Need Help with Information

Pharma / TRT Testosterone Replacement
1

Sorry, this is a bit of a long one, but please hang in there. I need some help/information and I know you guys are in the know and can save me a lot of needed time.

I started browsing through this site after my H started T replacement and his behavior started to change. This occurred somewhat slowly over the six weeks he had the injections, but the last week was terrifying.

Long story short, he ended up going on a bender (and he is a recovering alcoholic who has been very dedicated to sobriety, having been sober almost two years) after experiencing extreme paranoia, aggression and hallucinations. I had to take him to the ER and they said it was called “Steroid Psychosis”.

He’s still in the hospital and has been most of the week because the alcohol poisoning almost killed him. He is still having anxiety and paranoia, and his blood pressure and heart rate is still very elevated. They have him on 1-2mg Ativan through IV every two hours (anti-anxiety, anti-convulsant med) because of their fear that he will have seizures at this point.

Here’s the info I know:

42 years old
5’11"
180 lbs
T level was 155, blood just drawn at the hospital to check current level.
Last shot given July 19th which was his sixth weekly injection
Prescribed IM injections once per week T-CYP, 200mg/ml

I am limited for time, but I believe there was a mistake in the dosage amount. We called poison control when I started suspecting the dosage was wrong and they advised that the max dose recommended was 50-200mg every two to four weeks, with a max of 400mg per four week period.

I called his doctor who said it was not a mistake, that they start ALL low-T patients with that amount. I KNOW this is not true because his doc had failed to call in the scrip before he left the country for vacation so another doc in the practice called it in after we called them looking for it at the pharmacy. The scrip he called in was 200 mg/ml every other week.

That would be in line with what poison control said. When we called them back and told them that H’s doc said he was to take weekly injections, they simply called in more refills and didn’t adjust the dosage as I BELIEVE should have happened.

I explained to his doc the extreme symptoms he was experiencing and he never advised it was an emergency. He said to keep our appointment for the upcoming Tuesday so they could check his levels and not to give him another injection! He blew it off and my H almost died.

What I need is any information you guys have that shows a maximum recommended dose of Testosterone CYP IM injections. Also, any good articles on Steriod Psychosis, or Testosterone Induced Psychosis. While the hospital he is at is very good, they seem to have very limited knowledge of this. The ER doc told us what was up, but his primary in the hospital is trying to help by testing his levels, but doing nothing else except having psych people come in and talk to him and giving him physical support on the heart issues.

My H also lost his job from this. In one of his states, he told them I had died! When I called up there a couple of days later (I thought he was at work, they had given him time off to grieve and he was hiding out from the “bad guys” that were trying to kill him) they realized I was very much alive and quickly washed their hands of him. I am in contact with HR about what’s going on and I have to provide them some information on this.

Between him being in the hospital and having to care for him and the kids, I need your help in providing me info, aricle links, etc if you have it. This whole thing has completely turned our lives upside down in what feels like a matter of minutes.

Thank you so much

2

Forgot to add that during this, he also had a steroid injection for a herniated disc. Not the small shot, but the one where it’s administered on an out-patient basis. I don’t have the information on that, but it certainly couldn’t have helped this issue any.

3

Sorry to hear your troubles and best of luck getting everything back on track in the near future!!

Although 200mg administered 1x weekly is not ideal, frequent injections at a lower dose is the best way to go. For example 3 shots of 60mg every 3rd day is a lot better than 1 big injection. Blood levels are more stable and you avoid the roller coaster.

Honestly from my limited knowledge 200mg once weekly is not poison territory at all. People on here have those doses spread out over multiple injections weekly. People doing steroid cycles have double that dose if not triple or more.

Probably the biggest issue that would need looking at is if the 200mg once a week is needed spread it out over at least 2 injections weekly or 3. So 100mg on Monday and 100mg on Thursday. Or do 60mg every 3 days which will be less than 200mg weekly but better on stability of blood values.

The reaction your Husband had might have been caused from the alcohol binge. Maybe the mix with testosterone really plays havoc with him. When was his testosterone shot in relation to his binge the same day, next day?

You mentioned that his behavior changed over the course several weeks. Do you have any blood work done over those weeks that you could post up? That would help a great deal to determine what other issues need looking at. Maybe other values are off and need attention because of the testosterone injections. This is not uncommon and it is advisable to have regular blood work done to determine what is needed in conjunction with the testosterone injections.

Without blood work results I think the boys here are going to find it hard to nail down the problem what caused your husbands mood change during those weeks.

To me it sounds like the alcohol was the biggest factor in all of this and the blame is getting put on the testosterone unfairly.

Ultimately Booze + Testosterone injections might not be handled well by your husbands body. So he might just have to really lay off the alcohol, adjust the dosage and injections and get blood work done while on TRT to check if anything is out of whack that needs additional attention.

This sticky has it all. Have a read and if you have questions post up.

4

This is just a guess, but if he is injecting that all at once, he either went on his bender right as the T was really hitting him (“Yeah, I’m the man, I’m gonna go own the fucking town”), or like on the 6th day when it was all out of his system and he was low (depressed, needed to drink).

These are guesses. Has your husband been responding well to the TRT? Would love to see a full rundown of symptoms/bloodwork, but the above guess is all I have given the current information.

5

He went a bit psychotic again at the hospital last night. All booze fully cleared from his system. This caused the staff to take notice and they are running a more comprehensive panel today to see exactly where everything is.

They had written it off to the booze as well, but now that it’s cleared, they’re looking at the T again. Needless to say, we’ll still be here a couple more days at least…

I will post results as they come in and are given to me.

There was no blood work during that six weeks other than the initial test. His doc wanted to retest his levels after six injections. It was shortly after his 5th injection that things started to really get weird, and went downhill totally after his sixth.

I will post more info as I am able.

Thanks

6

My post was deleted?

Sorry, I should’ve been more clear - I meant what were his symptoms/bloodwork BEFORE starting TRT. There may be some other issues here, and if the doc is prescribing 1x/weekly doses than I’m not totally confident in his/her understanding of the issues.

7

[quote]scj119 wrote:
My post was deleted?

Sorry, I should’ve been more clear - I meant what were his symptoms/bloodwork BEFORE starting TRT. There may be some other issues here, and if the doc is prescribing 1x/weekly doses than I’m not totally confident in his/her understanding of the issues.[/quote]

I’m sorry. I’m also very tired as I’m operating on very little sleep and a whole lot of stress :slight_smile:

His T level before any injections was 155. Symptoms included ED, low libido, and a CT scan picked up demineralization of his bones. The CT scan is what prompted him to go a Urologist to test his T level. They ran about 4 tests at the Urologist’s office. One was a prostate level? I don’t know the other two.

Just got lab back here at the hospital and his T level as of yesterday was 682. This is ten days past his last injection. If he had continued them, he would have been due for another injection Tuesday of this week (the 26th). They are going to draw again in the morning to see what his level is as of tomorrow. They want to see the rate at which it’s falling.

They have run a comprehensive blood panel when he was in the ER and again yesterday. There is nothing evident in his bloodwork except elevated liver enzymes and concentrated hemoglobins. Both point to his bender. They are doing another CT scan of his brain today because of the episodes of last night. They did a CT scan of his brain in the ER and it was clear as way a chest x-ray.

While on the TRT, his libido increased, but no improvement in ED. He said several times that he was feeling very aggressive and it was bring back memories from a long time ago. Stuff he hadn’t thought of in years. Bad memories of combat. Hes back broke out in solid acne. Barely a place of normal skin.

That’s all I know right now. Thanks for your input.

8

[quote]rukiddingme wrote:

[quote]scj119 wrote:
My post was deleted?

Sorry, I should’ve been more clear - I meant what were his symptoms/bloodwork BEFORE starting TRT. There may be some other issues here, and if the doc is prescribing 1x/weekly doses than I’m not totally confident in his/her understanding of the issues.[/quote]

I’m sorry. I’m also very tired as I’m operating on very little sleep and a whole lot of stress :slight_smile:

His T level before any injections was 155. Symptoms included ED, low libido, and a CT scan picked up demineralization of his bones. The CT scan is what prompted him to go a Urologist to test his T level. They ran about 4 tests at the Urologist’s office. One was a prostate level? I don’t know the other two.

Just got lab back here at the hospital and his T level as of yesterday was 682. This is ten days past his last injection. If he had continued them, he would have been due for another injection Tuesday of this week (the 26th). They are going to draw again in the morning to see what his level is as of tomorrow. They want to see the rate at which it’s falling.

They have run a comprehensive blood panel when he was in the ER and again yesterday. There is nothing evident in his bloodwork except elevated liver enzymes and concentrated hemoglobins. Both point to his bender. They are doing another CT scan of his brain today because of the episodes of last night. They did a CT scan of his brain in the ER and it was clear as way a chest x-ray.

While on the TRT, his libido increased, but no improvement in ED. He said several times that he was feeling very aggressive and it was bring back memories from a long time ago. Stuff he hadn’t thought of in years. Bad memories of combat. Hes back broke out in solid acne. Barely a place of normal skin.

That’s all I know right now. Thanks for your input.[/quote]

If they only ran 4 tests I am extremely skeptical he is on a good protocol. Bare minimum you need 8am cortisol, TSH, FSH, LH, Total T, Free T, E2, probably a couple mandatories I am forgetting plus at least 5 that would be in the category of “highly recommended”

Has he ever taken hair loss meds? Low DHT could be the reason for his ED/libido issues.

Are you 100% certain he stuck to his dosing schedule? Is there any chance he was using more than 200mg of T per week because he liked the feeling? I’m NOT accusing, just throwing some ideas out there.

9

Yeah no doubt that the doc was not doing a thorough enough of a job. I’ve learned a lot since then and wish I’d investigated more before the injections.

Absolutely sure he stuck to his dosing schedule. No way he had more than that. I was in control of the vials and gave him the shots myself. He couldn’t self administer.

No hair loss meds, but his hair did thin considerably over the past few weeks. I kept thinking it was my imagination, but it’s not.

They are running another level tomorrow to see how quickly it’s dropping. I will update when I have that number.

10

For fuck’s sake…my head hurts from beating it against the wall while reading this thread…

Your husband’s problem is not with TRT. His problem is that he mentally unstable and is prone to psychosis. The media loves to play up this kind of shit when people that are on shitty testosterone protocols go nuts, and blame it entirely on the T and not on the fact that the person is crazy.

I am really sorry that you are put in this situation, but blaming the T is an idiotic copout.

Your husband’s doctor is an idiot and from what you’ve given us does not have him on a good protocol. He probably should be on a max of 100 mg/week of Test and something to control Estrogen. But 200 mg and no estrogen control will not induce psychosis in someone who is not already psychotic. That should be takenn into consideration once he is out of the hospital.

Steroid Psychosis sounds like something feminists made up to make sure that men aren’t taking steroids and are keeping their test levels in line with the wives, so everyone ends up passive and docile.

The people in the hospital need to be looking at real mental health issues, such as bipolar disorder, instead of some crazy notion that androgens force someone to go on a bender and see bad people.