T Nation

Panic Attacks After Injections Again

Hi All, I just started a new protocol on Monday through Defy, it’s as follows:

30mg Test Cyp SubQ EOD.

I’ve only given myself two shots so far but I’ve had panic attacks 1-2 hours after each administration. This happened the first time I was under the care of a Urologist. I was good for 6 months and feeling on top of the world then I would have massive panic attacks fmultiple times a day, for 2-3 days straight (that was at 200mg every 2 weeks). I should note that these new panic attacks seem to subside within a couple hours after they appear but they’re still getting in the way of living life.

The theory was that my Estradiol got too high last time (47) since the Uro didn’t think there was any reason to treat for it. However, I’m concerned I have another issue since my estradiol on my last labs was only 20.

So my question is: Could it have risen already after only 2 shots at 30mg each or am I looking at another problem? Defy has advised to drop the dose to 20mg EOD.

Here are the last labs I had done:

Endocrine:

Total Test: 181 Range 280-1100 LOW
Free T: 4.64 Range 1.9-27
E2: 20.1 Range <40
Dhea: 483.6 Range 34.5-565.9
SHBG: 15 Range 14.55-94.64
LH: 2.1 Range 1.5-9.3
IGF-1: 304 Range 137-199 HIGH

Thyroid:

Reverse t3: 20.7 Range 8-25
T3 free: 3.7 Range 2.3-4.2
T4 free: 1.77 Range .89-1.76 HIGH
TSH: .536 Range .55-4.76. LOW
Thyroid Peroxidase abs: <28.0 Range <60
Thyroglobulin abs: 23.4 Range <60

Coronary:

Triglycerides: 78 Range <150
Total Cholesterol: 130 Range <200
HDL: 38 Range >40 LOW
LDL: 76 Range <100
Chol/HDL ratio: 3.4 Range <5

Low SHBG men while having what looks like normal estrogen (30) can be deceiving because free estrogen can be sky high since low SHBG men tend to have a ton of unbound free hormones, we deal with this a bit differently than midrange and high SHBG men.

We inject smaller more frequent doses which can lower estrogen and therefore free estrogen. I’m also a Defy patient and am on 20mg EOD which sees my free testosterone at the top of the ranges, my SHBG is also low at 16.

Low SHBG men sometimes need estrogen on the lower end since we have so many unbound free hormones. Endocrinologists and urologists treat the numbers even as you are telling them you don’t feel right, so you tell them you don’t feel right and the endo or uro glances down at the estrogen number and says you are fine.

I had a slight panic attack/adrenaline rush after the first couple of injections, it will subside after a while. Remember you are going from low testosterone to normal testosterone levels pretty quickly and can be a shock to your body that has been used to low levels for a long time.

Your testosterone panel and thyroid labs are a mirror of my own pre-TRT labs.

Notice high IGF-1, what’s the plan to deal with it?

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Thanks again for the response, systemlord, this forum and people like you make this process feel a lot less isolating.

Do you take an AI as well? I’m holding off (which I’ve ok’d with Defy) for right now.

As far as the IGF-1, I don’t think anything is being done at the moment. The provider I spoke to didn’t sound too concerned (neither was PCP), I can’t remember exactly what he said it about it though. It was a long consult, as I’m sure you know, and I was trying to write down as much as I could but I definitely missed things.

Still learning as I go.

Glad I could ease your mind, starting TRT can be a big decision and can be difficult in the beginning, but can be life altering in the long term.

I’m on an AI and over-respond to them and have to dissolve the anastrozole in vodka using graduated droppers to get a consistent dose.

Also forgot to mention some men go on TRT and deplete magnesium and pregnenolone and this can cause anxiety. You’re in good hands with Defy so you are going to be just fine.

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“You’re in good hands with Defy so you are going to be just fine.” I like the sound of that.

I’ll start taking magnesium again, stopped a few weeks ago. I’ll have to order lab work for pregnenolone, I’ve never had that tested.

I prefer to test red blood cell magnesium because serum magnesium can look normal and cell magnesium can be depleted, serum magnesium is just a reservoir and RBC magnesium is where the rubber meets the road.

RBC magnesium cost about $100 dollars, it’s expensive but worthwhile. It would be a complete waste of money to test serum serum magnesium RBC was depleted which can shorten life expectancy.

I didn’t know that about the RBC magnesium. I’ll see if I can get that done as well.

By the way, is there a particular form of magnesium you take? I have a couple kinds at home, glycinate and citrate, thanks!

I use Pure Encapsules Citrate, this is what you want.

Do you feel like you have any anxiety about the TRT as a whole?

When I first started, there is no doubt that my adrenaline and cortisol were going out of whack.

I would have severe anxiety, and I would also wake up at 3 am WIDE awake. It subsided eventually.

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why not glycinate? https://www.amazon.com/Pure-Encapsulations-Magnesium-Glycinate-Physiological/dp/B0058HWV9S/ref=sr_1_1_sspa?s=hpc&ie=UTF8&qid=1539203431&sr=1-1-spons&keywords=pure+encapsulations+magnesium+glycinate&psc=1

Theres a better one on Amazon from KAL same mg gly. It is 200mg per tab instead of 120.
That’s what I take. And I get dreams often know.

Waiting for the sexual ones…lol
Btw do you guys get up to pee at night and how many? I get up once in the middle of the night to pee.

I will check it out. I just got a new bottle of mag asparate a couple weeks ago so will keep yours in mind in a few months. I had a great sex dream last week but go figure it was about my wife. It was good though.

LMAO

I cant even get some strange in my dreams!

Do you get to at night to pee and how often

You may need to watch some porn. Lol

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Sometimes once but thats only once or twice a week if Ive had too much water at bed time.

Ok. I get up 1 every night. And I hate it. And I even take Cialis which is suppose to help.

What’s a good cut off time to not drink?

If Im going to bed at 10 I will have a glass of water/seltzer with dinner at 7ish and thats it. Then right at bed I will have maybe half a glass. But I am figuring out that 1/4 a glass works better but sometimes I am just thirsty.

Edit: Sometimes I will have some warm lemon water after dinner but its really only like 6oz or so.

Ok thanks. I take citrucel tabs about 8pm need a full glass for that fiber. Then about 9 take the zinc and mg with about 1/2 glass. Sleep at 10

You have suggestions?