Need Help, Might Quit? 7 Weeks In

Pharma / TRT Testosterone Replacement
1

32, 185 lbs, 6’ 1”, don’t train but active life build my own house ect.

I started TRT 7 weeks ago. I’ve never had anxiety or depression in my life but Jan 7th I had a full blown anxiety/panic attack pretty much outta no where. I’ve since learned that stress kills T, and I was/am under a lot of stress. Before though, stress seemed healthy to me. I thrived taking on lots of projects and working long hours. Now the script has flipped.

Anyway I went to the doc a week after the anxiety started because I was so miserable. Just in a constant state of fear. First labs revealed.

Total t 177 ng/dl
Free t 10.1 pg/ml
Estradiol 11.pg/ml
High reverse T3
And low Vit D

After labs he started me in 100 mg once per week of test C and Vit D supp. Things were trending upward until mid way through the third week. I woke up 2 days before my next shot drenched in sweat and in a terrible panic. I told the doc and we ran labs right before the 4th shot. Those labs showed

Total T of 377 ng/dl
Free T of 14 pg/ml
Estradiol of 24.6 pg/ml
Reverse T3 improved into normal range
Didn’t test Vit d

The day after my 4th shot I felt real depression for the first time in my life. I wasn’t thinking of the S word, but I def wanted to die. This scared the life outta me. I decided to start lexapro that the doc had prescribed at the very beginning, he said to help even things out. Well I only lasted 6 days on that at half does (5mg) because it made the anxiety/derealization soooo much worse.

The following week, week 5, was my best yet. It helped that I took time off but I thought for sure I was finally coming outta it. I was also unhappy with the unavailability of my main doc so I went to a clinic for a second opinion. They drew blood directly AFTER my 5th shot and found

Total T 732 ng/dl
Free T 25.3 pg/ml
Dhea 300 ug/dl
Estradiol 35 pg/ml
SHBG 19.1 NMOL/L
Thyroid markers were all good, good insulin sensitivity, good Vit D.

Well 2 days into week 6 the anxiety came back and has been kinda present ever since. Now I’m halfway through week 7 and I experienced true depression again so I decided to reach out. I’m still off work looking for answers. Hopefully someone has a story like mine and can help. Maybe more frequent injections?

Tldr: suddenly developed anxiety at age 32 after never having it. Want to give TRT a chance but it hasn’t really seemed to help. Wondering if more frequent injections would help.

Edit: I should also add I have no libido at all. Which def wasn’t the case before this, my wife and I averaged 4 times a week. General lack of motivation, unhappy, and seemingly wild swings. 30 minutes I’ll feel like my old self followed by hours of anxiety. Shit sucks

2

So many doctors not giving second blood tests to confirm low T. SMH.

No LH or FSH tested? Prolactin?

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I forced a prolactin test at 3 weeks and it came back normal, as well at 5 weeks with the clinic

4

No LH ot FSH tested.

5

So really you have zero clue where the issue is. Testicles or pituitary. If prolactin is normal, that suggests no tumor there, but that doesn’t conclude you’re definitely primary.

6

Yeah man, just looking for some help? I’m wondering if moving to more frequent injections will help level me out? At this point idk if I want to try and stop.

7

Are you taking any other drugs?

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No just supplements. Don’t drink or smoke.

9

This protocol doesn’t show good results in all men. There is no one-size fits all approach to TRT.

I require a shot ant least every other day to respond to TRT, some feel a crash 3-4 days after their shot even though levels are normal.

Most guys take months to figure the optimal protocol. It took me 4 years!

A lot is going on under the surface, natural production is getting suppressed, exogenous T is still building in your system and your body is trying to adapt.

TRT is a marathon, not a sprint.

It would appear your provider is clueless on how to manage male hormones! Men’s testosterone peaks anywhere from 12-24 hours, so trying to abtain an accurate peak is impossible. You could be peaking much higher between 12-24 hours. Trough levels are what you’re after, because if by day 7, right before your next shot your levels are low, over the weeks this could end in treatment failure.

Libido and sexual function can be finicky if the protocol isn’t ideal for you. A lot of guys with mental problems expect TRT to cure them without any effect on their part.

You can’t take a Ferrari engine (TRT) and put it in an old clunker and expect the car not to fall apart, you need to address the worn out parts.

TRT isn’t a panacea, it’s a tool to achieving a healthy mind and body.

10

I’ve been dealing with anxiety depression shit since 32. If nailed me out of nowhere, thought I was dying, etc. I finally sought out treatment and have been managing well.

The reason for these mood issues can be anything at all. Just having the thought of the next possible episode can tigger you.
Mood swings can happen frequently like you describe, just a tad bit of extra stress can trigger.

The simplest answer here is that its the testosterone treatments causing it. You had this start for the first time after you got test. Adjust the treatment plan.
I suggest injecting more frequently. Split 100mg into to shots over the week. Keep your level more steady, should help keep your test levels more uniform, more steady. If you want you could try using less total test a week also, maybe 75mg.

If it continues or gets worse for you get help. Its a intimidating process but it can really make a huge difference.

Lexapro sucks btw, I took it for a year.

11

Maybe get an extensive vitamin and mineral panel.

12

Well man it seems that you’re depression and anxiety is fluctuating. It could be due to the frequency of your dose; possibly moving to more frequent injections will level you out? You added in an antidepressant, which muddies the waters a bit because it can have negative effects early on as well.
Definitely talk to your doc; but if it were me I would start injecting more frequently to see how I felt.

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Well the mental stuff all started out of no where and the endo suggested T as remedy. So T didn’t cause it, But I’m 7 weeks in and barely seeing any benefit, idk if there’s a downside? Hard to say. I know my hormones are going haywire. Cried more in 2 months than my whole life.

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I had pretty extensive panel done that I didn’t include and nothing was out of the norm. And the reason they took a measure t after a shot was because that was the only time I could get in to see a diff clinic for a second opinion

15

For TRT to show good results, I need dosing 1-2x daily and hormone levels must decline quickly. I can’t have flat steady hormones. This isn’t true for everyone, some are the exact opposite.

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Yeah man, I’m going to say its not the test. Get to a psychologist for help, they are really helpful.

Still spread out the injections of test, level is good.

17

Did you ever figure out what triggered your anxiety?

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Everything!!

The absolute breaking point was a malicious pregnacy claim/scam. Ordeal last lasted three months and I was drowning in fear.

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Sounds like your initial low T result was due to excessive cortisol caused by stress. That’s not hypogonadism that needs treated with T.

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That’s the conclusion I’m coming to, but what do I do now?