Stopped TRT 2 Weeks Ago, Feeling Better Now? Was it High E?

[LakeGuy81]

Was doing IM 150 mg/week, and had just switched to 20mg/day, via Sub Q. Was also doing 1000 IU HCG/week. Both on IM and Sub Q, I had battled anxiety and no libido on and off since starting TRT last June. The anxiety & obsessive worry got really bad 2-3 weeks ago, so I stopped taking both T and HCG cold turkey.

As the T/HCG left my system, two things happened: #1 my anxiety went down significantly, and has now completely disappeared. I was having HORRIBLE anxiety 2-3 weeks ago, and nearly had a panic attack with some of my employees at a dinner event and then also at a function the next day. #2--As the T/HCG left, it seemed my libido actually temporarily improved like 5-10 days after last injection? But now libido is back down again at 14 days since last injection. What could be going on here? I don't really suffer from fatigue as a low T symptom, and feel pretty good off T other than crappy libido. That said, my libido has been crappy on TRT too, so I'm questioning even to go back on?

I cannot deal with that bad anxiety, I feel so much more calm and relaxed off the TRT right now, but I would love to get my libido back. 36 years old, excercise weekly, generally healthy. 6'1", 220 lbs. My labs from past 8-10 months below:

Date	5/9/17	7/20/17	8/29/17	12/14/17	3/14/18
Lab	LabCorp	LabCorp	Vibrant	LabCorp	Quest
Weight	213 lbs	213 lbs	213 lbs	215lbs	220lbs
T Dose	Pre-TRT	100mg/week	100mg/week	100mg/week	150mg/week
Total T	292 ng/dl	745 ng/ml	851 ng/dl	641 ng/dl	863 ng/dl
Range	348-1197	264-916	348-1379	264-916	250-1100
Free T	NT	NT	21.8	NT	196.8 pg/ml
Range	NT	NT	9.00-30.00	NT	35.0-155.0
Estradiol	22.0 pg/ml	33.8 pg/ml	40.2 pg/ml	33.5 pg/ml	38
Range	7.6-42.6	7.6-42.6	25.8-60.7	7.6-42.6	<=39
SHBG	24.5 nmol/L	24.1 nmol/L	21.9 nmol/L	22.1 nmol/L	NT
Range	16.5-55.9	16.5-55.9	16.5-55.9	16.5-55.9	NT

 

[AbsoluteZ3R0]

Could be many things. HCG can cause anxiety in some. 5-10 days is enough time for it to clear enough from your system to offer relief. The other possibility is that with your low SHBG, you might feel better with less estradiol. Yours is at the top of the range, which is a bit much for someone with low SHBG (your free e2 is likely well over range). The last possibility is that you need to target a lower total testosterone number to feel your best. Of the three, the most likely explanation is that your e2 has been too high, and you felt your best when it reached a healthy number, before plummeting too low 2 weeks later.

 

[LakeGuy81]

Could be many things. HCG can cause anxiety in some. 5-10 days is enough time for it to clear enough from your system to offer relief. The other possibility is that with your low SHBG, you might feel better with less estradiol. Yours is at the top of the range, which is a bit much for someone with low SHBG (your free e2 is likely well over range). The last possibility is that you need to target a lower total testosterone number to feel your best. Of the three, the most likely explanation is that your e2 has been too high, and you felt your best when it reached a healthy number, before plummeting too low 2 weeks later.

Thanks for the quick reply! My current Dr. believes "the higher E2, the better, because E is GOOD for men." He claims his practice doesn't believe in AI's because there's so much evidence that E is actually good for men, blah, blah. He told me he might try an AI if I absolutely demand it, however. If I wanted to tip-toe into an AI to see if E was to blame, what would be a smallish does that would be safe not to crash my E? Also, in trying to isolate whether T or HCG is to blame for the anxiety, should I maybe do T only at first and see how it feels? Or try to do HCG mono for awhile?

 

[AbsoluteZ3R0]

Thanks for the quick reply! My current Dr. believes "the higher E2, the better, because E is GOOD for men." He claims his practice doesn't believe in AI's because there's so much evidence that E is actually good for men, blah, blah. He told me he might try an AI if I absolutely demand it, however. If I wanted to tip-toe into an AI to see if E was to blame, what would be a smallish does that would be safe not to crash my E? Also, in trying to isolate whether T or HCG is to blame for the anxiety, should I maybe do T only at first and see how it feels? Or try to do HCG mono for awhile?

Your doctor is correct that E2 is a necessary hormone and it wields many health benefits for men, however, having levels that are too high can be problematic for most. You should only change one variable at a time. There are many reasons to believe that HCG is a necessary component of any successful trt protocol, but some men simply don't respond well to it no matter what. The easiest way to reduce your e2 without using an AI is to reduce your dose of either testosterone, HCG, or both, but since you didn't feel well even on 100mg, this may not be a good option for you. The first thing I would recommend is cutting HCG out entirely for one week. If HCG is the culprit, you should notice rapid improvement throughout the course of the week, due to its relatively short 48-hour half life. The downside to this method is that you E2 levels will also drop as a result of cutting out HCG, so you'll have no way of knowing which of the two factors resulted in improvement (it could be both). You can always resume HCG if there is no improvement. Whether you experience improvement or not, I'd recommend going back on HCG and trying .25mg of anastrozole twice a week. The anastrozole will have a much more significant impact on your E2 levels than cutting out HCG, so if estradriol is to blame, then you will notice even more improvement after a week or two than you did by cutting out HCG. It may be that you'll need to reduce your HCG dose (perhaps in half) and use an AI. Unfortunately, successful trt protocols require a great deal of finesse and fine-tuning, and it is going to be difficult to manage with a doctor who is hesitant to use anastrozole when needed.

 

[1Draw]

LakeGuy have you ever had a FULL Thyroid panel done? Low T and Hypothyroidism are very related as mentioned here:

https://www.restartmed.com/thyroid-symptoms-men/

He also gives all the lab test to run and optimal ranges for a healthy thyroid. Fatigue, low libido and anxiety all symptoms of thyroid disorders as well as low T.....

Good luck and keep us updated...

 

[Systemlord]

Starting TRT with a poorly functioning thyroid can make a guy feel worse, but I believe E2 was high to start with if you're feeling better a week later. I also think your dosage is just too high given your somewhat low SHBG, you need to give 50mg twice weekly a try.

 

[Vince Carter]

I really don't subscribe to hormones bringing on this level of anxiety as related here, there's something else going on that did TRT use in a vacuum trigger a response...possbily. But CAUSE it...I'm not buying that one.

If you try again, go easy, 15mg/D and no HCG and titrate up your dose. Something I see in your labs that I don't recommend is using multiple labs and trying to lay things out next to one another for comparison...I suggest using only one lab for all your testing. Also note the glaring absence of Free T. If/when you restart titrate up (or down) your dosing based on the Free T.

I totally agree with AbsoluteZero on Free E and being too high, for YOU.

 

[timk]

I was started on a high dose of TRT and it caused the same problems for me...less the high E. I lowered my dose, on my own, and the anxiety went away. I don't understand why doctors prescribe a high dose right out of the gate. I bet if you started low and kept that for 90 days you'd feel a lot better.

 

[Charliebizz]

I have exactly the same experience with trt. I had anxiety in the past before low hormone issues. But was completely free of it for about 10 years. I'm not saying trt causes anxiety but it sure as hell pulled it back out. I've tried trt a few times over my 10 year low testosterone journey and every time it's the same story. Starts off ok then anxiety creeps in.this last go around I had strange intrusive thoughts with it. I was with one of the top docs in the field to we tried everything. I'm a low shbg guy. I'm around 15 when on trt. I tried many different shot schedules and doses and just couldn't get dialed in. My numbers looked great but I felt worse. Only thing trt really helped with was my body pain. I have a terrible back. And it just helped so much with it. And my recovery from workouts or hockey was better.

I also had the same experience when I first went off I felt pretty good but now I'm off almost 2 months and I feel worse then before I started this time around. I started clomid a few weeks ago but I never feel much benefit from. It cause it raises my shbg to top of range and despite good total t numbers my free t is low

 

[HelloMoto]

Are you going to continue TRT in the future?

 

[Charliebizz]

I also see a common trend. And this is just my speculation but seems like us younger guys. (I'm-35 had low t since 25) tend to have other things going on and do not do as well as the guys that have low t due to natural age related issues. I feel like my body has down regulated my testosterone for a reason. And boosting it I'm going against what my body is trying to sort out sounds crazy. But it's almost like the starvation mode theory's with the thyroid. Also if you read a lot of dr Mariano's work he speaks about just throwing one hormone at many of his patient doesn't seem to work or does at first and then slowly they decline.

 

[JBone]

His E2 isn’t high and his shgb is fine.

 

[swellco]

50yo here and a year and a half on Trt. I cut the HCG and AI and seem to have gotten rid of the anxiety, especially at night and am sleeping better. I think HCG might be the culprit.

 

[sh1973]

I’ve been on trt over 8 years and have tried hcg, dhea, Pregnonolone and briefly Arimidex. I can tell you for certain, all of these even at tiny doses were detrimental to how I felt. Hcg and dhea were by far the worse. I can’t even tolerate hcg at 200iu twice weekly. I along with many others do best on testosterone alone.