Something interesting happened to me last weekend and I'm curious to get you folks' opinions. But first, some context.

I was castrated in June 2015. While I had balls, my T level was a surprisingly low 287. After orchiectomy, I started doing 2 pumps Androgel every morning, which shot my T levels up to 570s. I felt fine, good.

In August 2015, 2 months post-orchie, I started having some really nasty anxiety attacks. Now it's true that there were a lot of factors in play--going off a med, coming to terms with some childhood crap, etc.--but I wondered at the time if castration and HRT had anything to do with it. My endocrinologist assured me that that wasn't the case, especially since I was simply replacing T rather than, say, going on E.

Fast forward to August 2016. Over the past year I've been working hard to manage my anxiety via meds and CBT (cognitive-behavioral therapy, not cock and ball torture ). I've made great strides, but still have my ups and downs. That's normal.

Here's the thing though. I went away over the weekend and forgot my Androgel. I was without it Saturday, Sunday, Monday, and Tuesday. Late Monday and much of Tuesday, I noticed that I was less anxious, calmer. The most noticeable change was that I felt less irritable, far less likely to swear and scream in traffic.

I know that T is tied to aggression in the popular imagination (and much of the medical lit suggests that's actually an oversimplification), but I find it interesting that having a few days without T-replacement really improved my mood. Now I'm wondering if part of the reason my anxiety got so bad last year was because I had basically doubled my T-level by jumping from 287 to 570s in such a short period. Obviously, I need to consult with my endo on this, but I'd like to know if other folks have had similar experiences.

At any rate, I'm going down to 1 pump of Androgel each morning for now and seeing how that works!

Yes, could be 570 are too much for you. The half is around 300 and could be closer what you need.

I have your symtoms on low T, seems to be I need more but your mileage may vary.

I share your experience. Once castrated I was on no T for 4 months, I loved the calm feeling but hated the hot flushes. Was prescribed T gel.After a week or so I was right back to old agressive ways.So I started reducing the T level by skipping a days T gel now and again. Grat improvement.I am experimenting with how little T I really need.I stopped for long enough for ther hot flushes to restart and then built up a little untill they just stopped

Stephenie

Yup--I've read that low T can lead to the exact same problems with irritability and anxiety. I can't find anything that says high T causes similar problems, but I strongly suspect it does.

I think that the lack of medical literature on the downsides of too high T is partly due to our machismo culture and partly due to drug company shenanigans. The Rx manufacturers have managed to convince every man over 40 who suddenly realizes he's no longer 25 that he NEEDS T supplements if he doesn't want to become a fat, passive, limp dick girly man. Therefore, there's probably little funding for studies that take a more evenhanded look at T replacement, and those that do get published don't receive a lot of exposure. It's a common issue actually; any studies that take a critical look at a particular drug tend to get buried.

chemistry of hormones is quite complex. There are several androgens along with testosterone that have different physical and psychical effects. Dihydrotestosterone (DHT) for example is much stronger Androgen than Testosterone and Androstenedione much weaker, but still can cause mood swings and other effects. Also Androstenedione can be converted into estrogen. And general T-levels doesn't mean much as 95-97% of that T is binded by Albumin and SHBG. It means inactive. What counts is free testosterone. And wether there is more DHT, or less.

https://en.wikipedia.org/wiki/Androgen

Simply going to one pump may lower your T level, but don't count on it being as simple as use half as much gel, have half as much testosterone in your system. These medications are strange like that, and simple math often doesn't work. Take that as nursing advice, to find out for sure consult your doctor.

Anxiety... I've had a lot lately. But I think it's due more to thing that you and spoke about in person last April. I'm hoping once I get those concerns resolved that my anxiety level goes down. Until then, I'm enjoying a supply of anti-anxiety medication coming to me via Washington state. I try to only use it once a week at most.

--LT

I plan to talk to my endo if she ever gets back to me. Her assistant seems legitimately overwhelmed, but I suspect she (the assistant) is also not particularly good at keeping on top of things. Not to be an entitled bitch, but I want to say "You know, I am going out of network here and filing for reimbursement every time I come in..." but anyways.

I figured it wouldn't be as simple as halve the pumps, halve the T. I'm just glad I feel better and suspect it's because my T is lower in any case. Or maybe, as erikboy pointed out, I've reduced some other hormonal thing and that's done the trick. Whatever it is, good stuff.

...

Qunuch81 (imported) wrote: Fri Sep 02, 2016 9:29 pm Here's the thing though. I went away over the weekend and forgot my Androgel. I was without it Saturday, Sunday, Monday, and Tuesday. Late Monday and much of Tuesday, I noticed that I was less anxious, calmer. The most noticeable change was that I felt less irritable, far less likely to swear and scream in traffic.

I know that T is tied to aggression in the popular imagination (and much of the medical lit suggests that's actually an oversimplification), but I find it interesting that having a few days without T-replacement really improved my mood. Now I'm wondering if part of the reason my anxiety got so bad last year was because I had basically doubled my T-level by jumping from 287 to 570s in such a short period. Obviously, I need to consult with my endo on this, but I'd like to know if other folks have had similar experiences. ...

My experience is similar. Ambient T level pre-2007 radiation for prostate cancer was 360 - 400; life was fine. Post radiation, T crashed to 210 for nearly 2 years and I felt typical low-T symptoms & PSA fell to excellent 0.2, enabling MD-supervised T replacement in 2010 using daily rub-on bio-identical crème supplied by a compounding pharmacy in a convenient Topi-Click dispenser. T jumped to 700-900 thereafter and I felt rejuvenated, including a peculiarly feisty temperament in speaking out at meetings. I reminded myself to think twice before speaking up. I got acclimated to the increased T and by 2013 reduced my dosage by 1/3, while my PSA rose past the point that cancer recurrence seemed likely. (ref: my updated profile.) I lost my feisty nature during that time. Never have had anxiety problems.

I ceased TRT in July 2016 and went T-free by (urologist-performed in an OR) castration as medical necessity on Aug 11; T= 36 and PSA down 40% on Aug 15 with symptoms of being T-free and E-free each becoming evident in next 2-3 weeks: No erections or libido now, memory less sharp, muscular strength down, but no hot flashes so far. I suggest that experiences vary from one person to the next, that acclimation to endocrine change does gradually happen, and that moods, etc. react slowly to rapid changes in blood hormone levels (days and weeks, not hours.) I'm seeking E replacement Rx as a priority.

Qunuch81 (imported) wrote: Sat Sep 03, 2016 4:01 pm I plan to talk to my endo if she ever gets back to me. Her assistant seems legitimately overwhelmed, but I suspect she (the assistant) is also not particularly good at keeping on top of things. Not to be an entitled bitch, but I want to say "You know, I am going out of network here and filing for reimbursement every time I come in..." but anyways.

I figured it wouldn't be as simple as halve the pumps, halve the T. I'm just glad I feel better and suspect it's because my T is lower in any case. Or maybe, as erikboy pointed out, I've reduced some other hormonal thing and that's done the trick. Whatever it is, good stuff.

Whatever happens, I hope you're able to get the questions answered. The doctors being incredibly busy doesn't surprise me. It's quite common in medical world to short staff and overwhelm those who are providing care. *shrugs* I used to be part of that world. Had to get out before it killed me.

I hope you're able to find a good in-network endo you like.