Hello. I’m 23 Years Old Male. I Suffered From Extreme

Posted on Tue, 30 Oct 2018

Question: Hello. I’m 23 years old male. I suffered from extreme anxiety, mood swings, hot flashes and insomnia which developed into derealization. I was prescribed ssris and it did work so, I was tested for hormones imbalance and turned out that My testosterone levels are low normal. 392 ng/dl. I was put onto testosterone replacement therapy. I got my first shot about 10 days ago (nebido 1000 mg testosterone undecanoate). I noticed that my anxiety, brain fog and derealization increased but at the same time i feel more calm and I know it’s very hard to explain. I read online that this could be due to high E2 levels, so I went to a private laboratory and did an E2 test. The results were; 44 pg/ml. I showed this to my doctor and he told me that he doesn’t know anything about E2 and this is not his specialty!. My question is, could E2 be the reason behind my symptoms? And is this considered too high for my age ? And if so, what should I do about it. Thank you.

Answered by Dr. Mirjeta Guni (2 hours later)

Brief Answer:
About low testosterone;

Detailed Answer:
Hello and thank you for asking!
During testosterone replacement therapy there are often seen side effects of high estrogen levels manifested with : infertility, gynecomastia, bloating or water retention and for this reason testosterone therapy may be combined with antiestrogenics.
Regarding to your mood changes, do you mean that your are more quiet or more anxious, would you please describe better this part?
The testosterone you reported is slightly low for your age and before starting testosterone we usually check the thyroid function and prolactin level.
Did you ever check them?
Please attach the reports.
Will be a pleasure to help you further.
Best wishes,
Dr.Mirjeta

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Above answer was peer-reviewed by : Dr. Yogesh D