Palpitations on Test Cyp

Hey guys new to TRT 54years oof good health no heath problems at all. All blood work within normal range. Been using gels and creams for years with mild success 400 was the highest I could get my T. Doc switched me to testosterone Cypionate 50mg once a week, did fine for the first 2 months then started having palpitations. No rapid heart beat just an occasional missed or skipped beat. No other symptoms at all. No dizziness, no pain, nothing.

I stopped the shoulda and went back on the Androgel and the palps are gone. What could be the cause?! I don’t want to be on gel or cream because my T will plummet again. I really need some help and advice as to what to check or what could be causing the issue. I had every heart test imaginable and all normal. Thyroid normal. Sugar normal. Please help!

You wound up with less testosterone than when you started by taking only 50mg a week. Your naturally production has been suppressed. If you’re doc is prescribing you only 50mg a week, change doctors. Find one who understands this stuff sufficiently. This is a subject that is not taught in medical school so you need someone with extensive experience.


There’s a reason why your doctor had a knee jerk reaction to use androgel, because he has no experience prescribing injectable testosterone. My goodness 50 mg weekly, speechless!

You’ll probably need two to three time that amount, most men are 100-160mg weekly, split up once weekly, twice weekly, EOD and daily. Everyones needs are different, some guys have varying sensitivity to hormone fluctuations needing different injection frequencies, I did well on 75mg once weekly dosing for 15 weeks and my body started having trouble reaching homeostasis (palpitations!) and I had to make drastic changes to my protocol.

I had no help from any of my doctors, I must have went through several and found these forums and learned my experience was as typical as the sun rising in the east. Most sick care doctors hardly know anything about how to prescribe testosterone because they specialize in other areas of medicine and TRT is the occasional experience and never really excelling at it.

I wouldn’t expect a different outcome switching doctors, it might be a little better, but sick care docs general suck at prescribeing TRT because medical school doesn’t teach sex hormones in medical school and prescribing guidelines are almost non-existent.

I’m amazing you did so well on 50mg for two whole months, whoa! You must have low SHBG, I wouldn’t be surprised if you doctor only tested Total T. Androgel sucks and men aren’t sustainable on the T-gels, a lot of men seem to stop absorbing after awhile and most never absorb enough to benefit.

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Doc sounds ignorant regarding TRT.

Double or triple your dose, split it into several injections per week, give it 6-8 weeks and you’ll probably be good to go.

That’s it.

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Thanks guys. He initially gave me a shot of 200Mg in the office and My T hit 1100. He does check total, free and shbg, LH, Estradiol, psa, CBC, metabolic panel, D, lipids, sex hormone binding glob. I think he’s pretty thorough just not as aggressive as I may need.

It isn’t amazing he did well for the first two months with 50mg. It was being added to his natural production and that’s why he felt great! Then his natural production crashed and he stopped feeling great!

Come on @systemlord! This is TRT101 for crissakes!

Did you get palpitations after the initial 200mg shot?
If yes, you might just be sensitive to the stimulatory effect of T if not your current 50mg dose is too low.

On the current 50 per week is there a time when you feel the palpitations the most? Like 24h after the shot or more towards the end of the week?

Anyhow the 50mg per week is low, you might want to increase to between 75 to 100 per week, wait for 4-6 weeks, do labs and depending on labs and symptoms adjust.

My guess will be within 24 hours if the shot. I see this often. Small daily dosing resolves the issue.

You never did email me @johann77

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To share my experience with palpitations.
I started TRT 3 weeks ago and inject 20mg daily and I have palpitations most of the time. It is strange. My blood pressure and pulse are not elevated, in fact even my BP has dropped a bit.
A friend of mine had such palpitations the first 3 months after starting TRT, after that they disappeared.
Hope this is just initial reaction of the body to the new situations

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I did not have palps after the initial shot or from any subsequent shots for the first 2 1/2 months or so. I guess I started to feel them as I got closer to needing another shot. Maybe my body used it all and was processing it quickly by then so maybe shots 2x a week are best to keep it up?

If you are sensitive to fluctuations change from weekly to 2x or 3x per week.

Here you can find some information about how T fluctuates (on an average person) on different injection frequencies

And here is some info on T dose and average T levels extracted from this forum. Maybe its helpful. But you need labs to make a decision based on data on which dose to select.

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I do this as a sort of hobby because I am on TRT and I believe/hope I can provide some scientific background.

No intention to bring this to another level, enough ongoing on a professional level already in my life.


Thanks I really appreciate the advice. It’s just so hard to find a Dr that knows as much as the great people on this forum!! So you believe the fluctuation causes the palpitations and the dosing is too low and not close enough together to avoid the ups and downs.

Oh, I hear ya lol! This is also a hobby for me. I have a successful business in a field that has zero to do with this stuff and I have no idea how I got sucked into this into the first place lol! Don’t change your mindset on this one, trust me :wink:

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@mjrmick here are the top reasons I am seeing why protocols aren’t working

  1. If they are taking an AI (we will tell them to wean themselves off over several weeks)
  2. Insufficient levels of free testosterone
  3. Once weekly or twice weekly injections (this DOES work fine for some people but doesn’t for many)
  4. Fluctuating levels (resolved with #3 but, again, some people are more sensitive to this than others)
  5. Not giving a protocol enough time (need a good 6-8 weeks to assess)
  6. Changing the protocol constantly
  7. Adding other supplements during the protocol and not knowing what is doing what
  8. Using testosterone proprianate or sustanon instead of Enanthate/Cypionate
  9. Using a transscrotal cream from a compounding pharmacy that doesn’t do it correctly
  10. Overcomplicating TRT!!

99% of the people who message me or the doctors in my group have one of the above issues. We make small changes to their protocol based on how they are feeling. 6-8 weeks later they are feeling better. When there is an exception to this rule I would say it is 1% of the time.

What is the issue of using sustanon daily for example?

Too many different esters that get metabolized at different rates and cause fluctuations. In theory, it should be fine but, in practice, I see this issue constantly. Not too many guys out there doing well with sustanon.

What should I do if it is the only pharmaceutical grade I can get?

I do not wanna use UGL not because it is illegal, but because I will always have doubts about the quality

No choice. Lots of guys in Europe using the cream through BMH and other places. At least you can get that.

Maybe I need to see how I will do with the sustanon, like you said to give it enough time?

So in your opinion even if I stay long enough on the same protocol and lets say inject enough daily I may not be able to achieve steady blood levels?

To be honest the difference in cost with the cream is significant for me and for now I would prefer injections. Also the delivery method including twice per day and the restrictions in sweating and sex after that seems a bit inconvenient for me. Injections seem more comfortable, clean and very cheap. They cost me like 15 euro per month with the syringes, cream will come at 80-90 with the delivery to Bulgaria.