trt needed test makes me fell like crap

Discussion in 'Men's Health Forum' started by tres, Dec 9, 2005.

  1. #1

    tres Junior Member

    so i feel like shit all the time ; total test 300 ; but test cyp,enan,and even prop make my bp go way high and anxiety level forget it. i mean to the point i cant get my self worked up or i feel out of breath (fyi 5'10 185 lean no fat).
    should i try androderm? or is test test? and if cant take that can i take deca and or anavar just to feel good?
  2. #2

    benrock Junior Member

    try a low dose or gel , test is best for well biend or acutally hcg too and leveling off of your totals estrogens , test , free t
  3. #3

    marianco Doctor of Medicine

    testosterone is a very calming hormone. It usually causes a sense of relaxation yet alertness. Testosterone also usually lowers the blood pressure.

    If a person with low testosterone levels gets high blood pressure and anxiety by the addition of testosterone, that may mean there are other factors involved.

    Estrogen activity: Testosterone may be converted too quickly into estradiol or other estrogens by the naturally occurring aromatase enzyme. Estrogens cause aggressive, irritable, anxious behavior. Options to reduce estrogen activity include DIM (which allows the body to convert estrogens to weaker forms) and aromatase inhibitors such as arimidex or aromasin (which prevent conversion of testosterone to estrogens). Estrogens are necessary, however. They promote neuron growth (important in learning and memory), promote muscle growth (important in body building), promote sex drive, increase brain serotonin levels (important in reducing depression). It is thus important to measure the estradiol level (if not the other estrogens also) to determine how much estrogen activity there is compared to testosterone levels. DaveZ on this site did well when his testosterone to estrogen ratio was about 20:1.

    High Sex Hormone Binding Globulin levels: SHBG is increased by estrogens. It can trap testosterone, leaving little free to work, leaving estrogen available to cause anxiety.

    Having low testosterone yet being lean with no fat is unusual.

    Usually, a person gains much weight when testosterone is low because the imbalance between estrogen and testosterone allows estrogen to block thyroid hormone receptors, resulting in a lower metabolism with fatigue and obesity.

    Thus, what is keeping a low testosterone person lean without fat and also prone to anxiety and high blood pressure? There may be other co-existing conditions to explain this.

    Hyperthyroidism: It is possible that there is also high thyroid activity to explain the situation. Hyperthyroidism can contribute to a thin build, anxiety, and high blood pressure.

    Pheochromocytoma: It is possible to have an adrenal gland tumor which secretes excessive epinephrine and norepinephrine, contributing to anxiety, high blood pressure, weight loss.

    Further medical evaluation is necessary.
  4. #4

    earthdog Junior Member

    Has anyone mentioned lately how great it is to have you here, Dr. M? :D What a fantastic answer. This question has come up before and has never gotten a good answer, as far as I can remember.
  5. #5

    pmgamer18 Member

    Yes and I second that. I feel from my own feelings on this that it is Estrodiol and I feel it can be tested and one could be good on the test. But it goes up and down fast all day and night. I can get real bad panic attacks from it going to high. I can feel my E2 going up after I give myself a 100 IU shot so my Dr. has me take a .5 arimidex with the shot this is working dam good for me and I am not going to low because I am still getting dam hard morning wood. I also take a Indolplex/DIM after dinner so what the Arimidex dose not block the IndolplexDIM converts the E2 into good E's so I feel very calm doing this. Yet if I don't do this I start to feel anxiety, hot and look red and a rash I get starts up.
  6. #6

    The_Skeptic Junior Member

    I agree. He lays it out there in layman's terms. Easy to comprehend yet very informative. I am so happy to have found this site.
  7. #7

    tres Junior Member

    i started the testim 5 days ago. the anxiety is not all that bad but now my face is very red....should i start dim or do blood first?
  8. #8

    BigRagu Junior Member

    well usually when u first start hrt your bp might go up your liver values or your cholestrol... your body isn't used to having all that test.... but if u give it a month or so 4 your body to get used to it i bet u will prob feel much better then b4... test isn't going to make u will like 100 bucks once u take it.... even on a steriod cycle it takes weeks to kick in
  9. #9

    ciobl Junior Member

    i know, i know...we homo sapiens want to read and hear what we want...we are predisposed....

    ...but i must tell you...i like marianco's answer.....:)
  10. #10

    tres Junior Member

    BP SEEMS OK. JUST VERY RED. could this be fixed by dim or arimedex?
  11. #11

    LiquidGib Junior Member

    I agree, that was an awesome post! It was very informative and yet I didn't have to read through every sentence twice lol
  12. #12

    marianco Doctor of Medicine

    A Flushing Reaction from testosterone treatment may occur.

    Both Estrogens and Testosterone help control core body temperature.

    The Estrogens tend to cool body temperature. When estrogen levels fall abruptly, this causes an estrogen withdrawal syndrome. This withdrawal syndrome causes the hot flash/hot flush experienced by women in premenopause and by men who reduce their estrogen levels/activity too quickly using estrogen-reducing substances such as arimidex or DIM.

    Testosterone may increase core body temperature. This may occur by improving thyroid hormone activity, among other actions. When body temperature increases suddenly, the brain temperature sensors will send out hormones to dilate blood vessels in the skin, to release body heat, to control body temperature. This results in a flushing reaction.

    Testosterone, itself, may directly cause dilation of blood vessels, resulting in a flushing reaction.

    Ideally, the flushing reaction is reduced over time as the body adjusts to a higher body temperature from higher testosterone levels.

    Trying to treat the flush with Arimidex or DIM may worsen the flush by causing estrogen withdrawal - adding another cause of flushing.

    In looking up the prescribing information for Testim 1% Gel, what is interesting is that 1% of men who used the 5 gram gel (delivering 5 mg of testosterone) get a flush reaction. However, 0% (none) of the men who used 10 grams of gel (delivering 10 mg of testosterone) had a flush reaction. The higher testosterone dose resulted in fewer flush reactions.

    A possibility is that a higher testosterone dose results in an increase in estrogen levels. The higher estrogen levels then lower body temperature, counteracting testosterone's increase in body temperature. So long as this higher estrogen activity itself doesn't have bad effects such as increasing irritability, anxiety, it balances the activities of testosterone.

    From this information, if there is a flush reaction, a person can:
    1. continue treatment - giving their body time to adjust to temperature changes induced by testosterone.
    2. reduce testosterone dose and increase gradually - making it easier for the body to adjust to core body temperature changes.
    3. increase testosterone dose - resulting in a balancing increase in estrogen.

    It is useful to monitor labs as per SWALE to help determine the direction in treatment.
    Last edited: Dec 27, 2005
  13. #13

    LiquidGib Junior Member

    Interesting. Can you tell us more about how testosterone affects thyroid activity?
  14. #14

    DavidZ Junior Member

    That's interesting because my experience with an hcg only protocol has been quite different than that.

    I find that when my T is up and my E2 is high, the skin on my face turns reddish, like a mild sunburn. When my T is up and my E2 is controlled, my skin looks tan. In fact, people often ask me whether I've been someplace sunny and warm. When I tell them no, they seem perplexed. :)

    Definitely do blood work first.

    Hormone management is difficult enough. You don't want to be doing it blind.
  15. #15

    marianco Doctor of Medicine

    One of the things I am trying to do is to understand the mechanisms of action (including biochemical pathways) that are occurring with hormonal treatment which then allows me to predict what will happen in a person with treatment.

    HCG only treatment is quite a different animal from testosterone replacement therapy with transdermal or intramuscular routes.

    From what I know so far (subject to correction):
    1. HCG is an analog to FSH, LH, and Thyroid hormone.
    2. It increases Cytochrome P450scc, the enzyme that turns cholesterol into pregnenolone, to start the cascade of steroid hormone production in the testes. This allows the testes to make numerous hormones besides testosterone - many of which we have inadequate knowledge as to the importance or function - yet they may be very important.
    3. It increases testosterone production.
    4. It increases sperm production - maintaining fertility - unlike pure testosterone replacement.
    5. It increases thyroid activity
    6. It allows the testes to make progesterone (which increases dopamine, serotonine, norepinephrine activity and blocks glutamate activity in the brain - giving it a mood stabilizing, anxiolytic, antidepressant effect. Progesterone also promotes nurturing behavior as opposed to aggression.)
    7. Aesthetically, it keeps your testicles large.
    8. Active testicles may have more sensation - thus sex may be more enjoyable - particularly oral.

    I do not know yet if Cytochrome P450scc in other tissues such as the adrenals and skin are also stimulated by HCG. If so, this is another wide area of difference between testosterone-only replacement and HCG treatment.

    Thus HCG is a more complete solution to hormone replacement therapy than testosterone alone. This may account for its many other advantages over testosterone treatment. And this means there is much that we do not know that are important considerations.

    The downsides of pure HCG treatment:
    1. The risk of testicular cancer from overstimulating the testes
    2. Possibly permanent primary hypogonadism - shutting down the testes because they become HCG-resistant when high doses are used.
    3. Frequent injections. Risk of infection if not careful.
    4. Higher cost (a 10% testosterone cream can cost you as little as $15 for 30 grams).
    5. Difficulty explaining what you are carrying on to examiners on airline flights - i.e. needles.
    6. Self-injection is not as natural an action as spreading a cream on your skin.

    The tan look you have DaveZ makes me wonder about the relationship between Testosterone, Estrogens, HCG, FSH, LH, Thyroid hormone, Cortisol, ACTH (which leads to increased cortisol and aldosterone and other adrenal hormone production), and melanocyte-stimulating hormone (which causes darkening of skin), and the other steriod hormones made from HCG stimulation of the testes.

    ACTH and Melanocyte-stimulating hormone are both products of cleaving the ACTH-prohormone. Some internal malignancies cause the brain to make excess ACTH, which then causes excess corticol production, leading to ectopic Cushing's Syndrome (characterized by generalized hyperpigmentation, muscle wasting, hypokalemia, edema, and hypertension). Increasing ACTH also happens to increase melanocyte-stimulating hormone since it is made simultaneously with ACTH. This leads to to the darkened skin seen in the syndrome.
    Last edited: Dec 27, 2005

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