I have another question: Is it normal for my heart to race at night? I waited to see if it happened on more than one occasion and now it has. On the past two injection days when I’ve went to bed I’ve had a feeling omy heart racing / pumping hard / almost a twitch that makes it difficult to fall asleep. It starts to manifest / build in the evening following injections and then fades throughout the day after injections.
Is this normal? Should I be concerned?
Let’s see what others say but I have never heard of it in regards to dosing. I will say that has happened to me on multiple occasions but had nothing to do with trt. I wasn’t taking anything. Maybe a side effect of anxieties? I’m sure you already are but when this happens try controlled breathing to get your heart rate under control.
Thanks for the reply! I actually have been using the “square breathing” technique to try to get things settled down.
It’s just odd because I don’t / haven’t typically had anxiety (besides obvious exceptions) and the timing seems to coincide with injections. Guess we’ll see if anyone else is familiar with this.
When my e2 and t were lowering I got nasty hot flashes and when trying to sleep laying down I felt heart palpitations and beating. It got much better since raising my t and e2 with it. I was so worried I went to cardiologist.
He ended up giving me Xanax lowest dose took it at night for 3 nights and it broke this cycle I was in. I have not taken it since.
Thank you very much; that’s definitely reassuring.
This may seem like a stupid question but I’m assuming you mean your T/E were dropping between injections? So my issue may be caused between the time that my levels are dropping and that day’s injection hasn’t really made it into my system?
I was describing before I started TRT.
I just started injections 12/18. Now I injected Monday 12/25 (100mg) last and today is Saturday. I wanted to see if i can make it to Monday, but I am feeling mild hot flashes on my face and seem to be getting tired early evening. I will see if i can wait until monday if not may inject tomorrow than do every 3.5 days.
It started to look like I loose the affect of the shot after about 4 days. But i really dont want to change weekly unless i have to because the body takes time to adjust and i cant keep confusing it.
Oh OK. Thank you for the clarification.
Tomorrow is my next injection and I’m still feeling these “twitches” / palpitations today so that makes me leery of taking the next injection.
I think I’ve read that potentially magnesium may help IF I’m now running in deficit compared to my new hormone levels. But I also don’t want to just start throwing a bunch of “stuff” in the mix that may compound the issue OR make it difficult to sort out what IS actually helping - if anything does.
IF magnesium is worth a shot what would be a safe dose to start with? I also thought I read that you need to take a certain combination of magnesium and something else to balance everything out BUT I cannot find those threads so any input there would be appreciated as well.
My opinion on the palpatations is that it’s related to estrogen change. It could be happening as it’s spiking or coming down. Estrogen being at 1 extreme or another causes anxiety and so does low t.
I mean you can throw a supplement at it but I personally would not. Just take a great multivitamin for men.
You may need to inquire with a physician.
I agree about not “throwing” various things at it but thought I’d get some opinions on here first. I’m going to call my GP doctor tomorrow morning just rule out anything potentially bad…that’s why I pay for insurance after all. I’m not looking forward to trying to get him up to speed on TRT though.
I’ve been checking my BP and heart rate periodically and nothing seems out of line and no irregular rhythms according to my at-home BP cuff so I’m fairly certain it IS anxiety / hormone related but I have a family history of heart disease so I take it pretty seriously.
Thank you very much for your input.
Everytime I change my dosage I experience palpitations at certain times, like running to the bathroom and I get hot while sleeping and this is when the palpitations peak. It’s just your body is adjusting.
I’m glad to hear others experience similar things; it can be a little worrisome if you don’t know what’s to be expected.
So I went to see the doctor about my racing heart and high BP yesterday. The EKG came back normal and they ran blood tests on various things that all also appear to normal. He did decide to run tests on my thyroid and these are the results I received…
Free t4 1.36(0.78-2.19ng/dl)
Free t3 4.50(2.77-5.27pg/ml)
TSH 1.17(0.47-4.68m[IU]/L
I have also been periodically checking my body temp and they range from 96.7 - 97.7 and the highest I have seen it is 98.0.
I don’t know what all of this means but if it could be contributing to my anxiety / heart rate / BP I’m all for trying to get it fixed.
Otherwise, if this doesn’t straighten up in the next few days I will have to quit the TRT because if I weren’t self-employed I’d be fired by now. I want to feel better but this is doing the exact opposite.
Oh…and I broke down and took 1/8th of a 1mg AI pill this morning because I feel like I’m bloating and my nipples were feeling itchy. Hopefully that amount of medicine won’t crash my E2 like last time and start this mess all over again.
You’ve only been on TRT for 15 days, you need to give it more time. Everyone goes through what you’re going through, you’ll be rewarded tremendously in the end with incredible energy and vitality. You need to stop making micro adjustments based on how you feel or I promise you will fail. I had tingling itchy nipples and I have never taken an AI to date, it’s not always E2 that causes itchy nipples and skin.
It take 4-6 weeks for your bloods to stabilize and everytime you make a small change you start the balancing of hormones all over, it’s a short term fix because unless you add that much to your AI dosing you’ll return to the state you were in before you added the extra amount of AI.
Dr should have gotten e2 sensitive lab while he was at it. It would suck if you took the AI and you are low e2. I got many of the same symptoms when my e2 was below 20. I know man this sucks but need to try and get where you want.
You get symptoms when to low or to high. Good luck.
fT3 is what counts and the tests done above are obsolete now that fT3 can be tested. fT3 is the only active hormone, there is no T4 receptor. TSH looks good, but is only one voice in the choir/quire.
TT=416 is not good
FT is the active hormone and not tested
SHBG is too high, lowering FT and creating more non-bioavailable SHBG+T that inflates TT, overstating your T status.
E2=23.8 is not bad, but VS low-T leaves you estrogen dominant which also can cause liver to make more SHBG.
On TRT, most guy do better near E2=22pg/ml and you are past that now, anastrozole will not be optional and waiting to see how you feel with an E2 crash is not in you best interests. You seem to be grasping the fundamentals well. Most need 1mg anastrozole for every 100mg T ester. So you can take 1/2mg at time of injections and may need more later after labs. But a few, not rare, are anastrozole over-responders who need 1/4th what others take. Those will crash E2 and they will know it, no way to know in advance.
When you inject T, LH/FSH crashes in 24 hours and FT increases rapidly and with more FT, FT–>E2 increases without any delay. You can take anastrozole with first injection as it takes ~1 week for serum levels of anastrozole to increase to steady state, so its effects are on that time lag. Anastrozole does not remove E2 from your body, it reduces FT–>E2 creation.
hCG .25ml is presumed to be 250iu at 1000iu/ml
250iu SC EOD would be better from a half-life point of view. But at your age, fertility is not a concern. Watch for size changes to your testes.
Please read the stickies found here: About the T Replacement Category - #2 by KSman
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.
KSman is simply a regular member on this site. Nothing more other than highly active.
I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.
The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.
Thank you very much. This is some of the info I was looking for; I can stick it out for a few more weeks in order to feel much better than I have in the past year or so but man…some of these things I have been going through seem almost worse than the issues I’m trying to solve and essentially rendered me useless these past few days and I have to be able to function for work.
Just to clarify (I’m not sure if I was clear on my post) I took the 1/8th mg of AI one day post-injection as directed by my T-Clinic. I did not take it simply because of the side effects I was feeling - those just lead me to believe it was time to try to resume AI after my E2 crashed (guessing by symptoms) this time last week.
Thank you too, Charlie. I actually just got off the phone with the T-Clinic just a little bit ago and they have ordered new T and E2 tests and I will go take those on Friday morning pre-injection. So hopefully this will give me a decent idea of where my levels are currently and how to adjust AI or if needed at all.
Thank you for chiming in @KSman !
Yes, it is 1000iu/ml. I apologize if I did not include all the info. So I end up taking 500iu a week split into two injections on the same day I inject testosterone. I actually opted for two separate injections instead of trying to load it all into a single syringe; I guess I’m not graceful enough to make that transition and I honestly don’t mind the SC injections that much.
I’m not sure if you saw my post earlier today but I did get those levels measured yesterday and have the results. I will post those for you here so they’re easy to find…
These clinics can be a hit or miss, most are terrible at dosing. Make sure when you get your E2 results that there the correct one or else you risk crashing your E2 levels. Make sure it’s LC/MS assay method or E2 sensitive. It took me 6 weeks before I started to notice I was starting to feel better, every month I noticed I was feeling a little better. I’m 8 months on TRT and still not 100 percent, for some (myself) it can take a little more than a year to get the full benefits of TRT.
I was in worse shape than most and could barely make it up a flight of stairs without getting winded, muscles were gelato at the start. I got red flushed in the face in the first few months, friends would freak out when my face would flush bright red do to the increase in red blood cells and estrogen. Your testosterone and estrogen are constantly fluctuating for the first 6 weeks and it’s only once they stabilize is when you “start” to feel a little better, how fast you progress is based on SHBG levels and receptor sensitivity.
Note that whenever you increase or decrease your dosage it will send you back to feeling like you did when your first started TRT, 4-6 weeks later after bloods stabilize is when you’re back on the horse.
You are right. At first, I was very impressed because a lot of their initial protocol was pretty darn close to all the things I have been reading on the forums and hearing the popular doctors stating in interviews but now that it seems my case is not exactly “cookie cutter” they don’t know what to do. They said that “testosterone does not cause anxiety”, etc. and it seems to me that is does fairly often…it may not be the norm but it’s also common enough that they should know.
The next suggestion the clinic had was that I switch to weekly injections but I was reluctant to do that. Their argument is that even though the testosterone levels swing more the E2 levels do not but I thought from my reading that one follows the other regardless of frequency so a higher upswing/downswing from a single testosterone injection would also do the same E2 - am I wrong?