Overwhelmed Looking for Advice

Pharma TRT
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That’s not my point, of course it is a huge difference. My point, apparently poorly made, it that the snowflake with all the side effects from a 150mg injection, would never have made it in a sport where AAS use was a requirement to succeed at the highest level. Huge increase in dose, huge increase in side effects, but we didn’t see that.

I do not think that is rare at all. I think it is the norm.

I have no problem with guys doing whatever necessary to resolve whatever symptoms are troubling them.

While I do not use scrotal creams or personally know anyone who does, I do know doctors who use them, though for other reasons than your doctor. Regardless, if they work for the patient and everyone is happy using them, I think it’s great.

No problem. No reason that you should. You do, however, believe Dr. Grant’s anecdotal experiences.

Good stuff.

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My story is similar except my anciety started at 17 stopped with ssris, restarted with trt. I’d say its something to do with estrogen/hormones because psychologically/physically when I don’t get the “anxiety” feeling, I’m very confident, secure everything positive. Like if I over do it on prework out or caffine I get this same feeling but not as intense. I’m not stressed or anything so its clearly one of these hormones doing something.

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I dont even take caffeine in any form. No coffee soda nothing. Im overly sensitive to it. I can drink coffee at 7am and have trouble sleeping at 11pm still. It makes me wired and anxious panic feeling on a smaller scale also.

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Ive read a few places that b12 deficiency is believed to be the cause of full on panic attacks.

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How is Dr Grant’s experience anecdotal? He is a physician who uses it with his patients. I know at least a dozen other physicians who have switched due to significantly improved results across the board. Have you seen the literature regarding the pharmacokinetics of trans scrotal cream? This is hardly anecdotal by any stretch of the imagination.

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My b12 was borderline high (i take supplements) i cut my b complex yo every 3 days or so now

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This was pre trt and pre anxiety issues btw, so doubt its a b12 thing, atleast for me.

I can drink up to like 100mg of caffine (1 big cup of coffee) anything above that and I get antsy

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Yes. However, I am not aware of anything that measures patient outcomes vs. other protocols.

His experience is unique to him. To me, it is anecdotal. If he runs a controlled double blinded study with his patients and it is published in a peer reviewed journal……………………it becomes evidence.

Really, it’s OK. Totally, he should practice based on his experiences. That’s the major leg of an evidence based practice, and in my opinion, the most important. Number one is the wants, needs and desires of the patient. Two, the best available evidence in the literature. Third, the experiences of the clinician. I know surgeons who have told me that there is no evidence in the literature for 95% of what they do. In their experience, they have learned from what has worked and those experiences have taught them more than anything they read.

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Dr Howell and Dr Nichols are working on these very studies as we speak. The literature will be posted once it comes out. If you only knew how many before and after labs I’ve seen with guys going from injections to cream. In the hundreds at this point. It’s undeniable evidence. There’s just so much of it. I’m looking forward to their studies being published.

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The 5th week of any protocol is the most intense, then closer to 6 weeks things calm down. I don’t feel estrogen sides, just show more agression.

So testosterone can affect mood as well.

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Estrogen sides?? Lol!

Doesn’t matter how many times this gets explained. Some people will never learn. Some people will remain in the stone ages on this stuff. Estrogen sides LMAO

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@highpull @dbossa

You guys have a bit of an interesting exchange going on. I want to ask a couple of questions that may pertain to the conversation at hand, and may even make the lines a little more clear?

First, the whole “back in the day” approach, while clearly has a ton of credibility to the person who is having the experience, really can’t be compared can it? I mean in all fairness, back in the day the only guys who injected hormones were athletes right? That can really in no way compare to today’s HRT / TRT world where there are literally just as many fat, obese, and grossly unhealthy people trying to take back control of their life as there are healthy guys trying to gain an edge in their respective sports.

Of course you’re going to see guys who experience side effects by the ton with small protocol changes. That’s because he is aromatasing 90% of what he injects! Now whether he feels bad because his Estrogen is too high or because his testosterone is still too low because he is converting it too much has already been beaten to death and has no bearing on the point at hand, which is that a really fat and unhealthy guy WILL MOST LIKELY experience side effects related to TRT upon starting a protocol, or upon a protocol change. It’s catch 22. The poor guy can’t lose fat because his hormones are fucked. He can’t correct hormone imbalances because his body won’t balance them properly due to his fucked up physiology. It sucks but it’s is what it is.

Estrogen sides being laughable? C’mon man. That’s not laughable. Crash your E2 and tell me that estrogen can NEVER be responsible for side effects. And again, whether you want to call it purple or violet is your choice, but when a guy has a Testosterone level of 180, and an E2 level of 75…he’s GOING TO FEEL LIKE SHIT with tons of symptoms. Now we can argue until the cows come home about whether or not his problem is because of low T or high E, but in the meantime, you have a poor guy feeling like death over here waiting to feel better while you guys try to figure out if the earth is round or oblong, or better yet, whether the sky is blue or aqua!

I personally think that TRT should be handled, at least for these guys, in a very dynamic, highly conditional, and controlled way. Give the poor guy T and TEMPORARILY block his E2 aromatase while he is on a strict supervised diet and exercise regimen. Then, monitor his progress and levels and blood work every 6 weeks, tweaking things to bring T to E2 ratios closer to optimal as this guy loses excess weight and regains his health. The end result…wind up in a place after a year or so where this hypothetical guy is injecting T at whatever frequency and dosage that keeps him feeling good, and his body is healthy enough to balance all other hormonal levels in it’s on without any pharmaceutical interference.

If this guy is not willing to adhere to a lifestyle change in diet and exercise, then TRT is not a good fit for him anyway and he should cease TRT / HRT because it’s never going to benefit him. Best case scenario, he still dies at the age of 50 from heart failure, the only difference being that with TRT he’ll likely die with a boner!!

Does this sound reasonable?

ETA, I guess we could also run this entire scenario all over again, comparing the fact that in today’s world there are also a lot of skinnier, “neurologically challenged” people trying to regain some sense of normalcy using TRT as well. I’ll leave that book for someone else to write though lmao!!

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152

I agree. Theres no way you can discount e2. To say levels dont affect how you feel just makes no sense. I see where bossa is coming from in a sense but to totally discount estrogen seems silly. I mean when you ingest a lot of ANYTHING it will almost always outweigh EVERYTHING else. Let me make a small very bad example. Do a line then drink 6 beers. You are high. Not drunk. Drink a case of beer then do a line guess what you are still drunk. I understand the more T to outweigh the e2 but at what point does it become unhealthy and no longer therapeutic. Thats my only question about that approach.

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I’m not going to have a ton of time to go into this today. However, a few points:

  1. When you expect to have side effects/issues, you get them. This includes small protocol changes.

  2. Only 3-4% of testosterone converts to Estradiol. That’s it. When people say “He’s a high converter!” he’s probably on the high end of that 4%.

  3. Give a fat guy enough testosterone and he should be able to lose fat with diet and exercise. Fat people will have higher levels of E2. It is not the E2 that is making them fat. E2 reduces visceral fat.

  4. Crashing E2 is not considered estrogen sides. It’s an estrogen deficiency. Once levels are raised, none of what you call “estrogen sides” are related to estrogen.

  5. If a guy has a T level of 180 and E2 of 75, he will feel like shit because he is in poor health and most likely fat. Fat men will have low testosterone and high estrogen. Again, the estrogen is an irrelevant factor here. Raise this man’s testosterone. By raising it, you are also raising estrogen. Suddenly he feels better and his E2 may very well be over 100. This has been demonstrated in the literature countless times.

  6. Why the hell would you want to block E2 in a fat man when E2 helps to reduce visceral fat, improves cardiovascular health, reduces the risk of diabetes, etc. etc.? You don’t believe that a fat man would require those benefits? Again, you have zero understanding of estrogen. The very first step to help a fat man is raise his testosterone levels, as he will surely be deficient.

  7. The longer you keep viewing E2 as the bad guy, the longer it is going to take you to understand this stuff. E2 is GOOD for you in every way imaginable. More than 50% of the benefits you are getting from TRT come from estrogen. Blocking these benefits, even in the slightest, is ridiculously counterproductive and causing harm.

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When i went on trt i didnt know jack shit about it. I had no clue what estrogen symptoms were or they existed from trt. I was wanting to get on it and excited when i did. I wasnt waiting or expecting symptoms. I was absolutely fine for quite a while. Only when i RAISED my dose did i experience anxiety and only after experiencing it did i start trying to figure out why and found out about e2. I realize it was gel and gel is shit. But why did it cause anxiety and panic attacks after 2 months out of. the blue. What was the cause of it. Wasnt stress or anything life pertaining.

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Here’s the thing: you raised your dose (slightly?) and got panic attacks 2 months later. How can you be certain that it was the testosterone that gave you the panic attacks?

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Danny my friend, it’s almost getting boring to yank your chain. It’s too damn easy! Lmao

The entire theme of my post can be summed up in one word brother, and I thought that that would have been easily apparent to you by now…

LEVITY

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@magneticstang15 I would love to hear your thoughts as to what level of estrogen one must attain in order to have issues and what would these issues be? How much is too high exactly? How could estrogen ever outweigh testosterone if it is testosterone itself that converts to estrogen? Where in the medical literature is the above demonstrated?

There is NO evidence of estradiol causing issues at any level. None. Nada. If you have something I have never seen before, please do share. Make sure it is a proper interventional study and not an observational or associative study (learn the difference between the two if you don’t already).

Visit our Facebook group called TRT and Hormone Optimization. Make a post asking how many guys have an E2 level above a given amount (pick a random number - 60? 70? 100?) and ask who is doing well and who isn’t. You’ll have one hell of an eye opener.

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I stopped testosterone gel and in about a week they went away and havent had one since. Hadnt had one in 20 years prior. So if it wasnt the testosterone what was it and why am i not the only one that has experienced it. Why are there many many people having anxiety symptoms after testosterone. Most are predisposed but some have never had anxiety in their lives.

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I don’t have answers to any of this i don’t claim to know. I have no idea. I will admit that i base my thought process solely on my own observations and common sense. There is no science involved. My only question to you is why out of the blue do so many men that aren’t suffering from anxiety develop it after trt. I am totally with you on no a.i. And also would much rather raise my testosterone to outweigh the estrogen rather than use an ai but i am just concerned if having to raise it to high outweighs the benefits.

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Just to be clear, were you also on the gel before this occurred or were you using a different form of TRT? Have you tried to use anything other than the gel? We do see guys getting anxiety but it’s rather rare.