TRT Protocol Log

Pharma TRT
1

This is my first post. I’m a 49 year old male who started TRT 6 months ago, mainly because I was having energy, libido, and ED issues since my early 40s. I’ve read up on TRT in this forum and elsewhere. Six months in, I feel worse and getting frustrated. I’ve had no “honeymoon” period, no improvement in ED and libido has gotten worse. I’ve put on weight, hair is shedding, mood is flat, girlfriend has said “you’ve changed since December.”

I went to a male health clinic and they prescribed 200mg test cyp/week, no hcg, and .5mg arimidex MWF (Yes, 100mg is recommended T dose, but since I am a big guy I wanted to see how I’d feel at higher dose.)

I sourced some hcg and wanted to go more conservative on the arimidex. My problem is I have ZERO libido, no nocturnal or morning wood, even with ED meds. I’ve had a few nocturnal erections when I’ve backed off of the arimdex and taken only .175 after not taking any for 3-4 days.

I know my T dosage and number is too high on last test. I might have inadvertently taken too much test, but I still want to lower my dose to 150mg test/week. In previous months’ tests my T has ranged from 1000-1300 range, and E2 has ranged from 24-40 and still no libido or morning wood.

If testosterone is above 900 range, should my E2 be higher than the recommended 20-30pg/ML?

Is it possible that I am experiencing sides from arimdex or hcg that is killing my libido and EQ? I am contemplating switching to Aromasin for AI.

My goal is to get high libido and consistent morning wood! Any comments would be appreciated.

My stats:
-age: 49
-height: 6’3"
-waist: 38-40 (increased from 36 pre-TRT)
-weight: 250 (increased 25 lbs since TRT)
-describe body and facial hair- typical, not bald, definitely noting increased -shedding/hair loss on scalp
-describe where you carry fat and how changed - gut has definitely gotten bigger since TRT
-health conditions, symptoms:
1. Vasectomy 9 hears ago, had chronic testicular pain. Went to many urologists and pain specialists and tried all kinds of pain meds to no avail. Took a lot of Ibuprofen for a few years but have stopped except for occasional use.
2. Have strange dermatitis-type rash on upper lips that appeared time of vasectomy. Seems to get worse with certain food.
-Rx and OTC drugs: None
-Diet: try to eat healthy. Maybe drink too much coffee (with milk and Equal sweetener). Drink wine with meals.

Current Protocol

E3D:
Started out at 100mg test cyp but dropped to 75mg last week
250iu HCG
.25 arimidex (though I have tried larger doses seeking some relief for libido and ED)

Latest Lab results with ranges

05/09/2018 (labcorp/discounted labs) (taken morning before next injection)
Testosterone, Serum: >1500 ng/DL (Range 264-916) high
Free Testosterone: 40.4 pg/mL (Range 6.8-21/5) high
Prolactin: 20.9 ng/mL (Range 4.0-15.2) high
Estrodial, Sensitive : 37.6 pg/mL (Range 8.0-35.0) high
Hemocrit: 47.4 (Range 37.5-51) (donated blood last month)

01/25/2018 (labcorp/private md labs)
TSH 1.72 (.45-4.5 uIU/mL)
Thyroxine (T4) 6.0 (4.5-12 ug/dL)
T3 Uptake 29 (24-39%)
Free Thyroxine Index 1.7 (1.2-4.9)
T3 106 (71-180 ng/dL)
T4, Free (Direct) 1.39 (.82-1.77 ng/dl)
Reverse T3 22.5 (9.2-24.1)
Triiodothyronine, Free 3.5 (2.0-4.4 pg/mL)

2

I’m certainly not the expert that some of the guys on the forum are but, to me, these seem like the likely culprits for the low libido and ED.

3

Lower your dose.

4

Thank you for the reply. I noticed a typo in the E2 range you quoted and fixed it in my original post.

My prolactin seems to have crept up. It was 11, then 15, then 20 in the last 3 tests.

I do have cabergoline on hand, but I think the high prolactin is a response to high test levels, though some say prolactin shouldn’t be affected by testosterone.

5

Thank you. I just lowered it to 75mg test cyp E3D last week.

6

I dont believe this to be the case. Some AAS cause increases in prolactin but I dont think Test is one of them. If it were me, I’d start increasing my anastrozole and cabergoline and see if you notice a change. Caber is strong stuff, you only need about 1 g/week divided in 2 doses.

7

TRT isn’t the problem, the doctor is the problem. Testing T3 Uptake and Free Thyroxine Index tells me your doctor knowledge is old school and behind the times. Understand most doctors have a lack of understanding in thyroid matters and the great majority of doctors out there have absolutely no experience or training on how to properly administer TRT.

SHBG is the gold standard for sex hormone evaluation and guides dosing and injection frequency, as a thyroid doctor his knowledge is outdated. Your suppose to test Free T3 and Reverse T3 together, Free T3 was never tested.

You are really going forward blindfolded not knowing your SHBG level. Injection once weekly is stupid unless SHBG is crazy high, most inject a total of 100mg weekly split up two or more times a week depending on SHBG levels.

Reverse T3 is a problem and should be below 15 ng/dL, high Reverse T3 prevents Free T3 from entering your cells and slows down every metabolic process in the body for which TRT requires optimal levels of thyroid hormone to work. I wouldn’t expect good results with high Reverse T3, TRT will never provide the results you would expect in this case.

It’s call reference range endocrinology, these type of doctors mostly chase lab numbers and take no action when you fall within these reference ranges even when symptoms of hypothyroidism are present. You need to find a doctor that doesn’t operate this way, you may need to go private.

8

Thank you for the reply. I ran my last blood test and the thyroid test on my own because, yes, the male health clinic I went to is useless. They only ran one blood test on me in house, and only checked testosterone and nonsensitive E2 and said the numbers were fine.

I must have missed choosing Free T3 from private MD labs.

And I apparently need to find someone to help with my thyroid. Thank you!

10

Here are my lastest labs based on

175mg test cyp total (dose split sunday/thurs IM injection)
.25 arimidex (taken sunday/thurs or .5/week total)
.25mg cabergoline (taken once tuesday)
250iu HCG (sunday/thurs)

06/02/2018 (labcorp/discounted labs) (taken morning before next injection_
Testosterone, Serum: 1350 ng/DL (Range 264-916) high
Free Testosterone: 37.1 pg/mL (Range 6.8-21/5) high
Prolactin: 7.9 (Range 4.0-15.2)
Estrodial, Sensitive : 21.8 pg/mL (Range 8.0-35.0)
Hemocrit: 54.4 (Range 37.5-51) high
Reverse T3: 24.3 ng/dL (Range 9.2-24.1) high
SHBG: 39 nmol/L (Range 16.5-55.9)

I still feel like crap on these numbers, especially no libido and no nocturnal, morning, or spontaneous erections, constant tiredness, brain fog, emotionally flat, waistline fat, and alarming hair loss.

I am dropping test dose to 150mg/week (75 mg on mon/thurs IM). I am not sure if I should ease up on arimidex.

The Cabergoline is strong stuff. Give me a headache I think. Probably will back off it and see if lowered test and estrogen will bring it back in line.

I ordered T3 cytomel from overseas to deal with the high RT3. My high test number is probably pushing this number higher. I read online to take 5mg in am and 5mg pm for two weeks and if symptoms don’t improve to increase to 2 in morning 2 at night, wait 2 weeks, increase to 3/3, etc. The goal is to get RT3 to around 10 ng/dL by 3 months. If anyone has any advice on taking that.I would appreciate it.

Lastly, how does my SHBG look? Should I be doing my test injection only once per week?

Thank you in advance for feedback.

11

Your TT and FT are way over range. Your messing with your e2 when it should be higher.

There has been a lot of discussion lately about E2 and management of it.

When you were young and a teenager, and had naturally high Test, your e2 was probably a little elevated too.

If I had to guess why you feel like shit, its because you are pushing your Test levels into supraphysiological ranges, but lowering your e2 down too much.

Look up Estrogen Testosterone Ratio.

Regarding SHBG: yours is higher, mine is on the high end too. With the amount of test you are injecting, splitting into once a week would make little difference. You will have more e2 conversion with 1 shot also. You need higher TT with high SHBG. Your Free test is above limits also.

12

Thank you for that, alphagunner. I think I saw on peaktestosterone forum the ratio can be 50:1 in young males but typically 20:1 -30:1 in most males.

I don’t like taking the arimidex at all, so maybe I will stop taking it until next blood test, but I am worried about it going sky high. My E2 was 40 in the first test I posted a month ago, so I probably need some estrogen control. I switched from IM to SQ injections too.

I need to keep lowering my dose until something starts to click and I feel better. I really am going for high upper limit. I’ve always played sports and lifted but have felt run down since I turning 40 (just turned 49 last month). I am really trying to optimize the next 20 years or so I have left.

13

Don’t do what I did and chase a number (22) for estrogen. Go by how you feel.

When you are zeroed, you will know, its like a light switch being flicked on.

You need good e2 to be zeroed.

14

I know nothing about caber but the advice alphagunner is providing aligns with my experience as well. I continuously chased my E2 way too low based on other advice commonly posted on this forum. I’m guilty of repeating some of it myself. If you feel good with sensitive E2 at 40 there’s no cause for alarm.

15

Thank you wx14. I’ve driven myself crazy reading about trt arimidex dosages. The bodybuilder forums say you don’t need arimidex for test doses under 250mg/week. This TRT forum recommends 1mg adex per 100mg test. Some say adex affects libido and recommend aromasin (I’ve ordered some). The clinic I went to originally prescribed me .5mg arimidex M/W/F. I thought that was way too high, so I’ve mostly averaged about .5mg/week in divided doses, but taking more or less without seeing any relief. I think I have to address my high RT3 as systemlord pointed out earlier in this thread.

16

Another thing to consider… Everyone will tell you to ignore “normal” reference ranges for TT and FT but then demand you hit the exact mid range for E2 (22).

The way I understand it you are on 175mg Test and 0.5mg Adex per week with e2 around 22 and feeling like shit. My advice (I did the same) drop the Adex and keep everything the same. Be patient for 6 weeks and reassess how you feel. I just went through this and I’m feeling much better after 5 weeks of dropping Adex. No joint pain and strong morning wood had returned.

17

wx14, that’s what I will do, thanks.

18

@wx14 @anon10035199 I have yet to read about Someone that has achieved a good e2 or even closer to 22 with 1 mg AI per 100 mg testosterone.

I urge @Mod_Brian @Chris_Colucci or any moderator to edit the sticky. Many guys read that and immediately crash their e2 starting an ever ending rollercoaster.

2 Likes
19

@Chris_Colucci please see above

20

The threads in the sticky were previously agreed upon as acceptable by forum members, but they’re still just posts by KSMan (who is a regular forum member, not a Mod or Admin).

If you disagree with the advice in it, it would be best to start a new thread (not post in the sticky) explaining why, and then further steps can be considered if necessary. They were started several years ago. I haven’t checked their edit history, but there’s certainly a chance the best recommended practices may have changed and the threads may call for updating.

21

My E2 sensitive is 70.6 pg/mL on only 50mg twice weekly (100mg weekly). I need an AI or I will turn into…