gland is trying to get more thyroid hormone do to this increased demand. fT3 should be 50-80% of the range, fT4 midrange is best because this would tell me there is a lot of hormones in reserve for the conversion from fT4->fT3 when you body needs it.

So are my numbers decent or na? Should I ask my endo for full thyroid panel?

Let me know how it goes, I pretty much know what your endo will say. He will say TSH is in range, no need to check thyroid hormones. Sadly I’ve seen men with normal TSH and abnormal fT3, your doctor is playing the numbers game, that the majority will not have thyroid problems at this TSH value, some will and these poor guys fall through the cracks going decades with hypo symptoms.

I’ve seen men make their way here and doctors told them everything was normal decades ago, he posts his labs and they are far from normal, the problem is the doctor became complacent and stop researching and staying ahead on current research years ago about updated treatment protocols.

An example, T3 is obsolete, fT3 should be tested, yet some doctors still test T3. I would even run a iron panel, ferritin if you’re going to go through the trouble doing a full thyroid panel. Often iron deficiency can cause thyroid problems and thyroid problems can cause iron deficiency.

I’m asking you if Thats what I should ask for though, since you’ve been around.

Yes that’s what you should ask for

Minimum:
free T3
free T4
Reverse T3
TSH