Been on pellets for the last couple of months with no improvements i.e low lobido, ED. Recently went in for 3 month checkup and here are the results i’m concerned that my Estradiol is high event though it’s showing within range. These are the only tests that were ordered at this time. Any thoughts would be helpful
Your T is still pretty low. Your E2 may be a LITTLE high in this ratio but probably not causing sides. If you havent had ANY benefit in 90 days at your level then I think you need to increase your dose. Test after 6 weeks. We have a member, @traveling-man, that is kind of our forum pellet guru and maybe he could give you some insight. Most of us here utilize injections.
Thanks for the response. I will be switching from pellets to injections next month when my pellets are up. I feel as though my E2 is a little high and could be causing some of my issues. I want to treat the issues and not the numbers as they say.
But if the issue correlate to the still lowish T then I would get that increased dose to get that up and see where you stand. That might alleviate the symptoms. You dont want to change multiple things at once.
Thanks, my T is up from where i first started at 240. I’m sure for a 42 yr old male my numbers should be much higher anyways.
I was around where you are (235) but didnt really feel great until I got in the 700 range FWIW as we are all different.
Agreed, thanks for your responses.
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You are not testing what you need. Here is what is going to happen - you are going to switch to injections, then run all the correct tests, make the changes and everything will be great. It was those bad pellets that didn’t work.
But that is not necessarily the case.
WHICH pellets are you on - BioTE or Testopel?
How many pellets were inserted on the first round at what dose?
Are you taking a DIM supplement?
Did you talk to your doctor about a pellet booster?
The elephant in the room is SHBG and you didn’t test it.
First pellet cycle is hard to gauge. Waiting 3 months makes it even worse. You should have had a full blood panel at 30 days. At the very least, you should have tested T, Free T, E2 and SHBG at the one month mark.
But … those are just my opinions. You may not have the right pellet doctor. My thread.
Thanks for tagging me @NH_Watts
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You are thorough with your protocol so I knew you’d have some insight.
This is estrogen dominance, estrogen is on the higher end and testosterone on the lower end and is why you have low libido and ED. Men are supposed to have higher testosterone in relation to estrogen.
Testosterone is still suboptimal and is low. You are also at the cut off point for cardiovascular disease/risk. Those with low thyroid hormones will see no benefit from TRT.
Seems like your doctor is short changing you on proper lab testing. We have no idea how much of the free portion of testosterone is circulating in the blood, Total T is not bioavailable and it would seem your doctor is inept to be replacing a man’s testosterone.
Your Free T could be abnormally low if SHBG were elevated. T-pellet therapy is a poor choice for TRT, the T-pellets do not absorb at the same rate and any doctor doing pellets is doing so for pure profit and is the least effective form of TRT.
You will always struggle with high, low levels between pellet insertions and risk scarring and infection. Suggest daily injections or T creams applied to the scrotum which I believe is your only chance to make TRT work for you. You can have very steady levels and maintain a lower estrogen.
There plenty of red flags here, your doctor is no good. Probably took one of the weekend training crash courses on how to implant T-pellets and no one educated him on proper blood testing.
Most doctors fail miserably at TRT, no standard of care for TRT and guidelines are horribly outdated so every doctor is doing his own thing and most get it wrong.
Describe height, weight, diet and do you exercise. Excess estrogen can be do to being obese and changing diet and losing weight can lower estrogen.
Thanks for all the responses so will try to address them all. Hight 6’0 weight 230 diet and exercise has been unchanged since i first started having low test issues back in sept. of 2018. The were a total of 8 pellets inserted and was made at a compounding pharmacy. I’m seeing a local Urologist which just called me to advise that my test is not in range of where it should be. I should be in the 600 range for my age and doing a follow up visit on Monday. Here is my free test that was taken back in October which seems low to me.
T pellet therapy will see levels all over the place and you will never feel the same, after pellet insertion levels will be very high and at the end near to another pellet insertion, you will be hypogonadal.
On injectable testosterone you feel the same every day 24/7 365. All men usually end up on injectable testosterone and get tired of the constant hormonal roller coaster.
Same Bullshit, different day. At least you are consistent with your dribble.
You just provided your own answer. You are not able to tell what the compounding pharmacy provided you nor are you able to hold their product to any standards or comparisons.
Your urologist isn’t helping you. IF you want to give pellets an honest chance, find a BioTE pellet doctor. Get the correct labs run before starting and at 30 days.
I actually agree with systemlord on this one statement. Wonders never cease.
I can’t provide any more suggestions than I have. You now have multiple opinions and multiple directions that you can go. Good luck.
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So I just had my 6-week blood done with the following results. I am on 280ml 200 mg test cyp every two weeks.
Testosterone Serum 352 ref range 264-916 ng/dl
Estradiol 43.5 ref range 7.6-42.6 pg/nl
Hemoglobin 18.1 ref range 13.0-17.7 g/dl
Hemtocrit 52.8 ref range 37.5-51.0%
I’m currently waiting to hear back from the dr on how to proceed from here but was wanting a little advice so I can have a better discussion with the dr on my protocol. Still, have the same issues as before with erection troubles and no morning wood. Any guidance would be appreciated.
So what is the dosing schedule, 200mg every other week?
Testosterone is VERY low still, no wonder you have erection issues
They also need to test free test and SHBG. I would guess your free T is very low as well. Free T is the most important one of all and it looks like they didn’t even test it. You will usually want to get free T to the high end or even a little over the high end of the reference range to resolve symptoms.
You need to go to something more like 150mg per week, divided into 2-3 doses per week. So something like 50mg every Mon/Wed/Fri is what I would be doing if I was you.
No I’m on 280 every two weeks. The dr wouldn’t let me raise my dose because hematocrit was high at last blood check and also this blood check.
When did they do this blood test? Just before taking another dose or what?
This is estrogen dominance, you’re even more estrogen dominant than pre-TRT.
You’re going to a doctor that doesn’t specialize in TRT, so you can’t expect your doctor to know what to do. Men who work with incompetent doctors struggle the most on TRT, you need to find someone outside of sick care to manage your TRT, someone with experience.
These large injections also increase hematocrit, more frequent dosing will lower hematocrit. Your estrogen is a big problem and can only imagine where estrogen was at peak, you need injections at least ED or EOD or you are going to prolong your recovery.
How long you want to draw this out is up to you, right now you doctor is operating in the dark and can only screw things more.
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You need twice the dose man. This is why we don’t use pellets. Cannot optimize on the go. Get vial of t and inject on top.
Doesn’t even have to test. You jsut take more t until symptoms resolve. Obviously labs show that but even if levels were higher I’d still tell him to try a bit more.