Long term 200mg TRT now having health issues

[TownTX]

Hi all

28 year old male. I'm currently being investigated for having possible seizures. Which I don't believe are actually seizures.

Every 2 to 3 months I wake up in the middle of the night unable to see properly. My vision is oscalating and I feel extremely weak and dizzy. I feel like I'm unable to move. Now here is where it gets strange. My partner pours a lot (80-150g) of sugar down my throat and within 10 minutes the symptoms are completely gone. My vision gradually returns back to normal.

My doc originally thought I was diabetic but that's been ruled out. Then they thought I had reactive hypoglycemia but again that's been ruled out with blood work.

Now they think I'm having seizures and I have another boat load of blood tests to get done.

Either way my doctor is convinced that it's caused by my 8 years of self prescribed TRT at 200mg a week.

I ran a good few cycles a few years ago but the most I ever ran was 500mg a week of test e for 12 months. And the last time I ran a cycle like that was a good 4 years ago. Since then I've been taking 200mg of test e or c every week.

My bloods are perfect. Cholesterol, liver, full count, E2 ect all in range.

Things just don't add up as the symptoms subside with sugar. And I really don't see how seizures cause low blood sugar?

Has anyone had anything similar to this? I'm also curious of the possible safety risks with running long term TRT at 200mg per week? As in will this likely kill me in the long run?

I'm also hypothyroid and I take 75mcg levo per day.

Just to point out I no longer run blasts or cycles. Last one was a good 4 years ago and although I've done some long cycles they have purely been testosterone at 500mg every week?

Thanks

 

[TownTX]

Also feel like I should add that I've been on long term NRT for a while. About 2 years and I use the 4mg nicotine lozenges. I have about 20 per day.

 

[PeterBond]

What's your blood pressure and glucose during such an episode?

I'm also curious of the possible safety risks with running long term TRT at 200mg per week? As in will this likely kill me in the long run?

What are your mid-interval testosterone levels on 200 mg per week? It's very unusual that that's an actual TRT dosage. Either way, higher dosages are associated with an increased risk of major adverse cardiovascular events and overall cardiovascular disease risk.

 

[PeterBond]

Also feel like I should add that I've been on long term NRT for a while. About 2 years and I use the 4mg nicotine lozenges. I have about 20 per day.

If I understand you correctly, you take 20 x 4 = 80 mg of nicotine daily?

Standard textbooks, databases, and safety sheets consistently state that the lethal dose of nicotine for adults is 60 mg or less (30–60 mg), but there is overwhelming data indicating that more than 0.5 g of oral nicotine is required to kill an adult.[7]

Obviously not a lethal dose, but seems plausible for nicotine poisoning:

Nicotine poisoning - Wikipedia

en.wikipedia.org

 

[GreenAmine]

I feel like I'm unable to move

I'm probably way off, but this sounds a bit like sleep paralysis. The sugar could simply be waking you up and snapping you out of it.

 

[lilhawk]

Of course the doctor would blame it on TRT. I highly doubt that has anything at all to do with it.

 

[Ferret]

I had seizers from drinking sugar free Mt Dew. You need to see a Neurologist. And possibly an EEG

It could be Demonic Possession also... have you accepted Jesus?

 

[TownTX]

If I understand you correctly, you take 20 x 4 = 80 mg of nicotine daily?


Obviously not a lethal dose, but seems plausible for nicotine poisoning:

Nicotine poisoning - Wikipedia

en.wikipedia.org

I can't say what my blood glucose is during these episodes because I've never been able to test it until after.

But I did do an advanced blood glucose test after 14 hours of fasting and it was completely normal. My doc said this rules out diabetes and reactive hypoglycemia. These episodes are also only every 2 to 3 months which also rules out these two possible causes.

Blood pressure is normal.

I'm convinced the symptoms are caused by low blood sugar though. Because they completely disappear after sugar. And oscalating vision is a common symptom of dangerously low blood glucose.

Regarding the nicotine mints. The pack states that it's safe to consume upto 20 of the 4mg mints per day. Honestly I've been doing this for years. I've done research but I've found no studies which say of long term risks associated with long term NRT.

 

[TownTX]

If I understand you correctly, you take 20 x 4 = 80 mg of nicotine daily?


Obviously not a lethal dose, but seems plausible for nicotine poisoning:

Nicotine poisoning - Wikipedia

en.wikipedia.org

I guess it's possible that I could be occasionally consuming more of the nicotine mints. Maybe I'm hitting 25-30 of the 4mg mints occasionally and that could be triggering a seizure on them particular occasions?

I know a couple times a month I do have more than 20 accidentally.

Regarding the cardiovascular risks of 200mg TRT do you have any studies which I can read on this? Or case reports? I'm very interested in learning if I'm actually killing myself or not.

 

[PeterBond]

I guess it's possible that I could be occasionally consuming more of the nicotine mints. Maybe I'm hitting 25-30 of the 4mg mints occasionally and that could be triggering a seizure on them particular occasions?

I know a couple times a month I do have more than 20 accidentally.

Regarding the cardiovascular risks of 200mg TRT do you have any studies which I can read on this? Or case reports? I'm very interested in learning if I'm actually killing myself or not.

Testosterone and Cardiovascular Risk: Meta-Analysis of Interventional Studies - PubMed

Data from RCTs suggest that treatment with T is not effective in reducing CV risk, however, when TTh is correctly applied, it is not associated with an increase in CV risk and it may have a beneficial effect in some sub-populations. Corona G, Rastrelli G, Di Pasquale G, et al. Testosterone and...

pubmed.ncbi.nlm.nih.gov

This meta-analysis did a subanalysis of studies which used testosterone below, according to, or above recommendations. The studies in which testosterone dosage was above recommendations showed a statistically significant increased risk of major adverse cardiovascular events (179% higher risk) and overall cardiovascular disease (88% higher risk).

They included 6 trials with 1,212 participants in the subanalysis for major adverse cardiovascular events and 7 trials with 1,282 participants in the subanalysis for overall cardiovascular disease. While I'm unable to tell you which studies they included, I don't know any study which reported about cardiovascular disease risk with a mean testosterone dosage of 200 mg weekly or higher, so rest assured that the dosages in these trials were below what you're taking.

I can't say what my blood glucose is during these episodes because I've never been able to test it until after.

But I did do an advanced blood glucose test after 14 hours of fasting and it was completely normal. My doc said this rules out diabetes and reactive hypoglycemia. These episodes are also only every 2 to 3 months which also rules out these two possible causes.

Blood pressure is normal.

I'm convinced the symptoms are caused by low blood sugar though. Because they completely disappear after sugar. And oscalating vision is a common symptom of dangerously low blood glucose.

Regarding the nicotine mints. The pack states that it's safe to consume upto 20 of the 4mg mints per day. Honestly I've been doing this for years. I've done research but I've found no studies which say of long term risks associated with long term NRT.

Never considered to do a glucose measurement with a home finger tip test? Way more convenient than speculating.

As a final note: it sounds highly unlikely your complaints are related to your testosterone usage.

 

[Theworm]

Testosterone and Cardiovascular Risk: Meta-Analysis of Interventional Studies - PubMed

Data from RCTs suggest that treatment with T is not effective in reducing CV risk, however, when TTh is correctly applied, it is not associated with an increase in CV risk and it may have a beneficial effect in some sub-populations. Corona G, Rastrelli G, Di Pasquale G, et al. Testosterone and...

pubmed.ncbi.nlm.nih.gov

This meta-analysis did a subanalysis of studies which used testosterone below, according to, or above recommendations. The studies in which testosterone dosage was above recommendations showed a statistically significant increased risk of major adverse cardiovascular events (179% higher risk) and overall cardiovascular disease (88% higher risk).

They included 6 trials with 1,212 participants in the subanalysis for major adverse cardiovascular events and 7 trials with 1,282 participants in the subanalysis for overall cardiovascular disease. While I'm unable to tell you which studies they included, I don't know any study which reported about cardiovascular disease risk with a mean testosterone dosage of 200 mg weekly or higher, so rest assured that the dosages in these trials were below what you're taking.


Never considered to do a glucose measurement with a home finger tip test? Way more convenient than speculating.

As a final note: it sounds highly unlikely your complaints are related to your testosterone usage.

Peter, what do you think or researched to be ideal testosterone level for longevity? I’ve read a study out of Australia that they recommended a TT level of 500
Any thoughts?

 

[PeterBond]

Peter, what do you think or researched to be ideal testosterone level for longevity? I’ve read a study out of Australia that they recommended a TT level of 500
Any thoughts?

Most studies aim at a treatment target of mid-interval levels of 500-800 ng/dL (more older ones also slightly lower, 400 ng/dL, if I'm not mistaking), with by far most patients ending up close to 500 ng/dL. I also think this is probably the wisest level in terms of health.

 

[Theworm]

Most studies aim at a treatment target of mid-interval levels of 500-800 ng/dL (more older ones also slightly lower, 400 ng/dL, if I'm not mistaking), with by far most patients ending up close to 500 ng/dL. I also think this is probably the wisest level in terms of health.

500 wisest for all age groups?

 

[PeterBond]

500 wisest for all age groups?

There isn't really much to say about young adults in particular as they rarely die or have a cardiovascular event. So in a nutshell; there isn't really any evidence to discriminate based on age. (sometimes cut-offs with for example older and younger than 65 years of age, or older than 80 years of age are used for certain outcomes, but I'm sure you're not interested in these)

 

[Theworm]

There isn't really much to say about young adults in particular as they rarely die or have a cardiovascular event. So in a nutshell; there isn't really any evidence to discriminate based on age. (sometimes cut-offs with for example older and younger than 65 years of age, or older than 80 years of age are used for certain outcomes, but I'm sure you're not interested in these)

So I’m 43, goal is longevity and health, what ideal TT to shoot for? 5-600? E2 between 20-30 etc
I think my goal of TT 1000 is associated with higher cardiovascular disease

 

[PeterBond]

So I’m 43, goal is longevity and health, what ideal TT to shoot for? 5-600? E2 between 20-30 etc
I think my goal of TT 1000 is associated with higher cardiovascular disease

Current recommendations are to decrease dosage when mid-interval levels exceed 600 ng/dL, so most likely it's better to be lower than that. As said, most trials end up with patients around 500 ng/dL, I would go for that.

There is no treatment target for estradiol levels.

 

[Theworm]

Current recommendations are to decrease dosage when mid-interval levels exceed 600 ng/dL, so most likely it's better to be lower than that. As said, most trials end up with patients around 500 ng/dL, I would go for that.

There is no treatment target for estradiol levels.

What if goal was longevity but add muscle, would one add something else like hgh or increase test (blast) for short intervals like 8-10 weeks once a year. Then cruise at a TT of 500

 

[PeterBond]

To add muscle it basically boils down to dosing as high as possible. It's a trade-off between the two; the higher the dose, the better for muscle-building but more harmful for health.

 

[Theworm]

Signs of High Testosterone: 28 Signs in Men and Women

Testosterone is a hormone that has many responsibilities in the body, but if levels are too high, it can cause problems. Learn the signs and treatment options.

www.healthline.com

Study showed that men lived longest with TT between 282 to 455 TT

Somewhat depressing cause I feel like crap at those levels

 

[PeterBond]

Signs of High Testosterone: 28 Signs in Men and Women

Testosterone is a hormone that has many responsibilities in the body, but if levels are too high, it can cause problems. Learn the signs and treatment options.

www.healthline.com

Study showed that men lived longest with TT between 282 to 455 TT

Somewhat depressing cause I feel like crap at those levels

It concerns this study: In Older Men an Optimal Plasma Testosterone Is Associated With Reduced All-Cause Mortality and Higher Dihydrotestosterone With Reduced Ischemic Heart Disease Mortality, While Estradiol Levels Do Not Predict Mortality

And men who received TRT were excluded from analysis.