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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Extremely low libido despite elevated lab values
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<blockquote data-quote="Cataceous" data-source="post: 223827" data-attributes="member: 38109"><p>I had similar issues in a similar time frame. My hypothesis is that these problems can arise from TRT's disruption of normal physiology, including the suppression of upstream hormones. In my opinion your relatively high dosing only exacerbates the situation and exposes you to possible risks. Normal healthy young men produce 6-7 mg of testosterone per day on average. You are taking 16 mg per day. Contrary to popular belief, elevated SHBG does not reduce free testosterone, and therefore does not by itself justify supraphysiological dosing. </p><p></p><p>There is no guaranteed fix for the problems you're experiencing. However, there are things that may help if you're sufficiently motivated to follow through. First though: Have you measured prolactin? An elevated level can hurt libido. This problem can be attacked directly with cabergoline or selegiline. I found these treatments helped some, but did not deliver consistent results.</p><p></p><p>As for more significant changes: One approach is to switch to a testosterone nasal gel. This replaces the cypionate and the hCG. Over time this form of TRT should allow your HPTA to reactivate. For a fair evaluation you must continue the treatment until a few months after LH and FSH are normalized. An alternative to the nasal gel is enclomiphene monotherapy. This drug stimulates the HPTA by selectively blocking estrogen receptors. Assuming you have secondary hypogonadism, enclomiphene use can lead to normal testosterone levels. The odds of good subjective results may be lower than with other methods, possibly due to undesirable changes in estrogenic activity.</p><p></p><p>Testosterone nasal gel wasn't on my radar when I started working on these problems. What I ended up doing was trying to correct the TRT imbalances individually. This approach is going to be overly complex for most guys, but you can read about the resulting protocol <a href="https://www.peaktestosterone.com/forum/index.php?topic=16143.0" target="_blank">here</a>.</p><p></p><p>Although your estradiol is elevated in absolute terms, as a fraction of testosterone it's at the lower end of normal or below.</p></blockquote><p></p>
[QUOTE="Cataceous, post: 223827, member: 38109"] I had similar issues in a similar time frame. My hypothesis is that these problems can arise from TRT's disruption of normal physiology, including the suppression of upstream hormones. In my opinion your relatively high dosing only exacerbates the situation and exposes you to possible risks. Normal healthy young men produce 6-7 mg of testosterone per day on average. You are taking 16 mg per day. Contrary to popular belief, elevated SHBG does not reduce free testosterone, and therefore does not by itself justify supraphysiological dosing. There is no guaranteed fix for the problems you're experiencing. However, there are things that may help if you're sufficiently motivated to follow through. First though: Have you measured prolactin? An elevated level can hurt libido. This problem can be attacked directly with cabergoline or selegiline. I found these treatments helped some, but did not deliver consistent results. As for more significant changes: One approach is to switch to a testosterone nasal gel. This replaces the cypionate and the hCG. Over time this form of TRT should allow your HPTA to reactivate. For a fair evaluation you must continue the treatment until a few months after LH and FSH are normalized. An alternative to the nasal gel is enclomiphene monotherapy. This drug stimulates the HPTA by selectively blocking estrogen receptors. Assuming you have secondary hypogonadism, enclomiphene use can lead to normal testosterone levels. The odds of good subjective results may be lower than with other methods, possibly due to undesirable changes in estrogenic activity. Testosterone nasal gel wasn't on my radar when I started working on these problems. What I ended up doing was trying to correct the TRT imbalances individually. This approach is going to be overly complex for most guys, but you can read about the resulting protocol [URL='https://www.peaktestosterone.com/forum/index.php?topic=16143.0']here[/URL]. Although your estradiol is elevated in absolute terms, as a fraction of testosterone it's at the lower end of normal or below. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Extremely low libido despite elevated lab values
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