Can't Find Optimal Dose. Help Me Get Dialed In

Pharma / TRT Testosterone Replacement
1

Higher dose = anxiety, lower dose = reduced benefits, think I may be naturally low E2 / a low aromatiser and I have quite low SHGB

Pre TRT I had the usual symptoms, anxiety, fatigue, lower libido, plus pretty poor penis sensitivity / orgasm intensity, maybe due to my natty lowish E2:

E2 measurements are all non sensitive, as this is the only test available in my country.

Pre TRT Bloods:

TT 12.7 nmol/l (range: 8.64 - 29) aka 365 ng/dl (range: 250 - 835)

FT 0.249 nmol/l (range: 0.2 - 0.62) aka 7.18 ng/dl (range: 5.76 - 17.9)

Estrogen 58.2 pmol/l (range: 41 - 159) (NON SENSITIVE TEST)

FSH 3.33 IU/L (range: 1.5 - 12.4)

LH 7.23 IU/L (Range: 1.7 - 8.6)

SHBG 31.10 nmol/L Range: 18.3 - 54.1)

Prolactin 310.00 mU/L (Range: 86 - 324)

TSH 2.42 mIU/L (Range: 0.27 - 4.2)

Free T3 4.6 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 16.7 pmol/l (Range: 12 - 22)

After a few months of 125mg p/w injected EOD (no AI or HCG):

TT 44.2 nmol/l (range: 8.64 - 29) aka 1150 ng/dl (range: 250 - 835)

FT 1.4 nmol/l (range: 0.2 - 0.62) aka 40 ng/dl (range: 5.76 - 17.9)

Estrogen 154 pmol/l (range: 41 - 159) (NON SENSITIVE TEST)

FSH < 0.3 IU/L (range: 1.5 - 12.4)

LH < 0.3 IU/L (Range: 1.7 - 8.6)

SHBG 23.5 nmol/L Range: 18.3 - 54.1)

Initially (for the first month to six weeks) felt very good, symptoms resolved, penis sensitivity + orgasm intensity improved dramatically, this dropped off a bit but still better than pre TRT.

As the weeks went on however I started to experience daily anxiety, I tried to ride it out for a month however it seemed to get worse than better, and along with this I started getting quite depressed as well as anxious, complete with feelings of hopelessness and despair, it wasn’t a good time and was interfering badly with functioning in my daily life. However I had good libido and plenty of energy, pretty good penis sensitivity, but the anxiety was unbearable.

So I dropped down to 100mg p/w injected EOD, I felt much better (best for a long time) within 2-3 days of reducing my dose, then after this I experienced a very brief bout of crushing depression that quickly passed within a day or two, then evened out, then daily anxiety / depression was essentially gone.

As of today (over a month since my dose reduction) I feel pretty even mood wise but have lost a bunch of the benefits of TRT, I don’t feel as energetic, my libido has dropped, and possibly worst of all my penis sensitivity / orgasm intensity has dropped right down to worse than pre TRT. Seem to be having some trouble maintaining an erection as well - I can get one fine but I think the lack of sensitivity is causing me to partially lose it again.

I’m not 100% sure what to think. What I do note is my natty E2 was pretty low, maybe more so considering it was the non sensitive test - although I have read differing reports as to whether a non sensitive test comes out higher or lower than a sensitive one. So once I started TRT my E2 went up along with my TT and FT and I felt great.

Then I started feeling very anxious - either this is from my TT / FT being too high for me to deal with comfortably, OR it’s due to my E2 going higher than what I can deal with comfortably (however it was still in range on my post TRT bloods - but maybe on the sensitive test it would have been too high?) or it’s due to my E2 being too low for my TT / FT levels so my ratio is out.

It’s a tricky one. When I dropped my dose I felt great initially, so I wonder if this was my TT / FT dropping rapidly and giving me a better E2 / TT ratio for a few days (as E2 lags behind I think?), then as my E2 dropped as well it ended up too low again. I am going to do bloods soon but I would expect to see a significantly lowered E2 come back.

So if we assume I am one of the lucky people who doesn’t aromatise as much, normal advice would be to inject less frequently to help raise up E2, correct? However I have quite low SHGB as well so my concern is that this wouldn’t work very well for me and would be too much of a hormonal rollercoaster

My other option is to add HCG but I’d rather not add another substance if possible.

Or I could go completely another way and try daily injections!

Of course I might be wrong and maybe it was high E2 (for me) causing me a problem at 125mg p/w, but this doesn’t seem as likely…

Any thoughts and advice would be greatly appreciated, I feel like I can get this right and feel good but if I can’t get this sorted in the next few months I might just have to give up and PCT off while I’m still in my first year (to increase odds of recovery) as it stands now I’m not sure it’s worth being on TRT…

2

It’s only been a month since you changed your dose?

When I make a dose change, either more or less, it takes a good 8 weeks, sometimes longer, to reach a point where I feel completely better. And for me, libido and sensitivity are the last to level out. I’d give it at least another month before you make any changes, fwiw.

3

You are overdosed. If you can’t make injections work, maybe Jatenzo is an option for you. No more waiting 4-6 weeks to reach steady states, more like 7 days to a steady state.

You can figure things out much fast and easier on Jatenzo. In 3 weeks time to can go through three dosage incresses and reach a steady state three times.

4

A restart for someone with poorly functioning testicles, not exactly recommended. Your LH is high normal and you have low-T, that points to testicular failure.

You need to find a way to make TRT work.

5

Thanks both. I guess I can stick with this lower dose for a while longer to see if things even out.

Don’t think I’d be able to get something fancy like Jatenzo in my situation / country unfortunately, but thank you for the suggestion :slight_smile:

If sticking with current protocol for another few weeks doesn’t pan out, would be interested to hear any other suggestions / if anyone thinks boosting my E2 without increasing test dose somehow might help. i.e. I could REDUCE injection frequency but not sure how good that would be with my SHGB of 23.5 - or add HCG, but I’d rather not do that unless absolutely required.

6

You don’t have low SHBG.

7

I don’t? That’s good news! It looked low on the GUI on the blood test results website ( SHBG 23.5 nmol/L Range: 18.3 - 54.1 had the little “needle” right over to the left, so maybe I just assumed it was low)) and with my high free test from a modest dose I assumed I was considered to have low SHBG.

If I really don’t then that gives me more options with dosing frequency, and maybe I can experiment with less frequent dosing to help boost E2 up?

8

An SHBG 20-35 is optimal and as SHBG hits the 40’s it starts to negatively affect your Free T.

I have low SHBG at 15 and don’t have any of the problems you speak about, my hormones are at peak 1000 at 2 hours, 715 at 4 hours and 287 at 12 hours.

This is similar to mimicking naturally produced T.

9

With the lower dose, inject daily. Man up! Time to just see it that way. If you hate injecting, man up! Learn to love it if it means living. I know that on esthers are like oil debates on Car Forums. When you feel like you cant get dialed in, override the system! Inject daily and watch your system adjust, sooner than later music sounds great again, every kind of cleavage is quality stuff, yoga pants catch your eye from a mile away, you sleep like a lion, eat sensibly, and feel like your old self again until you reach your goal, and suddenly you become hungry for more. Rinse and repeat.

10

Your dosages and lab ranges look very similar to mine, I did some genetic testing and i have a rare genome type which makes me produces less liver enzymes which process drugs and also testosterone and estrogen, may be worth looking into, there are some ways to up regulate the pathways, for me 100mg into 2 shots 3.5 days works and my E2 is a decent range.