Facial Flushing, Headache, Feeling Hot & Anxious on TRT.

Obizzey · Mar 16, 2018

Hello folks,

I have a bit of problem here. I just started getting these negative side effects after my last Testosterone Enanthate injection. I have been on and off TRT for a number of years. A bit of background for you guys.

I am a 31 year old male, 5'10, about 170 pounds. I was born with torsion and had 1 testicle removed at birth, and then struggled with heavy opioid addiction for about 14 years as well as many other drugs and ended up with gynocomestia about 5 years ago from severe opioid abuse. Got myself cleaned up and then after about a year clean, had my Testosterone levels retested and they were only about 9.8, so still kind of on the low side. Decided to go back on TRT Therapy, and have been back on TRT for almost 2 months now.

My Regular doctor started me on 100mg/week of Cypionate, and then my Endocrinologist switched me back to Test Enanthate 100mg/wk. I work out quite often, try and eat healthy, and try and keep on track with my health now.

So when I restarted my TRT therapy about 2 months ago I started with Cypionate for the first 2 weeks I think and I was taking maybe 150mg/week instead of 100mg/week. Then when I switched to Testosterone Enanthate, I actually did make a mistake the first week with this as the vial is 200mg/ml and I dosed it as if it were 100mg/ml, so the 1st week taking Enanthate I had taken 200mg.

Now everything has been mainly fine until my last shot of Testosterone Enanthate on Tuesday night.
After I injected 100mg on Tuesday night I started to get super anxious, and having panic attacks, facial flushing, tachycardia, and headaches. I was hoping this would go away, and it has gotten maybe a little bit better since then. But I am still not myself. Now, my concern is that my red blood cell count might be too high and its causing me problems, or there was too much Testosterone for my body and it converted the excess Testosterone into estrogen and I need an aromatize inhibitor.

Do these symptoms sound more like polycythemia (elevated red blood cell count) and I know this is dangerous as I am a smoker as well. Or does this sound more estrogen related as well? I don't understand as its not like I was taking massive amounts of Testosterone like some bodybuilders do, but then again they usually are taking aromatize inhibitors as well. Anyways, if anyone can shed some light on what may be causing some of these symptoms, please let me know.

If it does sound like polycythemia, I guess the only treatment is to go get blood-letting done?

Thanks in advance guys.

Obizzey · Mar 19, 2018

So I went to the Hospital on Saturday night just to rule out elevated RBC and Hematocrit. Everything was fine and my bloodwork was immaculate. So now I am thinking the only other thing that would make sense is too much testosterone for my body being converted to Estrogen. High Estrogen causing these symptoms.

I wonder if I was to get a script of Arimidex and take 0.25mg if these symptoms would vanish?

Blackhawk · Mar 19, 2018

Get the E2 sensitive test. Both High and Low E2 can cause hot flashes and mood problems. However that kind of reaction right after injection also points to either anxiety issues or possible reaction/allergy.

Vince Carter · Mar 19, 2018

Slow down and take a breath, and pay attention to what you're doing; dosing. You're trying to metaphorically jump off the deep end over something that's probably as simple as paying attention to what you're doing and not messing it up. you ended up in the ER because you had some kind of reaction....that's not hormonal...that's anxiety and OCD related behaviors manifesting themselves. What if any history do you have there?

Obizzey · Mar 19, 2018

No No, it’s definitely hormonal related. I went to the ER 5 days after the injection because I was concerned about elevated RBC and Hematocrit. These high blood pressure problems, anxiety attacks all started after my last injection. I know all about anxiety and how to manage it. I’ve had Generalized Anxiety Disorder for a long time and history of addiction as well. Everything was fine until my very last injection last Tuesday night which leads me to believe it has something to do with E2. Also the fact that I have been getting daily headaches since. It’s definitely related to the Testosterone, as this was not just normal anxiety of flushing.

Vince Carter · Mar 19, 2018

Obizzey said:
No No, it's definitely hormonal related. I went to the ER 5 days after the injection because I was concerned about elevated RBC and Hematocrit. These high blood pressure problems, anxiety attacks all started after my last injection. I know all about anxiety and how to manage it. I've had Generalized Anxiety Disorder for a long time and history of addiction as well. Everything was fine until my very last injection last Tuesday night which leads me to believe it has something to do with E2. Also the fact that I have been getting daily headaches since. It's definitely related to the Testosterone, as this was not just normal anxiety of flushing.

So you can read back these posts and still say there's no anxiety there. Can you really do that?

Systemlord · Mar 19, 2018

It's not really possible for testosterone to affect you like that right after an injection, it takes time for the esters to break down in your body before much of anything happens. When I had my very first injection on TRT I remember feeling as you describe, very anxious, a kind of fight or flight response.

While testosterone is still locked up in the ester not yet available to the body, you are reacting to the injection itself. Now it's possible 5 days after an injection, if the dosage is too high to get high E2 which can exacerbate anxiety disorders.

Please share your pre-TRT labs, you could be on the wrong protocol for you.

Obizzey · Mar 19, 2018

Yes but this is hormonal anxiety and testosterone in excess can cause high BP like I am having. And Vince, please read my post better. This was NOT my first injection. There was lots of injections before this and I never had this problem. That’s why my conclusion is excess testosterone being converted to estrogen causing these nasty side effects. Why are you harping that it’s just myself reacting anxiety wise? Because this is much different. I wouldn’t be continuously flushed for days on end like this if this was just normal anxiety.

Systemlord · Mar 19, 2018

I see your dilemma, you don't have access to the correct E2 labs. Anxiety is common in low SHBG men, perhaps these large weekly dosages are wrong for you. Most guys inject twice or multiple times a week to keep the peak lower in order to better control E2 levels. I believe you should focus on at least 2 injections a week. Try splitting up your shots 50mg twice weekly and see how it works out.

Obizzey · Mar 19, 2018

Yes I think twice a week shots would be much better. I wonder why most TRT professionals in Canada are either like once a week injection or every 2 weeks. Seems that is quite backwards. So if my E2 levels are elevated, would this eventually straighten out on it’s own without an AI? Or would I definitely need an AI to fix this problem now if my E2 is elevated?

Systemlord · Mar 19, 2018

Obizzey said:
Yes I think twice a week shots would be much better. I wonder why most TRT professionals in Canada are either like once a week injection or every 2 weeks. Seems that is quite backwards. So if my E2 levels are elevated, would this eventually straighten out on it's own without an AI? Or would I definitely need an AI to fix this problem now if my E2 is elevated?

Absolutely, E2 levels will come down eventually when dosages are reduced. At 50mg twice weekly I don't even need an AI and when I'm on a new protocol I always first lower the dosage, no need for an extra drug if I don't really need it. I was on Klonopin for 30 years which caused a pituitary disorder over long usage, these medications sedate the pituitary gland which affects LH production over time and is the reason I'm on TRT.

I now naturally have a hatred of chemicals and prescription drugs and don't trust my doctors who are too quick to hand out drugs.

Obizzey · Mar 19, 2018

^ Yes I hear you. I was addicted to benzodiazepines for 14 years myself a long with opioids which lowered my natural T levels terribly to the point where I ended up with gynocomestia.

Giantsrus · Dec 6, 2018

Obizzey said:
Hello folks,

I have a bit of problem here. I just started getting these negative side effects after my last Testosterone Enanthate injection. I have been on and off TRT for a number of years. A bit of background for you guys.

I am a 31 year old male, 5'10, about 170 pounds. I was born with torsion and had 1 testicle removed at birth, and then struggled with heavy opioid addiction for about 14 years as well as many other drugs and ended up with gynocomestia about 5 years ago from severe opioid abuse. Got myself cleaned up and then after about a year clean, had my Testosterone levels retested and they were only about 9.8, so still kind of on the low side. Decided to go back on TRT Therapy, and have been back on TRT for almost 2 months now.

My Regular doctor started me on 100mg/week of Cypionate, and then my Endocrinologist switched me back to Test Enanthate 100mg/wk. I work out quite often, try and eat healthy, and try and keep on track with my health now.

So when I restarted my TRT therapy about 2 months ago I started with Cypionate for the first 2 weeks I think and I was taking maybe 150mg/week instead of 100mg/week. Then when I switched to Testosterone Enanthate, I actually did make a mistake the first week with this as the vial is 200mg/ml and I dosed it as if it were 100mg/ml, so the 1st week taking Enanthate I had taken 200mg.

Now everything has been mainly fine until my last shot of Testosterone Enanthate on Tuesday night.
After I injected 100mg on Tuesday night I started to get super anxious, and having panic attacks, facial flushing, tachycardia, and headaches. I was hoping this would go away, and it has gotten maybe a little bit better since then. But I am still not myself. Now, my concern is that my red blood cell count might be too high and its causing me problems, or there was too much Testosterone for my body and it converted the excess Testosterone into estrogen and I need an aromatize inhibitor.

Do these symptoms sound more like polycythemia (elevated red blood cell count) and I know this is dangerous as I am a smoker as well. Or does this sound more estrogen related as well? I don't understand as its not like I was taking massive amounts of Testosterone like some bodybuilders do, but then again they usually are taking aromatize inhibitors as well. Anyways, if anyone can shed some light on what may be causing some of these symptoms, please let me know.

If it does sound like polycythemia, I guess the only treatment is to go get blood-letting done?

Thanks in advance guys.

Hey Bud. I actually had the same exact thing happen to me, except mine is a little more complicated as I also take mod grf 1-29 with a GHRP. My blood pressure is a little high; went yesterday to get hemocrit taken....waiting for the results. I do give blood every two months but its been six weeks since I've had it done. I take 200mg roughly per week; split it up to 80mg everything 3rd day, which puts some weeks at 240MG and another week at 160Mg... But all of sudden recently, I started getting headaches, watery eyes and a flush face. The flushing goes from slight to beat red. Blood pressure roughly normal..sometimes high, but always has been. Also a heavy smoker myself. I do take anastrazole infused with the testosterone; last time I had mine checked Estradiol was around 20 which is well within the normal range. But it could be Estrogen. I was leaning towards my grf 1-29 as a culprit, but I've never had that before, where flushing lasted most of the day. Let me know what you find out. If my hemocrit is normal I will get a more detailed estrogen test; especially if you do and it turns out to be that. Otherwise, I'll stop the peptides and see if that eliminates it. I've had people comment at work on my red face, so it's not subtle. Good luck.

Tommy Wall · Dec 7, 2018

When I started with TRT I was on 250mg every 2,5 week (old school protocol). My face was very red, and my wife said it almost looked blue. I was always hot and sweating even on winter days. The first week after my injections it did impact my mood and many times with increased anxiety. BP was on the higher end of what’s normal. etc...

I also tried Testim and it became a bit better, but it still gave me a red face and feeling warm. Sweating like nuts among other people isn´t very nice. Went back to injection 2x50-60mg per week and felt much better. However, I still have a reddish face with a rather big red bag under my eye (which I didn´t have before starting TRT), still feel warm most of the time. But I´m used to these things by now.

It wasn´t because of high Hema and Hemo, tested that many times. I believe it’s not that easy to explain why and blame E2 for all sorts of side effects. I think TRT comes with these things and it is dose dependent. I think there are much more factors to it like testo levels itself, DHT, E2 and for sure more hormones etc. involved. Adding a NO stack to this matter will make red even redder lol.

Maybe it’s like trimming an older car by putting more horsepower in it meaning making it over work. So far, I never read anything more than speculations what could for sure causes these side effects.

Giantsrus · Dec 7, 2018

Glad you shared that; thanks. What I found most interesting is the "red bag" under one eye because that's exactly what I have. One upper check, closest to the eye, is the red-ist part. Maybe it's TRT's effect on blood vessels..more vasculation maybe. Either case, makes me feel better there are others out there like me. I'll await my results for the hemocrit, but if it's normal, and it continues, I'll try stepping down the dose. Thanks again.

Giantsrus · Dec 11, 2018

Just to close the loop; my hemocrit and globulin came back with-in the normal range. Wrote the company who provides the TRT, and the Doc said basically don't worry about it, and I should get my blood pressure down a little bit. It wasn't really high. Surprisingly, the red face has largely subsided. Who knows what it was.

Sean Mosher · Dec 13, 2018

There's a podcast on the TOT Revolution channel where Dr. Rob deals with/discusses exactly what you're going through.
I'd encourage you to check it out.
He has seen patients over the years who've had issues similar to yours when starting TRT and new issues occurring during it.
We all can react differently so I'm certainly not going to dismiss your situation.
PM me if you're interested in the specific episode and I'll see if I can find it for you.

JimBob · Dec 13, 2018

Sean Mosher said:
There's a podcast on the TOT Revolution channel where Dr. Rob deals with/discusses exactly what you're going through.
I'd encourage you to check it out.
He has seen patients over the years who've had issues similar to yours when starting TRT and new issues occurring during it.
We all can react differently so I'm certainly not going to dismiss your situation.
PM me if you're interested in the specific episode and I'll see if I can find it for you.

Hey Sean. Can you post the TOT link here, please? I'd like to see it.

Sean Mosher · Dec 13, 2018

I believe it was this one.
I don't have time to double check it because I'm at work but I believe he discusses those types of cases in this one.

lemonflavor · Dec 21, 2018

I realize this in a week old thread, but the part about anxiety is at 21:36 (try this:

) in the above video. I wanted to put that in there for people who search for this topic. I had already seen this video but couldn't remember where it was, so thank you Sean. It's not the most encouraging.

This has been a dilemma for me. I tried TRT four years ago and couldn't handle it. I felt super over-stimulated. Endocrinologist said he'd never heard of that. I'm at it again. After working up to 90mg a week total for three injections a week (doing the dosing on my own), after being there a couple of weeks, I got pretty uncomfortable. I'm now at 70mg total a week and injecting every day. For now I'm able to handle it and I'm starting to feel a little better. I just contacted Defy, so hopefully we'll see if there's anything going on as far as estrogen, thyroid, or whatever else.

BTW, DHEA especially, and pregnenolone as supplements do exactly the same thing to me, even at 5mg and 20mg respectively.

Facial Flushing, Headache, Feeling Hot & Anxious on TRT.

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