Bloodwork Help. Libido and ED

[flow1985]

Good morning guys.
Stats: 36 Years old
180lbs fairly lean
5'8"
I have some bloodwork I would like some additional help with as Defy has not been able to improve my situation totally. I have been on TRT for about 5 years and a variety of different protocols that I do not recall exactly. I've been dialed in somewhat before, but for some reason over the last year+ I have developed ongoing ED. Now, Defy has changed my protocol once or maybe twice during that time due to libido issues and I will go through periods where the ED is gone, however only to return; which leads me to believe the issue is mainly hormonal. I can take a full dose of cialis and a full dose of Viagra and not end up in the hospital. I find this troublesome. After my last consultation, Defy made no changes other than adding DHEA and .1ml of deca. I supplemented with the DHEA but did not add the deca. I like the idea of using deca for joint pain (I always do due to heavy lifting), but I did not see the application in solving my ED issue. Perhaps I am wrong.

This bloodwork I am posting is on the protocol of .2ml Testosterone and .2ml HCG EOD. No AI.
I am also on 1 grain of armour thyroid every morning.

I am sure I did not cover all the required knowledge for assistance, but if any other information is needed please let me know. Thanks!

 

[madman]

Good morning guys.
Stats: 36 Years old
180lbs fairly lean
5'8"
I have some bloodwork I would like some additional help with as Defy has not been able to improve my situation totally. I have been on TRT for about 5 years and a variety of different protocols that I do not recall exactly. I've been dialed in somewhat before, but for some reason over the last year+ I have developed ongoing ED. Now, Defy has changed my protocol once or maybe twice during that time due to libido issues and I will go through periods where the ED is gone, however only to return; which leads me to believe the issue is mainly hormonal. I can take a full dose of cialis and a full dose of Viagra and not end up in the hospital. I find this troublesome. After my last consultation, Defy made no changes other than adding DHEA and .1ml of deca. I supplemented with the DHEA but did not add the deca. I like the idea of using deca for joint pain (I always do due to heavy lifting), but I did not see the application in solving my ED issue. Perhaps I am wrong.

This bloodwork I am posting is on the protocol of .2ml Testosterone and .2ml HCG EOD. No AI.
I am also on 1 grain of armour thyroid every morning.

I am sure I did not cover all the required knowledge for assistance, but if any other information is needed please let me know. Thanks!


View attachment 16759View attachment 16760View attachment 16761

I've been dialed in somewhat before, but for some reason over the last year+ I have developed ongoing ED. Now, Defy has changed my protocol once or maybe twice during that time due to libido issues and I will go through periods where the ED is gone, however only to return; which leads me to believe the issue is mainly hormonal. I can take a full dose of cialis and a full dose of Viagra and not end up in the hospital. I find this troublesome.


Other than the ED how do you feel overall?

My reply from a previous thread:

Unfortunately, when it comes to libido let alone ED they are multifactorial and there is much more involved than just having healthy hormones (TT, FT, estradiol, DHT, prolactin).

ED has multiple etiologies including vascular, neurologic, and endocrine disorders.

Underlying vascular health is critical!

Even when using PDE5is although effective for many most men have some degree of vascular/endothelial dysfunction.

Some men are poor responders and will end up needing to use intracavernosal injections to achieve/maintain an erection.

Having healthy testosterone levels is beneficial to one's libido/erectile function but it is far from the only thing that is required to achieve such.

Thyroid/adrenals, neurotransmitters, insulin sensitivity, stress (mental/physical), quality of sleep, diet, underlying vascular health to name a few can all have a big impact on one's libido/erectile function.

Unfortunately, libido/ED is much more complex than simply having healthy testosterone levels.

Even then when it comes to trt and libido many tend to get caught up in thinking that it will be through the roof once they hop on trt and get to the point of so-called dialed in let alone cure any ED issues they may have.

When you find that happy place you should have a healthy libido not raging, savage, insane.

There are many men who will see an improvement in libido, others will continue to struggle, some may even end up worse off than before trt and some of the lucky ones will see a drastic improvement.

I think too many get caught up in expecting to feel great 24/7 once on trt as if testosterone is going to cure all that ails them.

This is the panel you should have had done.

ED Test Panel: Detecting Erectile Dysfunction

Do you suffer from erectile dysfunction (ED)? This lab test panel includes hormones that can affect erectile function and libido. Some physicians forget to test for hormones beyond testosterone in men with ED.

www.discountedlabs.com

Good chance that your FT level is very high on such protocol as you are running a trough TT 1200ng/dL and seeing as your SHBG is 26 nmol/L then your FT will be very high.

Some men will not do well running very high FT levels.

Unfortunately, we have no idea where your FT level truly sits as it was tested using the piss poor direct immunoassay which is known to be inaccurate.

Comes down to the individual.

The only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).

Need more thorough labs (prolactin/DHT) and have your FT tested using an accurate assay.


I like the idea of using deca for joint pain (I always do due to heavy lifting), but I did not see the application in solving my ED issue. Perhaps I am wrong.

Although using therapeutic doses (50-100 mg/week) of ND can minimize joint pain/stiffness for some it is a grave mistake to think that using it will prevent any further damage to joints/ligaments and tendons especially if you continue to keep lifting heavy long-term.

No amount of ND/AAS let alone GH is going to prevent damage to joints/ligaments/tendons from overuse/repetitive heavy lifting long-term.

Talk to anyone who has been lifting heavy let alone training for years eventually there will be some degree of wear and tear especially on the joints/tendons.

Many men struggling with what they think is tendonitis end up having tendinosis which is degeneration of the tendons.

 

[madman]

I would bet if you tested using an accurate assay that your trough FT would be in the 40s with a TT 1200 and SHBG 26 nmol/L.

TT 1300 ng/dL (not much higher than yours) and SHBG 48 nmol/L (almost double yours) and his FT is through the roof.

My Most Recent Labs.

My protocol, 16 mg of testosterone cypionate daily, 500 iu of hcg twice weekly and no AI. Pregnenolone 10 mg and 25 mg of DHEA. My last injection before labs, about 28 hr.s. Labs are from LabCorp. Testosterone, Serum 1319 ng/dL range 264-916 Free Testosterone 47.9 ng/dL range...

www.excelmale.com

 

[flow1985]

I've been dialed in somewhat before, but for some reason over the last year+ I have developed ongoing ED. Now, Defy has changed my protocol once or maybe twice during that time due to libido issues and I will go through periods where the ED is gone, however only to return; which leads me to believe the issue is mainly hormonal. I can take a full dose of cialis and a full dose of Viagra and not end up in the hospital. I find this troublesome.


Other than the ED how do you feel overall?

My reply from a previous thread:

Unfortunately, when it comes to libido let alone ED they are multifactorial and there is much more involved than just having healthy hormones (TT, FT, estradiol, DHT, prolactin).

ED has multiple etiologies including vascular, neurologic, and endocrine disorders.

Underlying vascular health is critical!

Even when using PDE5is although effective for many most men have some degree of vascular/endothelial dysfunction.

Some men are poor responders and will end up needing to use intracavernosal injections to achieve/maintain an erection.

Having healthy testosterone levels is beneficial to one's libido/erectile function but it is far from the only thing that is required to achieve such.

Thyroid/adrenals, neurotransmitters, insulin sensitivity, stress (mental/physical), quality of sleep, diet, underlying vascular health to name a few can all have a big impact on one's libido/erectile function.

Unfortunately, libido/ED is much more complex than simply having healthy testosterone levels.

Even then when it comes to trt and libido many tend to get caught up in thinking that it will be through the roof once they hop on trt and get to the point of so-called dialed in let alone cure any ED issues they may have.

When you find that happy place you should have a healthy libido not raging, savage, insane.

There are many men who will see an improvement in libido, others will continue to struggle, some may even end up worse off than before trt and some of the lucky ones will see a drastic improvement.

I think too many get caught up in expecting to feel great 24/7 once on trt as if testosterone is going to cure all that ails them.

This is the panel you should have had done.

ED Test Panel: Detecting Erectile Dysfunction

Do you suffer from erectile dysfunction (ED)? This lab test panel includes hormones that can affect erectile function and libido. Some physicians forget to test for hormones beyond testosterone in men with ED.

www.discountedlabs.com

Good chance that your FT level is very high on such protocol as you are running a trough TT 1200ng/dL and seeing as your SHBG is 26 nmol/L then your FT will be very high.

Some men will not do well running very high FT levels.

Unfortunately, we have no idea where your FT level truly sits as it was tested using the piss poor direct immunoassay which is known to be inaccurate.

Comes down to the individual.

The only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).

Need more thorough labs (prolactin/DHT) and have your FT tested using an accurate assay.


I like the idea of using deca for joint pain (I always do due to heavy lifting), but I did not see the application in solving my ED issue. Perhaps I am wrong.

Although using therapeutic doses (50-100 mg/week) of ND can minimize joint pain/stiffness for some it is a grave mistake to think that using it will prevent any further damage to joints/ligaments and tendons especially if you continue to keep lifting heavy long-term.

No amount of ND/AAS let alone GH is going to prevent damage to joints/ligaments/tendons from overuse/repetitive heavy lifting long-term.

Talk to anyone who has been lifting heavy let alone training for years eventually there will be some degree of wear and tear especially on the joints/tendons.

Many men struggling with what they think is tendonitis end up having tendinosis which is degeneration of the tendons.

Other than ED I feel ok. I never had ED before starting TRT and really never developed it until the last year or so. I do not think its a physical problem because it will sometimes go away.

I believe I have bloodwork that I have done on my own using the dialysis test. Although I am not certain of my protocol when I drew the labs.