Shortness of breath, chest tightness and odd heart beat

[findingforever]

Hi there,

I am 29 years old and I've been on TRT since July 2019, taking the following protocol:

• 100mg Test Cyp SubQ per week (since Aug, I have split this into two 50mg injections per week)
• 1000iu HCG SubQ per week (however, I have been on HCG for about a month, as I was traveling and lost my vial)

For the past two weeks, I've had some very concerning issues, namely:

• Chest tight and a dull pain, especially on the left hand side of my chest (the pain has subsided recently)
• Heart beating harder than usual and during workouts, I sometimes feel it beat irregularly
• Shortness of breath. In general, I feel like I am finding it harder to breath even when at rest and during workouts it is especially difficult (I have to stop)

These symptoms have only shown in the last two weeks and the only thing that has changed in my protocol recently is the lack of HCG for the last month. My diet has also not been as great for the past three weeks, but I've never had this problem before.

As you can imagine, I'm very concerned. Does anybody know what could be causing this? My labs taken in August can be seen attached. Any advice would be appreciated.

I am going to see my urologist on Wednesday and will be setting up some time separately with a cardiologist this week too.

 

[Systemlord]

These symptoms have only shown in the last two weeks and the only thing that has changed in my protocol recently is the lack of HCG for the last month.

Your labs are indicating iron deficiency, when one has iron deficiency your immune system is weakened and may help explain your elevated white cell count. Your vitamin D is low and wouldn't be surprised if you were having IBS symptoms, this is dejavoo for me because I had unexplained fatigue for over a year on TRT which I later found out was iron deficiency.

In April I had the same MCHC and MCH numbers right before things went south, vitamin D was low, my potassium and vitamin C were also low. When an iron and ferritin panel was run, both were below range. When I looked back almost 3 year earlier, iron was at the bottom of the range.

Your hemoglobin should be higher on TRT, it is low and you more than likely have microcytic anemia. I need to see vitamin C levels, vitamin C is responsible for iron absorption, so if vitamin C is low, iron will also be low, so supplementing iron could be the wrong move as I found out the hard way.

Symptoms of iron deficiency, microcytic anemia are:

• Fatigue and chronic tiredness
• Shortness of breath
• Pale skin
• Easy bruising
• Dizziness
• Weakness
• Loss of stamina

 

[Joe Sixpack]

Hi there,

I am 29 years old and I've been on TRT since July 2019, taking the following protocol:

• 100mg Test Cyp SubQ per week (since Aug, I have split this into two 50mg injections per week)
• 1000iu HCG SubQ per week (however, I have been on HCG for about a month, as I was traveling and lost my vial)

For the past two weeks, I've had some very concerning issues, namely:

• Chest tight and a dull pain, especially on the left hand side of my chest (the pain has subsided recently)
• Heart beating harder than usual and during workouts, I sometimes feel it beat irregularly
• Shortness of breath. In general, I feel like I am finding it harder to breath even when at rest and during workouts it is especially difficult (I have to stop)

These symptoms have only shown in the last two weeks and the only thing that has changed in my protocol recently is the lack of HCG for the last month. My diet has also not been as great for the past three weeks, but I've never had this problem before.

As you can imagine, I'm very concerned. Does anybody know what could be causing this? My labs taken in August can be seen attached. Any advice would be appreciated.

I am going to see my urologist on Wednesday and will be setting up some time separately with a cardiologist this week too.

I would bring this up w/ Dr. Rotman, assuming he is your TRT doctor.

 

[madman]

Hi there,

I am 29 years old and I've been on TRT since July 2019, taking the following protocol:

• 100mg Test Cyp SubQ per week (since Aug, I have split this into two 50mg injections per week)
• 1000iu HCG SubQ per week (however, I have been on HCG for about a month, as I was traveling and lost my vial)

For the past two weeks, I've had some very concerning issues, namely:

• Chest tight and a dull pain, especially on the left hand side of my chest (the pain has subsided recently)
• Heart beating harder than usual and during workouts, I sometimes feel it beat irregularly
• Shortness of breath. In general, I feel like I am finding it harder to breath even when at rest and during workouts it is especially difficult (I have to stop)

These symptoms have only shown in the last two weeks and the only thing that has changed in my protocol recently is the lack of HCG for the last month. My diet has also not been as great for the past three weeks, but I've never had this problem before.

As you can imagine, I'm very concerned. Does anybody know what could be causing this? My labs taken in August can be seen attached. Any advice would be appreciated.

I am going to see my urologist on Wednesday and will be setting up some time separately with a cardiologist this week too.

Hi there,

I am 29 years old and I've been on TRT since July 2019, taking the following protocol:

• 100mg Test Cyp SubQ per week (since Aug, I have split this into two 50mg injections per week)
• 1000iu HCG SubQ per week (however, I have been on HCG for about a month, as I was traveling and lost my vial)

For the past two weeks, I've had some very concerning issues, namely:

• Chest tight and a dull pain, especially on the left hand side of my chest (the pain has subsided recently)
• Heart beating harder than usual and during workouts, I sometimes feel it beat irregularly
• Shortness of breath. In general, I feel like I am finding it harder to breath even when at rest and during workouts it is especially difficult (I have to stop)

These symptoms have only shown in the last two weeks and the only thing that has changed in my protocol recently is the lack of HCG for the last month. My diet has also not been as great for the past three weeks, but I've never had this problem before.

As you can imagine, I'm very concerned. Does anybody know what could be causing this? My labs taken in August can be seen attached. Any advice would be appreciated.

I am going to see my urologist on Wednesday and will be setting up some time separately with a cardiologist this week too.

When exactly did you switch over from 100 mg/week protocol--->50 mg every 3.5 days as you stated:

• 100mg Test Cyp SubQ per week (since Aug, I have split this into two 50mg injections per week)

What lab was your bloodwork done?

 

[findingforever]

Your labs are indicating iron deficiency, when one has iron deficiency your immune system is weakened and may help explain your elevated white cell count. Your vitamin D is low and wouldn't be surprised if you were having IBS symptoms, this is dejavoo for me because I had unexplained fatigue for over a year on TRT which I later found out was iron deficiency.

In April I had the same MCHC and MCH numbers right before things went south, vitamin D was low, my potassium and vitamin C were also low. When an iron and ferritin panel was run, both were below range. When I looked back almost 3 year earlier, iron was at the bottom of the range.

Your hemoglobin should be higher on TRT, it is low and you more than likely have microcytic anemia. I need to see vitamin C levels, vitamin C is responsible for iron absorption, so if vitamin C is low, iron will also be low, so supplementing iron could be the wrong move as I found out the hard way.

Symptoms of iron deficiency, microcytic anemia are:

• Fatigue and chronic tiredness
• Shortness of breath
• Pale skin
• Easy bruising
• Dizziness
• Weakness
• Loss of stamina

Wow, I think you really might be onto something.

I had labs earlier in the year before I started TRT in May, and my iron was checked in those labs (see attached). Whilst my iron was on the low end of normal, my UIBC/TIBC was abnormally high (an indicator of iron deficiency) and my total Iron % saturation was abnormally low. My ferretin was on the low end of normal (46 ng/ml in a range of 22-336). I was put on Iron tablets but I barely took them for two weeks as I lost them in transit and never bothered to refil (because I am an idiot). I didn't take it seriously.

As can be seen in my most recent labs, I also definitely have severe vit D deficiency, which I will begin supplementing this week. I've never had a vitamin C test but I will also begin supplementing that because I see no harm in taking Vit C tablets anyway.

I really think you might be onto something. I know I had iron deficiency before TRT and I believe starting TRT has exacerbated the symptoms of it (due to increase RBC, HCT or heamoglobin).

Thank you so much for your reply. I've been going crazy with worry that I may have a heart problem (which may still be true) but I think I may actually have an iron deficiency. I will discuss all of this with my doctor on Wednesday.

 

[findingforever]

I would bring this up w/ Dr. Rotman, assuming he is your TRT doctor.

Thank you, I will do on Wednesday. I will be going in armed with the advice Systemlord provided as I believe he is onto something.

 

[findingforever]

When exactly did you switch over from 100 mg/week protocol--->50 mg every 3.5 days as you stated:

• 100mg Test Cyp SubQ per week (since Aug, I have split this into two 50mg injections per week)

What lab was your bloodwork done?

I switched over to 50mg x 2 two weeks before these labs were taken. The bloodwork was taken by my urologist at his practice; i don't know what lab he used to get the results.

 

[madman]

Hi there,

I am 29 years old and I've been on TRT since July 2019, taking the following protocol:

• 100mg Test Cyp SubQ per week (since Aug, I have split this into two 50mg injections per week)
• 1000iu HCG SubQ per week (however, I have been on HCG for about a month, as I was traveling and lost my vial)

For the past two weeks, I've had some very concerning issues, namely:

• Chest tight and a dull pain, especially on the left hand side of my chest (the pain has subsided recently)
• Heart beating harder than usual and during workouts, I sometimes feel it beat irregularly
• Shortness of breath. In general, I feel like I am finding it harder to breath even when at rest and during workouts it is especially difficult (I have to stop)

These symptoms have only shown in the last two weeks and the only thing that has changed in my protocol recently is the lack of HCG for the last month. My diet has also not been as great for the past three weeks, but I've never had this problem before.

As you can imagine, I'm very concerned. Does anybody know what could be causing this? My labs taken in August can be seen attached. Any advice would be appreciated.

I am going to see my urologist on Wednesday and will be setting up some time separately with a cardiologist this week too.

Iron deficiency can easily be a cause of such issues!

Regarding your protocol/labs.

What stands out to me here is you started trt some time in July.....100 mg/week protocol.

Not to long after you decided either on your own (most likely scenario) or requested by your treating doctor (highly unlikely) to switch from the 100 mg/week protocol to 50 mg every 3.5 days.

Just so you understand when starting trt or anytime T dose is increased or injection frequency increased when using the same weekly T dose but broken up using more frequent injections your testosterone levels will be in flux during the weeks leading up until blood levels stabilize at 6 weeks and lab work needs to be done at 6 or 8 weeks to see where said dose of T puts your TT/FT/E2 levels......let alone how it effects overall health markers which will include hemoglobin/hematocrit.

During this time your protocol needs to be consistent.....meaning same dose/injection frequency for 6-8 weeks.....followed by blood work.

Seeing as you started trt in July on 100 mg/week and switched over to 50 mg every 3.5 days some time in August you most likely were not on the 100 mg/week protocol for a full 6 weeks.....let alone the big kicker here is not only did you switch over to the newer protocol of 50 mg every 3.5 days sometime in August.....but more importantly your blood work was done on August 21.....so there is no way you were on the 50 mg every 3.5 days for a full 6 weeks!

Your hormones were still in FLUX as you had not allowed enough time (6 full weeks on new protocol- same overall weekly T dose but now 50 mg every 3.5 days ) because your blood work was done on August 21.

Looking over your labs I can tell you that not only are your FT levels higher than you think but most importantly we truly have no idea where your TT/FT/E2 levels sit on your recent protocol because you did not allow blood levels to stabilize on the new protocol before getting blood work done.

Were these labs done at trough and most likely your TT/FT levels will be higher once blood levels stabilize at 6 weeks as your lab results do not give an accurate picture due to you starting the new protocol in August and having blood work done on August 21.....you did not wait 6 weeks for blood levels to stabilize.

 

[madman]

I switched over to 50mg x 2 two weeks before these labs were taken. The bloodwork was taken by my urologist at his practice; i don't know what lab he used to get the results.

Your labs were done at the wrong time.....you needed to be on your new protocol for a full 6 weeks to allow blood levels to stabilize!

The method used to test your FT is an outdated calculated method which has been shown to underestimate FT levels.

The only way to truly know where your FT level sits it to have testing done using the most accurate testing methods such as the gold standard Equilibrium Dialysis or Ultrafiltration.....or if anything just use the newer calculated TruT method which has been shown to be on par with results obtained by the gold standard Equilibrium Dialysis.

It is available online to the general public.

Looking over your most recent labs if we use the newer calculated TruT method than with a TT 1171 ng/dL, SHBG 60.94 nmol/L, Albumin 4.9 g/dL than your FT level is 34.61 ng/dL (over the top end of the reference range of 16-31 ng/dL).

As you can clearly see even with a high SHBG of 60.94 nmol/L and EVEN with a slightly elevated Albumin 4.9 g/dL (mean 4.3) that your FT is high due to your high TT 1171 ng/dL.

Now keep in mind if these labs were done at trough than your peak TT/FT levels will be even higher.....but again you had only been on the 50 mg every 3.5 days protocol for 2 weeks before having labs so I would say that your TT/FT levels may be even higher if you had blood work done at the proper time (after 6 weeks on new protocol).

It is now the end of September so your blood levels would have stabilized by now.....you need to get a new set of labs done to TRULY see where your TT/FT/E2 levels let alone hemoglobin/hematocrit sit!

 

[madman]

Critical that you get a new set of labs done!

 

[findingforever]

Thank you for all of that information Madman. I definitely concur with everything you lay out. This is all so much more complicated than people make out and I initially thought, despite doing a lot of research on the topic.

I will speak to my Doc on Wednesday in regards to redoing bloods. I've been on 50mg E3.5D for quite a few weeks now, so I agree that it probably makes sense for me to get retested.

In my initial labs, there are definitely some things that concern me. My SHBG is incredibly high - I have a severe Vit D deficiency so that is something I can immediately do to treat this.

I get a little anxious when trying to figure all of this out in all honesty. I am quite good at staying on top of my health but I want to get to a point where I have a protocol that is good for me which I have dialed. That takes time, I guess.

 

[findingforever]

Critical that you get a new set of labs done!

Quick question - is there anything else in my labs which jumps out as being alarming? Just so I know to ask that specifically when seeing the doc.

 

[madman]

You definitely need to start supplementation using Vit D 5000 IU daily and look into taking iron bisglycinate.

Forget worrying about your elevated SHBG (unless there was an underlying issue) as due to your high TT your FT levels are just over the top end of the reference range.....although those labs were done at the wrong time (2 weeks after protocol change)!

Also understand that when using exogenous testosterone hemoglobin/hematocrit levels will not only increase within the first 1-3 months but can take up to 9-12 months to reach peak levels.

 

[madman]

I also inject twice weekly (every 3.5 days).....Tuesday morning at 8 am and Friday evening at 8 pm.....so when getting blood work done it would be on a Tuesday morning at 7 am just before my next injection.....that would be at TROUGH!

 

[madman]

Quick question - is there anything else in my labs which jumps out as being alarming? Just so I know to ask that specifically when seeing the doc.

Nothing major.....not sure why your LH/FSH was tested as the hpta is shutdown when using exogenous testosterone.

 

[Systemlord]

The iron bisglycinate usually has vitamin C added to help with iron absorption, so there is your daily supply of vitamin C. This is also chelated iron without vitamin C in case your daily vitamin C is adequate.

Another thing, approximately 70-90% of vitamin C is absorbed at moderate doses of 30-180mg, however doses above 1000mg will see absorption decrease by 50%.

 

[findingforever]

The iron bisglycinate usually has vitamin C added to help with iron absorption, so there is your daily supply of vitamin C. This is also chelated iron without vitamin C in case your daily vitamin C is adequate.

Another thing, approximately 70-90% of vitamin C is absorbed at moderate doses of 30-180mg, however doses above 1000mg will see absorption decrease by 50%.

Would supplementing with the following daily be okay? I cannot find bisglycinate at cvs.

CVS Health Iron 65 Mg Tablets (with Photos, Prices & Reviews)
and
CVS Health Vitamin C Easy To Swallow Caplets 500mg, 100CT (with Photos, Prices & Reviews) - CVS Pharmacy

OR, would this be better (Iron plus Vit C):
Vitron-C High Potency Iron Plus Vitamin C Coated Tablets, 60CT (with Photos, Prices & Reviews) - CVS Pharmacy

 

[Systemlord]

The iron tablets are poorly absorbed and have the most side effects, I'm not a fan of CVS supplements. I would go for the high quality stuff like Pure Encapsules Optiferin-C, Pure Encapsules Iron-C or Bluebonnet Chelated iron.

The former two have vitamin C added. If you're looking for supplements, choose the natural route, I got Vitamin C Gold from Nutrigold and sure it's expensive ($27 qty 90), but I don't just put any supplement is my body unless I know it's natural and good quality.

I stay away from the synthetic crap which has side effects.

 

[madman]

Would supplementing with the following daily be okay? I cannot find bisglycinate at cvs.

CVS Health Iron 65 Mg Tablets (with Photos, Prices & Reviews)
and
CVS Health Vitamin C Easy To Swallow Caplets 500mg, 100CT (with Photos, Prices & Reviews) - CVS Pharmacy

OR, would this be better (Iron plus Vit C):
Vitron-C High Potency Iron Plus Vitamin C Coated Tablets, 60CT (with Photos, Prices & Reviews) - CVS Pharmacy

Now Foods, Iron, 18 mg, 120 Veg Capsules


Now Foods, Iron, Double Strength, 36 mg, 90 Veg Capsules



Iron Deficiency Without Anemia – Common, Important, Neglected

*Iron inhibits the absorption of thyroid hormones, and hence it is best to take the thyroxin tablet in the morning and the first iron pill around noon. Iron absorption is reduced by milk, calcium and magnesium products and by proton pump inhibitors. Also, coffee, tea and cereal products affect negatively the uptake of iron. At higher doses of iron intake, these diet restrictions have less importance. The impact of vitamin C as an uptake enhancer diminishes also when the iron dose increases. The role of the diet as a treatment modality of iron deficiency is generally modest, but once iron deficiency has been corrected, dietary iron is a significant iron homeostasis-maintaining factor.

 

[findingforever]

The iron tablets are poorly absorbed and have the most side effects, I'm not a fan of CVS supplements. I would go for the high quality stuff like Pure Encapsules Optiferin-C, Pure Encapsules Iron-C or Bluebonnet Chelated iron.

The former two have vitamin C added. If you're looking for supplements, choose the natural route, I got Vitamin C Gold from Nutrigold and sure it's expensive ($27 qty 90), but I don't just put any supplement is my body unless I know it's natural and good quality.

I stay away from the synthetic crap which has side effects.

I will purchase the first you mention: https://www.amazon.com/Pure-Encapsu...97&sprefix=iron+bisglycinate+v,aps,136&sr=8-4

So should I just start taking these? Or should I wait to see a doctor and get iron levels checked and have something prescribed?

I ask because I want to alleviate the symptoms (breathlessness and chest tightness) ASAP. I don't want to wait longer than I have to.