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GreenMachineX

Active Member
I've been using about 9-10mg daily Testosterone cyp and 15mg DHEA sublingual for about 8 weeks. Results as follows:

Total Testosterone, MS 558 ng/dL (250-1100)
Free Testosterone 147.2 pg/mL (35-155)
Estradiol, Ultrasensitive, LCMS 18 pg/mL (<29)
DHEA-Sulfate 174 mcg/dL (106-464)


Is that estrogen a little low? I'm still having terrible health anxiety/hypochondria and insomnia. Even this amount of dhea messes with my sleep, but cutting to 7.5mg sublingual dhea helps my sleep immensely. I can't list it all out right now, but it seems like I need more dhea to treat certain symptoms, but too much causes its own issues and there's no perfect in between. I'm at a loss. I also just got over covid a week or 2 ago, so maybe I'm dealing with residual post-covid symptoms? The Testosterone and free test seem perfect, right? Any insight would be great. Maybe I need to revisit adding pregnenolone in again...
 
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Systemlord

Member
Is that estrogen a little low?
I would want my estrogen higher if I were you, estrogen is part of the benefits of TRT. It wouldn't hurt to bump up the TRT dose in a little bit.

As far as the DHEA with no dose providing a perceived benefit, maybe you don't need it. The DHEA could be causing your hypochondria and anxiety.
 

GreenMachineX

Active Member
I would want my estrogen higher if I were you, estrogen is part of the benefits of TRT. It wouldn't hurt to bump up the TRT dose in a little bit.

As far as the DHEA with no dose providing a perceived benefit, maybe you don't need it. The DHEA could be causing your hypochondria and anxiety.
Thanks.

Regarding the dhea, I must've said it wrong. I meant that it definitely provides benefits, but also side effects as well.

It's also possible that estrogen level is causing the anxiety, correct?
 

GreenMachineX

Active Member
I should've also mentioned some of the other things I've noticed with this protocol.

My blood pressure finally in a healthy range! 115/70 morning to 125/75 afternoon. 22mg eod to 50mg twice per week kept it around 130/80 morning and up to 160/80 in the afternoon (would have to deliberately sit, deep breathe for about 10 minutes to get it to 135/70, and sometimes I couldn't get it that low). The other difference is through that intentional relaxation I can get the afternoon blood pressure down to 115/70 as well, whereas before, that was not even remotely possible.

I've recently been waking up in the middle of the night with a very mild, dull headache. I'll dall back asleep until morning and it's there until I get up and start moving around.

Libido is fair, but morning wood nonexistent. I have noticed DHEA kill this in the past.

I'll update more as I notice more. Very happy about the blood pressure.
 

Cataceous

Super Moderator
I wouldn't increase the testosterone dose, given that free T is close to top of range. Your low SHBG is what makes total testosterone relatively lower. Increasing the dose also won't improve your E2/T ratio. But at 0.32% the ratio is still in a normal range of 0.3-0.6%. With these numbers I would try lower dosing for a period to see if it helps, say 20-30% less. If that doesn't help and you still suspect estradiol is too low then you could consider supplementation. It's less common, but a few of us have tried it. Dosing would be tricky since it takes very little to push your level up a lot. You might only need 5-10 mcg of an injectable product. With a transdermal you'd want to apply more like 50-100 mcg of estradiol. I think you can get bi-estrogen cream over the counter, but you'd need to be sure you can measure small enough doses.
 

GreenMachineX

Active Member
I wouldn't increase the testosterone dose, given that free T is close to top of range. Your low SHBG is what makes total testosterone relatively lower. Increasing the dose also won't improve your E2/T ratio. But at 0.32% the ratio is still in a normal range of 0.3-0.6%. With these numbers I would try lower dosing for a period to see if it helps, say 20-30% less. If that doesn't help and you still suspect estradiol is too low then you could consider supplementation. It's less common, but a few of us have tried it. Dosing would be tricky since it takes very little to push your level up a lot. You might only need 5-10 mcg of an injectable product. With a transdermal you'd want to apply more like 50-100 mcg of estradiol. I think you can get bi-estrogen cream over the counter, but you'd need to be sure you can measure small enough doses.
Thanks. Any chance pregnenolone would increase e2 also? I have labs from a couple years ago my preg levels were 0, so I figure I'll need to try that at some point too.
 

Vince

Super Moderator
My two cents is, your E2 isn't too low. If you would like increase it, just increase your testosterone. I would drop the DHEA for a time and see how you feel. You could slowly supplement back in the DHEA, if you wish.

Low shbg guys seem to have more issues with TRTs.
 

GreenMachineX

Active Member
My two cents is, your E2 isn't too low. If you would like increase it, just increase your testosterone. I would drop the DHEA for a time and see how you feel. You could slowly supplement back in the DHEA, if you wish.

Low shbg guys seem to have more issues with TRTs.
That's not a bad idea to just drop dhea and see how it goes. It makes me pretty lethargic for a few hours every morning.
 

GreenMachineX

Active Member
It's possible, I mean maybe you convert more than usual on the DHEA. You could try splitting up the dosage of DHEA more than once per day.

I have to do the same thing with my iron supplements, I get side effects if I take it all at once.
Actually I was thinking the estrogen was maybe just too low and unrelated to the dhea, but first I'm going to lower dhea and see if it helps.
 

Cataceous

Super Moderator
Thanks. Any chance pregnenolone would increase e2 also? I have labs from a couple years ago my preg levels were 0, so I figure I'll need to try that at some point too.
Possible, but I'd bet against it. There are plenty of other paths for it to go down. For me, oral pregnenolone promotes anxiety. So does topical DHEA.
 

GreenMachineX

Active Member
Update here: For about a week now, maybe a day or 2 after I noticed the drop in blood pressure to normal range, I've been experiencing mild dizziness during the day and very mild and dull headaches in the middle of the night and when I wake up until I get moving around. I'm wondering if my blood pressure is dropping too low from the telmisartan. I'm skipping it today to see if today and tonight is better. Another potential variable here is that about also about a week ago, I filled my synthroid at a different pharmacy and they gave me brand name. I realize this shouldn't matter, but it's the only other change since the dizziness and headaches started. I think I have some leftover generic from walgreens I could switch back to when I get back from from out of town.

Otherwise, dropping dhea to 5mg sublingual the past couple days has improved the anxiety (still ready to attack at any moment, but I can actually control the response now instead of "buying in" and going off the deep end).

Lastly, night sweats are gone and I'm sleeping incredibly well. It's been years since I slept like this.

If the dizziness and headache aren't improved, I'll probably be making an appointment with my doctor as this is just too bizarre.

Any thoughts or insights are always welcome.
 

GreenMachineX

Active Member
I wouldn't increase the testosterone dose, given that free T is close to top of range. Your low SHBG is what makes total testosterone relatively lower. Increasing the dose also won't improve your E2/T ratio. But at 0.32% the ratio is still in a normal range of 0.3-0.6%. With these numbers I would try lower dosing for a period to see if it helps, say 20-30% less. If that doesn't help and you still suspect estradiol is too low then you could consider supplementation. It's less common, but a few of us have tried it. Dosing would be tricky since it takes very little to push your level up a lot. You might only need 5-10 mcg of an injectable product. With a transdermal you'd want to apply more like 50-100 mcg of estradiol. I think you can get bi-estrogen cream over the counter, but you'd need to be sure you can measure small enough doses.
Forgot to mention, the past couple days I reduced my test to 8mg daily. Granted, not a big drop at all from 9-10mg, but actually had morning wood last night too!
 

xcpatr922

Active Member
My result is quite similar with you (with same protocol minus DHEA and I'm not expert on DHEA)...except my FT is little bit lower than you.

Regarding headache due to low BP it is very easy to be determined. If your headache is coming from moving position from sitting to standup, it is low BP issue. You may want to drop any -sartan medication.

If your headache is general and has a sleep issue, check your Ferritin level in case it's too low.

With this daily protocol I also notice my penis is longer rather than 2x or 3x a week. If I miss a day then it's getting shorter LOL :)

With daily protocol also my morning wood is there, with our without Cialis. Cialis only makes it stronger (sometimes too strong)...
 
Forgot to mention, the past couple days I reduced my test to 8mg daily. Granted, not a big drop at all from 9-10mg, but actually had morning wood last night too!

Congratulations! BTW I too am a low-doser (just started TRT this week at 18 mg EOD), who also just dropped DHEA. I started with 25 mg/day and that might have been too much, but the 10mg-of-test-C-per-day guru himself, Emeric, recommended dropping DHEA entirely, so I did that. I feel like the DHEA interfered with my sleep and immediately killed off what remaining libido I had at 312 ng/dL total T and 6.35 ng/dL free T.

I hope you keep updating us with how you're faring on these lower doses!
 
Last edited:

GreenMachineX

Active Member
My result is quite similar with you (with same protocol minus DHEA and I'm not expert on DHEA)...except my FT is little bit lower than you.

Regarding headache due to low BP it is very easy to be determined. If your headache is coming from moving position from sitting to standup, it is low BP issue. You may want to drop any -sartan medication.

If your headache is general and has a sleep issue, check your Ferritin level in case it's too low.

With this daily protocol I also notice my penis is longer rather than 2x or 3x a week. If I miss a day then it's getting shorter LOL :)

With daily protocol also my morning wood is there, with our without Cialis. Cialis only makes it stronger (sometimes too strong)...
I've noticed that as well regarding flaccid length (and girth)! But I've also realized dhea was mandatory for that for me. Have you had dhea-s checked and is it low? Mine is bottom of the barrel low without supplementation.

Today is day 2 without telmisartan, and I haven't had any fatigue, dizziness or headache. I also didn't realize how dull my personality was until now. It seems like the lower my testosterone came down, and as such the blood pressure, the more side effects from telmisartan I got. When I get home tonight, I'll check my blood pressure again to make sure it's not riding too high since stopping telmisartan. Otherwise, it probably is time to check my ferritin anyway.

Thanks for the input.

Last update, sleep has still been amazing. I forgot what this is like lol.
 

GreenMachineX

Active Member
Congratulations! BTW I too am a low-doser (just started TRT this week at 18 mg EOD), who also just dropped DHEA. I started with 25 mg/day and that might have been too much, but the 10mg-of-test-C-per-day guru himself, Emeric, recommended dropping DHEA entirely, so I did that. I feel like the DHEA interfered with my sleep and immediately killed off what remaining libido I had at 312 ng/dL total T and 6.35 ng/dL free T.

I hope you keep updating us with how you're faring on these lower doses!
Thanks man. So your current low dose protocol has you at those test levels? Or those were before this current protocol?
 

GreenMachineX

Active Member
Congratulations! BTW I too am a low-doser (just started TRT this week at 18 mg EOD), who also just dropped DHEA. I started with 25 mg/day and that might have been too much, but the 10mg-of-test-C-per-day guru himself, Emeric, recommended dropping DHEA entirely, so I did that. I feel like the DHEA interfered with my sleep and immediately killed off what remaining libido I had at 312 ng/dL total T and 6.35 ng/dL free T.

I hope you keep updating us with how you're faring on these lower doses!
Also, do you have a link to Emeric's protocol?
 
Thanks man. So your current low dose protocol has you at those test levels? Or those were before this current protocol?

312 TT and 6.35 FT ng/dL were in my initial hypogonadal state after a few years of middle age following a few years of blasting and cruising in a very haphazard manner. I just started proper TRT this past weekend, so it will be another five weeks before I get blood work showing me where this protocol has my numbers. I'm hoping to land ~450 trough and ~675 peak.

Also, do you have a link to Emeric's protocol?

Not sure I'm allowed to drop links to other forums here, so I'll PM you.
 
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