The acne I was getting at a higher dose was cystic and appearing on my neck, face, shoulders, chest, and back. It was actually making me not want to leave the house and ruining my self esteem big time. That’s why I lowered my dose. If it wasn’t appearing in my neck or face I might not care as much, but being a 33 year old with cysts is not very appealing. My dermatologist gave me tazorac for my body acne and retin a for my face. Was also used 2% salicylic acid and 10% benzoyl peroxide with a scrubber in my arms, chest, back. It would help to flatten them quicker but it didn’t seem to prevent them. They would also leave hyperpigmentation which took months to go away.
I’d rather find an alternative if possible than up my dose and possibly feel better but never want to go around people because I have cysts the size of nickels oozing out of my neck and face.
I already replied above, but I agree with middleages, daily injections is probably the way to go. Ignore total T. If you don’t feel better, keep lowering the dosage until your free T is at the top of the range, tracking your E2 and how you feel.
You’re going to simply take the dose that works for all symptoms and allow libido to do its thing on its own. Clearly down is not optimal and up is too much. You have no choice. Or you could try a 300mg blast and see if you cross a barrier that doesnt cause acne. But other than that. Your test dose is limited to what you can handle.
Something I’ve noticed is with my dose changes in the past, my free T will change a lot… but my total T and e2 don’t fluctuate as much.
For example. One blood test shows:
TT: 1008
E2: 76
FT: 248
(I think this was at 150mg a week)
Then if you look at my recent at 192.5mg a week
TT: 1172
E2: 75
FT: 373
But for some reason at 210mg (and 3 months after I tried hcg for 1 week, but I don’t think it would affect me that long) this was my results. Huge jump
TT: 1389
E2: 110
FT: 413
This is when I was still dealing with acne. It was about 12 weeks after I tried hcg for 1 week but it made me feel awful and gave me acne. I had also upped my dose to 210mg at the time. Figured the acne would calm down since I discontinued hcg 3 months prior but it never did so I ended up lowering to 192.5mg because I assumed the test was a culprit as well. After a month or 2 my acne resolved. Maybe my e2 was somehow still elevated from hcg for that blood test? Idk if 750ui total of hcg could screw me up for that long tho. Comparing my current labs to my old 150mg labs my e2 doesn’t move and my FT changes dramatically. Not sure if this could be helpful or not.
IIRC, Total T = Free T + SHBG-bound T. You’ll notice that your TT and FT have increase by a fairly similar amount (in absolute terms) each time you upped the dosage, except the last time. But I’m assuming your FT wasn’t directly measured using an accurate method like equilibrium dialysis, so I think it’s just calculated indirectly using a more complex version of the formula above.
Hard to say why your E2 jumped so high the last time. If it wasn’t a sensitive test (LC-MS/MS), it may not even be a good representation of your actual E2 level. But I’d say it’s worth going to daily injections and, if that doesn’t work, slowly lowering your dose to see if you can get FT and E2 to optimal levels without having to resort to an AI. It seems like more doesn’t always lead to feeling better with TRT–most people seem to have a sweet spot, and it’s easy to overshoot.
Man everyday dosing sounds like a pain but I think I might give it a try not sure yet. I only pin my delts so I guess I’ll have to find another spot I feel comfortable pinning
Like I said, pin with 29g in the ventroglute. Daily shots to live a good life aint shit. Some folks have it far worse and have to go through extremely painful procedures just to make it another day.
Seconding middleages, 29G in the ventroglute is what I currently do, MWF, easy and painless. Yeah, it’s more work. But a couple extra minutes a day to feel optimized, seems way better than getting those 2 minutes back to not feel dialed in.
You can mess around with dose timing all you want. I doubt it will make a difference. Seriously, just try some arimidex. Do a trial for 2 weeks. If my E2 is too high my libido is non existent. Arimidex fixes it every single time.
Get your prolactin checked. This is a must.
Have you been on anti depressants now or in the past?
You won’t feel like garbage if you dose it appropriately. Take 0.5mg/week. You can split it into two doses. Your levels are high enough to justify that amount.
If for some reason it does completely crash (it won’t), it will take a week or two to bounce back, or you can speed it up by upping your testosterone dose to 200mg for one injection (not advisable as it adds more variables). But this is very unlikely to happen.
The only way you will get a handle on your libido is if you’re willing to try these things and learn your body. Everyone is different and it takes some experimenting. You need to figure out if your libido issues are E2 or prolactin. If it’s neither, then at least you’ve ruled those out and can further diagnose.
That’s fine. Just didn’t want to crash my E2 then it take 8 weeks to get back to normal before I could try something else. I want to only change 1 variable at a time
The guys that are crashing it are taking 1mg or more per week without even checking their labs that they need it.
I’m not trying to push it, I just want you to be realistic that daily dosing or making small protocol changes aren’t going to be enough, that’s more for optimizing it, but you need to at least get your libido on the radar first. You’ll get your answer a lot faster with an AI. You can start with 0.25mg/week if you’re afraid of it. You aromatize quickly, so you don’t need to worry about crashing it for 8 weeks.
Curious why you went on TRT in the first place? Was it your libido that led you to get checked?
My libido was part of it yes. Seemed like I never really ever had enough testosterone. Hit puberty basically as high school ended, could never grow facial/body hair, low/no libido, ED, HORRIBLE cystic acne for years in my 20s that nothing cured except accutane (this really made me feel like hormonally i wasnt right), couldn’t gain weight, was hypothyroid but got TSH under 1 and still felt crappy, small testes, bad memory, brain fog. Felt like nothing made a difference. It was like a switch just shut off and I developed all of these symptoms. Doctors felt I was just some young dude trying to get testosterone to bulk up or something, would never test me and if they did and it was very low normal they’d say its normal.
Finally found a doctor who thought my 255 on a 250-1000 scale for testosterone was way too low at age 25. I didn’t want injections for the longest time because I wanted to figure out other ways to boost it. Always came back nearly under range. Took clomid at different doses for years with great boosts in lab numbers but no difference in symptoms. When I quit to go to injections I was at like 944 TT from 50mg everyday. Had tried everything between 25mg EOD to 50mg ED.
Part of me almost thinks maybe it’s not a testosterone thing… but if it isn’t then I’m absolutely lost.
LH and FSH was normal, the boys were kicking just not enough which is why I went on clomid. Doctors assumed hypogonadism.
Prolactin last I checked was fine (10 on a scale of 2-18), I’ve tried adding zinc as a supplement but didn’t notice anything but never got tested for jt. DHEA is fine mid range and broke me out I think when I supplemented it.
Not sure how much dietary fat I don’t track everything, but I do try to eat nuts/seeds and add olive oil to my protein shakes.
I usually hit the gym to lift 3 days a week.
I will say one thing I’ve never been able to figure out is my sleep. I tend to wake up 2 or 3 times a night. I’ve been like this basically as long as I can remember though. Melatonin makes me groggy the next day same with benadryl. I’ve been tested for sleep apnea which came back negative as well.
Have you kept your weight fairly constant all this time?
Have you been deloading regularly?
I would try the AI and also try to gain some weight for the next several months. If that doesn’t work you could try some proviron and see how that goes.
I actually stopped lifting for about 2 months around December until February. I don’t ever really feel like I’m overtraining. My weight since trt went from 135ish to what it is now and has been pretty consistent. Even when I stopped going and came back my lifts were still the same or maybe very very slightly worse. Not even noticeable. I tried to keep up on calories during that time.
I’ve always tried gaining weight but I just have a hard time packing it on. Mostly because I don’t have the best appetite and to gain I feel like I have to eat uncomfortably. Protein shakes help with that but it’s still a struggle. I gained quick to get where I am but ever since it’s been pretty stagnant.
I was just at my doctor’s and told them I was feeling pretty good since they upped my synthroid dose from 112mcg to 125mcg. Not scheduled to go back for 6 months. At the time I did feel like it really helped but it almost seems like it was short lived or I was just going through one of those random phases where my libido spiked for a week because it’s been low/dead since. That was about 2 weeks ago. I’ll prob make an appointment soon and see what they say