Advice on my TRT therapy.

[AngryNinja]

Hello all,

I am 38 years old and have been on TRT for 4 months now(200mg cyp every two weeks). For the first 2 to 3 months of the therapy, my sex drive returned and I was able to keep and maintain an erection; however, this last month my sex drive has gone back to no existent and when I can get an erection, I am unable to keep it during intercourse. After doing some research, I figured my estradiol was high and I needed an AI, but after going back to the doctor and having labs, I learned my estradiol was normal. Any advice on what I should do would be appreciated. Below are my most recent labs. Thank you in advance.

Estradiol 12.9
% Free Testosterone 2.5
Testosterone Serum 407
Testosterone Free 10.18

[EDCG19]

What's your shbg ?

Not sure if im seeing this correctly but for 200mg you're only at 407 total t?
You need to drop that dose, change it two twice a week
80mgx2 week or 100mg twice a week if you want to stick with 200mg per week

My doc tried to offer me 200mg every 2-3 weeks and I said nope... It isn't a good way to run TRT

Lower the dose, also you sure it isn't fake gear?
did you get the e2 test or just estrogen?

I'm sure there's a few guides out there for proper TRT etc..

Tbh, your TRT is all over the place

[boricuarage78]

Im no trt expert, but 200mgs evey 2 weeks? That sucks. Maybe you can ask your doc for 100mgs weekly. 50mgs E3D.
Also your estrogens seems on the low normal range. This could be the case.
How u feel over all well being?

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[AngryNinja]

What is "shbg?"

Yeah my total was 407, however, I was at the end of my two weeks and due for another injection.

As far as "e2 test or just estrogen," I am not sure what you mean, the lab results just say Estradiol.

[AngryNinja]

Over all, I feel pretty good, I am training in the gym 5 days a week. Well, I feel a lot better than how I felt pre TRT.

[Windex]

Your TRT program is outdated which is unfortunately very common, which I think stems from that the majority of Doctors don't keep up with medical advancements or optimization in standard of care. 200mg of Cyp every 14 days is going to put your body through a hormonal roller coaster and possibly create just as many problems as the test is solving.

You need to be injecting a minimum of twice per week. So 50mg 2x per week would give 100mg of Cyp per week for example.

If you are doing the injections yourself at home this is an easy fix. If you are going to a clinic or having a doctor/nurse do it then you need to have that conversation with him/her.

[AngryNinja]

Yes, I do the injections myself. I will try the 50mg twice a week. Thank you all for the responses.

[EDCG19]

What is "shbg?"

Yeah my total was 407, however, I was at the end of my two weeks and due for another injection.

As far as "e2 test or just estrogen," I am not sure what you mean, the lab results just say Estradiol.

I just mean I'm confused on something. if your level is below 800 you're not getting TRT benefits (totalT)
Also, at 200mg I would think your estrogen would be much higher even if it was a week or so after pin

Not sure I'm understanding at all since every two weeks you pin 200mg test cyp and after two weeks you're back at 407, its like this protoocl isn't effeicnent since after two weeks the test is gone and you need to inject again.

I don't have the thread here but will find it, there's a guide to do proper TRT and twice a week or even once a week at a lower dose is much better for stable bloods/health benefits which most people on TRT want
400 (totalT) isn't optimal no matter how good someone feels

[EDCG19]

Yes, I do the injections myself. I will try the 50mg twice a week. Thank you all for the responses.

50mgx2 a week is a good place to start I don't know many peopel who stick with only 100mg per week so they increase it to get 125mg per week or up to 150mg.

I started at 200, went down to 185, went down to 150 and now trying at 125
I'm dropping the dose for a reason though, I live in high elevation for years now and while thicker blood doesn't concern me that much I dropped the dose lower to see how it works for about 2 months on a lower dose. Finding the good stable point is the goal, sorry but my doc also tried to suggest 200mg every few weeks becausde they were concerned with high red blood cell count, the reason it wasn't stable is because of the spikes in test and not staying consistent with the dosages

Anyway, here's a great wik
https://forums.steroid.com/hormone-r...rting-trt.html

[kelkel]

Yes, I do the injections myself. I will try the 50mg twice a week. Thank you all for the responses.

You will have much more stable and higher levels with a twice per week protocol. What your current doctor put you on is a hormonal roller coaster. He's dosing you on the terminal life of testosterone , not it's half life. A day or two after your current shot you're probably around 1500 Total T or so (educated guess) based on being in the 400's 13 days post injection.

Here's my favorite graph of what happens post injection:



Your doc simply doesn't understand hormones. You should also be using a Sensitive E2 Assay for your estrogen tests. Standard estradiol is geared for women and not sentisitive enough for a mans lower reading. It tends to read high, sometimes greatly so.

[Youthful55guy]

Hello all,

I am 38 years old and have been on TRT for 4 months now(200mg cyp every two weeks). For the first 2 to 3 months of the therapy, my sex drive returned and I was able to keep and maintain an erection; however, this last month my sex drive has gone back to no existent and when I can get an erection, I am unable to keep it during intercourse. After doing some research, I figured my estradiol was high and I needed an AI, but after going back to the doctor and having labs, I learned my estradiol was normal. Any advice on what I should do would be appreciated. Below are my most recent labs. Thank you in advance.

Estradiol 12.9
% Free Testosterone 2.5
Testosterone Serum 407
Testosterone Free 10.18

This is a really old school TRT protocol. No wonder you feel so bad. Forget the AI, you need to break that huge infrequent dose up into much smaller and more frequent injection. This will also allow you to drop down to a 28G insulin syringe for added comfort. I suggest 50 mg every 3 days.

Here's a graph of your daily release of T from the T ester with current program. You average out around 10 mg per day, which is about what the average male produces, but look at the HUGE variability over that 2 week interval!


Here's a graph of that same amount (close to it anyway) broken up into 50 mg every 3 days. You average out slightly higher at around 11 mg released per day, but the variability from day to day is much less. Since you never go out of physiological range with T, you should also remain within normal physiological range with E, so you don't need an AI with this protocol.


As some others posted, it would be good to know your SHBG, but looking at your numbers (which I assume are at the end of that long 2 week injection cycle), I think it will be fairly close to mid range.

[kelkel]

Damn. One-upped me on the graphs!

[Youthful55guy]

Damn. One-upped me on the graphs!

Love that new link that makes these graphs a breeze: SteroidGraph - Graph your cycle

Even better, it's mg of molecular T released per day. It takes into account both the decay curves of a variety of esters and the molecular weight of the esters.