Trt too high?

So if someone(me) has no water retention, no gyno, no itchy nipples), just no libido and some brain fog, would you call that having symptoms of high E2?

No, that's not a clear case of high e2. Although low libido can be caused both by E2 being too high or too low. You didn't mention irritability which is another symptom of high e2. Like I said in my previous post. Drop the AI and drop your T dose and see how you do.

testiculus said:

No, that's not a clear case of high e2. Although low libido can be caused both by E2 being too high or too low. You didn't mention irritability which is another symptom of high e2. Like I said in my previous post. Drop the AI and drop your T dose and see how you do.

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Got it! I will try that. Thanks alot for all your input!

mchadcota said:

Also wondering, there are a lot of drs out there that say don’t worry about E2. Don’t even check it because it doesn’t matter. And never use an AI. Can anyone tell me what their approach would be then for someone that has a T level of 1000 but has no libido?

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I'm just commenting after listening to a webinar on YouTube by Dr. Neil Rouzier. He doesn't try, he says, to control E2. A question was asked; If a patient isn't responding to a given dose of testosterone(and he prescribes compounded cream) what does he do? He said raise the dose. The follow up was asking if that doesn't work and he said he'd raise the dose, again, citing clinical abstracts that state that there is no upper limit for testosterone(That was my interpretation of what he stated). The pharmacokinetics of injectables and topical cream applied to the scrotum, being different, I don't know how one applies what he states to injectable testosterone.

EDIT: From my reading on Reddit, it appears that a percentage of men, and don't know what that percentage would be, aromatize at a greater rate, even on low dose dailies. Not challenging Dr. Rouzier but even Dr. Rand Paul respectfully questions the 'no ai' approach. True that Dr. Rouzier knows what he knows based on treating thousands of patients, along with his clinical observations and knowledge. So does Dr. Paul. Dr. Eugene Shippen, one of the pioneers in TRT/BHRT, believed that eventually, every man would be on an ai because of xenoestrogens in the food, water and air.

I've mostly avoided taking an ai and maybe that's why I've not experienced positive results from testosterone. I was ready to call it quits a few months ago, after 11 years, but I'm concerned that my mental/physical health will get worse and I can't let that happen.

@mchadcota: Your thread title is correct. I think @testiculus is offering the best advice, but consider dropping your testosterone dose into a physiologically realistic range over time. This is 50-100 mg of testosterone cypionate per week in divided doses. There's no evidence outside of a few anecdotes that men on TRT do better with over-range testosterone. On the contrary, TRT is already disruptive of other hormones, and going too high makes problems even more likely. You can review my opposing collection of anecdotes to see that excessive dosing of testosterone can lead to much misery. Unfortunately, lowering the dose of testosterone can itself cause temporary disruption for weeks or longer, particularly if done abruptly. Be mentally prepared to ride it out.

It sounds like you felt the best at 100 mg per week with no AI. I personally like splitting it into a Monday and Thursday subcutaneous and then I don’t feel any highs or lows which I did once a week.

Hmm... no one talks about SHBG and free T much, but I believe that is one of the major issues with long term TRT users... I started TRT with my total T in the 500s but my free T was really really low... I felt miserable. I have no idea why my SHBG was so high...

I started TRT and oh boy, did I ever get a honeymoon... I felt like a stallion, started at 120mg/w divided in two doses... It was heaven.... until... it wasn't anymore... so I started to chase that dragon again... I wanted to feel like in my first 6 to 8 months... so I upped the dose, and upped the dose to no avail... lol I ran superphysiological for so long... never feeling good until anxiety set in...

This group was a god send to me... eventually I figured out I needed to lower my dose, seriously lowering... At first I got my total T in range, 700s ~ 800s .... but my free T was still superphysiological... Hmm, Did my SHBG and it turned out low! Phenomena that is quite common amongst long time T users... especially if they ran hot for a long time... funny how the body works...

So I stopped worrying about my total T and focussed on my Free T ... to get that in a physiological range... which brings me to Total T in the 500s ... which I always thought was low but man, libido and erections were waiting for me in that range all this time... lol

I am now injecting every other day, and cruising between 60 and 70 mg per week depending if I am cycling HCG or not... and I can finally start to say I feel dialed in... (I am 66 and in decent shape)...

Also, I don't care much about estrogen, I see this as a bonus of trt as estrogen is protective of so many thing and if your T is in a good place, E will follow quite naturally... to lower E you are better with more frequent injections than with an AI... AIs are poisons...

Hope this helps

Sergel said:

Hmm... no one talks about SHBG and free T much, but I believe that is one of the major issues with long term TRT users... I started TRT with my total T in the 500s but my free T was really really low... I felt miserable. I have no idea why my SHBG was so high...

I started TRT and oh boy, did I ever get a honeymoon... I felt like a stallion, started at 120mg/w divided in two doses... It was heaven.... until... it wasn't anymore... so I started to chase that dragon again... I wanted to feel like in my first 6 to 8 months... so I upped the dose, and upped the dose to no avail... lol I ran superphysiological for so long... never feeling good until anxiety set in...

This group was a god send to me... eventually I figured out I needed to lower my dose, seriously lowering... At first I got my total T in range, 700s ~ 800s .... but my free T was still superphysiological... Hmm, Did my SHBG and it turned out low! Phenomena that is quite common amongst long time T users... especially if they ran hot for a long time... funny how the body works...

So I stopped worrying about my total T and focussed on my Free T ... to get that in a physiological range... which brings me to Total T in the 500s ... which I always thought was low but man, libido and erections were waiting for me in that range all this time... lol

I am now injecting every other day, and cruising between 60 and 70 mg per week depending if I am cycling HCG or not... and I can finally start to say I feel dialed in... (I am 66 and in decent shape)...

Also, I don't care much about estrogen, I see this as a bonus of trt as estrogen is protective of so many thing and if your T is in a good place, E will follow quite naturally... to lower E you are better with more frequent injections than with an AI... AIs are poisons...

Hope this helps

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What is your Free T level on the 60mg to 70mg per week protocol? Are you using T Cyp? Do you inject subq? What size needle do you use? Does the HCG affect your Free T level? What is your HCG protocol? What is your SHBG level? Sorry for all the questions. Im still trying to get dialed in after many years. Thanks!

Wanted to follow up and get opinions. I stopped the AI. Last one I took was 0.25 10 days ago. So I’m doing 80 mg Monday and Thursday for total of 160/wk. How long would you give it to see if libido improves before decreasing dose?

mchadcota said:

Brief history. Been on trt for 7 years and have never felt what I would consider dialed in. Up until a year ago I did it myself but joined a clinic to better manage. I had to get off for about 3 weeks before getting labs at clinic. First labs with no trt was T 45 E 11. Started me on 100mg per week. Labs came back trough 425 E33. Actually had some libido at this level. The clinic wanted to get me to 8-900 so I was excited that I was going to get better n better. They increased me to 150 per week with 0.5 AI once a week. Labs 485 17. Started not feeling quite as well. Bumped up to 170 mg and 0.25 AI. Labs 889 and E 54. Not much libido. Started split dose 90 and 90 and 0.25 AI with each injection. Labs 1050 E2 26. Not much libido. Had about a 2 week period of grear mental clarity. Decreased me to 90 and 80. Labs 1040 E 38. Still not much libido. Now I’m doing 80 and 80 with Ai each injection. My question is, can my T level be too high for me even if my E2 is kept in range? I also feel like they may have messed up when they increased me to 150 because my T level didn’t jump up much at all but then doubled when they increased from 150 to 170. Should I try a much lower dose?

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You want to find the weekly dose that doesn't require AI. For most people this will be between 100-140mg every 7 days; even 140 is probably pushing it for most people. I finally got dialed in at 130mg every 7 days. This put me at about 535 trough, if I remember correctly and estradiol at low 30s.
And don't listen to those telling you that you need to inject more than weekly. The idea is that your blood level concentrations even out after about 4-6 weeks, which they do.
I recommend 1ml syringes with 30g needles for injection; no pain and oil pushes out just fine.
Good luck!

Thanks a lot for your reply! That’s what I am hoping will do the trick. I’m at 160 total per week broken into twice weekly shots. I’m going to ask to keep dropping until I find a good spot.

Sergel said:

Hmm... no one talks about SHBG and free T much, but I believe that is one of the major issues with long term TRT users... I started TRT with my total T in the 500s but my free T was really really low... I felt miserable. I have no idea why my SHBG was so high...

I started TRT and oh boy, did I ever get a honeymoon... I felt like a stallion, started at 120mg/w divided in two doses... It was heaven.... until... it wasn't anymore... so I started to chase that dragon again... I wanted to feel like in my first 6 to 8 months... so I upped the dose, and upped the dose to no avail... lol I ran superphysiological for so long... never feeling good until anxiety set in...

This group was a god send to me... eventually I figured out I needed to lower my dose, seriously lowering... At first I got my total T in range, 700s ~ 800s .... but my free T was still superphysiological... Hmm, Did my SHBG and it turned out low! Phenomena that is quite common amongst long time T users... especially if they ran hot for a long time... funny how the body works...

So I stopped worrying about my total T and focussed on my Free T ... to get that in a physiological range... which brings me to Total T in the 500s ... which I always thought was low but man, libido and erections were waiting for me in that range all this time... lol

I am now injecting every other day, and cruising between 60 and 70 mg per week depending if I am cycling HCG or not... and I can finally start to say I feel dialed in... (I am 66 and in decent shape)...

Also, I don't care much about estrogen, I see this as a bonus of trt as estrogen is protective of so many thing and if your T is in a good place, E will follow quite naturally... to lower E you are better with more frequent injections than with an AI... AIs are poisons...

Hope this helps

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Congratulations! How long(weeks/months) once you brought down your dose, did libido and erectile function improve?

I've been all over the place with dosing for years and now just tired of TRT. Living with untreatable bipolar, mostly depression and caring for my wife. For the foreseeable future, nothing hopeful to look forward to. I've hoped that testosterone would bust the depression, especially high dosing. I've chatted with guys on Reddit who have depression and combat veterans with PTSD. For those men, it made a significant difference. My urologist is absolutely supportive, as is my psychiatrist. My brain and endocrine system haven't gotten the message. Oh well...

tropicaldaze1950 said:

Congratulations! How long(weeks/months) once you brought down your dose, did libido and erectile function improve?

I've been all over the place with dosing for years and now just tired of TRT. Living with untreatable bipolar, mostly depression and caring for my wife. For the foreseeable future, nothing hopeful to look forward to. I've hoped that testosterone would bust the depression, especially high dosing. I've chatted with guys on Reddit who have depression and combat veterans with PTSD. For those men, it made a significant difference. My urologist is absolutely supportive, as is my psychiatrist. My brain and endocrine system haven't gotten the message. Oh well...

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Any change I make I assess at 6 weeks, it takes that long to see real change... but aiming for a healthy physiological T level (including free/bio available T) is key. We all chase the superman feeling by going high but it is exhausting to some.... I for one get real anxious on higher doses... not good for my mental health that's for sure... feel much better and sure footed on a physiological dose.

You have to experiment and take notes! I have a calendar in the bathroom where I note all my injections/doses and symptoms/how I feel... Then I can go back and see oh... Last time I felt like that I was on that dose... and learn...

Good luck on your journey... one thing for sure, try to stabilize your dose for a long period, hormonal swings are not pleasant ...