Need Help with My HPTA Restart

Pharma / TRT Testosterone Replacement
21

Thanks for the response.

I didn’t get my rt3 tested, but as you mention, my body temps have been good, so hopefully not an issue.

I am starting to think my panic attacks are from eating too much black licorice candy (made from real licorice). In addition to the supplements given to me by my natruopath, I have been feasting on black licorice thinking it will offer additional help. But I have since read that too much can increase blood pressure and cause anxiety. I am prone to anxiety, so I think that may have triggered it. Either way, I will lay off them, just in case. Hopefully that helps reduce anxiety

When I was on TRT, I was an AI over-responder and never managed to dial in my E2 for more than a couple of days at a time. So this time around I am going to try with no AI initially. I will try to minimize my spike by injecting 30mg of Test Cyp EOD SubQ (totalling about 105mg per week). I have a script for Arimidex if needed. In which case, I will have to do the mix with vodka approach to get small doses

Thanks for the tip about the iodine. I did an IR as per your recommendation. Now I just take an Iodoral every week or so. I don’t think I have had one, since my anxiety worsened. I will do so today

22

Unfortunately my doc said no to HCG. But I may be able to get some pregnenlone, progesterone or dhea if labs indicate they are required. We can not buy them over the counter in Canada, but my naturopath is apparently certified to prescribe them. I am seeing a urologist and a naturopath

23

My anxiety does appear to have been triggered by eating too much black licorice. Apparently that really is a thing. If you google ‘too much licorice’, you will see a many references to this. Looks like it can drive potassium too low, which leads to high blood pressure, irregular heartbeats. Which feels a lot like a panic attack, so if you have a history with anxiety, this could lead to relapse. Knowing this has helped calm me down a lot, but I still have some lingering anxiety.

I got my lab results back and my AM, PM Cortisol and DHEA-S are all pretty much mid level. And given my body temps and thryroid numbers above, I think my adrenals and thyroid are in good shape to start back on TRT

AM Cortisol: 324 nmol/L (130-540)
PM Cortisol: 156 nmol/L (65-330)
DHEA-S: 5.6 umol/L (2.41-11.6)
Free Testosterone: 194 pmol/L (196-636) LOW

So now I will work on increasing my T, while managing my E2 and hopefully I will can be another TRT success story

24

Before I start back on injections, I am just going to make note of how I currently feel with low levels of testosterone, Other than my recent anxiety, I actually do not feel terrible, so I just want to have some sort of baseline to look back on later.

My main symptoms are low libido and low energy, especially with physical tasks. And of course wood could always improve

Sleep: On most nights, I am able to fall asleep without much issue. I usually wake up once or twice a night, and wake for good before my alarm goes off. Despite these interuptions, I usually wake up rather refreshed. However, on days when I am anxious, I have a much more difficult time sleeping. I am pretty sensitive to my wife’s snoring though. My best sleep is alone on the couch. I do snore now as well, but not so loudly where I wake up my wife. When I was on TRT previously I snored much louder. I have never been checked for Apnea

Fatigue: My fatigue is not bad. I am able to function at work and stay pretty mentally sharp through out the day. I read lots of books. It is physical tasks where I get tired. Sometimes I feel good, but then when I get up to play with the kids or something, I tire quickly and just want to sit back down. Somehow I manage to be strong still at the gym, but that is 100% willpower and adrenaline, which I now know is counterproductive. So I am now putting ego aside, and taking my workouts easier. I get sleepy in the evenings, which I imagine is pretty normal

Mood: Not horrible, but slightly depressed. Not motivated to get out of the house. When I am home from work, I have no desire/energy to go out and do anything fun. If kids really want to do something, I can do it, but again that is fueled by willpower and sense of duty. I have been anxious recently and that could be made worse by my low T.

Sex: Libido pretty much gone. Sometimes get in the mood, but not often. If I do initiate it, it is out of a sense of duty and not desire. For the most part ED is not a problem. I usually need to physically stimulate myself a bit to get the blood flowing, before I initiate and encounter. Sometimes have ED if I had recently taken too much DIM

Morning woods: I take a bit of DIM, usually just once a week. I usually get morning woods after taking it, and then again about 5 days later as I go back through my E2 sweet spot. I actually think I am a DIM overresponder as well as an Arimidex overresponder. So I get only one or two morning woods a week, if I am lucky. Very rarely I able to get them a few days in a row. During those times, I usually have a very good sense of well being and no desire to go back on Testosterone. If I could lock into that sweet spot, I would be happy enough and not have the need to go back on to TRT. I think I am sensitive to slightly low and high E2. A big part of my challenge is going to be finding that sweet spot and dialing it in. I will make this a priority and get lots of labs

No brain fog: Since chemo in 2013, that has been a problem. Even when I was on TRT. However after Iodine Replacement and taking better care of my adrenals, it is no longer an issue.

I cant think of anything else to say. So next step is go back on TRT and hope everything improves

25

One thing to add. Currently if I take an ED medication, it works amazing. I remember this was not the case on TRT. These meds did not help at all. I have read that can happen, if E2 is too low. Hopefully that was the case with me

26

I need help in a bad way. I think the supplements my naturopath gave me messed me up. One of the supplements contains glandulars including adrenal and thyroid. I am suspecting this has over stimulated my thyroid. My FT3 was already nice and high prior to this. I think this supplement has pushed it too high. I now have hyperthyroid symptoms. I have not slept in days, even after taking an Ativan. I am anxious and jittery and warm to the touch. I no longer trust my thermometer, but at the hospital yesterday, I was 98.6 at 7:30am

My blood pressure hit 160/85 yesterday. I am normally 120/80. I read this is caused by the black licorice, and should resolve itself after a few weeks of no licorice

I have stopped all the supplements she has given me and made an appt with my family doctor. Hopefully he can get me labs

My question is, if the thyroid extract caused me to have hyperthyroid symptoms, will it reverse now I have stopped taking it? If so, how long? Anything I can do to naturally reduce my levels. Or have I done damage

@KSman please take a look. I am pretty desperate. I don’t trust my doctors or naturopath now

27

Probably not that, the “supplements” probably increased thyroid hormones and TSH would go down and thyroid gland would be slowed down.

It takes a few days for things to wash out and your control systems need time to rebalance. Hang in there!

Your cortisol looked good. High cortisol and high thyroid would be synergistic in a bad way.

When you are out of balance, do not do labs! That has no value in a transient situation. Seeing your doc is not going to fix this or speed up recovery.

Drinking more fluids would help.

TRT should address many problems.

28

You are right. As usual. I am already starting to feel better. I will just let it run its course. The symptoms were not pleasant and I was just panicking thinking I may have permanently messed myself up.

29

I was hoping to get all these anxiety issues sorted out prior to returning to trt. But the lingering insomnia was killing me, so I started back on T Cyp this morning. I front loaded myself a 100mg shot. Not sure if front loading was a good idea or not, but it is done now. Going forward I am going to give myself 34mg eod. Not sure if it is the placebo effect, but I already feel much calmer

My first time going on T, I always felt that I did not need to be on it. My pre-trt numbers were low, but I was not living the cleanest and was just a year removed from chemo. I always felt, I could have gotten my numbers up naturally if needed. So I was beginning to think TRT was not worth all the hassles, which is why I went off. But now I have spent the past 10 months doing everything I can to improve my T naturally, with no luck. So I can go back on T, accepting that I need to be on it. As long as I do not encounter any horrible side effects, I will be on it the rest of my life

30

Any difference on how you with 100mg vs lower amounts?

31

He is restarting TRT and took one 100mg dose and will do smaller 34mg EOD doses. A reasonable thing to do.

32

If someone did not have ED prior to starting TRT, but then gets ED after starting TRT, is out of range e2 the only explanation (all else equal)? or are there other mechanisms which could cause this?

Also, if Viagra doesn’t help, does that mean e2 is low? Or can that happen if high also?

At this point, this is just for knowledge sake. Ultimately I won’t change my ai protocol without labs

33

E2 that is too low or too high can mess with sexual function and libido.

Low thyroid function can produce most of the same symptoms of low-T, even with high T levels on TRT.

34

Unfortunately my depression and anxiety became too much for me and needed to start on ssri (lexapro 10mg). I tried to fight off going on them and hoped the TRT alone would help restore my mood. But it is becoming unbearable and dont want to end up doing anything to hurt myself. I realize my libido will likely be shot for the duration that I am on them, and am prepared for that. My wife and I are prepared for that if it means getting better

Can TRT be safely combined with an ssri. Are there any members here who are on both?

35

@KSman, I got my most recent labs. Unfortunately, my doctor didn’t get FT3 or FT4, but my TSH is low. It is 0.29 (0.35 - 5)

That could explains my horrible anxiety I have had recently. Or perhaps, the anxiety has caused my thyroid to go bananas.

I guess I will need to get my FT3 and FT4 to know if I am hyperthyroid for sure. If I am, what can I do? I would like to get your input before I see my doctor, because I dont want them to make me worse

36

  1. Please see last paragraph below and post your AM and mid-afternoon body temperatures.

  2. What were you doing over these years for iodine and selenium?

  3. Can you feel lumps in your thyroid? Unevenness?

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

37

  1. My thermometer broke, but on my last visit to the doctors my temperature was 37.1 C, and that was at 7am. I definitely run hot.

  2. I was taking Iodoral for several months. But I gradually tapered off it months before my TSH started to tank. I eat sushi about once a week and have plenty of sea food. I used to eat a lot of Brazil Nuts for selenium, but stopped those recently. We use iodized salt at home, and I also take a multi-vitamin daily that has iodine and selenium. So I can not imagine that I am deficient in either of these

  3. I cant feel any obvious lump in my thyroid.

In February of this year, my TSH was 1.41 and my FT3 and FT4 were in the upper portion of range. I thought my thryoid was great, but my TSH has dropped considerably since then, and I have all the symptoms of hyperthyroidism

38

Try to get a thermometer to close the loop on this. Temperatures in doctors offices can be skewed by talking, climbing stairs etc.

Worried that low TSH may not be repeatable, need to confirm with another lab.

I have trouble with thyroid going hyper that fast. But have no experience with that aspect.