An Unusual Source of Anxiety

[Fortunate]

Interesting that you have experienced it with all three Enan / Natesto / Xyosten, which I would consider very different in terms of timing. If your theory is right, one would think Natesto would cause the worst problems for you because of how fast your T drops back to normal on any nasal T.

Have you considered that a spike in histamine could be causing these bouts? I have been looking into histamine as culprit in early morning awakenings. Histamine is known to cause symptoms similar to what you are descibing. I have had some success treating it with anti-histamine, but its still bit of a mystery.

Now that I pay attention to this phenomenon, Natesto is one of the culprits. I think (but am not sure) that it's less severe with Natesto. Maybe the overall levels aren't very high and thus the drop is less severe?

In the past, I have been on Natesto continuously for up to six months at a time. I have no idea if this was happening back then because I was not aware enough to pay attention. It is possible that it was happening. Maybe not. It is also possible that with time, if you stay on Natesto, you pick up some endogenous production. If so, maybe the episodes go away? I don't know. Just some thoughts.

I also think that I am one of those guys whose cardiovascular response to TRT is more robust than most. I haven't thought about histamine release. That said, on occasion, if I have a bad bout of one of these episodes, I'll take a small dose of propranolol (30mg), which does seem to help.