Longtime user with new intense anxiety, unsure of proper E2 levels, in desperation mode, please help! Bloodwork included

[TriumphBum675]

Sorry for the long trainwreck of a post but I have never been so scared in my life as I’ve been the last 2mos. Before that I’d say I barely ever had anxiety at all, about anything. I’m usually the one who likes taking risks and is always level-headed and calm/confident. I think I’ve been messing with my protocol too much to try to fix things to get back to my normal self (which I realize is stupid) and now I’m desperate for help. This forum has been a great resource over the years and I’d even be willing to pay people here somehow for their help or if I could at least be referred to a truly expert endo (I’ve had poor experiences before) that would be great. I’m desperate at this point, this is ruining my life and idk what to do.

To start, I’m 35 and have been on test for the last 8yrs. Done tons of research/reading over the years. Have played around with various doses from 80 to 500mg/wk, always pinned daily, played around with AI, without AI, kept e2 high (around 100 pg/mol) kept it low (30 pg/mol), and have generally always felt ok-to-great, never had anything like the last 2mos.

At the start of this ordeal I had been on a higher dose for 2-3mos: 250mg/wk of test-e (daily pins), took AI as needed, on average maybe 0.06mg arimidex E5D. Felt decent on this protocol, not amazing but good enough. Problem started on Jan 9th, I had a panic/anxiety attack due to some random stress and while I’ve had one before, the general anxiety lingered after this one. It stuck around mostly in the physical sense (ie felt a lump in my throat) for ~10 days. At that point I began to worry about the anxiety itself and started spiraling a bit, I decided to raise my test to 370mg/wk because I’ve generally felt great on “blast” doses, I know this was a dumb move but here we are.

Things got worse after that and in short for the last ~6 weeks I’ve had panic attacks and intense crying fits several times a week on average and have been bouncing around between various dosages of AI and test trying to fix things. Most of this period I’ve been on no AI but I did try taking it two times: first a week straight of adex (.06mg daily, a dose I’ve felt fine on in years prior) which felt great for the first day or two (not sure if placebo) but then got much worse. To the point I was getting scary insane intrusive thoughts. I stopped the adex but the week following that was still rough. I thought I was going crazy, almost called to check myself into mental facility.

I talked to my doctor, and a psychologist, and a therapist, and they all said that I’m not crazy—that I seem to have gotten a bout of severe anxiety disorder stemming from the panic attack (which I guess is somewhat common). But I’m sure the hormones have exacerbated or at least affected things.

I should mention here that there’s nothing really in my life to be stressed about, I have good family, friends, an amazing gf and a chill office job. I’m not on any drugs except propranolol (simple blood pressure med which helps with physical anxiety) which was rx’ed by my doctor for the anxiety but feels like it hasn’t made too much difference overall.

Anyway, after that experience I took a couple weeks off AI, and also lowered my test dose back down to 200mg/wk (so only spent 2wks on the higher dose, very dumb). Then decided to try AI a 2nd time, this time at 0.2mg EOD, again felt good for the first day or two and then things got much worse again and I stopped it after a week. I realize I should wait for at least 2-3 weeks before changing a variable but I have not been able to do that in my panicked state trying to fix things back to normal.

So now, I took that last AI dose (0.2mg adex) exactly 11 days ago. The first week after stopping was hell, the last few days have been better but I still get some real bad anxiety at times. And I do have that feeling of a lump in my throat which generally appears in the afternoon each day.

To throw a wrench into this I ran out of my test-enanthate 6 days ago and had to switch to test-cypionate (same dose) which I’ve been on for the last 6 days (same daily pins). It seems like I started feeling much better for the first 2 days after the switch but I wonder if that’s just because there were a couple days there where my test levels dropped from stopping the enanthate but the cypionate had not fully kicked in yet since it’s a longer ester?

I haven’t had any more attacks the last ~5 days but I’ve had some weird dark thoughts, I feel at some points of the day (generally in the afternoons) like I am completely incapable of love anymore. Like I don’t love my gf at all. Which is an absurd thought because I know I love her more than anything, prior to this we had an amazing relationship and she’s been so extremely supportive and understanding throughout this ordeal. But I get these fears—like what if I’ve messed up my hormones and I will no longer be capable of feeling love? I know sometimes my levels have certainly affected those types of emotions for me. This anxiety seems to pop up consistently starting in the afternoon and lasts til the evening. Morning and late evening I generally have felt ok. I pin mornings. Maybe a side effect of the switchover to cypionate?

BLOODWORK, this is 2 weeks after lowering test-e back down to 200mg/wk and no AI for 8 days leading up to the draw:

Test (lc/ms): 1957 ng/dl
Free test: 641 pg/ml (range 35-155)
E2 (ultrasensitive): 68 pg/ml
SHBG: 13 nmol/L (range 10-50)
Progesterone LC/MS: <0.1 ng/ml (range <=0.2)
DHEA Sulfate: 375 mcg/dL (range 93-415)
Pregnenolone LC/MS: 91 ng/dL (range 22-237)

8 days later (on same dose of test) I started the 0.2mg adex EOD and the day after my first dose my E2 was at 43, the day after that it was 56. So it does seem like that dose lowered my e2 a large amount.

For reference, 5 years ago on a test dose of 180mg/wk (daily pins) and no AI, my test was at 1650 and E2 was around 95 (confirmed with two separate tests).

It appears my free test is super high and my SHBG is very low. Please, constructive input would be immensely appreciated. I’m specifically not sure what to do now with the esters—I did re-stock on more test-e, should I switch back to that tomorrow since that’s what I’ve been on my whole TRT life or should I stick to cypionate since I’ve been on it for 6 days now and I don’t want to yo-yo my levels?

Also what should I do with my test dose? Raise it since I’ve felt better on high doses in the past? Keep it the same? I’m scared to lower or go off entirely in my current mental state. I generally have felt not as good on doses <150 but seeing my free test so high is kind of scary. Not sure about my E2 either, could I have “crashed” it with adex? Blood doesn’t show anything super low and I know I’ve felt decent on even slightly lower E2 numbers in the past. Or is my E2 too high and contributing to the anxiety? How does my low SHBG play into my E2 numbers? I know the general theory but would like reassurance. I’m deathly afraid of adex now though because it truly does feel like hell after taking it a few days straight (even though I used to take larger doses daily for months at a time in the past!). Just so confused by all this, could it really just all be in my head? Like this isn’t me, I just want to get back to being myself.

 

[Phil Goodman]

My general thoughts… which before sharing I’ll just say that I’m not a medical expert and mental health issues are serious, so if you don’t improve or get worse then you need to seek legit help (though due to your protocols you should realize it may be difficult to find somebody with experience in dealing with the complexities).


It sounds like you are stuck in a thought pattern that emerged from your panic attack and you’ve been stuck in since. My worst thought cycles have dealt with depression, but I have had a few with anxiety. Basically your mind gets stuck in loops and each time you go through the loop it becomes ingrained a little more. On this front I’d say meditation and time outside would likely be very helpful. You also need to get cognizant of when your anxiety is ramping up (meditation is extremely helpful at getting you more in tune with your body so you can recognize small changes and adjust more rapidly). When you find yourself going down those paths, whether it be anxious thoughts/feelings, depressive thoughts, intrusive thoughts, etc. you need to catch yourself and steer in a different direction. As you get better at this, the events will likely get less and less frequent until they are almost gone completely.

While this is happening you absolutely need to stop changing your protocols, and almost certainly lower your dose to a physiological level. I understand this might not be the ideal time from a psychological standpoint due to you thinking you need to blast your way through it and the thought of lower levels alone may be at least one source of anxiety… but it sounds like you are extremely amped and you need to take your foot off the gas. And more importantly, your body needs to be allowed to find consistency and predictability. Uncertainty is a key cause of anxiety… and on an internal level there is EXTREME uncertainty due to your constant bouncing back and forth. It’s understandable that you feel something is wrong, so doing something about it makes you feel like you’re in control. That’s probably why you feel slight relief for a day or two(feeling like you’re back in control)… but the adjustment causes more instability internally which results in the anxiety returning. You’re gonna have to resist the urge to make a change and just trust that it’ll be better to re-evaluate in six weeks or so.


My advice would be to lower to 150-160 per week. Go back to test E since that’s what your body is more used to and will clear your body faster. But realize it’ll take 5-6 weeks for the cyp to fully exit the picture. That may make it worse, or it may slow the transition to lower levels which will make it easier. Either way, that’s my advice… go to that dosage and drop the AI. Focus on meditation, getting outside in nature, and learning to break destructive thought patterns. Lastly, and I know some people may not agree with this, but a strong relationship with God can be invaluable in all phases of life, but particularly when it gets overwhelming. The feeling that you are incapable of love is just a mixture of current(NOT PERMANENT) state of hormones and some of the psychological effects that go along with it. And the best part is that the most difficult times in life result in the biggest transformations, so as long as you stay dedicated to turning all of this into a positive it’ll be one of the most valuable experiences of your life.

 

[TriumphBum675]

My general thoughts… which before sharing I’ll just say that I’m not a medical expert and mental health issues are serious, so if you don’t improve or get worse then you need to seek legit help (though due to your protocols you should realize it may be difficult to find somebody with experience in dealing with the complexities).


It sounds like you are stuck in a thought pattern that emerged from your panic attack and you’ve been stuck in since. My worst thought cycles have dealt with depression, but I have had a few with anxiety. Basically your mind gets stuck in loops and each time you go through the loop it becomes ingrained a little more. On this front I’d say meditation and time outside would likely be very helpful. You also need to get cognizant of when your anxiety is ramping up (meditation is extremely helpful at getting you more in tune with your body so you can recognize small changes and adjust more rapidly). When you find yourself going down those paths, whether it be anxious thoughts/feelings, depressive thoughts, intrusive thoughts, etc. you need to catch yourself and steer in a different direction. As you get better at this, the events will likely get less and less frequent until they are almost gone completely.

While this is happening you absolutely need to stop changing your protocols, and almost certainly lower your dose to a physiological level. I understand this might not be the ideal time from a psychological standpoint due to you thinking you need to blast your way through it and the thought of lower levels alone may be at least one source of anxiety… but it sounds like you are extremely amped and you need to take your foot off the gas. And more importantly, your body needs to be allowed to find consistency and predictability. Uncertainty is a key cause of anxiety… and on an internal level there is EXTREME uncertainty due to your constant bouncing back and forth. It’s understandable that you feel something is wrong, so doing something about it makes you feel like you’re in control. That’s probably why you feel slight relief for a day or two(feeling like you’re back in control)… but the adjustment causes more instability internally which results in the anxiety returning. You’re gonna have to resist the urge to make a change and just trust that it’ll be better to re-evaluate in six weeks or so.


My advice would be to lower to 150-160 per week. Go back to test E since that’s what your body is more used to and will clear your body faster. But realize it’ll take 5-6 weeks for the cyp to fully exit the picture. That may make it worse, or it may slow the transition to lower levels which will make it easier. Either way, that’s my advice… go to that dosage and drop the AI. Focus on meditation, getting outside in nature, and learning to break destructive thought patterns. Lastly, and I know some people may not agree with this, but a strong relationship with God can be invaluable in all phases of life, but particularly when it gets overwhelming. The feeling that you are incapable of love is just a mixture of current(NOT PERMANENT) state of hormones and some of the psychological effects that go along with it. And the best part is that the most difficult times in life result in the biggest transformations, so as long as you stay dedicated to turning all of this into a positive it’ll be one of the most valuable experiences of your life.

Thank you very much for the thoughtful reply. I have indeed sought legit help and talked to a couple doctors and a psychologist but they weren’t exactly experts in hormones and yes I imagine it’s difficult to find a professional who knows about all that too. Open to suggestions/recs if anyone has any!

I like the part about feeling like I’m in control again, never thought of it like that but makes total sense. And I have actually been meditating at least once a day for the past month or so. I’ve also been going out for hikes more over the last couple weeks. I feel all that helps, but when a spiral hits or if I’m having one of those low days it’s like there is nothing that can change it, like no amount of rational thought, and I’m just stuck in this irrational loop.

That really makes me think something physical (ie hormone related) is at play or at least contributing. Because normally I’m all about a Buddhist-type philosophy (or teachings like the Power of Now by Eckhart Tolle) just all about living in the moment and taking life as it is and being happy regardless of circumstances—like those truly are my core beliefs. But when I get these weird periods all that goes out the window entirely somehow.

I generally feel like I’ve been doing a bit better on the 6 days I’ve done cypionate (but that could also be due to my E2 recovering after the adex?). At least I haven’t spiraled or had a crying fit. Do you really think going back to enanthate is the move? The thought of switching something up again does scare me now. How much of a factor would you think it’d be to stay on cyp? And yes I will likely slowly taper down my dose.