Agree, thanks for the detail.
Update after 15 months on TRT:
Sleep, energy, body composition clearly better than pre-TRT. Sex side effects (libidon, sensitivity, erection) still persist. Cialis helps a small amount but if anything I think my sensitivity issue is worse now than it was pre-TRT.
Titrated up dose from 100/wk (6 months) to 130/wk (3 months) to 160/wk (4 months) and back down to 140/wk (last 2 months) because hy HCT and hemoglobin were out of range at 160/wk. Plus I felt no different at 160/wk than I did at 100/wk.
Bloods are attached after being at 140/wk last 6 weeks.
Free T seems optimized.
DHEA went from low to above-range after I supplemented 50 mg/day so Iāve dropped down to 25 mg/day.
Questions regarding next steps:
Peter Attia and others have referenced either a 20:1 TT:estrogen ratio being fairly ideal, or an estrogen range of 40-50 (Attia).
Given that symptoms of low estrogen and progesterone include sensitivity/libido/ED (and that both have historically been very low end of normal for me) and Iām a lean, higher-SHBG guy that may not aromatize much Iām thinking of trying HCG to see if it bumps estrogen and progesterone and moves the needle at all.
ETA: This was the first time in two years my SHBG had been within range and my estrogen was middle of normal range. (Both perhaps due to DHEA supplementation?) Historically my SHBG has been in the 60-80 range and my estradiol in the 15-22 range).
Any thoughts/suggestions?
If itās working, keep it up. i like my e2 around 4% of total (in US units), so I stick to that. Seems to work out fine