cannot get stable on TRT: insomnia, anxiety

[Tgrappler]

hello all. i really hope to get some hints on what could be going on with me or my protocol.
i've been on the TRT cream for about 4 months total. when i first started on the protocol my T numbers were extremely low and e2 was high. i felt like everything in my life became an unsurmountable challenge. going to a restaurant would usually give me a solid anxiety kick that drained me out of all the energy.
my love for exercising was also cut short because whenever my HR raises, my body starts going into a full blown panic mode.

in the first month of following the protocol i definitely felt better. there were days when i was so thrilled i really felt that all this nasty is finally coming to some logical conclusion. i got my "mojo back", i had strength and hope to push through whatever comes my way. although still difficult, but i was able to get back to training.

about a month ago i ran out of cream and pretty much around the same time came down with a bad flu. all in all instead of continuing my protocol as i should have, i messed up and didn't have access to the TRT for 3 weeks. all the "progress" i've made over the last few months seem to have disappeared. now i know that i had to keep going with TRT and it was a big mistake to stop, like i did... but i just cannot stabilize again.
my numbers from the last lab, after i ran out of cream... things got back to where i was before i had started TRT:

Free Test = 35 Range 46.0-224.0 pg/mL)
SHBG = 76 (Range 10-50 nmol/L)
Bio Test = 76 (Range 110.0-575.0 ng/dL)
Estradiol = 32 (Range < OR = 29 pg/mL)

it's been 2.5 weeks of constant struggle. maybe i'm forgetting how bad things used to be... but the insomnia and non-stop panic are becoming a little much to deal with. today i passed out around 11PM and woke up in cold sweat at 2AM my body is trembling, i'm crying and full panic and my poor wife is beside herself with worry.

overall i'm feeling like i have some good days and moments where i have no anxiety at all and then one little trigger and i'm literally spiraling out of control.

i'm currently on daily cream 2x / day 0.5 ml/dose. (concentration of 200mg/ml lipo compounded cream). i have also taken 2mg of AI twice in the last 4 days.

i'm looking for any advice or at least a hint that this might be "normal", that i'm still stabilizing. it's just so bizarre that i can go from seemingly feeling fine to shaking, crying and falling into a deep depression in a matter of hours.

 

[Vince]

My recommendation would be, try injections and forget about the creams. With your high shbg, once weekly injections may help. For someone like you that would probably be the best protocol. You may also want to consider HCG, to help give you or keep full testicles.

 

[mooseman109]

I had poor luck with creams as well. Some folks seem to do ok while others, read most, do not! I moved to injections and found it better. It really is no big deal. I have moved over to daily recently, will do labs in 2 weeks to see what changes have happened. I can say I feel like libido has climbed with the change in frequency. I am not as high in SHBG as you, but I am above the mean.

 

[Tgrappler]

thank you so much for your responses. i will definitely bring this up with my doc. i chose to go the cream route because of my preexisting anxiety and i wasn't sure how well i'd do trying to inject myself. perhaps i do need a stronger and more consistent option.

I am also wondering about Estradiol being at 30+ , my doc says that these "emotional" episodes are likely to be caused by high E and so far still rather low T. Doc is pretty confident that once I get this under control things will stabilize.
However, I am concerned about taking too much AI. I already took 2mg over 4days. Is it at the level where I actually should be worried? Could shots potentially raise my Estradiol even higher?

sorry for all the questions, i'm a complete noob when it comes to TRT (obviously)... but i am eager to learn. there's definitely some light at the end of tunnel... i've felt it. unfortunately most days i'm still stumbling through the dark. I greatly appreciate all the advice I've gotten so far.

 

[mooseman109]

when my e2 got to 32.5 I was emotional and full of anxiety. I like mine at 20 or below

 

[Tgrappler]

when my e2 got to 32.5 I was emotional and full of anxiety. I like mine at 20 or below

did you use Anastrazol or other AI for lowering e2? ... if so can you share the dosage that worked for you?
i've been reading that some people are very sensitive to AI and i'm cautious about taking too much and messing things up even further.

 

[mooseman109]

No I did not use an AI. I try to avoid it as it is just another thing that has to be balanced out. I stopped taking hcg and dhea, those were the 2 things that raised it up. I am not against an AI if it needs to be done, I just prefer simple. I am back to just Testosterone only and am happy.

 

[Weasel]

Get rid of the AI and see how you feel. 2mg in 4 days WILL crash e2. 32 on a non-sensitive test is not elevated.

Your symptoms fall right in line with low e2.

 

[Tgrappler]

Thank you so much for this clarification regarding e2... no wonder I am all over the place with this stuff. I did feel like taking that 1mg of AI yesterday kicked my anxiety and subsequent insomnia into high gear. I'm going to hold off on taking it for the time being.

it's just so strange that my doc said exactly the opposite; that these symptoms seem to be associated with *high* E2. otherwise he was right on the money with the protocol and other advice that i've read here and what he said is pretty much well aligned.

 

[Weasel]

That's the thing with e2, most symptoms are the same for high and low e2. I've been in your shoes before, it was the worst year of my life.

Constant panic, crying fits, heart palpitations, insomnia like no other, racing thoughts about random shit when I should be sleeping.

elevated e2 can also be these same symptoms, but generally not nearly as severe from my experience and readings. I've personally never had insomnia when I had elevated e2. 1mg a week of AI is to much for most. for myself, 0.25mg per week was to much.

 

[Tgrappler]

thank you. @Weasel ... wow. one year?! i couldn't imagine living like this for a few days. although my situation might be more desperate because of the pre-existing condition.

but all in all this makes sense. i haven't changed anything except taking that 1mg of AI... and it just completely sent me over the edge. lesson learned. and I hope that it will leave my system soon enough so i can stabilize. i sincerely hope that 2mg over 4 days wasn't enough to create a serious misbalance.

 

[JimBob]

Where do you apply the cream? Scrotally has a higher rate of absorption.

 

[Tgrappler]

Where do you apply the cream? Scrotally has a higher rate of absorption.

i use left shoulder / pec area.

usually i'm around my wife so i cover up with a loose tshirt shortly after application. that's also why i didn't try scrotum as of yet. today it doesn't look like i'm getting any action anyways.. so i may just try it tonight.

 

[Tgrappler]

just a quick update. my doctor agreed that i should stop taking AI... he also suggested that i take Propranolol to deal with these anxiety-like symptoms specifically tachycardia and sweating. i'm a little concerned about taking another pill, but maybe it will help with some symptoms. he said it will be extremely short term.

any ideas? i guess that's already beyond the realm of TRT. i was just wondering if anyone had experience with such combination of medications?

(to say this is confusing is an understatement.. .but i'm learning)

 

[Weasel]

Where do you apply the cream? Scrotally has a higher rate of absorption.

Scrotum has a higher DHT conversion.

 

[Systemlord]

Sometimes when guys start TRT they end up depleting magnesium and or pregnenolone and this will cause anxiety.