New guy, 10 mos. TRT, dosage/ED/libido questions

Thread starter #1
Hey all - I've been on TRT for 10 months and just found this forum today - what a MASSIVE wealth of information! I've been relying on a single thread on another forum that's totally unrelated to health, and it's been a huge help, but nothing like this.

I could really use your help today; TRT has been great but I am still struggling with ED/libido and it's so confusing to make my own decisions regarding dosage of TC and AIs - there's just so much conflicting information out there. I am so grateful in advance for your wisdom and your time in reading all of this. I literally just downloaded the Ebook and it is AWESOME.

10 months ago I was 38, 250 lb., and muscularly bigger and stronger than many men are at any point in their lives due to running x2/week and being dedicated at the gym x4/week. I went to my PCP because of serious ED and complete lack of libido, and otherwise had no symptoms of low T, except very low energy, which apparently crept up so slowly that I had no idea until I started TRT and experienced the massive difference. My T tested at 232, and he referred me to a urologist who immediately put me on 100mg TC x2/week and HCG x2/week via self-injection. At the time, E2 was 24, SHBG was 25, and DHEA was 264.

After 2 months, T tested at 1100 and E2 at 58; ED/dead libido persisted, so blaming high E2, he started me on 1/2 an Anastrazole once a week.

About three months after that, I had about two weeks where sexual function was pretty magnificent - then it just sort of faded away again.

Three months later, T tested over 1500 and E2 was only down to 56 (despite 3 months of half an Anastrazole/week), so doc bumped me up to a full Anastrazole once a week, again blaming high E2 for my symptoms.

One month later ED and libido symptoms persisted, so doc again blamed high E2 (but didn't order any blood work) and prescribed 1.5 Anastrazole a week. I just didn't feel good about that - no man naturally has T >1500, so instead, I lowered my TC dosage to from 100mg x2 to 70mg x2 and stayed on one Anastrazole/week.

One month after that (last week), T tested 797 in the trough and E2 tested 22 - just received these results today. Still ED and low libido.

I was REALLY surprised at that E2 at 22 - the best I could figure was that I was just a high E convertor and that E2 was causing my issues.

So - I'm so confused as to what to do next. So far:

100mg x2 TC with 1/2 AI/week puts me at T>1500 and E2 of 56
70mg x2 TC with 1 AI/week put me at T=797 in the trough and E2 at 22 (this was after 3-4 weeks)

I've been reading like mad because I am NOT ready to give up on this. I did read somewhere that the body often just needs time to heal after it's been through all of this - so perhaps I did have a decent dosage somewhere along the line but it just didn't have time to level things out? Also apparently it can take several weeks for a new regimen to really make a difference - also good for me to find out.

Right now the doc wants me on 100mg TC x2 and 1.5 Anastrazone per week, which will keep me T>1500, and I'm just not sure I like that - believe me I want these issues GONE YESTERDAY, and I'll do whatever I have to to get there, but since no normal human as T that high, it just doesn't seem like that's necessary.

ALSO

I just read a few sections of the ebook like mad, and it argues pretty strongly AGAINST any AI use at all except in extreme circumstances. SO - what do you all think about me trying 80mg TC x2 and ditching the AI altogether? Maybe give it three months, see how I feel, and do blood work?

This has really been a rollercoaster these past few days - I am DEEPLY grateful for any advice you all can give! Thank you so much for your time - and thanks for helping me get my life back.
 
#2
With levels that high I’m completely impotent and have zero libido. Only thing that worked for me was lowering my dose to 60mg per week which puts my trough 650-700ng. I feel horrible in several aspects with t over a 1000ng and can’t sleep. Can’t say it will work for you but you’re on a very hefty dose for trt. Most but not all men that start that high usually lower their dose and feel better. You shouldn’t need an ai if you’re dose is right.
 

Cataceous

Well-Known Member
#5
In line with what @trt reznor is saying, your fairly large dose of anastrozole has likely overly suppressed aromatization everywhere except in the testicles, where the hCG acutely stimulates aromatization and the level of testosterone in that environment is high enough to prevent AIs from working well. So you're probably not an over-converter; it's just that hCG, useful though it is, wreaks havoc with estradiol management.
 
Thread starter #6
Guys, thank you so much for the responses. I just finished injecting 70mg and HCG - no more AIs for me. I didn't know before now that HCG had any impact on E2 - what does that mean for me now that I'm lowering my TC dose and eliminating AIs? Anything out of the ordinary?

Again, thank you SO much. And TRT Reznor, your username is HILARIOUS.
 

Cataceous

Well-Known Member
#7
... I didn't know before now that HCG had any impact on E2 - what does that mean for me now that I'm lowering my TC dose and eliminating AIs? Anything out of the ordinary?
...
Unfortunately it may mean that estradiol will be somewhat elevated compared to the typical conversion rate of 0.3% of testosterone. If all goes well this won't cause any problems. Otherwise your choice is mainly between reducing the hCG or bringing back the AI at lower levels.
 
Thread starter #8
Ok - thanks for the explanation. When do you recommend I test again - maybe a month? Would the PrivateMDLabs' Female Hormone Panel cover what I need (T serum,
E2 sensitive, albumin among others, but no SHBG so no free T)? Not bad to get T and E2 sensitive for $69. Unfortunately they test through LabCorp, which is an hour drive for me, and I have a Quest 5 minutes away :/. Anybody know of good/cheap testing services that use Quest?
 
#9
A month out for testing is probably enough to stabilize serum levels.

That does seem like a very good price for test panel, but are you sure that's the sensitive estradiol test? Personally I prefer the non-sensitive test—the sensitive test has churned out some whacky results.

These days I try to always get SHBG; it's the only way to get an accurate estimate for free testosterone short of ordering one of the expensive tests. In order to get the best overall price I don't hesitate to mix requisitions from different vendors in a single draw.
 
#10
Balance is the key here and adjusting your injection frequency and dosage will get you where you need to be, but the anastrozole is part of the problem. You TRT dose was pretty high starting out, you just need to play around to find out what works best.

The HCG is known to lower libido is some men while other men absolutely need it. I suggest you dial-in on TRT in isolation and maybe add in the HCG and microdose it daily or EOD to minimize the E2 impact.
 
Thread starter #11
Ok, it could be in my head but I do think things may have begun to improve for me already. Also, I do seriously think my low E2 has caused me some very uncharacteristic emotions, but at least I feel like I'm on the right track now with my dosing and treatment plan.

This is the first I hear of HCG possibly interfering with libido; while I really do want to preserve fertility and keep my balls, I also want to find out if it's causing any of this issue. How long do I need to stay off it to find out? Maybe a week or two given how short its half-life is? Also I have ZERO issues dosing HCG daily or EOD if it will help - very grateful for your guidance here!
 
#12
How long do I need to stay off it to find out?
The half life of HCG is 24-36 hours so you should start to notice something within 4-5 days because there is a lag time between changes in E2 and when you feel actually feel the changes.

Another thing to consider regarding HCG, it supports adrenal function and if you go too far in one direction, it can throw off other hormones. It's not normal to stimulate your LH receptors on a constant basis because LH is pulsatile throughout the day and may cause problems for some if keeping levels elevated 24/7.

The most common scenario is men stop HCG and libido increases. I have heard of some who cycle HCG every other week and still benefit as far as keeping the testicles hanging, but your mileage may vary.
 
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