If you feel better getting off HCG and the AI, then listen to your body.
I have found that elevated T levels from injection can cause anxiety. There are other reports on here of people having symptoms of anxiety as their shot works into their system. On my dose, about 24 hours later I get a buzz almost like Iāve had coffee but with no jitters.
Once when I injected about 25% too much, after 36 hours (peak) I ended up with paranoia like Iāve never had in my life. Footsteps from 40 feet away in the supermarket sounded like they were right behind me and coming towards me. Oddly it didnāt really bother me too much, it was just weird. Just my own experience. A lot of people, including doctors, will say this is impossible or all in your head. I donāt.
The good news is it wonāt necessarily be this way forever, especially as your natural production shuts down.
This is where smaller T injections is better, less of a spike produces less anxiety.
These T spikes are not natural anyway, your natural T is getting a gradual refill as you sleep.
I agree!
Who else in this country other than defy 
uses empower to get .125 mg ai??
Empower makes it and it has to be prescribed! Thatās why defy prescribes it upfront with the disclaimer āif you need itā. But he still prescribes it. And most guys end up taking it because of what thet should feel when just starting trt. Thinking they need it.
Its bull shit to make money and it hurts the men.
So you came up with this based on reading forum entries.
Unless you have seen hundreds of patients ā¦ It is bad for you to make recommendations based on this.
Stick with providing your experiences.
My doctor doesnāt even check shbg he does because I ask him. The Dr is rightā¦ The goal either way is to bring the free t up.
Justin Saya at Defy doesnāt take an AI anymore and his E2 is over 100. This is an absolute fact. Yet he keeps prescribing it to men. Someone explain that to me please.
I just did. Read my post above.
That was his protocol, and he has low SHBG. He tried all the other different dosing. It worked the best for him, so advises others with low SHBG having issues to try it. Thatās the point of a forum, to get opinions from other guys. Like high E2 causing ED. It does that to some guys. It doesnāt do it to me, but that doesnāt mean that it canāt do it, and those guys might want the .125 dose AI. Itās a lot easier than cutting up a pill into 1/8ās or grinding one up and making your own vodka suspension to micro dose. Thereās nothing wrong with a prescription for āJust in caseā. Almost all doctors do that on a regular basis. Itās a lot safer than advocating a one size its all viewpoint.
High E2 does not cause ED. Elevated levels of E2 combined with low testosterone levels will. Find me a single guy with free T above 30 ng/dL who has E2 regardless of his E2 levels. You wonāt find any. High E2 does not cause ED. I cannot stress this enough. Get a manās T levels up enough until he is no longer symptomatic. I donāt know how else I can explain this. No man, other than a rare case of mastalgia, requires an AI on TRT. None. I understand this is the way a lot of doctors were doing it, and still do it. The high level docs have completely eliminated it from their combined thousands of patients. If thatās not enough I donāt know what else to tell you. E2 has never been demonstrated to cause harm. Ever. You really need to watch that Rouzier video and it will clear up A LOT.
You can stress your opinion all you want, hrdlvn absolutely has this issue, and he doesnāt get relief by increasing the dose to increase free T. It only gets worse for him when he get those numbers into the ranges you are advocating. Is he an outlier? Almost certainly, but itās still what it is and insisting it isnāt doesnāt change the fact that it is. Heās your āone guyā you keep asking for.
Itās not an opinion. Iām not a doctor. I have 10+ doctors telling me the same thing. The literature Iāve read tells me the same thing. Itās been demonstrated to me over and over again. I guarantee you send hrdlvn to a doc like Dr Nichols and heāll get him optimized and off his AI regardless of what his issue is. Iāll bet you any amount of money you wish. Several of the docs I know could do the same thing. The issue isnāt E2. Thatās just a number he sees going up and down and blaming that because that is the number he is measuring. There are other factors that he is not taking into consideration.
@dbossa - somewhat related to ED - what would you attribute to losing an erection mid sex? Has happened to me the last two times out now.
Last night started greatā¦a little foreplay, nice and aroused, some felatio, then into sex. About 3-5 minutes into sex, while having a great time, it just went limp.
Iāve been on a really long daily sex streak that started on 6/7 and has gone on every day except 1 and itās happened 4 total times, but the last two times in a row.
Not thrilled about it, but not sure why it happened. Thoughts?
I went through the same thing you describe for a period of 2 years. It was maddening. I felt like I wanted sex. Iād get an erection and felt like I was good to go. The whole time I was having sex I just felt like I was missing some sensitivity as if there wasnāt enough feeling. Then half way through, just goes limp. My wife was so frustrated about it and so was I. I kept having to tell her that it wasnāt her, it was me. I took Dr Nichols advice and eliminated the AI and began to slowly increase dose over time. Getting rid of the AI helped within 2-3 weeks. The magic number for ME was a free T of 28 ng/dL. Once I got there, all the sensitivity came back, sex felt like it was supposed to feel like, having an orgasm was WAY easier compared to having a hell of a time not being able to finish, and I could stay hard the entire time. Not just that, my erections were rock hardā¦ as if I had taken cialis. Night and day. Nobody could pay me enough money to convince me to put my Free T back into the ālab rangeā (designed for a population of sick people) and youād have to shoot me to take an AI.
Just had this conversation again last night and this morning. It doesnāt happen all the time, but when it does it seems to come in clusters. Sounds a lot like everything Iāve been dealing with over the years.
Iām awaiting my lab results as we speak. Will be interesting to see what my free t is, Iāve never had it measures. Urologist just said with total t and shbg, we can calculate free tā¦ But I just got my own labs.
I donāt take an AI, never have. I take 40mg test cyp EOD, 4mg tadalifil, 300mg B6 and 90mg armour thyroid.
I have an appointment next week. Iām going to ask if my urologist minds of I up my dose.
Thanks again.
And looking at the last blood work where both SHBG (38) and total T (657) were measured, assuming albumin of 4.3, my free t would have been 13.4 ng/dl.
Seems thatās not cutting it. Weāll see what most recent blood work shows, hopefully tomorrow.
That works out to 100mg a week. Thereās the problem. I donāt know a single man who is optimized on 100mg a week even if heās doing daily injections. My guess is that you will need to increase your dose.
I thought 40mg EOD worked out to 140mg a week?
I donāt skip weekends or anything, I just inject 40mg EOD. 7 injections over a 2 week span - 280mg injected over a 2 week span/2 = avg of 140mg per week. No?
heās not watching a number. He reacts to symptoms, and he decided to get labs to look for symptom correlation. And it was there. There are other guys who say the same thing, but he got number to go with it.
@bcostigan41 apologies. Yes, youāre taking 140mg a week. I misread it as twice a week. Still, even 140mg is considered a low dose these days. My guess of you having to increase still stands. Hereās the thing: if you were taking 200mg a week and still having symptoms what would you do? Tell everyone that you canāt take more because the dose is too āhighā? Or would you increase the dose to resolve your symptoms? You can either focus on a number and be symptomatic, or find the dose that makes you feel better.
I guess this should be the right way to approach this, itās the reason I started down this path to begin with. Just need to make sure my doc is on board too so he continues to write my test script. Everything I do is through insurance and want to keep it that way as private is cost prohibitive.
Does Dr. Nichols take insurance??
Thanks again for the replies, appreciate it.