Is My TRT Protocol Causing My Depression? Two Weeks on T-Cyp

[kafahmy]

Age: 28
Height : 6'1
Weight : 215
Body Fat % : around 20%

-started TRT on April 6th 2017
-Protocol: 140 mg Test Cyp/week, 800 HCG , .25 Armidex/week ( Spliting my dose twice a week )

-Blood work prior to TRT:

CBC With Differential/Platelet
WBC 5.0 x10E3/uL 3.4 - 10.8
RBC 6.79 High x10E6/uL 4.14 - 5.80
Hemoglobin 13.7 g/dL 12.6 - 17.7
Hematocrit 42.1 % 37.5 - 51.0
MCV 62 Low fL 79 - 97 01
MCH 20.2 Low pg 26.6 - 33.0
MCHC 32.5 g/dL 31.5 - 35.7
RDW 18.8 High % 12.3 - 15.4
Platelets 190 x10E3/uL 150 - 379
Neutrophils 28 %
Lymphs 57 %
Monocytes 9 %
Eos 5 %
Basos 1 %
Neutrophils (Absolute) 1.4 x10E3/uL 1.4 - 7.0
Lymphs (Absolute) 2.8 x10E3/uL 0.7 - 3.1
Monocytes(Absolute) 0.5 x10E3/uL 0.1 - 0.9
Eos (Absolute) 0.2 x10E3/uL 0.0 - 0.4
Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2
Immature Granulocytes 0 %
Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1


Comp. Metabolic Panel (14)
Glucose, Serum 92 mg/dL 65 - 99
BUN 19 mg/dL 6- 20
Creatinine, Serum 1.02 mg/dL 0.76 - 1.27

eGFR If NonAfricn Am 100 mL/min/1.73 >59
eGFR If Africn Am 116 mL/min/1.73 >59
BUN/Creatinine Ratio 19 8 - 19
Sodium, Serum 139 mmol/L 134 - 144
Potassium, Serum 4.6 mmol/L 3.5 - 5.2
Chloride, Serum 98 mmol/L 96 - 106
Carbon Dioxide, Total 25 mmol/L 18 - 29
Calcium, Serum 9.8 mg/dL 8.7 - 10.2
Protein, Total, Serum 7.4 g/dL 6.0 - 8.5
Albumin, Serum 4.8 g/dL 3.5 - 5.5
Globulin, Total 2.6 g/dL 1.5 - 4.5
A/G Ratio 1.8 1.1 - 2.5


Bilirubin, Total 0.4 mg/dL 0.0 - 1.2
Alkaline Phosphatase, S 31 Low IU/L 39 - 117
AST (SGOT) 24 IU/L 0 - 40
ALT (SGPT) 34 IU/L 0 - 44
Lipid Panel w/ Chol/HDL Ratio
Cholesterol, Total 161 mg/dL 100 - 199
Triglycerides 79 mg/dL 0 - 149
HDL Cholesterol 58 mg/dL >39
VLDL Cholesterol Cal 16 mg/dL 5 - 40
LDL Cholesterol Calc 87 mg/dL 0 - 99
T. Chol/HDL Ratio 2.8 ratio units 0.0 - 5.0

Hormone Panel
Testosterone,Free and Total
Testosterone, Serum 456 ng/dL 348 - 1197
Free Testosterone(Direct) 9.6 pg/mL 9.3 - 26.5 01
Estradiol, Sensitive 19.3 pg/mL 8.0 - 35.0
Sex Horm Binding Glob, Serum 31.5 nmol/L 16.5 - 55.9
DHEA-Sulfate 316.9 ug/dL 138.5 - 475.2 01
TSH 3.910 uIU/mL 0.450 - 4.500 01
Luteinizing Hormone(LH), S
LH 7.1 mIU/mL 1.7 - 8.6

Prostate Specific Ag, Serum 0.5 ng/mL 0.0 - 4.0

Symptoms prior to TRT:
-lack of energy & fatigue
-poor memory & concentration
-lack of interest in life in general
-bad lipido
-terrible body composition ( minimal muscle gain despite lifting weight for 2 years and fat acumulation despite following clean diet)


I have been on TRT for only 2 weeks and I know it's way to early to judge the effectiveness of my treatment at the moment. However, I have started to feel the some positive effect (great lipido and my strength is getting a little better). however, there is one side effect that worries me a lot -->depression !

I have noticed that I get very depressed the day following my injection, it's like my body reacts in a negative manner to the increase of my Testosterone level ? i read a lot of forms on here and I realize this might be related to an elevated E2 but I highly doubt it for 2 reasons : 1) I am on Armidex 2) my lipidio is over the roof ...I wake up with morning woods, I have spontaneous erections during the day and I get great hard erections with no cialis (used to take cialis to maintain good erection)

Can TRT cause depression ? can it be that my body is still adjusting and the depression would go away with time ? (what if it get worse?) I was under the impression that low Testosterone contributes to depression and not the other way around ! I have a follow up meeting with my doctor in 2.5 month But I am worried that my depression will get worse and thought I should ask you guys first before I call my doctor and ask to get an appointment sooner. Also, My TSH was high for an unknow reason 3.9 (prior to TRT) , I was tested on December and my TSH was 2.0 ...My doctor (great guy btw) will order T3 and T4 suring my follow up. Can Thyroids level be a potential cause ?

I am a little bit lost here and I would really appreciate your input !

Thank you in advance !

 

[kafahmy]

Bump for replies

 

[CoastWatcher]

Your TSH was at 3.9, dropped to 2.0 and he isn't all over that? He's not working up t3, t4, rt3, and antibodies right away? As has been pointed out many times, failure to diagnose and correct thyroid abnormalities can lead to a frustrating journey for a patient as he tries to dial in a TRT protocol. The thyroid is called the master gland for a reason. Why are you on an AI when your estradiol on the sensitive test is below 20? Are you possibly pushing it too low, even with the administration of exogenous testosterone? Low e2 is a place you don't want to visit.

 

[Vince Carter]

Lots of changes are happening and as you state its very early and unless something is very very troubling, its advisable to ride it out.
I do like to question blanket Anastrozole inclusion in a protocol though, its putting drugs in to a situation that may not even warrant the drug.

 

[kafahmy]

Sorry if i wasn't clear...my TSH was 3.9 on my LAST blood work, it was weird as i had no symptoms of low thyroids .When we discussed my numbers i mentioned that in my previous lab work tsh was 2.0 so he suggested that we test Free T3 and T4 on our next appointment to see what is going on. As for E2, it was 20 before TRTi asked why armidex and he said now that my free testosterone is borderline i do not have much Test to convert but with TRT it will more than likely go way up and that's why he only prescribed 0.1 armidex twice a week until he sees my next blood work. I should probably order a total T, Free T and estradiol in 2 weeks to see where i am

 

[CoastWatcher]

Sorry if i wasn't clear...my TSH was 3.9 on my LAST blood work, it was weird as i had no symptoms of low thyroids .When we discussed my numbers i mentioned that in my previous lab work tsh was 2.0 so he suggested that we test Free T3 and T4 on our next appointment to see what is going on. As for E2, it was 20 before TRTi asked why armidex and he said now that my free testosterone is borderline i do not have much Test to convert but with TRT it will more than likely go way up and that's why he only prescribed 0.1 armidex twice a week until he sees my next blood work. I should probably order a total T, Free T and estradiol in 2 weeks to see where i am

Thyroid issues have foiled many as they seek success with androgen protocols. A TSH of 3.9 demands attention - symptoms or no symptoms. It's that important. As for testing, you've only been at it two weeks, the minimum time for serum levels to stabilize is four weeks, I believe Dr. Saya has written he asks for five weeks, and my own doctor holds out for six. If you want to test on your own now, go and pull the relevant thyroid hormone labs.

 

[kafahmy]

Lots of changes are happening and as you state its very early and unless something is very very troubling, its advisable to ride it out.
I do like to question blanket Anastrozole inclusion in a protocol though, its putting drugs in to a situation that may not even warrant the drug.

I lost you when u mentioned "Anastrozole inclusion" lol

 

[kafahmy]

Thyroid issues have foiled many as they seek success with androgen protocols. A TSH of 3.9 demands attention - symptoms or no symptoms. It's that important. As for testing, you've only been at it two weeks, the minimum time for serum levels to stabilize is four weeks, I believe Dr. Saya has written he asks for five weeks, and my own doctor holds out for six. If you want to test on your own now, go and pull the relevant thyroid hormone labs.

I'll wait till i hit a 5 week mark and run a full blood work . Thank you Coastwatcher !!
You think it's beneficial to run an over the counter thyroid support supplement?

 

[Vince]

I agree, it takes time for your body to the new hormones, I'm surprised to see you're taking Armidex.

 

[Vince Carter]

I lost you when u mentioned "Anastrozole inclusion" lol

I mean that its given automatically, when you don't have any labs that would support using the drug.

 

[kafahmy]

I agree, it takes time for your body to the new hormones, I'm surprised to see you're taking Armidex.

i skipped my armidex dose today and will see if the depression and overall mood get any better. If so i might just take it once a week (0.1 mg) instead of twice until my next blood work.

Is there a relation between TSH level and overall mood ?

 

[Vince]

i skipped my armidex dose today and will see if the depression and overall mood get any better. If so i might just take it once a week (0.1 mg) instead of twice until my next blood work.

Is there a relation between TSH level and overall mood ?

I know crashing your E2 will make you feel like s***

 

[CoastWatcher]

i skipped my armidex dose today and will see if the depression and overall mood get any better. If so i might just take it once a week (0.1 mg) instead of twice until my next blood work.

Is there a relation between TSH level and overall mood ?

There is certainly a relationship between thyroid and mood.

 

[KSPhD]

Was just checking into see if Kafahmy worked out this depression issue? I am noticing a similar thing on a similar protocol.

 

[kafahmy]

Was just checking into see if Kafahmy worked out this depression issue? I am noticing a similar thing on a similar protocol.

I've been skipping one dose since then and depression went away completely. Give it a try! I guess some people are more sensitive to armidex than others ?



On the other hand, i still don't think I'm dialed in completely, libido and erection have taken a toll since then ( I still get occasional morning wood) and I went back to using Cialis until I figure out what needs to be adjusted in my protocol. It's been 5 weeks since I started my protocol and will have a complete blood work at week 8. Will keep you posted.

 

[KSPhD]

Thanks Kafahmy. I am noticing it is worst on my trough day - not sure if that points to low T, or the effect of the arimidex. Right now erections and sex drive a great. But the downs - seem lower than I am used to.

Very interesting to hear your experiences.

 

[kafahmy]

Thanks Kafahmy. I am noticing it is worst on my trough day - not sure if that points to low T, or the effect of the arimidex. Right now erections and sex drive a great. But the downs - seem lower than I am used to.

Very interesting to hear your experiences.

How long you've been on your protocol ?

 

[KSPhD]

I have only been on ~ 4 to 5 weeks.

 

[kafahmy]

I have only been on ~ 4 to 5 weeks.

From what I've read so far, Arimidex is usually introduced to the protocol around week 4 and not from the very beginning since it takes our bodies an equivalent amount of time to start raising estrogen levels. Maybe that's why .25/ week was a little too much for me.

 

[CoastWatcher]

From what I've read so far, Arimidex is usually introduced to the protocol around week 4 and not from the very beginning since it takes our bodies an equivalent amount of time to start raising estrogen levels. Maybe that's why .25/ week was a little too much for me.

An AI shouldn't be introduced at all in the absence of elevated estradiol levels (via the sensitive, LC, MS/MS labs test) and symptoms that correspond to those elevated levels. To simply "introduce" it, as a given part of a protocol is a risky undertaking. Easy to knock e2 into the ditch - and with it a lot of problems.