You are not absorbing well, dose is too small and T–>E2 conversion is shutting you down. E2 has a much higher negative feedback effect than T. The HPTA is really mostly the same as the female HPOA blueprint and estrogens rule.
E2 can also increase if liver clearance is not good. Always good to see AST/ALT. Some meds increase E2 by competing with liver enzyme pathway capacity that clears estrogens.
Application to the thin skin, inner surfaces of forearm and upper arm will absorb better *, instructions are written to reduce opportunity to transfer during hugging etc. * this is well known from female HRT
Your work also means that you will sweat-off a lot of your dose.
Transdermal T is not working. You need TRT, end of statement.
hCG or LH/FSH induced bu a SERM [clomid, nolvadex …etc] can only flog your internal testicle. LH 5.5, FSH 14.4 with your low T means that increasing LH receptor stimulation would not get you very far. I am also worried about FSH=14.4
High FSH or high relative to LH is a hallmark of testicular cancer. In 100mg/week injected T, LH and FSH should go to zero. You should test on injected TRT and if FSH does not get near zero, you should be worried.
Elevated E2 is increasing SHBG and lowering FT while SHBG+T, which is not bio-availalbe is inflating TT, so T status is worse than TT labs now suggest.
Self-injected T is most effective, 100% absorption and least cost, with lowest T–>E2 potential.
Your doc not testing E2 shows that he really does not have a good grasp of these things. Urologists simple have been shown to not be very good at these things. You will have to drive the bus and cannot be passive. If you can’t get this doc on the bus, find another wing-man. Passive does not work.
You are off to a good start and have been doing your homework.
I suggest this all of the time:
- self-inject 50mg T cyp/eth twice a week, subq, #29 1/2" 0.5ml insulin syringes
- pinch up fold of skin over upper leg, inject into end of fold with needle parallel to underlying muscles
- 0.5mg anastrozole at time of injects, adjusting to get near E2=22pg/ml
- hCG: you do not need it, but might find a mood improvement, 250iu subq EOD
pregnenolone and DHEA may decrease, hCG might oppose
TRT will LH/FSH–>zero
Cholesterol is way too low. <160 is associated with increased all-cause mortality. Some simply have low cholesterol. Cholesterol is the foundation for the whole steroid hormone cascade, including Vit-D3 and cortisol. Your DHEA-S indicates that things are ticking along nicely despite your low cholesterol.
Please read the stickies found here: About the T Replacement Category - #2 by KSman
- advice for new guys - need more info about you
- things that damage your hormones
- protocol for injections
- finding a TRT doc
Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.