HELP - Heat Rashes, ED, and Cracking Joints - A journey Riddle with Side Effects

To preface this, I am a post-drug patient with lasting sexual side effects (yes, PFS, PSSD, and PAS exist and I will not argue this).

I have had enduring sexual dysfunction (dead libido, loss of morning wood, weak erections, etc.) for about 5 years since discontinuing psychiatric drugs. Most blood tests put me in LabCorp's mid range for TT, FT, E2, and prolactin.

Seeing that others in the post-drug community have seen success with elevating testosterone levels (and e2) much higher, I tried this approach. I started on 200mg/wk -- 30mg/day IM -- and had pretty great results, sexually, for the first 5-6 weeks. I had the returning of morning wood, my erection quality improved dramatically, I had libido again, and even the return of some long-lost emotions. However, after about week 5-6, I lost all benefits and seemed to become even worse (became extremely difficult to get an erection even with manual stimulation).

Labs showed TT over 1500, free T just over range, and E2 in reference range (LabCorp for male's 18-40).

The side effects on 200mg:

While running 200mg/wk, I had a slew of side effects mostly related a massive increase in adrenaline: loss of appetite, sleep issues, agitation, very bad anxiety (normally have zero), etc. Within the first week of starting, I also noticed the development of strange heat-induced rashes. These rashes felt and looked like strong allergic (histamine) reactions. In spite of switching from testosterone cypionate in cottonseed oil to test E in sesame oil, these rashes persisted. I thus concluded that these may be caused by higher estrogen levels (estrogen sensitizes mast cells and inhibits the DAO -- the main enzyme responsible for breaking down histamine).

Aside from the rashes, as mentioned above, I also developed ED after the initial 5-week or so honeymoon period. I have absolutely not idea how this happened. It didn't appear gradually but was quite abrupt. Thinking back on it now, it may have been related to taking antihistamines for the rash but I am not completely sure, as it still significantly seems erection quality is worse to this day.

Side effects on lower doses:

On lower doses of testosterone (I tried 160mg/wk, 140mg/wk, and 120mg/wk -- which i'm currently running), I experienced a reduction of negative adrenaline/norepinephrine-related side effects; however, I completely lost all sexual benefits and feel asexual again. In addition, I STILL have the rashes on 120mg/wk, which I consider something of a replacement dose (don't have bloods to confirm yet but will probably get them soon). Additionally, I've developed some low E2 symptoms I didn't have prior to starting TRT (namely, joint cracking/popping and joint pain).

This has been a very poor experience overall. I can't reap the benefits of high TRT because of the rashes, and on low doses, I am practically asexual, seem to be getting joint pain/cracking, and still have rashes (albeit less severe).

Has anyone encountered these heat-induced rashes and found a solution? Any other advice? I tried posting on what is probably considered the competitor TRT forum (won't post name here), and they didn't offer any solutions :/.

I'm quite knowledgeable about hormones in general. I did a LOT of reading prior to starting. I just didn't anticipate this many roadblocks.
 

madman

Member
To preface this, I am a post-drug patient with lasting sexual side effects (yes, PFS, PSSD, and PAS exist and I will not argue this).

I have had enduring sexual dysfunction (dead libido, loss of morning wood, weak erections, etc.) for about 5 years since discontinuing psychiatric drugs. Most blood tests put me in LabCorp's mid range for TT, FT, E2, and prolactin.

Seeing that others in the post-drug community have seen success with elevating testosterone levels (and e2) much higher, I tried this approach. I started on 200mg/wk -- 30mg/day IM -- and had pretty great results, sexually, for the first 5-6 weeks. I had the returning of morning wood, my erection quality improved dramatically, I had libido again, and even the return of some long-lost emotions. However, after about week 5-6, I lost all benefits and seemed to become even worse (became extremely difficult to get an erection even with manual stimulation).

Labs showed TT over 1500, free T just over range, and E2 in reference range (LabCorp for male's 18-40).


The side effects on 200mg:

While running 200mg/wk, I had a slew of side effects mostly related a massive increase in adrenaline: loss of appetite, sleep issues, agitation, very bad anxiety (normally have zero), etc. Within the first week of starting, I also noticed the development of strange heat-induced rashes. These rashes felt and looked like strong allergic (histamine) reactions. In spite of switching from testosterone cypionate in cottonseed oil to test E in sesame oil, these rashes persisted. I thus concluded that these may be caused by higher estrogen levels (estrogen sensitizes mast cells and inhibits the DAO -- the main enzyme responsible for breaking down histamine).

Aside from the rashes, as mentioned above, I also developed ED after the initial 5-week or so honeymoon period. I have absolutely not idea how this happened. It didn't appear gradually but was quite abrupt. Thinking back on it now, it may have been related to taking antihistamines for the rash but I am not completely sure, as it still significantly seems erection quality is worse to this day.

Side effects on lower doses:

On lower doses of testosterone (I tried 160mg/wk, 140mg/wk, and 120mg/wk -- which i'm currently running), I experienced a reduction of negative adrenaline/norepinephrine-related side effects; however, I completely lost all sexual benefits and feel asexual again. In addition, I STILL have the rashes on 120mg/wk, which I consider something of a replacement dose (don't have bloods to confirm yet but will probably get them soon). Additionally, I've developed some low E2 symptoms I didn't have prior to starting TRT (namely, joint cracking/popping and joint pain).

This has been a very poor experience overall. I can't reap the benefits of high TRT because of the rashes, and on low doses, I am practically asexual, seem to be getting joint pain/cracking, and still have rashes (albeit less severe).


Has anyone encountered these heat-induced rashes and found a solution? Any other advice? I tried posting on what is probably considered the competitor TRT forum (won't post name here), and they didn't offer any solutions :/.

I'm quite knowledgeable about hormones in general. I did a LOT of reading prior to starting. I just didn't anticipate this many roadblocks.

To preface this, I am a post-drug patient with lasting sexual side effects (yes, PFS, PSSD, and PAS exist and I will not argue this).

post #6




Seeing that others in the post-drug community have seen success with elevating testosterone levels (and e2) much higher, I tried this approach. I started on 200mg/wk -- 30mg/day IM -- and had pretty great results, sexually, for the first 5-6 weeks. I had the returning of morning wood, my erection quality improved dramatically, I had libido again, and even the return of some long-lost emotions. However, after about week 5-6, I lost all benefits and seemed to become even worse (became extremely difficult to get an erection even with manual stimulation).

Labs showed TT over 1500, free T just over range, and E2 in reference range (LabCorp for male's 18-40).



210 mg/week let alone 30 mg T daily is a whopping dose of T which would surely have your TT/FT sky high and in many cases depending on the individual very high estradiol!

As you can clearly see that on such dose not only is your TT >1500 ng/dL absurdly high but more importantly your FT level is high and even then I would put money on it that it was not tested using an accurate assay and may very well be much higher than you think.

Also, keep in mind that if these are trough levels then the peak level will be much higher.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

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

Critical to know where your FT level truly sits let alone SHBG as it will have a significant impact on what FT level is achieved on such protocol (dose T/injection frequency) let alone can dictate what injection frequency may suit you best.

Hope you understand that when starting trt let alone tweaking a protocol (dose T/injection frequency) the first 4-6 weeks mean nothing when looking at the bigger picture.

*This should be hammered into every patient's head before starting trt or tweaking a protocol (dose T/injection frequency).

Keep in mind many fail to realize that when starting trt or tweaking a protocol (dose T/injection frequency) that hormones will be in flux during the weeks leading up until blood levels stabilize (4-6 weeks when using TC/TE) and it is common for many during this transition to experience what we call the honeymoon period where there may be a strong increase in libido/erections and overall euphoric feeling due to increasing T levels/dopamine.

Unfortunately, this is temporary and short-lived for most as the body will eventually adjust.

It is also very common for many men to experience ups/downs in energy/mood/libido/erections/recovery during the transition as the body is trying to adjust which can be very misleading.

Even then do understand that once blood levels have stabilized (4-6 weeks) it will take another 2-3 months for the body to fully adapt to those new levels and this is the critical time period when one should gauge how they truly feel overall regarding relief/improvement of low-t symptoms.


When looking at the big picture the first 4-6 weeks is very misleading for most!




On lower doses of testosterone (I tried 160mg/wk, 140mg/wk, and 120mg/wk -- which i'm currently running), I experienced a reduction of negative adrenaline/norepinephrine-related side effects; however, I completely lost all sexual benefits and feel asexual again. In addition, I STILL have the rashes on 120mg/wk, which I consider something of a replacement dose (don't have bloods to confirm yet but will probably get them soon). Additionally, I've developed some low E2 symptoms I didn't have prior to starting TRT (namely, joint cracking/popping and joint pain).

Unless you had given each protocol you have tried (160--->140--->120 mg/week) a fighting chance.....4-6 weeks for blood levels to stabilize (adjustment period) and 2-3 months to adapt then you can truly claim failure on such!

Need to wait until blood levels have stabilized on your current protocol (120 mg/week) to see where your TT/FT/e2 let alone other blood markers sit.

Again testing using accurate assays TT/e2 (LC/MS-MS) and FT (Equilibrium Dialysis or Ultrafiltration) is critical to know where your trough levels truly sit on such protocol (dose T/injection frequency).




This has been a very poor experience overall. I can't reap the benefits of high TRT because of the rashes, and on low doses, I am practically asexual, seem to be getting joint pain/cracking, and still have rashes (albeit less severe).

Again unless you had given each protocol a fighting chance then how you truly felt overall on such protocol (dose T/injection frequency) means nothing when looking at the bigger picture.

Need to get out of that mindset that very high T levels are needed to truly reap the beneficial effects of testosterone.

Too many get caught up in that more is better mentality only to end up struggling and chasing their tale on that never-ending merry-go-round.




I tried posting on what is probably considered the competitor TRT forum (won't post name here), and they didn't offer any solutions :/.

There are no competitors as Excels in its own LANE!
 

JA Battle

Active Member
Low e2. 1500 is very high to be having reference range estradiol. I have the same issue. I inject estradiol
 

Cataceous

Well-Known Member
To the wisdom of the other's I'd add that you seem to be exerting only an indirect influence over the source of your issues. So if, for example, your problems were rooted in neurotransmitter imbalances then large testosterone doses could appear to work temporarily. As @madman notes, the honeymoon phenomenon is common with TRT, and may be due in part to dopaminergic effects. Without wanting to sound too pessimistic, I think you can fiddle with testosterone and estradiol till the cows come home and still maybe not end up where you want to be. TRT is a further mixed bag in that you're potentially disrupting a multitude of other hormones: LH, FSH, GnRH, kisspeptin, progesterone, DHEA and pregnenolone. The one positive is that if these hormones are out of kilter then there's less to lose by forcing them wherever you think they should be. What's your DHT like? You mention that prolactin is mid-range. What exactly? I've found that just having mine a few ng/mL over my baseline is enough to cause problems. Have you tried anything like trazodone, selegiline, cabergoline? Though it's restating the obvious: you need to home in on the aspects of the high testosterone dosing that are giving you the improvements—is it about neurotransmitters, perturbations to other hormones, etc.? If you develop and test some hypotheses then you'll be closer to finding a sustainable treatment.
 

JA Battle

Active Member
@JA Battle How can a person who is 15 kilos fatter and that fat belly have a low estradiol <10?

It would be my guess that belly is largely caused by visceral fat. My father has this phenomenon and while I currently don’t, I believe that I am predisposed to this fat deposition pattern as well.

Low estradiol seem to have excessive visceral fat type of pattern. The type of belly that is firm to the touch but is a noticeable keg.

Estradiol excess (usually also accompanied by excess cortisol) is tied to subcutaneous fat storage. The type of stomach with lots of just under the skin fat.

Healthy dht levels usually creates this phenominon of keeping subcutaneous fat to a minimum but does not prevent the visceral fat.

Dht lowers subcutaneous fat.

Estradiol lowers visceral fat.

If both are low then you get both types of fat. If both are nice and upper range you should have no issues with losing weight.

This is the reason for bodybuilder belly’s. I’m not convinced it’s exclusively growth hormone. It’s lowering estrogen with ai’s that does it and the expected visceral fat gain.
 

JA Battle

Active Member
It would be my guess that belly is largely caused by visceral fat. My father has this phenomenon and while I currently don’t, I believe that I am predisposed to this fat deposition pattern as well.

Low estradiol seem to have excessive visceral fat type of pattern. The type of belly that is firm to the touch but is a noticeable keg.

Estradiol excess (usually also accompanied by excess cortisol) is tied to subcutaneous fat storage. The type of stomach with lots of just under the skin fat.

Healthy dht levels usually creates this phenominon of keeping subcutaneous fat to a minimum but does not prevent the visceral fat.

Dht lowers subcutaneous fat.

Estradiol lowers visceral fat.

If both are low then you get both types of fat. If both are nice and upper range you should have no issues with losing weight.

This is the reason for bodybuilder belly’s. I’m not convinced it’s exclusively growth hormone. It’s lowering estrogen with ai’s that does it and the expected visceral fat gain.

I’d also add that there are a number of factors tied to fat and muscle deposition patterns including the influence of the other hormones you referenced as well as cortisol and thyroid hormones but there is definitely at least a semi clear pattern between the e2 and dht controlling fat deposition patterns as I have read
 

gerardo

Member
It would be my guess that belly is largely caused by visceral fat. My father has this phenomenon and while I currently don’t, I believe that I am predisposed to this fat deposition pattern as well.

Low estradiol seem to have excessive visceral fat type of pattern. The type of belly that is firm to the touch but is a noticeable keg.

Estradiol excess (usually also accompanied by excess cortisol) is tied to subcutaneous fat storage. The type of stomach with lots of just under the skin fat.

Healthy dht levels usually creates this phenominon of keeping subcutaneous fat to a minimum but does not prevent the visceral fat.

Dht lowers subcutaneous fat.

Estradiol lowers visceral fat.

If both are low then you get both types of fat. If both are nice and upper range you should have no issues with losing weight.

This is the reason for bodybuilder belly’s. I’m not convinced it’s exclusively growth hormone. It’s lowering estrogen with ai’s that does it and the expected visceral fat gain.
I worry about making estradiol replacement because I'm in doubt with this excess fat, it's not that firm belly, it can get worse. What I also noticed is that the libido is low and does not care much about sex, normal dht. If the libido has decreased I believe that even with this fat it can be low estradiol that also helps to increase this fat.
 

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