TRT - negative sides, looking for possible causes

Thread starter #1
Hey guys,


This is a past experience, I've discontinued since but considering trying one more time. The first TRT session was with pellets, overall experience was good, mild short of breath but wanted to try injections because of the long-term scar tissue of using pellets. I was on TRT for about 2.5 to 3 months with injections, most of the experience has been very positive until up to the past couple weeks I begin to notice facial and ear redness flushing with a warming sensation then this past week a rapid heart rate during workouts and evenings I get heart fluttering or palpitations off and on. The heart symptoms didn't occur until after a dose of arimidex at .25mg, so maybe the arimidex is to blame for my heart symptoms but the symptoms did not reside after weeks of waiting. I considered splitting the dose in to two injections a week to see if that helps with my estradiol having a chance to spike if that is the issue. Side note, I gave blood (double red) to confirm my hematocrit wasn't the issue and begin taking an aspirin during the evenings.
I workout and exercise 6 days a week.

Looking at my labs, I thought maybe it was due to my thyroid TSH elevating but talked to an endo and he said it's an upper range but not mandatory for me to take meds. He prescribed me a baby dose of synthroid incase I do elect to take it. The only theory based on my labs is it's due to low blood sugar levels "hypoglycemic".

Age: 36

When reviewing my labs, please note the top ones listed are older when using pellets.


Code:
[B]Pre TRT[/B] (- TESTING PERFORMED AT ASSOCIATED REGIONAL UNIVERSITY PATHOLOGISTS, INC)
5/2/16
Total T: 640.0 300.0-1080.0 (ng/dL)
Free T: 83.2 47.0-244.0 (pg/mL)


F TSH 3.4 0.5-4.7 (UIU/ML)
F T3 TOTAL 93 60-181 (NG/DL)
F THYROID PEROXIDASE AB 1 <9 (IU/ML)
F THYROGLOBULIN AB <1 <4 (IU/ML)


F ESTRADIOL 22 SEE BELOW (PG/ML) - ****** EXPECTED VALUES FOR ESTRADIOL FOR PATIENTS >18 YEARS ******
- ADULT FEMALES
- EARLY FOLLICULAR PHASE . . . . . . . PG/ML 46 - 143
- LATE FOLLICULAR PHASE . . . . . . . PG/ML 143 - 557
- LUTEAL PHASE . . . . . . . . . . . . PG/ML 74 - 212
- PREGNANT . . . . . . . . . . . . . . PG/ML UP TO 35,000
- POSTMENOPAUSAL . . . . . . . . . . . PG/ML </= 34


[B]During TRT[/B]
[B]2/27/17 (Pellets)[/B]


F DIHYDROTESTOSTERONE 518 112-955 (pg/mL)


F TESTOSTERONE 590 300-1080 (NG/DL)
F SEX HORM BIND GLOBULIN 72.4 H 16.5-55.9 (NMOL/L)
F CALC FREE TESTOSTERONE 7.3 4.8-25.7 (NG/DL)
F SEX HORM BIND GLOBULIN 56.5 H 16.5-55.9 (NMOL/L)


F ESTRADIOL 28.9 <=60.7 (PG/ML)


[B]Post TRT[/B]
[B]6/30/2017[/B]


F Testosterone, Serum 457 348-1197 (ng/dL) MB
- **Please note reference interval change**
F Comment: MB
- Adult male reference interval is based on a population of lean males
- up to 40 years old.
F Free Testosterone(Direct) 11.5 8.7-25.1 (pg/mL) BN


F Sex Horm Binding Glob, Serum 59.4 H 16.5-55.9 (nmol/L) MB


F DHEA-Sulfate, LCMS 130 (ug/dL) ES
- Reference Range:
- Adult Males (31 - 40y): 33 - 416




-----------------------------------------


[B]Pre (Second TRT attempt)[/B]

Testosterone, Serum
Pre: 508 ng/dl 
range: 348 - 1197

Testosterone Free, serum
Pre: 7.2 

T4 Free, serum
Pre: 1.42
ng/dL

TSH
Pre: 2.330
uIU/mL 0.45 - 4.5

T3 Free, Serum
Pre: 3.0 

Glucose, Serum
Pre: 89     


[B]During TRT Most Recent  (200mg x 1 Injections)[/B]

Testosterone, Serum
During: 801 ng/dL
range: 348 - 1197

Testosterone Free, serum
During: 15.3 pg/mL
range: 5 - 21

TSH
During: 3.170 
uIU/mL 0.45 - 4.5

T3
During: 2.8 
pg/ml

T4 Free, serum
1.19 
ng/dL

Glucose, Serum  
During: 53 L          
mg/dL
 
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#2
When I started TRT I had the same symptoms, friends would see my face flush bright red and I would break into a sweat, then quickly return to normal. I no longer get red faced anymore or experience heat intolerance. Twice weekly injections is a great starting point. FT is low, increasing TT will alway increase free T. Your body will adjust to the increase in red blood cell which could be what's causing red flushing and heat intolerance.

Your body's thermostat is constantly in flux, it will find a new balance. SHBG is high, you require larger injections. This is why pellets provided low free T levels. High SHBG equals low free T, large shots will decrease SHBG and increase free T. Pellets are terrible, there are better choices. How long have you been on your current protocol? 200mg is too much unless you're a hyper T metabolizer, keep an eye on your E2.

I'm concerned about no E2 testing, a lot of doctors fail to do this. If you think you can inject 200mg without high E2 sides, you're in for a rude awakening! We see it all the time.

https://naturalbiohealth.com/2015/05/06/shbg-critical-to-your-health/
 
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#3
Pellets are the worst possible method for TRT and its around 15 years out of date. Modern protocols typically have you injecting T twice weekly along with HCG twice weekly. AI is not used unless its proven to be needed by symptoms or blood work (Not automatically given as part of a cookie cutter TRT protocol, which is unfortunately quite common)
 
#4
I am 3 months in like you. I had the exact same symptoms and thought they were related to high HCT which they weren't. The reason was high E2. When I increased my dose from 100 to 160 a week, my E2 went from 32 to 105. Since starting .25mg adex 2x/wk, the sides got MUCH better but not perfect yet.
In my opinion, since you already took an AI, take .25mg twice a week and have E2 tested in about 5 weeks.
 
Thread starter #5
When I started TRT I had the same symptoms, friends would see my face flush bright red and I would break into a sweat, then quickly return to normal. I no longer get red faced anymore or experience heat intolerance. Twice weekly injections is a great starting point. FT is low, increasing TT will alway increase free T. Your body will adjust to the increase in red blood cell which could be what's causing red flushing and heat intolerance.

Your body's thermostat is constantly in flux, it will find a new balance. SHBG is high, you require larger injections. This is why pellets provided low free T levels. High SHBG equals low free T, large shots will decrease SHBG and increase free T. Pellets are terrible, there are better choices. How long have you been on your current protocol? 200mg is too much unless you're a hyper T metabolizer, keep an eye on your E2.

I'm concerned about no E2 testing, a lot of doctors fail to do this. If you think you can inject 200mg without high E2 sides, you're in for a rude awakening! We see it all the time.

https://naturalbiohealth.com/2015/05/06/shbg-critical-to-your-health/

E2 results from most recent test on TRT
Estradiol, Sensitive
20.9
pg/mL
- - -
 
Thread starter #6
I am 3 months in like you. I had the exact same symptoms and thought they were related to high HCT which they weren't. The reason was high E2. When I increased my dose from 100 to 160 a week, my E2 went from 32 to 105. Since starting .25mg adex 2x/wk, the sides got MUCH better but not perfect yet.
In my opinion, since you already took an AI, take .25mg twice a week and have E2 tested in about 5 weeks.
You had the heart palpitations? That's really what bothered me the most, with shortness of breath/winded very easily
 
#11
You had the heart palpitations? That's really what bothered me the most, with shortness of breath/winded very easily
Hi kc, This is real easy to test. Stop the AI and see if you get better.
You can quit cold turkey.

What about HCT ?
Also double check your T dosing make sure you are not overdosing and
have you considered you might be having a reaction to the Tes fluid (usually cottonseed oil).

hth
 
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#12
its arimidex brother... I never felt any bad side effects from trt before I started messing with arimidex.. the only sides from testosterone without arimidex were bloated face, acne and maybe more sweating but with arimidex i've got all kinds of stuff.. heart palpitations, dizziness, anxiety and feeling not healthy overall.. try ditch the arimidex and you gonna be feeling great but it will take a while
also arimidex made my blood sugar all messed up and I feel like its crashing it I don't eat every 4 hours
 
#13
I had the same exact experience with arimidex. It was horrible and I thought I was dying because my heart was beating fast and I had horrible anxiety. I also felt dizzy and i could not sleep to save my life. Do you think those side effects are due to the arimidex knocking down you're e2 too low or is it just a side effect of the drug itself?
 
#14
i see some people have these issues even with normal e2 level but are on arimidex.. labwork shows us serum level but we have no idea whats going on at receptor level. I remember there was a time I thought if you are using testosterone you should be on estrogen control (it was like a common thing back then since there wasn't a lot of knowledge about whole trt) so I never felt "right" when on estrogen control even though numbers were looking alright.. then I decided to do no AI and man so many things got better.. even my nipple tingling sensation went away after I stopped anastrozole! so many issues resolved and I felt way better but it took few months full of anxiety and some panic attacks to get there after I stopped AI.. and my e2 stabilized on itself was a bit highish (a bit over normal range) but I felt great.. it was long time ago.. then 1 year after that I started anastrozole again (I couldn't get rid of water bloat and decided to go on AI again that was bad mistake) and somehow few weeks in my whole endocrine system crashed and I stopped responding to testosterone the way I did when I was healthy.. I have no idea what happened I obiously crashed estrogen but the situation never improved
 
Thread starter #15
i see some people have these issues even with normal e2 level but are on arimidex.. labwork shows us serum level but we have no idea whats going on at receptor level. I remember there was a time I thought if you are using testosterone you should be on estrogen control (it was like a common thing back then since there wasn't a lot of knowledge about whole trt) so I never felt "right" when on estrogen control even though numbers were looking alright.. then I decided to do no AI and man so many things got better.. even my nipple tingling sensation went away after I stopped anastrozole! so many issues resolved and I felt way better but it took few months full of anxiety and some panic attacks to get there after I stopped AI.. and my e2 stabilized on itself was a bit highish (a bit over normal range) but I felt great.. it was long time ago.. then 1 year after that I started anastrozole again (I couldn't get rid of water bloat and decided to go on AI again that was bad mistake) and somehow few weeks in my whole endocrine system crashed and I stopped responding to testosterone the way I did when I was healthy.. I have no idea what happened I obiously crashed estrogen but the situation never improved
Sorry to hear this bud, so did you discontinue TRT? What's your status now? I really feel like the arimidex made things worse when I took it, or else things just took a turn for the worse at the same time
 
#16
This is odd. I had the same sides as the OP BEFORE going on adex. It wasn't until that I found out my e2 was 105 (15-30) that I started taking adex and it's been relieving my symptoms
If you truly tested 20.9 (8-35), you definitely don't need an AI. 20 is not high at all.
 
#17
I am on trt now but the side effects that I got from arimidex didn't go away sadly. But I overdosed on it so your situation should be totally different.. just keep it simple and take lower dose of testosterone istead of testosterone with AI and issue should resolve. I always felt bad with arimidex no matter the dose.. even 0.25mg which would put me in normal range (I was a bit over normal range usually but didn't have any bad symptoms actually felt great) but I would feel bad with it.. I have no idea why maybe my body needs more estrogen to function optimally but that was something I definitely noticed from my experience with trt. Especially the the heart palpitations from arimidex that was scary since I never had them before. It took very long time for them to dissapear after quitting arimidex. And couldn't drink much coffee because it would make it worse.
 
#18
for those of you that havent seen me in a while i got a new job, haven't lifted in 8-9 weeks. I got off the 500mg a week blast ive been doing for a long while. Ive been off high doses of testosterone for 8-9 weeks. Ive been doing TRT using PARAPHARM test E at 0.3ml-0.8ml INJECTING ONCE every 7-14 days the past 9 weeks to keep my balls somewhat functioning naturally. I have arimadex on hand, parapharm as well ive been using 1mg a week @.5mg every 3.5 days(which i havent used since i stopped the high dosages). these past 9 weeks my doses have been around a half ml every 2-3 weeks, with NO ARIMADEX (due to low dose test).

9 weeks ago sitting on my couch i ran a random 135 heart rate out of nowhere, made me dizzy, heart was skipping beats at a high rate, not functioning correctly. Got sent to the er via ambulance ekg came back normal. Stayed 135bpm for 3.5 hours in the er with nitro patch on. Got blood work done no enzymes found, good thyroid, t3 free and total were in normal range.

Fast forward 2 days ago happened again at work. Heart rate ran high around 130bpm started messing up again.
I went to urgent care so my pcm could see for himself.
They did 4 pages of bloodwork, total and free t3 and t4 once agsin were normal..testosterone was 198ng/dl.
Estradiol was 5!!!!!!!! lack of estradial caused heart palpitations and abnormal heart beat.

With .5ml testosterone every 2-3 weeks you would think with no arimadex tsken there would be some estrogen in the body. Despite not taking adex for 8-9 weeks my estradiol came back at 5. This makes no sense to me. Can someone elsborate on this?
look here one guy had same thing going on
 
Thread starter #19
look here one guy had same thing going on

Thank you for sharing this!!! I can almost guarantee mine was a similar case, after I took that one minor dose of arimidex i felt tired as hell and had all the heart issues, I believe some people react dramatically to arimidex. I never got tested after taking arimidex but can bet my E2 flat lined...
 
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#20
I had the same exact experience with arimidex. It was horrible and I thought I was dying because my heart was beating fast and I had horrible anxiety. I also felt dizzy and i could not sleep to save my life. Do you think those side effects are due to the arimidex knocking down you're e2 too low or is it just a side effect of the drug itself?
Same here, I believe in my case it was taking e2 to low for me. I really feel best with e2 around 40.
 
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