Libido needs good T levels and favorable E2 levels which are necessary but not sufficient. Libido is a state of health for males and other health issues can interfere. Thyroid is a great example.
What sleep aids are you using or have tried?
Can’t fall asleep?
Sleep is not deep or steady?
Wake up during night?
Snoring?
Room quiet and dark?
Melatonin can help but needs to be time release.
Your protocol method is OK, but doses too small for you.
Do not inject once a week! You need stable T levels to manage E2 properly as serum anastrozole needs to match serum T levels and if T levels are moving a lot …
You need high range TT[probably over-range] and FT. FT is lacking.
High SHBG is creating higher amounts of non-bioavailable SHBG+T, reducing FT and inflating TT so TT then overstates your T status. Higher TT will help push down SHBG. You probably need TT well over range to get high range FT. You may end up needing more anastrozole to remain near E2=22pg/ml. Note that higher E2 can promote more SHBG.
SHBG is made in the liver to scavenge sex hormones. Higher estrogen levels increase SHBG while higher bio-available T levels decrease. Some liver conditions can increase SHBG. Sex hormone-binding globulin - Wikipedia
Some guys metabolize T faster than others and need more than the typical 100mg/week. Some needs 300mg/week to get where others are at 100mg/week.
See if you can get 200mg T per week and double anastrozole. Check E2 at 3-4 weeks and adjust anastrozole dose as needed. If SHBG starts to go down, could be a long process, FT will be increasing and TT may be declining. So you would then be needing to potentially be adjusting T dose that then drives other changes. All through this E2 management is critical. While SHBG is high, TT levels should be noted but should not be a concern when high or very high. FT is driving the process. You can also test Bio-T. And to shift SHBG, you also should not be afraid of FT and Bio-T that are well above range.
Low thyroid function has most of the same symptoms as low T. Please eval this via oral body temps, more below. TSH is notably below 1.0, T4 may be below mid-range and fT3 a little bit too. Body temps will tell us more.
Key points:
- double T and AI doses
- Increase FT to high end or range or higher
- Manage E2
- Disregard high TT
- Eval thyroid via oral body temperatures
- Sleep hygiene and time release melatonin
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.
KSman is simply a regular member on this site. Nothing more other than highly active.
I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.
The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.