At this point, I think my ideal route would be re-incorporating the cream – either switching back onto cream or supplementing injections with it. But, given the laws in MA, that probably isn’t an option for the next couple months. I’m also not due for labs and a follow-up until February. So that might be the time, if I decide to go back to cream, to make the move.
At the moment, I’m considering a few routes:
Drop danazol and otherwise stick with current protocol: 200 mg injected 3X week IM. I have the least confidence in this route, but it could be ‘safest.’
Drop danazol, follow @bmbrady77’s original idea of 210 mg injected ED SQ.
Drop danazol, shoot back up to 250 mg to (hopefully) regain libido. Would also likely inject ED.
Any of the above, but also ask my doctor to add desiccated thyroid meds (per @enackers and @bcostigan41 experience) to my stack. As I noted in enackers’ thread, earlier this year, my TSH to Free T4 was 1.89 (Ref 0.45-4.5); T4 Free was 1 (0.8-1.8); T3 Free was 2.7 (2.3-4.2); Prolactin was 5.6 (2-18); and T3 Reverse was 31 (8-25).
Thyroid is definitly something I think you should explore. I am still not sure how much stock to take in with the whole reverse t3 thing as some “experts” say it matters and some say it don’t. Saying that though your rt3 is high and you have somewhat low ft3. I would be real curious if that is possibly why you need such high levels to feel optimal because you are having to overcome the thyroid.
Were these thyroid #s from when you were on a long cut? If so, I’d be hesitant to start messing with thyroid as things can slow down when you’re in a caloric deficit for a while.
I’m on a combo of cream and injections. 120mg test C split 3.5 days, 600IU HCG split 3.5 days and 50mg cream daily, half on the balls and half on inner thigh. 1700TT, 35 FT, 36 E and 32 SHBG. Good libido. Actually reduced the test C to 100mg a week as hematocrit was climbing too quickly, I know you don’t have a problem with that.
I still think your E is too high and may be causing the libido issues, no way I could run E that high and feel good. What was your E on cream only when libido was better?
Understand you can’t get cream now so I’d go to more frequent injections to reduce E or try a small dose of AI (temporarily as a trial to see if it improves libido) and then try the cream/injection combo when you can.
Bottom line it’s going to be some trial and error.
Yeah, the thyroid numbers came near the end of a long cut, so they could be misleading for sure. IIRC, that’s why my doctor wasn’t concerned.
That combination is something like what I think I’ll end up doing. Did you have experience with just injections before adding the cream to it? How does it compare?
My E numbers over time: 50 (one month into cream), 91 (couple months into injections), 84 (4 months into injections). So when my libido was at its best, I’d guess E was between those 50-91 numbers – probably on the lower end of that range. That lends credence to the AI idea. But @enackers has amazing libido and I believe has very high E (80s?).
And before I started TRT, my E numbers came back at 61 and 51, and I had no libido. So it’s hard to make sense of it!
I was on pellets, cream only, then my current protocol. My only experience with injections only was a steroid cycle 20 years ago so not really applicable to TRT.
I had low libido prior to any TRT (423 TT and below range free T with SHBG in the 50s). My libido was best on cream only but I was only on 100mg a day with TT just under 800 and E of 20. Doc and I wanted levels a little higher but didn’t want to increase the cream dose to get there due to the lack of data and concerns with running DHT way above range indefinitely, hence the switch to injections and lower dose cream.
I know esnackers doc (Nichols) likes to run high FT with no regard to E (I believe he doesn’t even measure it regularly) and that works for some but you’ll find plenty of guys that doesn’t work for as well across multiple
forums and that’s essentially what you’ve been doing.
The quickest way to know if E2 is causing you libido issues would be to try a low dose AI. If libido improves then you can look at ways to lower E without AI, if not then look at adding cream, thyroid, etc.
Hi, thanks for the tag. I looked over your post again, and all I see is you started at 25EOD and then went 25ED for Danazol. I didn’t see anything you posted negatively about it - only positive. What bad things happened?? Are you blaming the libido issues on the danazol? I’m confused.
I agree that there was promise there and was definitely considering giving this another shot. At the time, I was taking Danazol 25 mg EOD. That’s what I’m back to right now, after a brief run at 25 mg ED that was not good. I was thinking I might take a break from the Danazol altogether.
My current thought is that it may be best to do a period with just T (injected daily).
I would probably do the same thing. You’ve been with Dr. Keith for about a year? Any idea (ballpark) how much it’s cost? I’ve been happy with Defy, and their insurance setup is great, but trust that he’d be better.
Yeah, I overvalued convenience. The cream wasn’t conducive to my lifestyle but inconvenience outweighs feeling like garbage, for sure.
I understand what you’re saying about “toxins” but hard to know why – I really have all the lifestyle factors (diet, nutrition, sleep, etc) dialed in. So it’s frustrating when I hear guys (like Jay Campbell) say high SHBG is always a result of poor lifestyle. It isn’t.
You’d be looking at about $2K up front for becoming a member with him which covers all consults for the year. Then lab/meds you pay as you go, similar prices to what you’re seeing now.
Is insurance paying you back for what you’re paying defy or are they actually covering the visits directly? I’ve submitted for reimbursement but still haven’t gotten anywhere with blue cross
Yep, insurance (Cigna) has been – or should say had been – covering everything through reimbursement. It was awesome. But they stopped covering anything about 2 months ago…still not sure why and haven’t gotten a good answer. It’s another reason I’m reopening my mind to Dr. Nichols.
Such a steep upfront cost though. Do you have to travel to see him for the first appointment?
Yes, technically most places are supposed to do at least 1 in person visit to “establish” the relationship. He’s one of few that enforces that rule.
I’ve been considering switching to him too but yeah the up front cost isn’t cheap. He sure seems to change a lot of people’s lives though.
Interesting on the insurance… I’m going to call about my claim again today. I was at least hoping to get the labs and some of the visits covered but not sure if that’ll happen
I’ve always found him very compelling on Jay’s podcast and seems like a good dude with a seasoned perspective. Have you seen others here besides @enackers who have gone to him?
I can’t think of any offhand. I’ve seen a lot of people in some Facebook groups that use him though and lots of positive experiences. My wife may end up going to him, haven’t decided yet