Do Psychiatric Meds and TRT Mix?

How were you able to check your T almost weekly, is that normal for TRT patients?

That’s crazy how it got so low, were you working out at this time?

For instance, I took 3.5 weeks off of SSRI (haven’t taken in about a month now) and Adderall (started on it again only after my most recent labs), and my total T was 224 ng/dL this past week. Awful.

Did the TRT help your mood / ability to function improve? Feel like my personality’s been evacuated almost, and that I have to force myself to have fun a lot more than I did.

That’s awesome. One of my friends does BJJ and swears by it. I honestly just want to feel better so I can go to school and achieve something. I was doing well in college, had 2 years down and a 3.91 GPA before leaving because I became terribly depressed.

Did you find that you were passionate about jiujitsu before you had started, or did someone just introduce it to you? These meds like Adderall right now just make me feel overstimulated sometimes, and while it helps in that I don’t feel like going straight to bed and can think somewhat, I also can’t focus.

I.e. tried reading the stickies and I kept scrolling through them like a tweaker

As an update, and I know it’s off topic here are my most recent labs:

If it’s too small, the big numbers are as follows:

Total T: 224 (range, 250-827 ng/dL)
T4, free: 1.3 (range, 0.8-1.8 ng/dL)
TSH: 2.89 (range, .40-4.5 mIU/L)
Prolactin: 5.1 (range, 2.0-18 ng/mL)
LH: 3.3 (range, 1.5-9.3 mIU/mL)
FSH: 3.6 (range, 1.6-8.0 mIU/mL)
Thyroglobulin Antibodies: <1 (< or = 1 iU/mL)

The total T numbers are without a doubt the lowest they’ve ever been.

Granted, this was after 3.5 weeks of no Adderall or SSRI, and my diet / sleep schedule was garbage, but those are still drastically low numbers. Thought it actually would’ve went up since I read that Adderall can lower testosterone production, and this study shows that it did in rats:

I’m seeing my endocrinologist tomorrow afternoon to discuss these results, any advice would be useful.

Labs are cheap in Brazil, T test is the equivalent of 10 dollars, at the time I just paid to do it every week. Now on TRT I asked the doc for a few labs to test weekly, my insurance covers it.

Yes, overall mind health improved dramatically, daily energy levels and quality of sleep. I am not 100% as I’d hoped to be, but TRT was like a jump from 20% quality of life to 70%.

I am following KSman protocol, 100mg test weekly, got to constant 700~ levels. I created a log of all labs and adjusments of my TRT journey, if you wanna take a look: thread.

This is the study about SSRI on rats: The effect of sertraline, paroxetine, fluoxetine and escitalopram on testicular tissue and oxidative stress parameters in rats - PubMed

Your TSH is very high, ideal should be close to 1.0, you are likely iodine deficient, please check thyroids basics stick: Thyroid Basics Explained

Buy two or three thermometers and checks temps waking up and on mid afternoon. Put thermometers bellow tongue, not on armpit.
Waking up should be > 97.3 F. >= 97.7 F is ideal.
Mid afternoon should be >= 98.6.

Do this for a few days, if your numbers are off, you likely have sub-clinical hypothyroidism. Most common case is iodine deficiency, in that case you can get your hands on Iodoral to boost your levels. Read the link for more info, KSman goes in much more detail.

From my experience with psychiatrist, it is like that old saying “when you have a hammer in your hand everything looks like a nail”. They will look at your problems and just prescribe meds and more meds, without looking at the root cause. And more often than not, meds create more problems than they solve.

Your T is very low, and it is not unlikely your mind problems are related to that. You should consider TRT, but before that, read as much as you can from this forum to make a informed choice.

Woah! That’s a crazy price difference.

If you don’t mind me asking, what were your test levels originally?

Another factor might have been the fact that I didn’t get much sleep the night before the exams, but regardless of that the numbers are incredibly low

Definitely going to set aside time everyday to study the stickies

From 10+ labs before TRT I have records of, most of them between 250 and 300.

Yes, read and ask a lot, you will get there. Don’t forget about the temps, that’s very important.

I’d been thinking about learning a martial art for a while & I got to meet a guy through work who’s done tons of different stuff. I had no idea what I wanted to do though, so just left it up to him.

He thought Jujutsu would suit me plus kick boxing & eventually Thai boxing.

He actually had me just do tai chi for a couple months to see if I was patient & if I’d persevere.

I got to a reasonable standard with Jujutsu with him, then I was introduced to where he trained.

Like I said it’s probably too unsettling a thing to do until you’ve got your meds and testosterone stable, but once you do, I really recommend martial arts.

Will do. 250 and 300 with the treatment or before?

Wow, that’s awesome.

Yeah it’s definitely unsettling. It’s annoying because my sleep schedule is so screwed now, as is keeping tabs on my diet. Not overeating by any means, but not keeping track of what I eat, macros, etc. either.

I guess right now what I keep doing is comparing myself on Prozac vs. without. Now my energy is so low that when I wake up I have to pump myself full of Adderall to even stay awake, and all that provides is mental stimulation, nothing physical at all.

On top of that, I notice that the Adderall speeds me up too much, whereas at least when I was on Prozac I had a sense of mental clarity and centered-ness if that makes sense. I remember vividly the last day I was on either med, I did an hour of cardio and felt amazing.

Even the first two weeks being off of Prozac or Adderall was still ok since the serotonin was still in my body (Prozac takes about two weeks to be completely out of the body due to its long elimination half-life), and I was able to sub the Adderall with coffee.

Don’t go to school right now or have a job, so this is literally my main focus, and I want to be able to build something positive so I don’t have to worry about it when I head back to college in the summer.


Here is my log of T values on time:

|02/05/2017|1043| (5000 UI of HCG for 2 weeks to test if hypogonadism is primary or secondary)
|03/11/2017|336| (Started SSRI)
|11/02/2018|722| (Started TRT, Stopped SSRI)

Wow. That’s really, really helpful. So in February 2017 you underwent HCG therapy to test if it was primary hypo and then came off?

I know the thread got off topic, but as an update to my current situation with psych meds:

I got back on 10mg Adderall PRN a little over a week ago just so that I could function. I was drinking coffee instead during the 3.5 weeks I was off of it, but just didn’t have any mental energy with coffee at all. All I’ve been doing at the gym as well has been cardio, and overall I noticed my self-esteem has probably dipped as a result. Also, the Adderall makes me feel really spaced out by itself. For example I was grocery shopping today and it took me way too long to get what I needed because I kept walking around the store slowly. That could be the Adderall or the psychomotor slowing due to the depression but I’m not sure.

Additionally, Prozac helped me reel in my temper and I also became more patient. My frustration tolerance definitely improved. Now that I’m only on the Adderall, I feel more awake and am functioning at a pretty low level, but also am not half as “zen” as I was when I combined it with an SSRI.

My sleep’s also been pretty bad, for instance I woke up at 5 PM on Saturday night and didn’t go to sleep until 8 PM yesterday, and even then only slept for 6.5 hours. My whole life feels out of whack right now. I also saw my endocrinologist on Friday and he said I could begin TRT therapy if I wanted, and plan on starting it in a few weeks (prob 1.5-2 weeks). Will keep everyone posted on that.

Yes, that is correct, the purpose was to test if my testicles were functional, they were, so hypogonadism is secondary.

Ah, I see. Is that standard practice for patients with low testosterone, or were there symptoms that worried you and made you want to start HCG beforehand?

I am not sure, that is just what the doctor suggested at the time. AFAIK there is no difference in TRT between primary and secondary. But I guess that if the problem is primary, further investigation is important, as you may have other issues in your testicles that may be causing the problem.

Dude I would talk to your dr. Seriously. I’m sure I’m opening a can of worms, but my heart meds made me as horny as hell. He gave me a rx that chilled me out and didn’t have side effects. Now I’m like a teenager which still sux but at least get a medical opinion cuz mental health meds can really fuck up other parts of your body…in fact anybody can have a rxn to any med. you don’t want permanent damage

I suffer from depression and am on TRT, so can offer another set of anecdotes.

I was on Zoloft / Sertraline for a few years. Started at 50 mg per day, and went up to 100 mg, before coming off.

I find that TRT tends to be about as effective as a low dose of an SSRI, but I don’t get the side effects that I was on Sertraline. I wouldn’t view it as a replacement, but it helps.

In Australia, TRT is delivered via preloaded syringes containing 250 mg of testosterone enanthanate. I’ve got high SHBG (60 nmol/L before I started), and respond to bigger but less frequent doses. So I felt better on 250 mg every ten days than 125 mg every five days.

There’s a lot of negative sentiment towards SSRIs on this forum, and rather a lot of opinion given as though it’s medical fact. There’s evidence that they work, and if they make you feel better, use them. In my case I found that the side effects were bad, and they didn’t do more than take the edge off the depression.

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Incidentally I agree with @girlgotguns (who’s certainly living up to her name) to work with your GP. I’m using two: one for my depression, and the other for TRT.

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Wow, that sucks. If you don’t mind me asking, what meds were you on for your heart and what settled you down?

Yeah I got one from my psychiatrist who said that he doesn’t think Adderall could, but that Prozac might. Turned out that there was actually a 59 ng/dL drop in my total after 3.5 weeks off of the meds, which wasn’t what I expected. Granted, I hadn’t worked out much at all (maybe once or twice) in that time and ate like garbage, so maybe that was a factor.

The endocrinologist who I saw last week for a follow up of the labs I did (who will most likely be my TRT-prescribing doctor) actually said that he’d consider TRT as safer than antidepressants based on the black box warning alone.

Now, I’m not suicidal or anything, and the antidepressant was actually originally prescribed as an anti-anxiety after I had so many panic attacks that were most likely caused by Adderall. Kinda like your case where one med caused a negative reaction and you had to be given another one to counteract the side effects.

Ultimately, I’m hoping that I won’t need either in the long-run. Like I said, my mood’s been terrible… the guy that I know myself to be is normally pretty lighthearted, but I’ve been getting frustrated way too quickly recently and can’t seem to slow down my mind.