From our other thread I talked about using a cream on the testes, it's not Testim though and my DHT hasn't been over lab ranges but close to the top with 25mg daily on the scrotum. It'd be interesting if you do this how you feel and what you're tested values come out to be.
Life Extension established that range based on research using the immunoassay estradiol test. This test is no longer recommended by the leaders in the field of TRT who recommend the LC/MS/MS method. The immunoassay method typically overstates the actual E2 level, but if you go to order an E2 test from Life Extension that's the one you will get.
It is unknown what the optimum range is using LC/MS/MS, but if LEF's range is right then it is probably safe to assume it will be lower than 20-30.
I've always been a little puzzled with the whole standard vs sensative testing. I understand the bell curve and how the standard test was designed with woman in mind so it exaggerates estradiol levels in men. That said, my first 1.5 years on TRT, I only did the standard test (with two exceptions where I paid to have both tests done with the same blood pull), and although my standard numbers were higher than my sensative numbers, there was always consistency with the standard numbers. If I would keep the same T dose, my standard E2 numbers were always about the same. If I increased or decreased my dose, the standard numbers would follow suit. For the last year I've only tested E2 by sensative assay and the numbers are always lower than standard testing, but consistent as well. I've bought into Nelson's T/E ratio and use that, with the sensative E2 test, and how I feel more than the lab range, when determining proper E2 levels. But as for the standard test, my experience has been that the numbers were always consistent and would increase/decrease with changes in my T dose.
It's a simple as you're using a test designed for women that does not accurately present levels in males. Quest Diagnostics even states that on the lab results, that it's the wrong test for men. You can't reason it out to be a test that can be used by men. There's PLENTY of discussion on this with a search than derailing Tommy's DHT thread.
For me boosting libido:
Hcg eod 250-275
E2 in the 20-30 range but really going by feel .25 ai about once a week.
Test in upper 1/3 but not as important as Hcg and e2.
Keep prolactin down.
My dht is naturally at the top of range.
My theory is as we age a lot of peoples neurotransmitters are depleted due to past use/abuse of drugs/alcohol/stimulants/porn......especially DOPAMINE which is one of the KEY PLAYERS in sex drive and as far as ED definitely psychological/physical issues especially VASCULAR HEALTH.
Even with trt TESTOSTERONE boosts DOPAMINE but only temporarily and you hear a lot of people state that TOPICALS mimic the natural circadian rhythm of a young mans daily testosterone fluctuations where as with IM unless you are dosing smaller amounts frequently you get the peaks and valleys which is more unnatural.
I understand everyone functions better at different levels of TT/FT but it seems that most prefer to be in the upper range 900-1200 and is that really healthy in the long run to be at that constant high end range day in and day out especially for someone in his 30-40s and beyond?
Current cigarette smoking, frequent nocturnal voiding, and a low SHIM score were the independent risk factors for a severely low libido. K Shigehara, Y Kato, M Iijima, et al. Risk Factors Affecting Decreased Libido Among Middle-Aged to Elderly Men; Nocturnal Voiding is an Independent Risk Factor...