Hi everyone looking for some advice. Really unsure on what to do at this point in my life. I’m 23 and have been having a lot of problems. I have felt like crap for the past few years. I’m motivated, tired all the time, sex drive bad, anxiety, I literally never want to go out or be around people. My head hurts bad everyday I wake up three to four times a night every night. With all that being said I went to the doctor and did labs discovered my test was 284. There range was 250-1000. I have went through several test and several doctors.
The best my test has gotten was up to 300. Several doctors said I was in range so I was fine. I finally found a doctor that decided to help me. He suggested trt I’m currently on test cyp/prop. Mixture with an AI. It’s been three months and my test is now at 419. My estrogen was low not even in range. My vitamin D was low as well. He suggested going to straight test cyp. And a vitamin D supplement. I feel bad guys. I honestly don’t feel any better.
I’m afraid I’m treating the wrong thing? I have a family history of sleep apnea so I’m getting a sleep study done in a few weeks. I’m also worried every single day I’m gonna have a heart attack. Probably my anxiety. My heart rates at 70-80 during the day sometimes at 100 walking around. Drops to 60 at night in bed. I went and jogged and it was up around 150 kinda scared me.
I guess what I’m asking guys in yals opinion do you think I should give the testosterone a longer shot andsee if it will work out. Maybe I should try a anxiety!depression med in combination? They say it goes hand and hand so… I just don’t want to be treating the wrong thing and hurt myself worse in the long run. Any advice would be great and thank yal for your time!
Well if your estradiol is low you will feel like crap. I had high heart rate high pressure when it was low. So the AI mixture maybe to much.
And estradiol out of range can have anxiety panic even.
Really need to get the labs done. Need
Total t
Free t
Tsh
Free t3
Free t4
Reverse t3
Lh
Fsh
Prolactin
Estradiol sensitive test
Shbg
Your testosterone levels are still low, you need youthful testosterone levels to feel good. TRT requires optimal thyroid hormones, lagging thyroid can make it feel as if TRT isn’t even working and can even make you feel worse as TRT attempts to restore metabolic rates that the thyroid cannot keep up.
We see a lot of guys coming here with undiagnosed thyroid problems, it common for doctors to run not enough tests before putting a guy on TRT. Often not being thorough enough.
Taking your body temperatures using a glass thermometer before you get out of bed and at 2 p.m. will show if you have thyroid issues, you need to be 97.7 upon waking and 98.6 by 2 p.m.
If body temperatures are low it will confirm low fT3 thyroid hormone, sometimes supplementing iodine and selenium can restore normal body temperatures if subclinical hypothyroidism.
Low E2 can cause headaches, I had headaches throughout the entire day when my testosterone and estrogen were low especially after waking up in the morning! Estrogen lowers while you are sleeping, rising during the day and falling again in the evening. Therefore headaches in the morning and headaches in the evening.
Have you ever seen a psychiatrist or been prescribed any psychiatric medications? I ask because A.) basically everyone with your symptoms get put onto an SSRI, since on paper you have clinical depression and probably GAD, and B.) over the next decade we’re going to probably learn that SSRIs are screwing up the hormones of the young men who are being fed them like candy. I ask these questions because your story sounds an awful lot like mine did when I was 20-26, and I know what you’re going through. Waking up with a racing heart is the most terrifying thing I’ve ever experienced, so I feel for you man. You’ll get better, it’s just a matter of getting the right doctor and the right combination of drugs/lifestyle changes/maybe some CBT. For me it was getting off SSRIs and getting in trt. It changed my life, but it took some time and some trial and error. You’ll be ok, man.
We really need your free t. If you have a midrange or high-normal free t, I recommend trying the anxiety depression meds.
I got diagnosed at 20. Low free t. Meaning I had a total testosterone in the 900s but all of it was bound up so I failed to go through puberty right. It was just as good as me having a level in the low 200s. Lots of docs said I was fine but really wasn’t–could be fvice versa for you.
About your question: should I give the testosterone more of a shot? Well, assuming free t is just as low in the range, YES. Levels in the 200s are proven unhealthy for your arteries and can lead to heart disease and weak bones. 400s is not great either for a guy in his 20s. Find a new doc. Don’t settle until you are at 800+. If you do happen to ever have sex drive in the 400s, you’ll still crushed by your competition whenever you’re around other guys trying to impress the ladies.
T is the power and dominance hormone, from my experiences, when those levels get below the range, you get the opposite effect.
Also. The testosterone or lack of it should not be making you feel like you are having a heart attack dude! Get that checked out.
Ignore calls for depression meds for a while at least.
Get your pre-TRT labs and post with ranges.
TT
FT
E2
LH/FSH
Prolactin
if done.
If you were put on TRT without LH/FSH or following up low LH/FSH with Prolactin, the doctor should have his balls cut off.
Headaches:
Has your width of peripheral vision become narrowed? Should be near 180 degrees. Concerns is a prolactin secreting pituitary adinoma that can press on optic nerves and reduce LH/FSH and T. Don’t panic, that is easily shrunk and managed with 0.5mg/week Dostinex/Cabergoline pills.
Many come here with some thyroid issues. Please evaluate via oral body temperatures, see below, and don’t consider this trivial.
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 Aand 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.
Here is my lab test since on trt. Sorry it took me a few days to get all the info from my doctor.
Total T 419
Free T 13.7
Bioavailable T 356.8
TSH 1.09
LH < 0.20
FSH 0.13
Prolactin 6.70
Prostate specific antigen 1.1
Estradio <20 below the range
SHBG 6.70
Total T4 6.39
T3 3.8
Free T4 0.91
Thank you all for taking the time to respond to my post it means a lot. Let me know if there is anything I left out. I also wasn’t sure if I need to respond individuals or by just posting if all of you would see?
We need labs ranges, there’s no way to tell if T4 is low, midrange or not. TSH is great, but thyroid hormones always tell a better story.
Your FT according to your TT and SHBG is 15.1 ng/dL = 3.6 %, 2-3% is considered normal.
You should be injecting smaller doses of T EOD or ED do to lower SHBG. Larger doses less frequently can drive what little SHBG you have down even lower, you need adequate SHBG levels to activate androgens.
You might not be able to tolerate much estrogen with lower SHBG, do not shoot for high normal testosterone levels. Go for midrange T levels and monitor E2 levels closely. Try to keep E2 levels at 20 pg/ml.
Mate I’ve been on SSRI’s since I was like seven. My hormones were fucked up by the time I was 15-16, I believe SSRI’s screw up developing endocrine systems, for my chronic pain I was also given neuropathic nerve medication such as lyrica and gabapentin, both of which turned me into a walking zombie for a while and likely also had a contributing effect to me becoming hypogonadal. They need to do large studies on these medications and hormones, if doctors found out they were making a generation of kids hypogonadal they’d probably stop prescribing them for everything. I believe the SSRI’s have caused some of my… dysfunction.
What is your TRT dose? How long is the interval between your shots. If given properly, your TT shouldn’t still be that low (unless you have an absurdly low SHBG)… nvm just saw your bloodwork, that is a very low SHBG, still I’d shoot for a TT of around 600-800, try that out for a few months and then make a verdict on whether TRT is for you.
Total T (419) 175-781
Free T (13.7) 1.59-24.23
TSH (1.09) 0.45-5.33
Prolactin (6.70) 2.64-13.13
Estrodial (below 20) 20-47
SHBG (6.70) 13.3-89.5
Total T4 (6.39) 6.09-12.23
Free T4 (0.91) 0.61-1.12
Free T3 (3.8) 2.5-3.9
Total T3(127.86) 87-178
I will start checking this every day and getting back sooner! Can yal please explain the deal with SHBG why is mine so low? It was low before TRT is that a bad thing is there anything I can do to fix how low it is? Does that mean I’m just not suppose to have as much testosterone. I do a shot every 7 days so once a week it’s just one cc 200mg it was a test prop/cyp mixture he had me on with an AI. He has now switched me to just test cyp. Same dose 200mg once a week and dropped the estrogen blocker. He called in a prescription of a high dose vitamin d said it would support more testosterone and make me feel better. I haven’t taken it cause I was unsure. Also told me to take fish oil for any cellular damage? Yea I haven’t taken any medication for the anxiety one thing it does is make me unsure to just pop a pill. I question everything. I see a different doctor for the anxiety/depression. Since doctors say they go in hand. The anxiety doctor is with Scott and white here in Texas. She suggested either lexapro or Wellbutrin. But I’m scared to death to take either one after reading up on them. Scott and white wouldn’t help me with my testosterone even when it was at 240 said I was in the normal range that I was perfectly fine. So I found this guy an outside party seperate from them. Anyways how I’m feeling. Well this is my third week on just test cyp no estrogen blocker don’t feel much different I will say today I’ve been more tired then usual and I went to have sex and I got like halfway hard and then it just went back down it’s like I can’t maintain an erection at all. Granted my sex life hasn’t been great the past few years with this LOW T but it seemed worse then usual today. I don’t know if that has anything to do with dropping the estrogen blocker. Also I was reading about cardio lowering heart rate but read that if you are on trt your heart rate won’t lower is that true guys? Can I not get my heart rate down if I want some more by doing more cardio. Hey once again thank yal for responding and helping!
I almost forgot to mention it feels like my breast underneath where the glands are I guess are slightly sensitive not like a bad pain just noticed a slight difference from the first few months. The doc told me to check back with him I’m three months but I might go in this coming week and do blood again three months is a long time if my estrogen went from low to high…
Low SHBG can be genetic, you were just dealt a low hand in life. TRT will drop SHBG even further and you may feel nothing from it. You must inject testosterone every day do to your low SHBG, doctor is useless! Insane to have a super low SHBG guy on 200mg weekly, you’re headed for hormone hell!
Low SHBG guys have a shit ton of free hormones, you can’t handle all of that testosterone. Low SHBG and anxiety go together like flies on flypaper. SHBG is needed to activate androgens and without it androgens don’t do anything for you.
A lot of good responses in here! Definitely drop your dose and inject more frequently. It will take time for things to even out and reach a steady state.
Your heart rates seem fine overall, about the same as mine. When starting TRT and altering your protocol, a lot of things are changing in your body. Your body needs time to adapt and make adjustments. I had a slightly elevated heart rate with a heavy heart beat for about 6-8 weeks after starting TRT. It scared me too, and made it hard to sleep sometimes. It has since subsided and returned to normal.
I went in and spoke with my doctor and brought up what yal said about low shbg and injecting more frequently. He had no issues with it and was open to try anything that could potentially help me. He suggested twice a week at .5 an injection. Instead of me doing what I have been at 1cc a week at 200mg. .5 is barely any oil in the syringe yal really think that’s what I need to be getting the benefits? Also can yal please tell me if you think I should do test cyp. Or the test cyp/prop. Combination the doctor said it was completely up to me he has patients that prefer one over the other but he doesn’t see a difference. I believe it’s 50mg test prop. 150 test cyp. On the specific bottle. He told me I could take out the anaztrozole and do it seperate if I feel I need it. I’m just unsure on which test is better and if I need an AI. I thought test cyp was a long acting ester so does it make sense to do it more than once a week?
Test prop is shorter ester and ml for ml is very slightly more potent. In the case of TRT it depends on how much you believe in splitting injections. Personally I pin once a week cause im lazy and didn’t really notice any difference splitting my dosage.
In your case if your splitting it’ll probably be test prop 50mg three times weekly or test cyp 150mg split over two doses. As for your AI the only way to really gauge it is by keeping eye on bloods. Some people will get estrogen sides on 150mg others can go 250mg+ and experience non.