T Nation

TRT Since July, Heart Palpitations/Anxiety Since December

Been on 200mg cy injected once a week since july 2017. December started having heart palps at night and anxiety during the day. Havent really ever felt great on the trt. Last bloodwork was t-900, free t 23 (normal scale topped out at 22) estrodial was 14.9. I switched clinics early on because the dr didnt want to put me on a estrogen blocker. At that clinic test was over 1000 never checked free t and estrogen was over 300? I take 1/2 mg anestrizol a day after my shot. I feel like after reading these forums that I should drop my dost to 120 once or 60 twice a week. Anyway Im trying to see if any of this would cause anxiety and palpitations. Nothing has changed in my life, today is shot day and no anxiety yesterday or today. Seems worse right after the shot. Thank you for the help and advice.

200mg once a week seems like way too much to start with for TRT Try scaling down to something like 100mg/week

1 Like

No wonder you’ve never felt good, that’s twice the recommended dosages. Dosage and frequency of injections is determine by your SHBG level. The level of care you receive from your doctor will largely determine how successful TRT will be for you. TRT isn’t just about injecting testosterone, it’s about knowing how to balance all your hormones.

Sadly that cuts out more than 80% of doctors.


shgb was 21.9 on a scale of 10-50

Are you still taking an estrogen blocker? e2 that low is not good.

I recently had an issue where I dropped my e2 too low and I had similar issues. Anxiety, increased BP for me.

1 Like

I was taking 1/2 mg twice a week. (Dr said to take 1mg twice a week). Now Im taking 1/2mg once a week.

Nothing will ever change under the care of your current doctor.

1 Like

Im just trying to research this myself, there isnt much info around here that I can go by. I have friends that get this done at most of the clinics in town and its the same thing. Im going to try 100mg a week and 1/4 anestrizol the day of the shot to see if that helps.

Your e2 was 14. Stop taking anastrazole.


Im going to drop from 200mg to 120mg tomorrow. Hopefully that will get me on the right track. Will I need the anastrazole at 120 per week?

There is no way for me to tell you that. You will have to find that out on your own, through testing and labwork.

120 is reasonable. On 100 mg a week, my TT was in the 1100-1300, and I had very mild E2 symptoms. Nipples were itchy a little. So I dropped to 80 a week, no AI, no e2 symptoms. test between 700-900 range.

I have heard it said on this board before that its useless to know what your E2 would be without an AI, I think its crucial.

How else will you know if you even need one at a reasonable dose? Crashing your e2 will cause a ton of issues down the road. Better to wait and see if you need one, then use sparingly.

1 Like

I’ve crashed my E2 multiple times and have noticed marked anxiety everytime.


Thank you for the replys. Also, Im 44 6’0 tall and a fat 245lbs. Not sure if this helps you with my situation or not.

Seems like the anxiety palpitations happen worse in the couple of days after my 200mg shot. Towards the end of the week the anxiety falls off but I get moodier. Thanks

You need to follow a protocol similar to the ones followed on this site. 200mg shot at a time is not good.

Do not use term estrogen blocker.
You should use an AI, Aromatase Inhibitor.
Need to avoid vagueness that could mean a SERM

When injecting once a week, T and E2 levels are changing every day and then lab results are rather useless. Then lab results are largely determined by lab timing and if you change lab timing, what do the changed number then mean?

Inject twice a week and take AI at time of injections.
Always to labs half-way between injections.
Labs at time of doctor office visit mostly wrong.
Get lab order and go to a lab draw station or docs office to get labs done. Do this 10-14 days before office visit. Then at appointment go over the labs with you doctor and agree on protocol changes. You should have a copy of the labs in hand and preferably before the visit so you can study implications, get review here and provide what you want in writing to your doctor. Not doing this means getting labs done at visit then getting a phone call from a brain dead office assistant/nurse with useless info.

Please read the stickies found here: About the T Replacement Category

  • 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.

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 numbers 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.

1 Like

Got a 50mg shot today. Taking .25 AI today as well. Thank you all for the help. I’ll let you know how it goes.

did you ever let your e2 recover before starting to take the AI again?

1 Like

I dropped the dose down to 1/2mg per week from 1mg.

without labs, you are asking for problems. Just make sure you follow up and don’t go by how you feel. E2 high and low symptoms are confusing.

1 Like