Questions about Mental Health

Pharma TRT
1

Hi guys, I’m new here, this is my first post on the forum.

I will start by saying I’m 29 years old, from the UK and I am 5ft11 and 78kg.

I’ve been having issues recently mainly pointing to mental health, I’ve had severe anxiety/panic disorder that has appeared out of no where within the last year or so, this is now at the point where my social anxiety is so high I don’t even want to go out with my friends. I’ve never been this way and always a seriously confident outgoing person which has now suddenly switched. I’ve noticed a lot of “changes” within my self which I’m going to list below.

  • Severe anxiety, this has been giving me panic attacks which have been getting worse, it used to be in certain situations however now it’s alot more frequent and I can literally be laying in bed and I’m in a panic attack. This is at the point where I avoid any social setting.

  • Morning wood, haven’t had it for well over a year and erections rarely at full capacity

  • Building muscle at the gym has been extremely slow and almost non existent, I am in a caloric surplus and hitting my protein/calorie goals daily using a tracker but muscle building has been very very slow, I’m training correctly applying progressive overload and training to failure.

  • Struggling to sleep, once I’m asleep I’m great, I sleep the night through, getting to sleep is the issue

  • motivation is non existent, the stuff I used to love doing I now have zero interest in. I’m heavily into my cars, I have 3 of them for different purposes but I’ve completely neglected them as my interest in my hobby has disappeared

  • itchy scalp, may or may not be related however it’s there and wasn’t before

  • Hair loss in the shower, when I wash my hair there is at least 10/20 strands of hair in the shower, I have no history of balding in my family

  • I used to drink a lot of caffeine without any effect to myself. Tea/coffee/Energy Drinks/Pre etc. Now one cup of tea and I’m in a full blown anxious and panicky state to the point I can no longer drink caffeine at all. Having to switch to decaf everything (which sucks!)

  • constantly overthinking and dwelling on certain situations or worrying about stuff (e.g health) which is never an issue. I never used to worry about anything regardless of the situation

  • Belly fat which will not shift, I’m not an unhealthy eater and never have been, always had a decent diet even before training however I’ve got the typical skinny fat belly however I’m lean everywhere else

  • Sex drive has dropped a little but it’s still fairly high, nothing like it was a couple years ago it’s dropped drastically but it’s still there

  • I used to be a very short tempered and fairly aggressive person, however now a days I’m alot more placid and avoid confrontation where as before I would happily have confrontation.

I went to my GP about this who wasn’t helpful at all, he just said “here, take this sertraline and you will feel better” i went home, did my research and politely declined. I agree that these meds certainly do have a place however I really think they cause more harm than good. I’ve been forced with no option but to try and figure this out on my own and get back to my old much happier self.

I have read about testosterone and the link to mental health so decided to get my Hormone bloodwork done, these are my bloodwork results

lbumin - 48g/l

SHBG - 39nmol/L

FSH - 5.98iu/L

LH - 7.2iu/l

oestradiol - 93pmol/L

testosterone - 17.5nmol/L

Free test - 0.316nmol/L

free androgen index - 44.9%

Prolactin - 189miu/L

DHEA - 11.2umol/l

I understand my testosterone isn’t classed as low at 17.5nmol/L (504ish) however I do feel at 29 years old, healthy guy who trains consistently this is certainly on the lower side? I may be wrong but that is why I am here. I’m not looking at jumping on TRT ideally as we plan to have kids in the near future.

If you’ve made it this far i really appreciate the time you have given to read through my post and hopefully point me in the right direction.

TIA

James.

2

Nope. Perfectly normal from one lab draw. You could pull it tomorrow and be higher or lower with a high degree of variability.

You have more symptoms of mental health issues but decided an SSRI is ‘not for you’ but injecting hormones you may not need is? I’m a little confused.

Your symptoms lead to a lot of possible causes most if which I would say look to be mental health. Morning wood is an indicator of nothing, I rarely get it even on TRT. Sex drive is ok despite these mental episodes which is good. I’m not saying “take the SSRI” that’s a personal decision but you should at least leave it as an option.

Lastly, the NHS will not deviate from the standard lab ranges for care. There are some private places popping up now, but I believe they are pricey and far more scare than they are in the USA.

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3

This sounds like a recipe for problems down the road, excessive stress over a long period of time can cause permanent changes in the brain, effectively rewiring of how the brain functions.

I would recommend checking for metal toxicity or imbalances in heavy metals in anyone with an abrupt change mental status.

I would finish by saying I don’t think your issues are hormonal, 85% sure.

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4

I think this is somewhat important. I notice when i get morning wood, it’s accompanied by a full bladder. SO, i actually think the full bladder has an effect on the wood.

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That and honestly you either get it and can maintain during sex or you can’t. Something I noticed even in youth is that morning wood had no bearing if I can actually go with a female or not.

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Not really. ‘Lower’ in the sense of someone who wants to be swole as fuck? Sure. But you don’t have anything in your labs that indicate needing/benefiting from “TRT”.

“TOT”, however, you could justify any multitude of ways. Given your mental state though, I don’t know if I would recommend this as your first move. TRT/TOT isn’t to be ‘dabbled’ in.

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I don’t Think TRT could be damaging. (Even if not needed)

SSRI’s although needed in certain cases, can ruin lives.

Not saying this guy needs/doesn’t need either one of those. Just saying your view on them is not even remotely close to how I view it.

I’ve been on TRT for a while and I was on SSRI’s for a bit. there isn’t enough money in the world to make me take SSRI’s again.

8

His Free T translates to 9 ng/dL. The Labcorp range for Free T is 9.3 to 26.5 ng/dL.

How is his Free T not low? Don’t tell me you’re using Total T to determine potential hypogonadism.

@James93 , your Free Testosterone, which is what matters when looking at symptoms of hypogonadism, is very low. Given all the symptoms you list I disagree with others here and think you very likely could benefit from exogenous Testosterone supplementation.

A lot of people are still somehow confused at the difference between Total and Free T and will use the former to diagnose potential Testosterone deficiency, which makes no sense whatsoever

9

We don’t know what the testing method was. If not Equilibrium Dialysis, theres a high chance that number is bunk.

Unit translation and lack of reference ranges doesn’t make things easier. Do you have any advice or OP or did you just come here to argue with me?

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Any sources on that or just something you’ve read? Anecdotally I’ve tested both Direct and Equilibrium Dialysis at the same time several times and results were almost identical.

Correcting the wrong advice you gave him, which could have life altering consequences, is giving advice to OP.

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OP, plz send me your TRT should you jump on it. I need it for experimental purposes, yanno. Thanks in advance!

12

Commonly used cFT formulae significantly overestimate FT relative to laboratory measurement by ED in male serum samples.

However, we have demonstrated that even the calculated fT values derived from the prevailing equations, based on linear law-of-mass action models or empiric equations, differ systematically from free testosterone measured by equilibrium dialysis by as much as 40%.

When someone posts “I have a severe anxiety condition but also I want to be in even better shape”, this doesn’t read like an excuse to get on TRT to you? Not sure what I said that was “wrong” but I do hope OP would follow the advice of a doctor over some dude on the internet. Apparently you think he would follow my advice first (though 99% of doctors in a clinical setting would agree not to pursue TRT with these labs).

You can justify being combative all you want, but I’m not the first person in this thread who recommended NOT to pursue TRT. You still chose to argue with me instead of others.

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How is this an argument against the Direct method of testing Free T? Are you confusing that method with cFT?

My point was that the Direct method isn’t as accurate as Equilibrium Dialysis, then as a response you quote me two papers that compare cFT with Equilibrium Dialysis, no mention of the Direct method, let alone a comparison between Direct and Eq. Dia. methods. What am I missing here?

What about this?

So someone with Free T at the very bottom of the range only needs exogenous Test to get swole as fuck? And bottom of the range Free T means "you don’t have anything in your labs that indicate needing/benefiting from “TRT”?

You then justified yourself by confusing the Direct method with calculated Free T, confirming you don’t know what you’re talking about.

I’ll tell you why I’m arguing with you. Because your tone when you responded to him was full of absolute confidence in what you were saying even though you didn’t even take the time to look at his Free T levels and obviously know nothing about HRT/TRT beyond some lingo you learned on here and perhaps reddit.

It’s dangerous, period. We’re talking about giving potentially life changing advice. When someone comes in with crashed Free T and gets completely wrong feedback, it irks me and I will explain why it’s wrong so I’m not just a single dissenting opinion, but OP actually has a chance to understand specifically why I disagree and can then do further research, in this case about the importance of looking at Free T, other methods of measuring it, etc…

Here’s a question for you. Your main response to my criticism was that maybe OP didn’t use Eq. Dia. to measure Free T, therefore it’s meaningless.
If that’s the case, why didn’t you mention it to him?

If you’d actually looked at his Free T and translated it to ng/dL, you would’ve seen it’s at the bottom of the range. Then based on your belief that Eq. Dia. is the only accurate way to measure Free T, you would’ve logically asked him to clarify which method he used. No?

So clearly you didn’t, but felt confident enough to give life altering advice regardless. Personally I think that’s unacceptable

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It isn’t.

15

Goodness, so many people coming here looking for life altering advice from unliscensed internet strangers.

You’re reaching Rachel Maddow levels of fear mongering.

If you’ll read through the rest of the responses in this thread, you’ll see that I’m not the only one advising against TRT at this time. You keep ignoring this point like it’s going to make you ‘right’.

“TRT”, as I’m sure you know, is used medically to bring up TT levels to within the lab range. Though I don’t believe we should be treating to TT, that is the medical practice. While we should be treating to fT, that just isn’t the case outside of TRT Clinics - many of which prescribe “TOT”, not “TRT”. I’m sure you’re aware of this as well. You assumed the labs in which OP got his results run through, which I’m sure you also know is not the ‘correct’ thing to do as different labs have different reference ranges.

Nice talking to you, but let’s not do this in the future. I don’t care enough about you to continue to justify giving the advice I give, particularly when it’s repeated by everyone else in the thread.

FWIW, I was able to put on more mass than most with fT levels below OP’s (measured with direct method, your favorite).

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16

I am not up to date on fT measurements, but understand there is some nuance there. I think you need to understand those nuances. Your TT and SHBG seem pretty normal to me. By that I know people who would be considered “jacked” by most with those numbers.

From here, what I think you should do is more learning along with more testing. You may find that this was a high reading or a low reading. I think it is wise to really have a good picture of where you are before committing to something like TRT. Be open minded to other things as well.

To me, it sounds like you are suffering more from a mental health issue than a hormone one. They can be related, but I wouldn’t assume that hormones will fix it at this point. It is really easy to jump to conclusions with TRT. I probably did just that. My levels were low, but TRT didn’t really fix the issues I wanted it to. For me, I had a lot of similar issues to you. Anxiety (and depression), lacking morning wood, struggling to fall asleep (this one was bad, I was probably sleepless 3 nights a week, and usually took 1-2 hours to fall asleep if I did), building muscle struggle (but everyone suffers from that haha), motivation and interest in things, belly fat, overthinking.

Of the common things listed, TRT helped me a with social anxiety (but not depression, or general anxiety), belly fat, and helped a bit with building muscle. The social anxiety thing was probably in good part to looking better TBH.

On further thought, can you detail your typical week of sleep for me? If you are lacking there, it might explain a lot of the other symptoms, along with your T levels not being where you want them. Really consider this! Sleep is really important. Insomnia can cause all sorts of issues.

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29 years old…man up, get a girlfriend, get some confidence and enjoy life. So many god dam ppl more than ever with this anxiety and mental health talk. Say what you want im an assshole but you cant tell me im wrong, ppl and doctors and tv are making it the norm so everyone is running with it. ughhhhh go tell a 11 year old fatal cancer patient that you’re anxiety and panic attacks are driving you out of your mind you don’t know what to do with your life and watch the face they give you lol

18

I have a partner, we’ve been together 10 years, so that isn’t an issue at all. I was like you in this aspect, I didn’t believe in mental health and always thought it was just “todays generation” then one day it hit me like a truck and I honestly wish it never hits you buddy, it’s a dark dark unexplainable place to be in that’s for sure!

———

Thankyou for all the responses within this thread, I did however state at the bottom of the Original Post that “I’m not looking at jumping into TRT as I plan to have kids in the near future” and don’t want to mess about with HCG etc. I’m more looking at something (supplement or simular) which is known for freeing up a bit of FT, my TT is within range but as one of the guys said in here my FT is low, real low.

I can imagine the amount of posts you get in here with people looking for excuses to get on TRT however this isn’t one of them, I’m trying to exhaust all methods while avoiding the SSRI route. I haven’t always been like this so there must be a way to fix it, I’m trying to find that fix.

Im currently waiting for my Vitamin D results to come back as I work 2 jobs back to back (full time and part time) and hardly ever see any sunlight and also going to get my thyroid levels checked.

Sleep I tend to get 7 hours a night during the week with 8+ on the weekends, I don’t finish work until 11pm during the week and start again at 8, so I’m up early. By the time I’m home showered and ready for bed it’s already past midnight.

Other than working alot (70ish hours a week) I don’t have any issues which could be causing this, I’m in a great relationship for the last 10 years, finances is good, job is secure and stress free etc (just to remove those from the equation)

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We can, because you are wrong, considering you don’t know why everyone with psychological disorders have them.

Though it helps, having a woman doesn’t miraculously cure whatever disturbs a man. Many people with spouses are mentally disordered.

A push for drugs does seem to be out there; that I agree with.

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For real damn, it may even make things worse especially if you are messed up in the head before hand.

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