I hear you. But… Guys sometimes have multiple things going on in addition to hypogonadism. Like thyroid is sluggish or adrenal. And even neurotransmitters being off. So your theory of increasing free t and dose can be unnecessary.
Being on this board I’ve read many guys that have over the top free t and they still complain of multiple symptoms.
Well the advice I have is just that, my advice. I would really like to see some bloodwork to determine what could/should be done.
I will say however I completely disagree with you. Higher t doesn’t necessarily mean better libido. Higher t usually equals higher E and depending on your sensitivity to estrogen AND your sensitivity to higher levels of testosterone this could be no good.
In my experience a lower dose does a lot more for my libido than a higher dose.(100 mg Per week VS 250 VS 500 VS 1000mg)
You start with T. Once optimal, if you still have symptoms you address thyroid.
I was literally just coming on here to post THIS EXACT TOPIC. let me tell my experience as to what I have read and am currently going through. I am 32 years old recovering alcoholic/drug addict. I believe that has to do with my low T. I was tested levels came back at 300. I had been suffering with mid ED for years and like you couldn’t take it anymore. I started TRT first dose was 150mg 2x a week and like you I felt better instantly. Started getting random erections always horny as fuck. Mood was better but I was still experiencing mood swings and things like that. Got tested again a month later and my levels were 430. Decided to up my dose to 200mg 2x a week
After about a week I noticed my erections are GONE ED is worse than before. Did some reading and from what I am understanding when you increase test estrogen can skyrocket BUT WAIT after levels settle estrogen will go back to normal levels. DO not use estorgen blockers unless absolutely necesarry. For me it’s only been about 2 weeks since I upped my dose but I am already starting to see ED is slowly going away again. Also on 200 a week I feel WWAAY better no more mood swings, energy is through the fucking roof and my lifts in the gym are going up I am feeling way more powerful and actually getting visibly leaner. I would say give it some time before messing with estrogen blockers. If things don’t get better then drop to 150 a week. For me as far as ED goes 150 a week was great but I was still experiencing mood swings and was feeling extremely irritable. I got into random fights with people and was just extremely on edge a lot.
Are you saying you’re taking 150mg or 200mg by dividing it into 2 doses of 75mg or 100mg respectively, or your taking 150 or 200mg twice a week for a total of 300mg or 400mg?
I honestly can’t tell.
You should probably get a larger hormone panel done, Total & free T, e2, shbg, full thyroid panel, and probably some others.
200ml/week test cyp divided into 2 doses (100 ea)
This was my last full bloodwork by doctor on 3/6/19. I felt great at the time and all worked well.
TESTS RESULT FLAG UNITS REFERENCE INTERVAL LAB
Albuminuria: 31.0 - 300.0
Clinical albuminuria: >300.0
PSA Total+% Free
Prostate Specific Ag, Serum 1.1 ng/mL 0.0 - 4.0 01
Roche ECLIA methodology.
According to the American Urological Association, Serum PSA should
decrease and remain at undetectable levels after radical
prostatectomy. The AUA defines biochemical recurrence as an initial
PSA value 0.2 ng/mL or greater followed by a subsequent confirmatory
PSA value 0.2 ng/mL or greater.
Values obtained with different assay methods or kits cannot be used
interchangeably. Results cannot be interpreted as absolute evidence
of the presence or absence of malignant disease.
PSA, Free 0.39 ng/mL N/A 01
Roche ECLIA methodology.
% Free PSA 35.5 %
The table below lists the probability of prostate cancer for
men with non-suspicious DRE results and total PSA between
4 and 10 ng/mL, by patient age (Catalona et al, JAMA 1998,
279:1542).
% Free PSA 50-64 yr 65-75 yr
0.00-10.00% 56% 55%
10.01-15.00% 24% 35%
15.01-20.00% 17% 23%
20.01-25.00% 10% 20%
25.00% 5% 9%
Please note: Catalona et al did not make specific
recommendations regarding the use of
percent free PSA for any other population
of men.
Testosterone,Free and Total
Testosterone, Serum 708 ng/dL 264 - 916 01
Adult male reference interval is based on a population of
healthy nonobese males (BMI <30) between 19 and 39 years old.
Travison, et.al. JCEM 2017,102;1161-1173. PMID: 28324103.
Free Testosterone(Direct) 28.0 High pg/mL 6.8 - 21.5 01
Hemoglobin A1c
Hemoglobin A1c 4.8 % 4.8 - 5.6 01
Please Note: 01
Prediabetes: 5.7 - 6.4
Diabetes: >6.4
Glycemic control for adults with diabetes: <7.0
Thyroxine (T4) Free, Direct, S
T4,Free(Direct) 1.32 ng/dL 0.82 - 1.77 01
TSH 1.710 uIU/mL 0.450 - 4.500 01
Estradiol 25.0 pg/mL 7.6 - 42.6 01
Roche ECLIA methodology
Vitamin D, 25-Hydroxy 29.3 Low ng/mL 30.0 - 100.0 01
Vitamin D deficiency has been defined by the Institute of
Medicine and an Endocrine Society practice guideline as a
level of serum 25-OH vitamin D less than 20 ng/mL (1,2).
The Endocrine Society went on to further define vitamin D
insufficiency as a level between 21 and 29 ng/mL (2).
Sorry yes I should have clarified that. Started at 150 (2x75 a week for a total of 150) then went to 200 (2x100 a week for a total of 200.
I know I definitely need to get my estrogen checked. All I did last time was get a testosterone and CBC because I wanted to keep an eye on Hematocric. As far as thyroid goes I have always been able to maintain a very lean physique without much effort and have an extremely healthy appetite. Why, does test affect thyroid?
I am still pretty new to this, there is a lot I don’t know yet.
This goes to what other guys have experienced. I believe that free T is important. What I don’t believe is that the other numbers don’t matter. While everything is technically anecdotal, there are a lot more than one guy who have found that a certain threshold of E2 triggers ED. Most guys will get past it once they adjust to the dose and the E2 balances itself. Other guys, based on complicating factors, simply cannot get it done over a certain threshold. Is it a ratio? Maybe. Is it a number specific to the individual? Maybe. It does seem clear that it can make a difference. It also is in every new TRT patient’s best interests to start low and work up, as the sides are just worse at the higher dose. Better to adjust to a starter dose and adjust up as you find necessary. I think.
@hardartery there is something here that you need to recognize. Correlation does not prove causation. You’re seeing a number going up that you are measuring (E2) and immediately stating that is the issue. You’re failing to realize that there are a whole bunch of other things at play here. Those other things are what is causing E2 to rise but it is not E2 that is the issue, it’s the other things. You’re just not looking at the other things.
Here is an example: Take a guy who is obese. He has poor cardiovascular health, issues with libido, and ED. His E2 is very high. We see that high E2 and say, “Look! E2 is 'above the clinical range! This proves that E2 is bad!” Well, it’s not. There is more aromatase in fat. Obese people will always have more E2 because of it. It’s not the E2 that is causing issues, it’s the fact that he’s obese. The E2 is just a innocent side effect of being obese.
E2 is your friend and not your enemy. You guys need to learn to stop worrying about E2. It goes completely against the literature. Watch Dr. Rouzier’s video that I’ve posted in several threads where he goes through all the studies and explains it in incredibly simple terms. Free T is where it’s at. Free T is the solution to probably 85% of the problems. Then thyroid. Forget about E2, DHT, and donating blood when you have 'high h/h/ which is also nonsense.
Mr.@dbossa, I believe in one of your videos you stated a Free T of 30 or 40ng is minimal for optimizing. I’m in Canada and we use pmol/L. How far away am I from your thinking? My free T is 621 pmol/L and the Canadian Medical Guideline thingy says (110-660) is normal range. My numbers in bold, bracketed is guideline numbers.
Test Cyp 17mg daily with a 30G 5/16" for a total of 120mg a week - SubQ into tummy
SHBG 15 nmol/L (13 - 89 nmol/L)
Testosterone Total 20.3 nmol/L (6.1 - 27.1 nmol/L)
Testosterone Free Calculated 621 pmol/L (110 - 660 pmol/L)
Testosterone Bioavailable Calculated 14.6 nmol/L (2.8 - 15.5 nmol/L)
Estradiol 156 pmol/L (40 - 160 pmol/L)
@phil65 I’m quite familiar with Canadian units of measurement. I live in Montreal 
621 pmol/L converts to 18 ng/dL. Don’t thank me. Thank this awesome site I found that allows you to convert anything you want.
Holy crap, I’m not even at HALF of what you’d consider optimized at 40 and I’m at the TOP of guidelines. Wanna be my URO? LMAO
Thank you sir!
Keep in mind that you don’t just aim for a target number. Most men start feeling better around 30. Some need less. Some need 40, 50, even 60. I’m feeling pretty good at 28. You increase until your symptoms resolve. I’m not a doc though you could probably say that I was trained by Dr Keith Nichols and Dr Eric Seranno in a manner of speaking.
I’m at the top prescribed weekly amount allowed,120mg. He won’t go any higher. Also, threatened to bring me back to 100mg a week if I didn’t get my HCT down:
HCT 0.534 L/L H (0.380-0.500)
HGB 179 g/L H (125-170)
I had to donate blood. How do you get away from this problem, the uro/gp bringing dosage down if HCT is a bit high? Go on your own I presume, Dr. Nicholls, States etc…
Your doctor is uneducated on this subject. Sorry to say. You don’t donate blood. Higher levels of h/h are erythrocytosis which is normal and to be expected on TRT. Your doc is also too caught up with the clinical ranges. He is treating numbers and not symptoms. That is not the way you do medicine. Find a new doc. You won’t get optimized on 120mg a week.
Here are a directory of docs trained by Dr Rouzier though Dr Nichols is far and beyond the best at this.
Yup, well aware and have told him all that. I had to resort to daily shots to up my Free T, not telling him. He wanted once a week, was okay with twice a week but was like pulling teeth for okaying 3x a week but relinquished. I do DAILY, made a difference, YUUUGE. Low SHBG guy.
His comeback is… “I’ll get my license pulled, have to follow the guidelines etc…” How can I argue with that? What a mess…
One person in Ottawa… a chick. LOL! Just my luck. HAHAHAH
https://worldlinkmedical.com/Sys/PublicProfile/46312855/4639649
Because the guidelines are fucked. Very few people understand this stuff.
Ask him to demonstrate evidence of higher levels of testosterone causing harm (there are none).
Ask him to demonstrate evidence of higher levels of E2 causing harm (there are none).
Ask him how providing daily SubQ administration to minimize ups and downs could possibly be harmful.
The first endo I saw tried to convince me to inject 400mg once a month at his office.
Have you ever looked at the directions on a vial of enanthate? Even the pharmaceutical companies are saying one injection once every two weeks.
It’s utter nonsense. I rely on what the doctors in our group tell me. They are constantly providing research for free. I speak to Dr Nichols and Dr Serrano every day. There is no denying what they are saying. All experiments to protocols I did on myself provided precisely the results they stated. If they tell me something, I do it. They are at the top of the field for this.