TRT /4 months, Saw Palmetto, PFS - Need Advice

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lookingforhelp

New Member
A little bit of background. Originally I was unsure of whether alot of my symptoms were a result of a head injury or the use of Saw Palmetto. After being on TRT for some time along with HCG and by bloodwork supposedly being dialled in I am contemplating coming off as I believe I have some sort of PFS.


Things TRT improved:

My ability to sleep better has improved. I can now fall asleep easily or easier should I say than before TRT. I was stuck in this constant wired mode before. Unfortunately now I just feel tired all the time. I just want to sit and sleep or watch TV. Initially I had a boost in energy and now that has worn away. I wake up tired still and dont have much motivation to work out or anything. So i have gone from this wired tired state to just plain tired now.

In the first week or so I felt strong and masculine and my ability to get aroused was significantly improved. Erections seemed fuller and sensitivity was improved.

TRT has restored my orgasms to a more intense state. Before they were not very powerful or enjoyable.

I am growing alot of body hair and it is going very dark.

My penis feels more healthy, it felt shrivelled and uncomfortable before.

I felt more confident the first week of TRT, thats now disappeared.

My hips do not crack and hurt all the time anymore, joints feel stronger.

Bad Things:

As mentioned above, I feel tired all the time.

I also feel depressed in ways. I have a lack of enjoyment in life. I believe the term is anhedonia? I find it hard to motivate myself. I used to love playing music but now rarely pick up a guitar or instrument anymore and when I do I just feel foggy headed and unable to focus.

I have been suffering RESTLESS LEGS. Its extremely uncomfortable and comes and goes throughout the day. It is usually with me in the mornings and evenings and makes an appearance at lunch too. I have read alot of guys saying TRT cured their restless legs. TRT did this for the first week for me.

I still do not have much of a libido. It comes and goes in tiny flutters but does not last long.


My erections are not that great again compared to what they were when I first started TRT. During the whole process I have not enjoyed any spontaneous erections.

Morning wood and night wood is there but weak. The first week on TRT it was good morning wood which stayed with me when I went to pee.

Hair loss. I am experiencing faster recession than before which I am not thrilled with to be honest. I figured hair was worth sacrificing to be well but i dont see the point in continuing TRT, losing my hair and still feeling like shit.

I am growing thick body hair on back and ass cheeks so 5 alpha reductase must be working to an extent.


I feel anxious occasionally in social situations and feel like my body is crashing. I cannot drink alcohol as for some reason it now gives me horrible insomnia. Never used to do this before I got ill.

I think my main issue is DOPAMINE. The only time I recovered spontaneous erections and libido was early on in my illness when I tried cabergoline to lower my prolactin. My prolactin was hovering above the 20 nmol/l mark for a lot of the time. Since TRT that has lowered. When I initially took cabergoline it was great but this usually only lasts a couple of weeks then symptoms are back. I have had every single test imaginable hormonally. I originally went down the Thyroid adrenal root. All of that is optimal. My hormones all now appear to be optimal. I am currently on 100mg of Testosterone Enanthate a week (sunday) and 250ius HCG x2 a week (tues, fri).

I am unsure what route to take to be honest. I want to be well again and enjoy life but this whole deal with my health is making life pretty miserable.

I have been having issues with suicidal ideation. I think this stems down to the fact I am so unwell in myself. I do not want to be labelled as some sort of mental patient as Drs would label me. Yes, granted, I am sure I have a chemical imbalance in my brain but its starting to look like it may be Post Finasteride syndrome or something. Not just simply cured by an SSRI like Drs seem to want to give me. It took a lot of persuading to get a Dr to help me and the fact I am still not better makes me feel extremely sad. If i try and speak to a DR it will be a case of I told you so and more people telling me there is nothing wrong with me.

I am at a loss of which way to turn and who to go to. I cannot go to Drs as they do not seem to care. I cannot tell my family of these things because they will be too upset. All I have is this forum.

I do not want to die, I want to be well but this illness makes me feel trapped and like the last bit of control I have is my own fate. Jeeze this is heavy. Ive always cringed at reading stuff like this post because I am normally one to push through and keep optimistic! I dont know, today is not a good day.

Here are my bloods which as you can see are pretty optimal right now.

Some blood that I had done privately:

DHT: 1.590 nmol/l (0.34-2.06)
E2 finger prick: 69 pmol/l (<192)
E2 Venous sample: 99 pmol/l ( <192)
E2 NHS : 138 pmol/l (<130)

The E2 blood tests were all done at the same time by an NHS nurse. The two other E2 tests were sent to a private lab. I wanted to really get to the bottom of all this E2 hype regarding TRT. I thought maybe it was the missing link to my symptoms? But as you can see, the difference in the tests is a joke. Finger prick tests are in my opinion completely and utterly useless!


I dont know if I have some sort of Dopamine receptor issue. The depression and the focus, foggy thinking the restless legs, the lack of ambition. Its like TRT worked breifly, just like cabergoline does, then it fades back to nothing.

Anyone with some input would be great.


I should add I am lean and optimal weight, do not drink, smoke or drink caffeine. I do not eat gluten and try to avoid all inflammatory foods. I do not eat anything processed, only fresh fruit vegetables and meat. A lot of fish and seafood especially salmon.
 

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Defy Medical TRT clinic doctor

CoastWatcher

Moderator
First of all, you are correct - you do not want to die. The fact that you took the time to write a detailed post here is evidence that you want to feel better, and you hope that someone can give direction. It is imperative that you seek professional assistance and begin to discuss your feelings with that man or woman. You don't want SSRIs, or to be labled "some sort of mental patient;" I get that. But turning to someone to help you doesn't mean you will spend the rest of your life on anti-depressant medications, and it certainly doesn't indicate that you are a "mental patient." Please, find a capable therapist.

In regard to your TRT, there is a private clinic in Dorset, that I'd urge you to contact. The question of how to respond to patients with post-finasteride syndrome, should that be what you're dealing with, is a complex one. It requires a doctor who is willing to take some time to listen and think broadly. I understand that TRT in the UK is a frustrating experience, but this doctor seems to grasp the complexities that it presents.

Please - don't simply give up.
 

lookingforhelp

New Member
I won't! I have been battling this for some time now and have had these moments. I think i put alot of hopes into TRT and whilst it has helped with many things it still has me suffering in some respects.

I just do not understand the energy thing with myself. Before my system crashed I had had years of stress from one thing to another. Too much drinking and recreational drugs! I feel its a definately something going on within the brain chemistry. Thank you so much for your advice on that clinic. I did not realise there were any PFS type Drs in the Uk so that is reassuring.

My whole family know about what is going on with me and so does my Fiancé. I just do not have it in me to tell her about the dark stuff as she does not deserve to carry that weight!

Thanks for your support!
 

lookingforhelp

New Member
I used to watch a lot of porn and was addicted to anything sexual but have not touched porn in a long time due to the effects that porn addiction is known to cause. My grandfather had restless legs and Periodic Limb Movement Disorder which is all dopamine related. I have RLS at the moment but not the later.

I am sure I am genetically susceptible to dopamine issues which is why I am suffering and my system could not tolerate all the abuse. I dont know what to think it is! Whether its PFS, dopamine issues, head injury? All I know is I have tried most things so far.

I just miss that extreme urge to have sex or masterbate or watch porn. Those were the days! You really take for granted the simple things in life!
 

lookingforhelp

New Member
Oh and can anyone point me to a protcol for coming off TRT and tell me if Clomid necessary? It is my understanding that in some people it can cause depression etc so I am not sure if this would be that great for me! Are there alternatives? I have been taking HCG throughout the Enanthate and have been on TRT since roughly around the 2nd week in January this year.
 

CoastWatcher

Moderator
Oh and can anyone point me to a protcol for coming off TRT and tell me if Clomid necessary? It is my understanding that in some people it can cause depression etc so I am not sure if this would be that great for me! Are there alternatives? I have been taking HCG throughout the Enanthate and have been on TRT since roughly around the 2nd week in January this year.
May I suggest you give this a bit more thought and, if you can, consult the clinic that was referenced in my earlier post before making a decision that may seem attractive at the moment? Your wish to abandon TRT may be influenced by the fact that you've never consulted a physician who knew what they were doing.
 

lookingforhelp

New Member
I have been seeing a Dr at a private clinic near me who gave me access to TRT. I am finding on the 7th day after my 100mg shot I am crashing with the most uncontrollable shaking and anxiety. Wired, dizzy strange feeling. Is this a crash?

It is now 2 am and I am going to have to inject my T. Should have done it today but put it off thinking I could maybe call my Dr on Monday regarding a Restart. I am not really enjoying this crash if thats what it is so I am thinking to come off T is going to be hell.

My total T before starting ranged between 400 and 500 ng/dl sometimes lower but I had high SHBG which I believe was causing me the low T symptoms. I really dont know what to think anymore! One things for sure this feeling sure reminds me before T, maybe not as horrific though!
 
You're not receiveing competent or even caring, care. Jsut because he's a Dr and treats you doesn't mean he knows what he's doing and he clearly is questionable in that respect. Don't blame TRT...blame that Dr and take CoastWatchers advice in post #2, things for you UK guys are pretty tough.
 

lookingforhelp

New Member
I know this believe me! But in the UK it is so hard to find anyone like that. At the moment I have a source of medication for HCG and Clomid And T if I need it. To get the former two in this country is extremely rare. I have messaged the clinic the Coastwatcher mentioned. What I am wondering now..

I have been on for roughly 17 weeks. I have had numerous E2 labs and some say its high, some say its okay. I am in the UK and cannot access the sensitive test but there is part of me wondering if before I give in on TRT maybe I should have trialled anastrazole at a low dose. From extensive reading of the forum I have put off doing this because of peoples advice but there is part of me that wonders maybe that was the missing link to why I never felt optimised on TRT.

The E2 test from the NHS is done via RIA. The others are done via ELISA. Which are more accurate?

I dont like the hairloss I am experiencing on my hairline and do not want to be on TRT if I do not feel good and end up with no hair at the same time.

Last night the anxiety was so bad I bit the bullet and shot 50mg of T Enanthate rather than my regular 100mg. I was shakey and had cold sweats and felt like my heart was jumping out my chest. I have not slept at all last night. I know this all sounds crazy but it is really difficult to find a solid restart procedure on the internet and even on this forum. I do not really want to use a SERM due to the sides but if I have to I have to.

Today I feel shakey again and extremely emotional and anxiety from hell.

Sorry if I am sounding eratic but I feel like someone coming off heroin. Short term advice would be great. I got a little concerned regarding the length of time you are on TRT equates to the amount of time it takes to feel ''normal'' again and in reading this I think I sort of panicked and decided to come off seen as I didnt feel ''cured'' although I had improvements. Anything over 12 weeks can be more difficult according to research.

What do you guys think about me coming off restarting, analysing how I feel, if I still feel shit go back on? It is so hard to know what to do anymore. I am stuck in a difficult situation.
 

CoastWatcher

Moderator
I know this believe me! But in the UK it is so hard to find anyone like that. At the moment I have a source of medication for HCG and Clomid And T if I need it. To get the former two in this country is extremely rare. I have messaged the clinic the Coastwatcher mentioned. What I am wondering now..

I have been on for roughly 17 weeks. I have had numerous E2 labs and some say its high, some say its okay. I am in the UK and cannot access the sensitive test but there is part of me wondering if before I give in on TRT maybe I should have trialled anastrazole at a low dose. From extensive reading of the forum I have put off doing this because of peoples advice but there is part of me that wonders maybe that was the missing link to why I never felt optimised on TRT.

The E2 test from the NHS is done via RIA. The others are done via ELISA. Which are more accurate?

I dont like the hairloss I am experiencing on my hairline and do not want to be on TRT if I do not feel good and end up with no hair at the same time.

Last night the anxiety was so bad I bit the bullet and shot 50mg of T Enanthate rather than my regular 100mg. I was shakey and had cold sweats and felt like my heart was jumping out my chest. I have not slept at all last night. I know this all sounds crazy but it is really difficult to find a solid restart procedure on the internet and even on this forum. I do not really want to use a SERM due to the sides but if I have to I have to.

Today I feel shakey again and extremely emotional and anxiety from hell.

Sorry if I am sounding eratic but I feel like someone coming off heroin. Short term advice would be great. I got a little concerned regarding the length of time you are on TRT equates to the amount of time it takes to feel ''normal'' again and in reading this I think I sort of panicked and decided to come off seen as I didnt feel ''cured'' although I had improvements. Anything over 12 weeks can be more difficult according to research.

What do you guys think about me coming off restarting, analysing how I feel, if I still feel shit go back on? It is so hard to know what to do anymore. I am stuck in a difficult situation.

Now is not the time to make a change, any change. Just because your experience with TRT hasn't yet resulted in the improvements you hoped for doesn't mean TRT has failed. What clearly has failed is the protocol/the doctor(s) that you have so far worked with. Anxiety is driving your actions right now and that can result in all sorts of complications in the future.

You asked for short-term advice.

1. Remain on TRT. Don't attempt a self-directed restart.
2. Contact the Dorset clinic and see if you wish to consult them.
3. Engage the services of a therapist experienced in Cognitive-Behavioral Therapy. Your anxiety is out of control.
4. Everyone's experience is different, but most encounter ups and downs working to balance our protocols.
5. If you are dealing with PFS, it is going to require patience. It's a challenge for doctors and patients alike.
 

lookingforhelp

New Member
The thing is with TRT that I love and hope returns once I fix this anxiety is the calmness it gave me. My sleep seemed a lot better these last few months. For the first time in 3 years I had been drifting off naturally in the evenings and felt like I could nap which after years of wired and tired this was a blessing.

Can you tell me if what I have done this last week could cause this chronic state.

Took 100 mg last Saturday 29th April. Took my 250iu of HCG on the Wednesday as I missed the Tuesday. This Friday I was meant to do my next HCG but was so busy with work I missed the morning slot and did not want to take in the evening due to disrupting sleep. Yesterday I was due my T shot of 100mg again but missed it again due to being so incredibly busy with my business (no excuse I know). Then in the evening came the crash, thats when the real anxiety started and all to familiar symptoms came creeping back. At 2 am in the morning I decided to inject my Testosterone but only 50 mgs as I have read splitting the doses in the week reduces E2. I was not sure if the symptoms were from high E2 so was hesitant to do the full dose. Maybe that was the issue?

All I know is that the labs at the top of the page were done on a Tuesday and I inject T on a Saturday. My TT was at roughly 864 ng/dl on the Tuesday. Taking that as sort of a baseline for 3 days after my injection, could my T drop that much for the remainder of the week to make me feel like this?

I honestly cannot thank you enough Coastwatcher for your help and support. Really means a lot to me when I am sat here going through this. I just tried to get the NHS to do some bloods for me as I said that I was having these horrible panic attacks and anxiety and I explained the issue with my T dosing. They asked me a bunch of questions like do I want to hurt myself, am I confused, do I want to hurt my family then pretty much hung up. A nurse was meant to ring me back over an hour ago!

My family have used this service many times before and with any other issue they are excellent but for some reason anyone on TRT in this country is labelled as a Steroid abuser or a loon. I tried to explain regarding high Estrogen levels and anxiety and she did not have a clue about anything so I may as well bang my head against a brick wall.
 

CoastWatcher

Moderator
The thing is with TRT that I love and hope returns once I fix this anxiety is the calmness it gave me. My sleep seemed a lot better these last few months. For the first time in 3 years I had been drifting off naturally in the evenings and felt like I could nap which after years of wired and tired this was a blessing.

Can you tell me if what I have done this last week could cause this chronic state.

Took 100 mg last Saturday 29th April. Took my 250iu of HCG on the Wednesday as I missed the Tuesday. This Friday I was meant to do my next HCG but was so busy with work I missed the morning slot and did not want to take in the evening due to disrupting sleep. Yesterday I was due my T shot of 100mg again but missed it again due to being so incredibly busy with my business (no excuse I know). Then in the evening came the crash, thats when the real anxiety started and all to familiar symptoms came creeping back. At 2 am in the morning I decided to inject my Testosterone but only 50 mgs as I have read splitting the doses in the week reduces E2. I was not sure if the symptoms were from high E2 so was hesitant to do the full dose. Maybe that was the issue?

All I know is that the labs at the top of the page were done on a Tuesday and I inject T on a Saturday. My TT was at roughly 864 ng/dl on the Tuesday. Taking that as sort of a baseline for 3 days after my injection, could my T drop that much for the remainder of the week to make me feel like this?

I honestly cannot thank you enough Coastwatcher for your help and support. Really means a lot to me when I am sat here going through this. I just tried to get the NHS to do some bloods for me as I said that I was having these horrible panic attacks and anxiety and I explained the issue with my T dosing. They asked me a bunch of questions like do I want to hurt myself, am I confused, do I want to hurt my family then pretty much hung up. A nurse was meant to ring me back over an hour ago!

My family have used this service many times before and with any other issue they are excellent but for some reason anyone on TRT in this country is labelled as a Steroid abuser or a loon. I tried to explain regarding high Estrogen levels and anxiety and she did not have a clue about anything so I may as well bang my head against a brick wall.

You are doing many things wrong. You must maintain regularity in regard to your injection schedule. You were late with your HCG shots during the past week, and then you injected half the amount of testosterone you'd normally inject yesterday. You can't do this and expect success. I understand that you don't feel well, but a harum-scarum approach to your protocol will lead you deeper and deeper into the darkness.

Please confirm - when did you draw blood for the tests you posted? They were drawn sometime in the middle of your protocol and not immediately prior to your injection?
 

lookingforhelp

New Member
I agree with what you are saying Coast Watcher and its my own doing. I have been very strict up until these last couple of weeks.


They were drawn a couple of weeks ago on a Tuesday. I took my shot the Saturday before that. The bloods were drawn before my HCG shot. It is hard for me to gauge my E2 levels when the tests available here are complete crap. I have 3 different results from bloods taken at the same time. Its hard what to believe. I guess if the NHS RIA E2 test is most accurate then the additional HCG could be spiking my E2 levels. I know this forum is against un necessary AI usage and I am too. The lesser drugs the better but I cant help wondering if something like E2 could be causing my issues.
 

CoastWatcher

Moderator
I agree with what you are saying Coast Watcher and its my own doing. I have been very strict up until these last couple of weeks.


They were drawn a couple of weeks ago on a Tuesday. I took my shot the Saturday before that. The bloods were drawn before my HCG shot. It is hard for me to gauge my E2 levels when the tests available here are complete crap. I have 3 different results from bloods taken at the same time. Its hard what to believe. I guess if the NHS RIA E2 test is most accurate then the additional HCG could be spiking my E2 levels. I know this forum is against un necessary AI usage and I am too. The lesser drugs the better but I cant help wondering if something like E2 could be causing my issues.
We need to leave the realm of speculation. There is a lot going on in your situation not yet addressed - particularly the use of saw palmetto and the possibility of post-finasteride syndrome playing a role in why you feel as you do. In cases where pfs is involved it is not unusual to see normal hormone levels but less than hoped for subjective response.

It might be elevated estradiol. It might not be. I'm not a doctor and can't give you the answer you want. All the more reason for you to pursue the best treatment you can find in the UK.

If you do not hear from the clinic that you contacted via email, call them.
 

lookingforhelp

New Member
Yes it is a mystery illness and one I hope that they will find a cure or working treatment for soon.


I received an email back from Dr Robert Stevens from the clinic and he seemed extremely caring and actually interested in helping me. I am going to compile all of my health reports and testing over the last few years and send him a detailed email.

Thanks again Coastwatcher
 

CoastWatcher

Moderator
Yes it is a mystery illness and one I hope that they will find a cure or working treatment for soon.


I received an email back from Dr Robert Stevens from the clinic and he seemed extremely caring and actually interested in helping me. I am going to compile all of my health reports and testing over the last few years and send him a detailed email.

Thanks again Coastwatcher

That is excellent news. All the best.
 

lookingforhelp

New Member
Just a quick question to you caostwatcher seen as you have a vast experience with all this. Is it common for guys who have been on TRT for 4 months, at my age of 27 to be able to recover from a restart?

Since getting hit with the Saw Palmetto my SHBG has always been fairly high for my age and is what I believed to be causing my symptoms. Basically what I am wondering is if it is possible to return to my baseline?

I thought it was fairly common to be able to restart once on TRT. You hear about body builders and athletes doing it all the time. I just feel slightly foolish now upon reading from other stories that this might not be the case. It is not helping how I am feeling stressing that I may have messed myself up more potentially.

Thanks again.
 

CoastWatcher

Moderator
Just a quick question to you caostwatcher seen as you have a vast experience with all this. Is it common for guys who have been on TRT for 4 months, at my age of 27 to be able to recover from a restart?

Since getting hit with the Saw Palmetto my SHBG has always been fairly high for my age and is what I believed to be causing my symptoms. Basically what I am wondering is if it is possible to return to my baseline?

I thought it was fairly common to be able to restart once on TRT. You hear about body builders and athletes doing it all the time. I just feel slightly foolish now upon reading from other stories that this might not be the case. It is not helping how I am feeling stressing that I may have messed myself up more potentially.

Thanks again.
Lots of factors determine the success of a restart. Age, time spent on TRT, what the baseline was prior to the commencement of therapy, and other underlying issues. You may be dealing with post-finasteride syndrome, a complicating factor. It's impossible for me to say. Working with am doctor experienced in restart protocols certainly increases the odds of success.
 
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