Just starting TRT

[Johnnie8870]

I am a 49 yr old male and have struggled with anxiety disorder for over 20 yrs. About a year and a half ago it became debilitating after having it under control with medication so my doctor started looking for answers. He found it when my lab work came back with a total test at 25! Lab results( I read the intro to community hope I post it correctly, apologize if it’s not the correct format)
Total Test: 23 ng/dL Range(250-1100)
Free test: 4.3 Range(35-155)
SHBG: 27 range (10-50)
My primary doctor so far has given me a shot of 200 mg of test Cypionate weekly each Wednesday. I have had two shots and I feel a little better but anxiety is still bad. The plan according to the doc is to do the weekly shots at 200 mg, recheck labs after 1 mth of treatment then switch to the gels for long term stability. I am at my wits end with the symptoms, having struggled with anxiety disorder, it is the biggest struggle. Brain fog, irritability, weight loss. It has taken a toll. We are running more tests to see what may be causing the low T but we are pretty sure the cause is due to other medications. I had a bad back injury and went through pain management and went down a path with doctors that just kept filling opiate prescriptions. I am currently on methadone which I hate but it’s stabilized my back pain without all the other issues associated with OxyContin. My concerns are: -should I trust my primary to take on this issue of getting my endocrine system back in check or seek out a specialist. - His plan to switch to the gels after reaching normal test levels, I have read mixed reviews on the effectiveness of the gels over injections. Given the fact that I am on methadone for the pain and am working hard to get off but my levels will always be pushed down as long as I am on the pain meds. - how long I to treatment can I expect to see any changes, if any with my anxiety levels.

I thank you all in advance for any assistance you may provide in helping me make the right decisions to get this turned around

 

[Vince]

I am a 49 yr old male and have struggled with anxiety disorder for over 20 yrs. About a year and a half ago it became debilitating after having it under control with medication so my doctor started looking for answers. He found it when my lab work came back with a total test at 25! Lab results( I read the intro to community hope I post it correctly, apologize if it’s not the correct format)
Total Test: 23 ng/dL Range(250-1100)
Free test: 4.3 Range(35-155)
SHBG: 27 range (10-50)
My primary doctor so far has given me a shot of 200 mg of test Cypionate weekly each Wednesday. I have had two shots and I feel a little better but anxiety is still bad. The plan according to the doc is to do the weekly shots at 200 mg, recheck labs after 1 mth of treatment then switch to the gels for long term stability. I am at my wits end with the symptoms, having struggled with anxiety disorder, it is the biggest struggle. Brain fog, irritability, weight loss. It has taken a toll. We are running more tests to see what may be causing the low T but we are pretty sure the cause is due to other medications. I had a bad back injury and went through pain management and went down a path with doctors that just kept filling opiate prescriptions. I am currently on methadone which I hate but it’s stabilized my back pain without all the other issues associated with OxyContin. My concerns are: -should I trust my primary to take on this issue of getting my endocrine system back in check or seek out a specialist. - His plan to switch to the gels after reaching normal test levels, I have read mixed reviews on the effectiveness of the gels over injections. Given the fact that I am on methadone for the pain and am working hard to get off but my levels will always be pushed down as long as I am on the pain meds. - how long I to treatment can I expect to see any changes, if any with my anxiety levels.

I thank you all in advance for any assistance you may provide in helping me make the right decisions to get this turned around

I wonder if your meds are affecting your testosterone levels?

 

[Johnnie8870]

I’m sure they are, i have researched for weeks to educate myself on low testosterone. The methadone, SSRI’s can definitely dramatically lower testosterone levels. My primary is pretty confident that is the reason for the extremely low level.

 

[Vince]

I’m sure they are, i have researched for weeks to educate myself on low testosterone. The methadone, SSRI’s can definitely dramatically lower testosterone levels. My primary is pretty confident that is the reason for the extremely low level.

People with anxiety issues can really struggle with TRT. It would be best to keep your weekly dose low. I would think something like 10 MG of testosterone cypionate daily and I would also incorporate hCG. To keep your testicles full.

 

[swoops36]

Why would you stop the injections to switch to gels? You’re going to have to get dialed in all over again, and you’re likely not going to feel as good. See if you can just stay on shots, and adjust the dose based on your labs? 4 weeks is too soon anyway, 6-8 would be better

 

[Deleted member 16042]

I vote for a specialist. That your primary care doc put you on 200mg 1 dose/week indicates he or she does not know the nuances of TRT.

And agree, with your blood T levels, I would not mess around with gel unless managed by a specialist who knows various such protocols inside out. You need a serious correction which seems would be managed much more effectively with injections. Absorption via transdermal delivery can vary wildly patient to patient. Injections guarantee that the T at least enters your body in a known amount.

And a question, on the 200mg one dose per week, are you noting any weekly mood swings? It is very common with weekly doses, men feel symptomatic towards end of weekly cycle before next dose. Many of us even with higher SHBG inject every other day or even daily due to this effect and for other benefits.

 

[fifty]

Why would you stop the injections to switch to gels? You’re going to have to get dialed in all over again, and you’re likely not going to feel as good. See if you can just stay on shots, and adjust the dose based on your labs? 4 weeks is too soon anyway, 6-8 would be better

Right. A 200mg injection and gels are different worlds.

 

[jws1300]

For someone with anxiety 200/week seems like a lot. IMO it should be half that or even better 50mg every 3.5 days and give it a couple months.