Anxiety, Again

[tamaharbor]

Back in 2009, I had anxiety, insomnia, night sweats, and panic attacks. My total testosterone was measured at <300, and I used compounded testosterone, and then HCG monotherapy to get my TT numbers up to 800-1000. I felt good, thought I had completely recovered, and gradually went off the HCG in early 2017.

Two months ago (July 2018), the anxiety (etc) returned with a vengenance. This is NOT fun. This time my blood numbers are as follows:
Total testosterone: 616 (264-916)
Free testosterone: 17.4 (5-21)
LH: 3.7 (1.7-8.6)
FSH: 1.9 (1.5-12.4)
Prolactin: 9.1 (4.1-15.2)
SHBG: 59.0 (19.3-76.4)
E2 (NON-sensitive): 21.3 (7.6-42.6)
DHEAs: 109 (31-701)
Hemoglobin: 16.4 (13-17.7)
Hematocrit: 47.7 (37.5-51.0)
Vitamin D: 22 (30-100)
IGF-1: 104 (52-194)

I hate to think I have mental health issues. Is there any chance that these hormone levels are the cause of my anxiety (etc) problems? Thank you for your help in advance...

 

[Systemlord]

You need to run a sensitive E2 test as the one you have could be reading high, your estrogen could be lower and it's the only way to confirm anything. Low E2 and anxiety go hand in hand.

You left out thyroid labs, low thyroid hormones will cause anxiety. Check Free T3, Free T4, Reverse T3 and antibodies. Vit D is low, my Vit D was low when T was low.

I don't see how your Free T can be so good with SHBG so high, doesn't make sense. High SHBG guys usually need higher E2 since a lot of it is bound to SHBG.

Is this calculated Free T?

 

[Mountain Man]

You do have mental health issues. Your mind is a part of your body and there is no shame in it. By all means get your hormones checked and balanced, but don’t assume that some counseling won’t help. It may even be all that you need to change. CBT is the treatment of choice for most people dealing with anxiety and men who train regularly are great candidates for it because they are used to working to get better. Only difference is that CBT trains the mind directly and the bod benefits. Most of us train the body and the mind benefits. I posted a link to a book on CBT that I wrote that keeps the process simple and it is easy to understand. Give it a try, but do get hormones checked.

The second link explains how to proceed with anxiety.

 

[Deleted member 16042]

Back in 2009, I had anxiety, insomnia, night sweats, and panic attacks. My total testosterone was measured at <300, and I used compounded testosterone, and then HCG monotherapy to get my TT numbers up to 800-1000. I felt good, thought I had completely recovered, and gradually went off the HCG in early 2017.

Two months ago (July 2018), the anxiety (etc) returned with a vengenance. This is NOT fun. This time my blood numbers are as follows:
Total testosterone: 616 (264-916)
Free testosterone: 17.4 (5-21)
LH: 3.7 (1.7-8.6)
FSH: 1.9 (1.5-12.4)
Prolactin: 9.1 (4.1-15.2)
SHBG: 59.0 (19.3-76.4)
E2 (NON-sensitive): 21.3 (7.6-42.6)
DHEAs: 109 (31-701)
Hemoglobin: 16.4 (13-17.7)
Hematocrit: 47.7 (37.5-51.0)
Vitamin D: 22 (30-100)
IGF-1: 104 (52-194)

I hate to think I have mental health issues. Is there any chance that these hormone levels are the cause of my anxiety (etc) problems? Thank you for your help in advance...

It has been quite revealing going through TRT adjustments over almost the last 2 years. Prior to TRT I never imagined what major effect hormones had on my mental/emotional state.

I have a history of PTSD, related anxiety issues and depression. I have learned to understand and deal with this over many years through counseling, heart rate variability and capnometry based biofeedback, CBT, and meditation, but never seemed to make progress beyond a coping level of success dealing with the anxiety and frequent depression.

In my case, additional psych therapy was not the entire answer. It was essential in terms of becoming aware of the psycho physiological triggers and sympathetic nervous system reactions to stress, and uncovering subconscious/unconscious/habitual processes undermining my mental health, but never dispelled my underlying physiological responses.

In the course of starting a bad TRT protocol, then subsequently undergoing what I would consider three major readjustments, I have been through the ringer in terms of low T, high T, low E2, high E2, plus Thyroid adjustments. Having had hormone levels all over the place, I have become acutely aware of the effect of hormones on my emotional/mental health. There is no uncertainty for me, when they are out of whack, so is my emotional health. But when they are right, the difference is pretty much miraculous. I passed through this hormone zone a couple times in the roller coaster ride and now am close to staying in it. In this zone I feel mentally normal, relatively un-stressed and not depressed. We are all human, and of course I still have stresses and worries, but the difference in emotional stability is remarkable.

 

[tamaharbor]

Thank you everyone, I am going to cry because you are being so nice (yes, that is the way I feel...).

That free testosterone is an actual (not calculated) reading. I will get my E2 tested via the sensitive test. And thank you for the CBT information.

I have been plagued with Low E2 for a long time, with no solution: 4 (sensitive, 5/2012); <6 (sensitive 6/2013); 12.4 (7/2014); <6 (3/2015); 12.4 (7/2014); 15.6 (11/2016); 7.2 (12/2016); and 6.6 (3/2018).

Any suggestions to get my E2 up? I am desperate.

 

[Deleted member 16042]

You could try a few things:
-Larger dose of T or going to injection.
-Add back the HCG
-DHEA

 

[Systemlord]

Check pregnenolone and magnesium, if either of these is deficient you could expect anxiety.

TRT has been known to deplete both of these hormones in some individuals.

 

[Sean Mosher]

Yes, what SystemLord said.
Check both of those as well.