question from a user
What can cause severe anxiety and palpitations (especially at night) on trt and Hcg?
AlphaMD's Answer
Well, TRT is not typically known to cause anxiety, though elevated estradiol levels can, so you should look into that. hCG is more likely to aromatize, so the combination increases the risk of high estradiol levels.
So, testosterone has never been shown to cause arrhythmia. TRT has actually been shown to increase cardiac output. It has been shown to increase ejection fraction and myocardial contractility. So that means each heartbeat is stronger, and it also pushes out a larger volume of blood with each beat.
In addition, TRT is known to cause vasodilation of peripheral vessels, reducing afterload. That means your heart is pushing against less resistance with each beat.
Because of these effects, it is a common complaint for men to say "I can feel my heart beat when I lay down at night and try to sleep". Thats because when you lay flat, your blood pressure drops even further, and the venous return to your heart increases. So each beat of your now stronger and more powerful heart pushes a significantly higher volume of blood with each beat. This feeling can be disconcerting, but it is not something to be concerned for.
The most common cause for palpitations in developed nations is caffeine overdose. We consume far to much of this stimulant. Check how much you are intaking, as we have discovered most of our patients use a lot of caffeine in an effort to help fuel their workouts.
But ultimately, TRT is not the cause of your palpitations.
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