Anxiety Low E2 can't seem to get my levels up

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RAS

Member
I really need some help, I am having severe anxiety, I have never had anxiety before ever. I have been on TRT for over 9 years without issues, @ 200MGs per week and AI twice a week. My TRT doctor is out of the office till Monday, and I was hoping this issue would go away but its not. After my last appointment in May my Dr told me to lower my testosterone does because my levels came in pretty high on the last test (The cause for the high levels were discovered shortly following my last appointment, and it has to do with a popular sleep drug and doing things without being awake, it also explains the new espresso machine, items that have been moved, and the 10 pounds I put on. I set up motion-activated cameras and saw what was happening and flushed the medication.) So I lowered my dosages as directed to 170mg per week splitting that dosage up into equal injections EOD, and even lowered it a little more, and around May 19th I started to feel tired all day, dry skin, dry mouth, no energy no drive, and tired like I could just fall asleep, then the anxiety kicked in, just slightly at first, then to what I can only describe as a full blown anxiety attack, I couldn’t sleep, eat, think or sit still, this went on for 9 hours straight.. Went to the ER and they said it was just an anxiety attack and gave me some Xanax (Xanax is a different kind of hell.) to help me calm down and get some sleep. So in retracing what changed in my life the only thing that changed was lowering my TRT does, so I went to get a blood test run.

Results from said test are below and attached.
  • SEX HORMONE BINDING GLOBULIN = 8 Range: 10-50
  • Testosterone Free = 448.6 Range 46 - 224

  • Testosterone Total = 1145 Range 250 - 1100
  • Testosterone Bioavailable = 863 Range 110 – 575
  • Estradiol, Ultrasensitive LC/MC = 9 Range: < OR = 29
So looking at the results I saw that my Testosterone was just slightly over the top but it had decreased significantly from the last test of 2436 and that my Estradiol was very low, compared to 51 from the last test. I cut out the anastrozole, and after a few days I started to feel better. When I started to have oily skin I just added 50mg of zinc eod to help manage estrogen levels. This worked but then I started to feel worse, back to extremely dry skin, then slight anxiety, then anxiety, so I ditched the zinc. Wednesday Night June 12th, skin was still drier than usual, I took my scheduled shot of ~55mg of testosterone, almost exactly 24 hours later I started to get anxiety that lasted everyday until Saturday evening June 15th I skipped Fridays dose. Sunday figuring my estradiol must be really low and want to keep my job, and added some left over hcg 2.5iu’s and it helped a little, proceeded to do my testosterone injection Sunday night and Monday morning anxiety so bad that I couldn’t concentrate not causing the racing heartbeat but to sit and do my job was impossible. My last injection had me up the entire night and then anxiety. What can I do to get rid of this anxiety? Would more hcg help raise my E2? My SHBG is slightly low should I lower the dosages and increase injections, will that allow for more conversion testosterone to Estradiol, will that help? Please just let me know how I can get this resolved.
 
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fifty

Well-Known Member
What was your original exact protocol and what is it now?

Sometimes people will decrease their test dose by 25% and keep their AI the same...then their E2 ends up too low.
 

RAS

Member
My Original Protocol was 200mg Test split into 2 doses, 1mg anastrozole 2 times a week, .25 hcg twice a week, 25mg of DHEA/Prenorolone (SP?) daily. I am very E sensitive, so went to 200mg of test per week split into EOD injections, and dropped the hcg
 

RAS

Member
Also what do you mean the cause of your high levels was a sleep drug? Were you sleep injecting???

Yes I was without any memory of doing it, I also did all kinds of other things like cook and eat an entire pizza, order things on line, moved furniture, I am just one of those lucky people who can't take that med. I had two friends die in one month and have a stressful job, so my PCP gave me ambient (SP?) to help me sleep while dealing with the stressors.
 

Systemlord

Member
SEX HORMONE BINDING GLOBULIN = 8 Range: 10-50


You should be injecting T daily with SHBG this low, this would lower estrogen even without the AI, you may not even need the AI at all.

I never needed an AI on daily dosing, but did on EOD dosing. I have low SHBG as well.

Surprised you doctor has you on twice weekly dosing a massive dose at that.
 

RAS

Member
You should be injecting T daily with SHBG this low, this would lower estrogen even without the AI, you may not even need the AI at all.

I never needed an AI on daily dosing, but did on EOD dosing. I have low SHBG as well.

Surprised you doctor has you on twice weekly dosing a massive dose at that.
When I switched to E3D Dosages I didn't drop the AI so that is the cause I my current issue that got my E2 level to 9. So are you saying that EOD injections actually lowers my E2 levels? I thought EOD and ED injection actually caused the reverse ?
 

Systemlord

Member
When I switched to E3D Dosages I didn't drop the AI so that is the cause I my current issue that got my E2 level to 9. So are you saying that EOD injections actually lowers my E2 levels? I thought EOD and ED injection actually caused the reverse ?

There is less testosterone to convert when injecting smaller doses, also infrequent dosing you need more testosterone to compensate for the drop in levels that occurring between injections.

So you need more testosterone when injecting less frequently and less when injecting more frequently and this lowers E2.

You want to use 27-29 gauge insulin syringe in the shoulder and quads.
 
Last edited:

fifty

Well-Known Member
You were on 2mg anastrozole per week now you’re on 0 and you’re worried about getting your e2 up? Non sensical imo. Simply from 2mg to 0 will bring your e2 up. No need for MORE changes than that.
 

TLR

Active Member
I took an Ambien ONCE..... Slept like a champ and was sitting at lunch and realized I had no re collection of anything I had done that morning and it was like I just woke up and was there. Promptly threw that shit in the trash. You've got a lot of shit going on at once. You've likely driven the SHBG down with the high test level you are at, and 2 mg of anastrozole is a lot. Throw the AI out, stay on your dose until your levels come back up. If you start to become symptomatic either CONSERVATIVELY reintroduce the AI or lower your dose until you don't need it. Also, don't forget you were stressed and having trouble sleeping so some of what you experienced may not ALL be hormone related.
 
Held separately, T that high + E2 that low can easily cause anxiety. What is your resting heart rate at those levels?

Would have to believe that a normalization with both of those levels will take your anxiety back to baseline (which sounds like non-existent in your case based on your comments).
 

RAS

Member
Held separately, T that high + E2 that low can easily cause anxiety. What is your resting heart rate at those levels?

Would have to believe that a normalization with both of those levels will take your anxiety back to baseline (which sounds like non-existent in your case based on your comments).
Resting heart rate when anxiety is only slightly elevated is 88bpm, When its in full swing 96. Thats what I am thinking, I stopped taking everything hoping that the levels come back within range. With a gap that big between T and E2 I am guessing that each time I even gave myself a low does of test I would just increase the gap and cause the anxiety. I just don't get why in almost 24 hours after my shot I would see an increase in anxiety
 
Resting heart rate when anxiety is only slightly elevated is 88bpm, When its in full swing 96. Thats what I am thinking, I stopped taking everything hoping that the levels come back within range. With a gap that big between T and E2 I am guessing that each time I even gave myself a low does of test I would just increase the gap and cause the anxiety. I just don't get why in almost 24 hours after my shot I would see an increase in anxiety

Personal experience is that too high T = high anxiety (along with high HR, sweaty and feeling intolerant to heat, etc.) as well as too low E2 = high anxiety (along with hot flashes, irritability, and ED so bad Viagra would do nothing for it).

Re: high T - it was less about the values and more about the dosage in my case. I was taking 210mg per week (30mg/day) because I am very low SHBG. Total T came in around 700ish but with Free T at the high end around 25. High anxiety, ED + libido problems at this dose. I was focused on E2 balance, but the issue ended up being too much T. I’ve reduced to 26mg/day and WOW the difference, at least subjectively. 90 day labs coming soon and I’ll see where the numbers are.
 

rugbyhit

Member
you're getting a lot of good advice...like drop the AI and keep up with the injections.....but for moral support...I've been there. I tanked my E by over dosing AI and it was hell. It took me 15 weeks to sort everything out. There was incremental improvements week to week, but there wer also days where the anxiety really hit me. What I did learn was to listen to my body and adjust AI based on that. Hang in there, it will get better, but it takes time.
 

RAS

Member
you're getting a lot of good advice...like drop the AI and keep up with the injections.....but for moral support...I've been there. I tanked my E by over dosing AI and it was hell. It took me 15 weeks to sort everything out. There was incremental improvements week to week, but there wer also days where the anxiety really hit me. What I did learn was to listen to my body and adjust AI based on that. Hang in there, it will get better, but it takes time.

I have had to stop the injections, when I did do the injections it makes the anxiety worse. My last injection was 7 days ago and the anxiety just started to go away. I am assuming that my test levels are coming down and my E2 levels are coming up closing the gap and hence why the anxiety has for the most part subsided 9Still having sleep issues like not being able to). I am getting blood work done today to see where I am at but it takes 5 days for results. Now I am faced with when do I reintroduce my injections?
 

Gman86

Member
you're getting a lot of good advice...like drop the AI and keep up with the injections.....but for moral support...I've been there. I tanked my E by over dosing AI and it was hell. It took me 15 weeks to sort everything out. There was incremental improvements week to week, but there wer also days where the anxiety really hit me. What I did learn was to listen to my body and adjust AI based on that. Hang in there, it will get better, but it takes time.

What dose of ai do you usually have to take most weeks?
 

rugbyhit

Member
What dose of ai do you usually have to take most weeks?
i run 2 protocols, 150mg T per week and might run .5mg per week of anastrozole. I also run a 12 week blast once a year of 500mg and run 2mg per week. I've also reduced/dropped my T to 150mg/wk and not taken any AI for a couple of months. Dialing in AI and finding your optimal E level is very personal. I tend to convert T to E at a high rate, and running at the high end of E feels ok for me. Low E for me on the other hand is hell. But i know guys who are opposite, feel better with a lower E and feel like hell with high end of E.
 

Gman86

Member
i run 2 protocols, 150mg T per week and might run .5mg per week of anastrozole. I also run a 12 week blast once a year of 500mg and run 2mg per week. I've also reduced/dropped my T to 150mg/wk and not taken any AI for a couple of months. Dialing in AI and finding your optimal E level is very personal. I tend to convert T to E at a high rate, and running at the high end of E feels ok for me. Low E for me on the other hand is hell. But i know guys who are opposite, feel better with a lower E and feel like hell with high end of E.

Thanks. How do you feel on 150/ week with an ai, compared to 150/week when u don’t use one?
 
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