TRT and Anxiety

Btoledo85

New Member
I am living with bipolar disorder and anxiety, and my medication regimen includes Buspar and Propanolol as needed. Tomorrow, I will commence testosterone cream treatment, which will be administered in conjunction with hcg. I am anxious about the potential for this treatment to worsen my anxiety symptoms. Have others experienced negative symptoms?
 
You can’t compare other people‘s experience to particular compound and apply it to yourself. Your situation is unique to you.

HCG can cause men anxiety and lead to other side effects. Some men can’t tolerate HCG at any dose.

HCG increases other hormones like cortisol, which is ideal if someone’s is starting TRT with low cortisol levels due to the fact that TRT lowers cortisol.

Increase cortisol, the stress hormone can worsen mental disorders.

The testosterone cream is usually well tolerated if absorbed well. The very short half-life formulations of TRT tend to produce less side effects than the injectables.

If I were you, I would start the testosterone cream in isolation and allow your body to balance itself and add hCG later on and determine whether or not it’s going to cause issues.
 
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You can’t compare other people‘s experience to particular compound and apply it to yourself. Your situation is unique to you.

HCG can cause men anxiety and lead to other side effects. Some men can’t tolerate HCG at any dose.

HCG increases other hormones like cortisol, which is ideal if someone’s is starting TRT with low cortisol levels due to the fact that TRT lowers cortisol.

Increase cortisol, the stress hormone can worsen mental disorders.

The testosterone cream is usually well tolerated if absorbed well. The very short half-life formulations of TRT tend to produce less side effects than the injectables.

If I were you, I would start the testosterone cream in isolation and allow your body to balance itself and add hCG later on and determine whether or not it’s going to cause issues.
My cortisol is low and my testosterone is low . I’m incorporating hcg to preserve fertility
 
My cortisol is low and my testosterone is low . I’m incorporating hcg to preserve fertility
Infertility is not a guarantee on TRT, especially on the shorter half-life formulas like cream and oral formulations. Being on the very short half life testosterone cream, you could get your testicles up and running after seven days of stopping therapy all without ever having been on hCG.

It didn’t take very long to get my fertility back after stopping therapy. 92 million sperm.
 
I am living with bipolar disorder and anxiety, and my medication regimen includes Buspar and Propanolol as needed. Tomorrow, I will commence testosterone cream treatment, which will be administered in conjunction with hcg. I am anxious about the potential for this treatment to worsen my anxiety symptoms. Have others experienced negative symptoms?
Some men experience (increased) anxiety with TRT (See posts Here on the forum).

My advice to you is to start with a low dose. What is your prescribed dose? With the cream you can make quick dosage adjustments.
 
Some men experience (increased) anxiety with TRT (See posts Here on the forum).

My advice to you is to start with a low dose. What is your prescribed dose? With the cream you can make quick dosage adjustments.
My prescribed dose is two pumps in morning and one at night equal to 150mg not sure if I should just do 100
 

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My prescribed dose is two pumps in morning and one at night equal to 150mg not sure if I should just do 100
I would start with 2 clicks in the morning after a shower and get a testosterone test at week 3, right before your next dose.

Get the test here: Testosterone, Free, Bioavailable and Total, Immunoassay

This T test results get back faster than the LC/MS test. Depending on the results, you can adjust the dose.

The label on the container indicates that the testosterone cream contains:

Testosterone Micronized 200 mg/g.

The usual prescribed dose written on the label is:

0.5 gram (2 clicks) applied topically per day

That equals 100 mg of testosterone daily, since 0.5 grams × 200 mg/g = 100 mg

Some providers may start with 0.25 grams (1 click = 50 mg) daily, depending on the patient's baseline testosterone levels, symptoms, age, and absorption considerations.

Typical compounding topical testosterone doses range from:

25 mg to 100 mg daily (0.125 g to 0.5 g of this 200 mg/g formulation)

Application sites usually include the shoulders, inner thighs, or scrotum (depending on instructions and absorption goals)

Because absorption varies among individuals, dosing is often adjusted based on follow-up blood tests (usually total and free testosterone levels measured 2–6 hours post-application on steady state).

STEADY STATE TIME:

For testosterone creams applied daily, the usual steady state is typically reached within:

14 to 21 days (2–3 weeks) of consistent daily use¹².
However, some studies suggest steady serum testosterone concentrations may begin to stabilize as early as 7–10 days, especially with daily application and appropriate skin site absorption. Full pharmacokinetic equilibrium—where the rate of absorption equals the rate of elimination—typically occurs by 14 days, with minimal further fluctuations beyond that point under consistent dosing and application conditions³.

Important Notes:
Daily application is essential due to the short half-life of testosterone in topical formulations (roughly 8–14 hours, depending on the base and application site)⁴.

Blood levels should be checked after reaching steady state, usually at 2–4 weeks, and ideally 2–6 hours after morning application to assess peak absorption⁵.

Variability in absorption due to skin site, hydration, temperature, and cream base (e.g., lipoderm vs. Versabase) can influence both time to steady state and overall effectiveness.

References
Wang, C., Swerdloff, R. S., Iranmanesh, A., Dobs, A., Snyder, P. J., Cunningham, G., Matsumoto, A. M., & Berman, N. (2000). Transdermal testosterone gel improves sexual function, mood, muscle strength, and body composition parameters in hypogonadal men. Journal of Clinical Endocrinology & Metabolism, 85(8), 2839–2853. https://doi.org/10.1210/jcem.85.8.6747

Guay, A. T., Perez, J. B., Fitaihi, W. A., & Vereb, M. (2003). Testosterone treatment in hypogonadal men: prostate-specific antigen level and risk of prostate cancer. Endocrine Practice, 9(1), 17–19. https://doi.org/10.4158/EP.9.1.17

Swerdloff, R. S., Wang, C., Cunningham, G., Dobs, A., Iranmanesh, A., Matsumoto, A. M., ... & Berman, N. (2000). Long-term pharmacokinetics of transdermal testosterone gel in hypogonadal men. Journal of Clinical Endocrinology & Metabolism, 85(12), 4500–4510. https://doi.org/10.1210/jcem.85.12.7071

Dobs, A. S., Meikle, A. W., Arver, S., Sanders, S. W., Caramelli, K. E., & Mazer, N. A. (1999). Pharmacokinetics, efficacy, and safety of a permeation-enhanced testosterone transdermal system in comparison with bi-weekly injections of testosterone enanthate for the treatment of hypogonadal men. Journal of Clinical Endocrinology & Metabolism, 84(10), 3469–3478. https://doi.org/10.1210/jcem.84.10.6066

Morgentaler, A. (2022). Testosterone deficiency: A clinician’s guide (3rd ed.). Springer.
 
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