New Protocol, Elevated RHR/Poor Sleep/Eye Floaters. Abort or Stay the Course?

[DS3]

Are you still having memory issues now that you dropped your deca down to 50mg/ week?

Very moderate memory, yes. It is harder to recall people's names and remember certain events. I have continued to supplement with alpha-lipoic acid and acetyl-l-carnitine to help mitigate the side effect. They seem to have a modest effect.

Definitely sucks because my skin, joints, hair, and anxiety are all better while taking Deca. So there is obviously a trade-off.

 

[DS3]

• Basic Info
  • I'm 6 days into a major protocol change overseen by Defy Medical and feeling really strange and unsettling side effects.
  • There are some confounding factors that are making it hard for me to know what to do. Defy is closed for a few days for the holiday so I can't get a consult and would appreciate any help.
  • My SHBG tends to run on the low side; at my prior steady state SHBG was 25.7; on the low blood levels on test prop (see more below) my SHBG was 19.2 nmoL/L.
• Protocol Change Info
  • Failed on a test propionate trial that started October 22nd due to trough levels being too low and rapid decrease in libido, mood, etc. On Nov 27 I went back to test cyp (pharma, not compounded, different carrier oil than currently) for a few weeks at 24mg EOD. This was lower than my 40mg EOD protocol I was on prior to the test propionate trial. As of December 18 Defy has me on 30mg test enanthate EOD and 30mg nandrolone EOD. I'm only injecting 24mg of the nandrolone currently. My first injections were on 12/18 of this new protocol.
  • I am not taking any AIs or other hormone-affecting supps (no pregnenolone, DHEA, progesterone, etc).
• Symptoms
  • Elevated heart rate/"awareness" of my heartbeat
    • This is confirmed by my Oura sleep ring; my average RHR at night has gone up by over 10bpm over the last week on this new protocol
    • I'm aware of my heartbeat during the day in a different way than I have been before except when I used progesterone cream (see below).
  • Disrupted sleep
    • I've previously experimented with using a bit of progesterone cream at night to help with sleep and water retention. If I used too much of it I experienced similar sleep disruption to what I'm dealing with now (no deep sleep, lots of light/REM sleep, not feeling rested) as well as the elevated heart rate.
    • I had a few days of morning wood after my first few shots but it's been weaker the last few days, with morning wood decreasing as RHR elevates
  • Rapid increase in eye floaters
    • These are noticeably increased lately. Weirding me out. I've seen people refer to these happening when they took Clomid but I'm obviously not on that.
• Confounding Factors
  • I have a moderate cold right now, so I have a tight chest, congestion, etc. I know that being sick can increase RHR and disrupt sleep.

I'm feeling freaked out by the elevated heart rate. I'm a reasonably fit guy and not used to feeling my heartbeat except when I'm exercising. It's now been 24/7 for several days and nighttime RHR is increasing by around 1bpm every day. Since some of the symptoms are things I experienced when I previously tried progesterone cream, I'm wondering if the nandrolone might be binding to my progesterone receptors too much. The eye floaters are freaking me out too.

Do any of the following seem like reasonable explanations?

1. Elevated E2
2. Elevated Progesterone/Excess Binding at Progesterone Receptor
3. Decreased E2
4. Excess Free Androgens

Which course of action would you guys recommend of the following?

1. Stay the Course: change nothing, let my body adjust especially since I've been sick
   1. Get bloodwork or not?
2. Drop the Nandrolone: only inject the testosterone and see if symptoms abate; then get a Defy consult
   1. Get bloodwork or not?
3. Try an AI
   1. The eye floaters and increased RHR make me wonder if my E2 is elevated. I have some 0.1mg arimidex caps I could try taking.
4. ???
   1. Something else I'm not thinking of?

I'm going to tag some members who have been super helpful in the past to see if they may be able to weigh in here or on the off chance they're active: @Cataceous @Dr Justin Saya MD @Gman86 @madhacker @madman
@Nelson Vergel

I feel your pain. Having bothersome side effects are unsettling to say the least. Something that I always keep top of mind is that these are powerful hormones that affect every system in your body, especially your central nervous system. Experiencing side effects within the first few weeks of a protocol change should be expected, especially if you are sensitive which it seems you are. (I am as well).

In regard to your specific symptoms, the elevated heart rate could be due to edema, it could be due to changes in neurochemicals (perhaps cortisol or catecholamine production is temporarily increased) you may be experiencing as a result of the changed protocol, or some other unexplained reason. Sleep disturbance is a cited potential side effect of nandrolone (NANDROLONE DECANOATE INJECTION | Compounding Pharmacy - Empower Pharmacy).

You have changed protocols 3 times in what appears to be the past 3 months. And while I can empathize with you as I have been guilty of the same thing in the past, this frequent of changes can definitely create side effects.

From my perspective and experience using various protocols:
1. You need to give a single protocol 6 weeks to work before passing conclusive judgment on its efficacy. Both your central nervous system and the rest of your body will adjust during that time period. 6 days is only enough time to feel temporary side effects that can result from your body being 'out of wack' or out of a TRT homeostasis.
2. Nandrolone can cause increases in anxiety, antisocial behavior, sleep disturbances, memory issues, edema, among other things. It is not a bad drug. It does, however, have potential side effects. I would highly advise giving it 6 weeks before determining whether its right for you.
3. I have low SHBG as well, always around 20 nmol/L. EOD injections of both enanthate and cypionate always caused significantly increased anxiety in me. EOD propionate injections has been the only thing that works consistently for me. ED propionate injections also made me feel suboptimal.
4. Floaters are definitely something to monitor. However, I can't find evidence that nandrolone or test can cause floaters.

 

[Gman86]

I feel your pain. Having bothersome side effects are unsettling to say the least. Something that I always keep top of mind is that these are powerful hormones that affect every system in your body, especially your central nervous system. Experiencing side effects within the first few weeks of a protocol change should be expected, especially if you are sensitive which it seems you are. (I am as well).

In regard to your specific symptoms, the elevated heart rate could be due to edema, it could be due to changes in neurochemicals (perhaps cortisol or catecholamine production is temporarily increased) you may be experiencing as a result of the changed protocol, or some other unexplained reason. Sleep disturbance is a cited potential side effect of nandrolone (NANDROLONE DECANOATE INJECTION | Compounding Pharmacy - Empower Pharmacy).

You have changed protocols 3 times in what appears to be the past 3 months. And while I can empathize with you as I have been guilty of the same thing in the past, this frequent of changes can definitely create side effects.

From my perspective and experience using various protocols:
1. You need to give a single protocol 6 weeks to work before passing conclusive judgment on its efficacy. Both your central nervous system and the rest of your body will adjust during that time period. 6 days is only enough time to feel temporary side effects that can result from your body being 'out of wack' or out of a TRT homeostasis.
2. Nandrolone can cause increases in anxiety, antisocial behavior, sleep disturbances, memory issues, edema, among other things. It is not a bad drug. It does, however, have potential side effects. I would highly advise giving it 6 weeks before determining whether its right for you.
3. I have low SHBG as well, always around 20 nmol/L. EOD injections of both enanthate and cypionate always caused significantly increased anxiety in me. EOD propionate injections has been the only thing that works consistently for me. ED propionate injections also made me feel suboptimal.
4. Floaters are definitely something to monitor. However, I can't find evidence that nandrolone or test can cause floaters.

So if EOD propionate injections work better for u than ED, can you conclude that your body seems to prefer fluctuations of testosterone levels opposed to very consistent levels?

When using cypionate or enanthate, did you ever try injecting them infrequently, like E5D, or E7D for example?

 

[DS3]

So if EOD propionate injections work better for u than ED, can you conclude that your body seems to prefer fluctuations of testosterone levels opposed to very consistent levels?

When using cypionate or enanthate, did you ever try injecting them infrequently, like E5D, or E7D for example?

I can confidently say that my body seems to prefer modest fluctuations in T levels as opposed to super consistent levels. EOD keeps my estrogen at a good level. And when I refer to estrogen I am not just talking about the quantitative measurements; I am also referring to the overall health and look of my skin and hair, as well as cognitive function. With EOD Test Prop shots I have no need to an AI.

With both Cyp and Enanthate, I have heavy conversion into estrogen that I cannot control with an AI because all AIs kill my joints, libido, and mood. EOD shots of longer esters seemed to help with estrogen conversion, but also made me severely anxious (which I do not get with Propionate). 1x per week shots or E5D also doesn't work because I feel too much fluctuation in energy, mood and libido throughout the week (i.e. first 3 days I feel supercharged, then drop off heavily over days 4-5 or 4-7).

 

[Gman86]

I can confidently say that my body seems to prefer modest fluctuations in T levels as opposed to super consistent levels. EOD keeps my estrogen at a good level. And when I refer to estrogen I am not just talking about the quantitative measurements; I am also referring to the overall health and look of my skin and hair, as well as cognitive function. With EOD Test Prop shots I have no need to an AI.

With both Cyp and Enanthate, I have heavy conversion into estrogen that I cannot control with an AI because all AIs kill my joints, libido, and mood. EOD shots of longer esters seemed to help with estrogen conversion, but also made me severely anxious (which I do not get with Propionate). 1x per week shots or E5D also doesn't work because I feel too much fluctuation in energy, mood and libido throughout the week (i.e. first 3 days I feel supercharged, then drop off heavily over days 4-5 or 4-7).

Awesome, thanks for reporting your experience. Everyone’s different obviously, but I just like hearing experiences like this so that we don’t get stuck in black or white thinking. “ED injections are the most optimal injection frequency in regards to feeling optimal for everyone” (not true). “Nobody needs an ai on TRT” (not true). I just hate seeing guys get so polarized with their thinking. Thanks again.

 

[xqfq]

I’m curious, you say you’re not willing to use an AI long term. I’m not either (at this point). Are you worried about cardiovascular effects? That is my only concern.

Did you every try an AI (shorter term) and did it alleviate some of your symptoms?

 

[Gman86]

@DS3 whats your SHBG?

 

[DS3]

@DS3 whats your SHBG?

It sits at 20 nmol/L

 

[DS3]

Awesome, thanks for reporting your experience. Everyone’s different obviously, but I just like hearing experiences like this so that we don’t get stuck in black or white thinking. “ED injections are the most optimal injection frequency in regards to feeling optimal for everyone” (not true). “Nobody needs an ai on TRT” (not true). I just hate seeing guys get so polarized with their thinking. Thanks again.

I agree 100%. I think that as time goes on, more of us will adopt a 'thumbprint medicine' approach to this as Dr. Thomas O'Conner (Anabolic Doc on Youtube) has wherein everyone is different and there is no cookie-cutter approach.

 

[eyeheartny]

While having such symptomatic changes at the time of a protocol change points to the protocol change as the cause, don't wear blinders. There may be something causative that is co-incidental.

Your combination of symptoms is not anything I have personally had, but I did have increase in resting pulse, plus orthostatic circulatory symptoms (dizziness, elevated bounding HR on standing), and general decreasing energy ability to exercise etc. This was coincidental with being prescribed Alfuzosin. Dr and I thought it was side effects. I also went to the cardiologist had an EKG and ran a treadmill test... negative for arrythmia or ischemia. By the time I had my next CBC, I was profoundly anemic:

RBC 1.9 (4.4-6.38)
HGB 7.0 (13.5-17.5)
HCT 20.1 (30-51)

It had nothing to do with Alfuzosin side effects.

Thanks for this perspective. My cold has gotten worse so I am thinking that some of what I've been experiencing is due to that, as my sleep has been atrocious due to breathing issues from a cough, nasal congestion, etc.

The bounding HR on exertion/standing symptom you had is similar to what I'm experiencing, but again in my case it could easily be due to this nasty cold I've got.

Did you ever find out the cause of your anemia?

 

[eyeheartny]

I feel your pain. Having bothersome side effects are unsettling to say the least. Something that I always keep top of mind is that these are powerful hormones that affect every system in your body, especially your central nervous system. Experiencing side effects within the first few weeks of a protocol change should be expected, especially if you are sensitive which it seems you are. (I am as well).

In regard to your specific symptoms, the elevated heart rate could be due to edema, it could be due to changes in neurochemicals (perhaps cortisol or catecholamine production is temporarily increased) you may be experiencing as a result of the changed protocol, or some other unexplained reason. Sleep disturbance is a cited potential side effect of nandrolone (NANDROLONE DECANOATE INJECTION | Compounding Pharmacy - Empower Pharmacy).

You have changed protocols 3 times in what appears to be the past 3 months. And while I can empathize with you as I have been guilty of the same thing in the past, this frequent of changes can definitely create side effects.

From my perspective and experience using various protocols:
1. You need to give a single protocol 6 weeks to work before passing conclusive judgment on its efficacy. Both your central nervous system and the rest of your body will adjust during that time period. 6 days is only enough time to feel temporary side effects that can result from your body being 'out of wack' or out of a TRT homeostasis.
2. Nandrolone can cause increases in anxiety, antisocial behavior, sleep disturbances, memory issues, edema, among other things. It is not a bad drug. It does, however, have potential side effects. I would highly advise giving it 6 weeks before determining whether its right for you.
3. I have low SHBG as well, always around 20 nmol/L. EOD injections of both enanthate and cypionate always caused significantly increased anxiety in me. EOD propionate injections has been the only thing that works consistently for me. ED propionate injections also made me feel suboptimal.
4. Floaters are definitely something to monitor. However, I can't find evidence that nandrolone or test can cause floaters.

Many, many thanks for this and your prior reply. I know that I've been changing protocols too much and I am going to stick it out for longer on this enanthate/nandrolone protocol to see what happens as I settle in. Message received, and thank you (and others like @xqfq and @Vince Carter as well) for the push to be patient and prudent and slow down with all the changes.

It's funny because I'm normally willing to give things a try and be patient, but the failed propionate trial has had me on a roller coaster that I am very eager to get off of. I felt like straight up garbage on the ED propionate shots. I know that everything you're saying about being patient and giving this protocol at least six weeks is the right choice, and it is also really hard to do so when I feel so suboptimal. As of today my libido is lower than on my old test cyp only protocol, my testicles are riding way up higher than they normally do, and the lack of vascularity is a signal that my body is off in some other way with regard to fluid balance, NO production, or something else related to those systems. This all definitely points to things being in flux, plus there's this nasty cold I have to get over. I will ride this out for while and hopefully these things will settle out. If it doesn't, I may seek your advice about what variables to switch next if that's okay with you.

In terms of the floaters, my wife is getting over the same nasty cold I'm currently sick with and she said she noticed more eye floaters while she was really sick, so I'm going to wait and see what happens with those. If they get worse/don't improve, I will get an eye exam and also report the symptom to Defy so they can note it in my chart.

What are your peak/trough levels of TT/FT/E2 like on EOD propionate shots? Do you feel you experience any issues with having big swings based on a larger EOD shot + low SHBG?

 

[DS3]

Many, many thanks for this and your prior reply. I know that I've been changing protocols too much and I am going to stick it out for longer on this enanthate/nandrolone protocol to see what happens as I settle in. Message received, and thank you (and others like @xqfq and @Vince Carter as well) for the push to be patient and prudent and slow down with all the changes.

It's funny because I'm normally willing to give things a try and be patient, but the failed propionate trial has had me on a roller coaster that I am very eager to get off of. I felt like straight up garbage on the ED propionate shots. I know that everything you're saying about being patient and giving this protocol at least six weeks is the right choice, and it is also really hard to do so when I feel so suboptimal. As of today my libido is lower than on my old test cyp only protocol, my testicles are riding way up higher than they normally do, and the lack of vascularity is a signal that my body is off in some other way with regard to fluid balance, NO production, or something else related to those systems. This all definitely points to things being in flux, plus there's this nasty cold I have to get over. I will ride this out for while and hopefully these things will settle out. If it doesn't, I may seek your advice about what variables to switch next if that's okay with you.

In terms of the floaters, my wife is getting over the same nasty cold I'm currently sick with and she said she noticed more eye floaters while she was really sick, so I'm going to wait and see what happens with those. If they get worse/don't improve, I will get an eye exam and also report the symptom to Defy so they can note it in my chart.

What are your peak/trough levels of TT/FT/E2 like on EOD propionate shots? Do you feel you experience any issues with having big swings based on a larger EOD shot + low SHBG?

Reach out any time with any questions you want to bounce off of me. I will always be open to talk.

When I have changed protocols in the past from a short to a long ester, the delay in feeling the testosterone begin to work in terms of libido, endurance, and mood has always taken about 4 weeks for me to start feeling it. Cyp and enanthate basically have felt like nothing for the first few weeks (like I was back to low T). It takes time to build in your system.

My peak hovers around 1100-1200 ng/dL and trough around 800 ng/dL, so I always feel good. I don't feel big swings doing larger EOD shots with the propionate ester. I honestly feel terrible with ED shots of prop; mood, energy, and libido were in the garbage. I changed it to EOD at 75 mg and feel the best I have on TRT. My body seems like it needs time to metabolize the ester, peak, and drop slightly before it is ready to take another dosage. So I just listen and respond accordingly.

 

[eyeheartny]

I’m curious, you say you’re not willing to use an AI long term. I’m not either (at this point). Are you worried about cardiovascular effects? That is my only concern.

Did you every try an AI (shorter term) and did it alleviate some of your symptoms?

I am definitely worried about cardiovascular issues, as well as a supposition on my side that my libido and erection quality do better when my E2 runs a little higher. On test cypionate I never really had runaway E2 levels like some guys get, so I actually suspect that my water retention issues may have nothing to do with estradiol at all. Regardless of what I settle on for the androgen portion of my TRT (test alone or nandrolone + test) I will probably talk to Defy about a trial of eplerenone to see how a potassium-sparing diuretic affects me. If it helps I may go back to test only and a diuretic as my libido and erection quality are fantastic on around 140mg/week of test cyp. It's the water retention that is a problem. I notice it in my face, abdomen, etc. Occasionally I've gotten a bit of edema around my ankles or noticed my wrists swelling a bit but that's been coincident with eating more salt, drinking alcohol, etc. If I can have the libido/energy of a higher dose of testosterone and drop the excess water I'd be absolutely thrilled.

I've tried both exemestane and anastrazole. If anything, the exemestane made me more bloated, especially in and around my face. I've tried anastrozole at everything from 0.1mg EOD to higher doses, and while I did notice myself peeing out more water, I tend to get migraines and didn't notice any improvement in other domains.

 

[eyeheartny]

Reach out any time with any questions you want to bounce off of me. I will always be open to talk.

When I have changed protocols in the past from a short to a long ester, the delay in feeling the testosterone begin to work in terms of libido, endurance, and mood has always taken about 4 weeks for me to start feeling it. Cyp and enanthate basically have felt like nothing for the first few weeks (like I was back to low T). It takes time to build in your system.

My peak hovers around 1100-1200 ng/dL and trough around 800 ng/dL, so I always feel good. I don't feel big swings doing larger EOD shots with the propionate ester. I honestly feel terrible with ED shots of prop; mood, energy, and libido were in the garbage. I changed it to EOD at 75 mg and feel the best I have on TRT. My body seems like it needs time to metabolize the ester, peak, and drop slightly before it is ready to take another dosage. So I just listen and respond accordingly.

That's absolutely fascinating about your propionate dosing. I wish I'd talked to you before I dropped the propionate. My abdominal bloating got noticeably worse on ED prop but I wonder what would have happened had I tried EOD dosing. My trough was so low on ED dosing that I just didn't think it was going to work, but I only tried it for about 4 weeks.

I've been back on a long ester (either cyp or now enanthate) for about 4 weeks after terminating the propionate trial, but the dosages and esters have changed, plus I added nandrolone. I took it slow adding back in the cypionate for a few weeks before switching to enanthate. I'll wait and see what happens with my subjective sense of libido and erection quality before looking at any changes, but I do still feel more than a bit low when it comes to both right now.

 

[Gman86]

Reach out any time with any questions you want to bounce off of me. I will always be open to talk.

When I have changed protocols in the past from a short to a long ester, the delay in feeling the testosterone begin to work in terms of libido, endurance, and mood has always taken about 4 weeks for me to start feeling it. Cyp and enanthate basically have felt like nothing for the first few weeks (like I was back to low T). It takes time to build in your system.

My peak hovers around 1100-1200 ng/dL and trough around 800 ng/dL, so I always feel good. I don't feel big swings doing larger EOD shots with the propionate ester. I honestly feel terrible with ED shots of prop; mood, energy, and libido were in the garbage. I changed it to EOD at 75 mg and feel the best I have on TRT. My body seems like it needs time to metabolize the ester, peak, and drop slightly before it is ready to take another dosage. So I just listen and respond accordingly.

It’s crazy that there was such a drastic difference for you going from ED prop to EOD. Was the weekly dose the same when injecting daily with the prop?

 

[Gman86]

That's absolutely fascinating about your propionate dosing. I wish I'd talked to you before I dropped the propionate. My abdominal bloating got noticeably worse on ED prop but I wonder what would have happened had I tried EOD dosing. My trough was so low on ED dosing that I just didn't think it was going to work, but I only tried it for about 4 weeks.

I've been back on a long ester (either cyp or now enanthate) for about 4 weeks after terminating the propionate trial, but the dosages and esters have changed, plus I added nandrolone. I took it slow adding back in the cypionate for a few weeks before switching to enanthate. I'll wait and see what happens with my subjective sense of libido and erection quality before looking at any changes, but I do still feel more than a bit low when it comes to both right now.

I still theorize that the 105mg of test per week might not be enough to keep your levels where you feel good. Nandrolone shouldn’t add anything to your total testosterone level, so you may just have way too little testosterone in your body for its liking. Deca should theoretically free up more free T though. But the 105mg/ week of test still might not be enough. Just a thought.

The other thought I have is that a 1:1 ratio of testosterone to deca is not ideal. I would theorize that a roughly 2:1 of test to deca would yield better results. Dr Lichten has been using Deca with his HRT patients for around 20 years, and I’m sure has trialed and errored it with many patients over the years to see what works and what doesn’t, and seems like he actually prefers a 3:1 ratio of test to deca. He said his patients usually run around 120-140mg of test per week, and around 40-60mg of deca per week. He also uses low dose Winstrol, around 25mg per week, with some of his patients, but not all.

 

[Blackhawk]

Thanks for this perspective. My cold has gotten worse so I am thinking that some of what I've been experiencing is due to that, as my sleep has been atrocious due to breathing issues from a cough, nasal congestion, etc.

The bounding HR on exertion/standing symptom you had is similar to what I'm experiencing, but again in my case it could easily be due to this nasty cold I've got.

Did you ever find out the cause of your anemia?

Leukemia

 

[eyeheartny]

Leukemia

Ah shit. I'm sorry to hear that. I've had cancer myself in the past (a very rare soft-tissue sarcoma). I hope your treatment went well and that you're in a durable remission.

 

[eyeheartny]

I still theorize that the 105mg of test per week might not be enough to keep your levels where you feel good. Nandrolone shouldn’t add anything to your total testosterone level, so you may just have way too little testosterone in your body for its liking. Deca should theoretically free up more free T though. But the 105mg/ week of test still might not be enough. Just a thought.

The other thought I have is that a 1:1 ratio of testosterone to deca is not ideal. I would theorize that a roughly 2:1 of test to deca would yield better results. Dr Lichten has been using Deca with his HRT patients for around 20 years, and I’m sure has trialed and errored it with many patients over the years to see what works and what doesn’t, and seems like he actually prefers a 3:1 ratio of test to deca. He said his patients usually run around 120-140mg of test per week, and around 40-60mg of deca per week. He also uses low dose Winstrol, around 25mg per week, with some of his patients, but not all.

I hear you. I'm going to ride it out for a while on this dose and see what happens, especially after this cold clears. God knows being sick can kill the libido and I got some decent nighttime wood last night, so who knows where things actually are.

If I don't settle in after 6 weeks to a strong libido or if my bloodwork looks off I'll talk to Mike at Defy about adjusting my dosing with an increase in testosterone and will bring up the question of the test: deca ratio.

 

[Blackhawk]

Ah shit. I'm sorry to hear that. I've had cancer myself in the past (a very rare soft-tissue sarcoma). I hope your treatment went well and that you're in a durable remission.

Glad you got through it!

I'm in the thick of it, but thanks.