We only know what we know with @angral23.
We don’t have pre TRT labs. 1400 TT was likely a trough reading on 250/week on his original protocol. I estimated based on his description of his new protocol that he mistakenly upped his dose to 280/wk when he switched to daily. He might be flying near 2000 TT most of the time. The only initial symptom we know was ED. And as @johan77, per the usual, astutely pointed out ED has a modest correlation/cure rate with TRT(about 50%). It’s easy to see that the OP is in distress. Bouts of ED are traumatic for men. I empathize and can relate from experience. Given what we know, it’s unclear whether TRT should have been initiated in the first place. Furthermore, the initial 250mg/week dose was too high. Then, we likely have a patient who made a dosing error and has increased that dose. My mind is blown that @dbossa treats this as a wait and see how it shakes out case. If he were to show this to his buddy Dr. Grant I’m sure he would agree that there were errors made across the board …from the diagnosis to the dosing and the inclusion of the AI and HCG. We don’t even know his initial labs??? Why wasn’t he prescribed Cialis as a first line treatment since his only reported symptom was ED? He might have underlying psychological issues causing the ED. What if he’s bipolar and he just got thrown on a nearly 300mg/week protocol? Mania anyone? The costs of the mistakes are real for the OP who is obviously suffering. All these threads devolve into arguments about the same 2 or 3 things and the OP doesn’t get help. And then he turns to the guy who’s beating his chest the hardest and screaming the loudest. OP needs a careful, thoughtful, look at the whole picture approach which may include taking TRT off the table.
Is he bi-polar? I think you’re over reacting here.
Probably not, statistically this wouldn’t be the case considering 1000-1300ng/dl is the (median) trough when given 300mg weekly (numerous studies I can link here)… however he may be a few standard deviations off the norm regarding his response/metabolic rate.
Are they? I had ED for a good year before TRT (proper as in… a perfect 10 could be standing right in front of me… propositioning me and not a thing would happen downstairs)… There was actually one time wherein I was going to hook up, but couldn’t get it up… I found the way I was picked on for many years to be far more traumatising (unrelated to ED).
According to literature, testosterone and even synthetic androgens… in relatively high dosages (up too 600mg) are well tolerated in the vast majority of men within an acute fashion (up to 6 mths)
Perhaps he doesn’t need TRT. I didn’t read his case, but to state “you’re TT is 1400, cut the dose in half” is overkill… perhaps cut it back to 190-200… see where that puts him. Why induce another dramatic hormonal change? Throw the body WAY off it’s already massively altered equilibrium
Do I think dbossa is biased? Perhaps, however I’d rather follow his advice of “take things slow, remove variables slowly” than “drop the dose by 50% right now”… If the reading truly is at trough, then the dosage needs to be reduced considerably… by about 40%, but even then… I’d taper the dose down… not outright drop it immediately (though the long ester itself will induce a taper).
Also if his test cyp is prescribed to him… wouldn’t it be 200mg/ml given that generic/branded formulations of test cyp are marketed as 200mg/ml, not 250mg/ml?
I would hate to be one of those people.
It’s not clear. He said 250mg/ml. Maybe it’s sustanon. The bottom line is we know very little about him. Cutting his dose in half isn’t a problem. You guys act like it’s drastic or the body can’t handle it. It’s Testosterone. Not cortisol or blood sugar levels. Plus the long esters provide a smooth transition.
Its not drastic for the average individual. But for someone already struggling, prone to anxiety and whatnot… it’s never a good idea to make sudden drastic changes.
The sudden drastic change in this example was the initiation of TRT at 250+mg!
Once again he states its test cyp… if it’s 1ml weekly it probably isn’t 250 as test cyp isn’t formulated as 250mg/ml unless it’s UGL… More likely 200mg
That being said, giving this guy TRT in the first place was reckless and irresponsible… without labs to even determine whether the individual had hypogonadism/subclinical low T or not… what the fuck was that doc thinking?
I think he had pre TRT labs but couldnt find them.
I’m working with him by email. He was making a screwup with his dosing calculations which led to him injecting 280mg a week. I know plenty of guys doing well taking that much (myself included) but it’s much too high of a dose for someone that has never once been dialed in. Dropping this down to 210 a week through either 30mg daily injections or 70mg 3 times a week. He will report back to see if he is feeling better or worse and then adjust from there. No labs of any kind are available, thyroid, prolactin, Vit D, DHEA-S, or anything like that. He’s trying to get a hold of his past labs to send to me. He’s ditched the HCG and AI.
I’ll work with him and we’ll let you know what happens.
Oh, and guys, when I said “postal”… I meant figuratively, not literally. I thought you were able to pick up on the fact that it’s just an expression. Relax!
@blizzardtest if you are under the impression that Dr Grant would lose his shit with me if I showed him the details of this thread, and what I recommended, I’d be happy to share it with him and post his reply here.
We chat all day. I’ll bet you a steak dinner he’d agree with my position… but I’ll do it if it helps you to sleep better tonight 
I realize. I’m just giving you a hard time.
You are quite talented at it too lol
You’re Canadian, so we know you don’t have a gun.
I’m glad he’s getting some help. We agree on the course of action. Lower dose, drop AI and HCG. I’d take the dose a bit lower. But Thats that. The issue for a guy like him is that if in 8 weeks at 210 no AI and HCG if his ED isn’t resolved, where do you move from there? Increase or decrease? Or get him off TRT to see where he restarts? It’s a tough case given how it was initiated.
I’m Italian… That opens a whole other ball of wax 
If no improvement I’m dropping the dose down. Absolutely. I just don’t want to do something that drastic yet. One step at a time.
depends where 280mg gets you
If you’re going year round with a cavg TT of 2500-3000ng/dl… ft 3x top of upper limits of normality… I just don’t think that’s maintainable long term (well it is, but I think it’d cut quite a few years off you’re lifespan, exert somewhat of a deleterious effect on long term cognition, cardiac health)
That being said, many won’t budge even 1500 on said dose, there’s a wide variety of response from the same dosages one can have.
Let’s see what happens… I just want to get this issue resolved already. I’m miserable feeling like this.
Sorry I thought I was responding to the guy who came in with cardiac autonomic dysfunction on the Pharma forum lol