Progesterone as Anti-Estrogen

[AndroChishti]

Hi All, this is my second post here and it is going to be a long one so please bear with me.

I am amazed at the quality and depth of information available here, and grateful for the advice and help that experienced men on TRT provide here.

Bloodwork : (After 3 months on TRT)

• Total Testosterone : >1000 ng/dl
• Free Testosterone: 30 pg/ml
• Estradiol: 50pg/ml
• DHT: 1200 pg/ml ref. range: 250 - 850 pg/ml
• SHBG : 26 nmol/L
• Progesterone : 1.5 ng/mL or 4.77 nmol/L
• Urine Free Cortisol : 57 ug/Day
• Serum Cortisol (Mid-day): 22 ug/dl
• DHEA: 500 ug/dl
• TSH: 1.8

In this post I would like to discuss some my case in a bit more depth. I have been on TRT for the past 6 months and have never had full symptom resolution on it. Though gains in the gym are great, but I have not so great Acne (bad) , Libido, ED and Anxiety (which I never had prior to TRT).

Especially Anxiety, my resting heart rate has increased from 75bpm to 88bpm, I run out of breath very easily easily with clapping jaws and heart palpitations when I lie down to sleep. These symptoms get worse a lot more worse with 0.05mg Arimidex MWF which is already an extremely low dose, and I get all the low E2 symptoms (especially joint pain, palpitations and anorgasmia) even with it being in the 20-25 range.

I always thought that the culprit would be SHBG but after seeing bloodwork here, I believe my SHBG is not that low to cause such symptoms.

Which brings me to Progesterone, it is known that Progesterone acts as an indirect antagonist to Estradiol. My adrenals are overactive and that is the source of excess progesterone and not the testis (because of HPTA suppression). My progesterone levels are 4 times the normal (as mentioned by Nelson in one of the posts) I need advise if my progesterone is really that high to cause low E2 symptoms? If so should I supplement oral Estradiol Valerate to offset high progesterone?

Note : I have pubertal gyno, but on TRT (50mg EOD Test E) and 1500IU HCG MWF, I dont suffer from nipple sensitivity or swelling and I also dont get a lot of water retention or the bloaty look.


Thanks in advance for any advise/help.

 

[Cataceous]

Typically progesterone is considered to be calming. Both it and its metabolite allopregnanolone are positive allosteric modulators of the GABA-A receptor, with effects described as anxiolytic, sedative and anticonvulsant. Your relatively high hCG dose is likely contributing to your progesterone production.

Your estradiol does seem low relative to testosterone. Nonetheless, with your TRT dosing being quite high I would start there in looking to reduce imbalances. You're averaging 18 mg per day of testosterone. That's approaching three times what healthy young men make, on average. As a first step I would try reducing to 28 mg EOD TE and also reduce the hCG to 750-1000 IU per week. Dose reductions are often unpleasant, but you need to ride it out and then evaluate how you feel after a few months. It's possible that additional dose reductions would be useful. If you're still having problems after you've fairly evaluated a number of physiological testosterone doses then you might start playing with other variables, including estradiol.

 

[AndroChishti]

Thanks for the reply. The progesterone test is from when I haven't started taking HCG, I started HCG to increase Estradiol such that the Prog to E2 could improve in favor of E2. The only source of my excess progesterone is adrenals because when the test was taken my HPTA was suppressed for more than 3months.

 

[AndroChishti]

I feel even worse on low dose, I started with 30mg EOD, no libido, joint pain and acne.

 

[Cataceous]

So you were on the lower dose of testosterone and no hCG for three months? Did you have the anxiety and higher heart rate then? Did you try the lower dose for a period of time with hCG first? It seems like the trial periods would be too short if you've only been on TRT for six months total. Did you take both the high dose and hCG for the entire second three-month period? What exactly improved?

What is the lab range for your particular progesterone test?

 

[AndroChishti]

For the first 3 months, I was on low dose trt and no hcg. Anxiety wasnt that bad, libido and erections were weaker than pre trt. Since then to test the high progesterone hypothesis I went on the higher try dose, 50mg eod. Libido improved and erections but not still better than pre trt. At this point, with e2 of 50 pg/ml I tried using a very low dose AI and things got bad very rapidly within a week got severe acne and achy joints.
Since I am hcg, things have gotten to baseline and have plateaued.
The reference range for progesterone is 0.28-1.2 Ng/ml.

 

[DS3]

For the first 3 months, I was on low dose trt and no hcg. Anxiety wasnt that bad, libido and erections were weaker than pre trt. Since then to test the high progesterone hypothesis I went on the higher try dose, 50mg eod. Libido improved and erections but not still better than pre trt. At this point, with e2 of 50 pg/ml I tried using a very low dose AI and things got bad very rapidly within a week got severe acne and achy joints.
Since I am hcg, things have gotten to baseline and have plateaued.
The reference range for progesterone is 0.28-1.2 Ng/ml.

@Cataceous is right. Your dosage of T is too high and could be contributing to your anxiety. HCG can also increase anxiety in some men, though I find it to be calming in sufficient dosages. The best advice you will get is to reduce your dosage of T and HCG, wait 6-12 week to assess how you feel, and go from there. 30 mg EOD is a good starting point for you to drop your T to, but I would ask that you consider dropping your HCG to 400- 500 units 2 to 3 times per week. The current research from BCM suggests that 500 IU HCG 3 times per week is the ideal dose to keep your testicles where they should be.

AIs are terrible drugs. If you can avoid taking it, I would.

 

[Nelson Vergel]

I have pubertal gyno, but on TRT (50mg EOD Test E) and 1500IU HCG MWF,

I would reduce TRT to 50 mg twice per week and hCG at 500 IU twice per week. I bet your anxiety and heart palpitations will get better. But something tells me that you are taking something else beyond TRT plus hCG. Your DHT is very high. What medications and/or supplements are you taking?

 

[Cataceous]

I'd missed that your lab work was taken at the lower dose rate. As far as I can tell you never gave yourself a chance to experience normal testosterone levels. The lab results do not reflect a "low dose". They show that 105 mg per week (of cypionate?) is approaching double the testosterone that's normal for your physiology. Upon seeing that you should have titrated down to 20 mg EOD instead of up to 50. It's not too late to rectify that, but it will take time and may not feel so good until you've been at a normal level for some months. It's not surprising that you're doing well at the gym. That's the one thing excessive testosterone is good for. But for most other things, more than natural is rarely better.

Read some posts from other guys who came to see that more is not better:

Anyone combine injections and cream? How do you feel?

I’m a long term TRT patient, 39 years old. I’ve been on cypionate and inject a total of 154mg weekly in EOD subQ shots of 44mg each. I have been doing some thinking about the potential benefit of keeping dosing the same but experimenting with using a low cypionate base around 80-100mg weekly...

www.excelmale.com

Anyone combine injections and cream? How do you feel?

I’m a long term TRT patient, 39 years old. I’ve been on cypionate and inject a total of 154mg weekly in EOD subQ shots of 44mg each. I have been doing some thinking about the potential benefit of keeping dosing the same but experimenting with using a low cypionate base around 80-100mg weekly...

www.excelmale.com

Anyone combine injections and cream? How do you feel?

Interesting anecdote. I’m curious what what your SHBG and current protocol are? @JoeMatts im curious for this as well

www.excelmale.com

First labs after starting TRT - WOW!

My hematocrit was 0.55 with a normal range of 0.40 to 0.54. It is only slightly too high. My doctor didn't seem concerned about it. I'll post my full labs in the future. Very much appreciate your feedback. I'm also a bit confused how a dose of 120mg/week can have such a dramatic effect. It...

www.excelmale.com

Hello, 60yo starting TRT.

Hi All. I'm 60yo, lucky with relatively few health problems so far. Total T 350-400. After about a year of research/consideration, about to start TRT, plan is just Test C, 150mg per week separated into two subq injections/week into delts/VGs, draw/inject using 29G 1ml. Get labs in ~8 weeks...

www.excelmale.com

Have you ever DECREASED your dose?

Hey guys. I've only been on TRT for about 9 months. I'm on Test Cyp 100 mg Q3.5d with 350iU of HCG IM. I recently (this week) lowered my Anastrozole from 0.5 mg on injection days to 0.25mg to see how it will effect me (side effects, changes in libido, and also then lab values). ****I'm happy...

www.excelmale.com

Hello, 60yo starting TRT.

Hi All. I'm 60yo, lucky with relatively few health problems so far. Total T 350-400. After about a year of research/consideration, about to start TRT, plan is just Test C, 150mg per week separated into two subq injections/week into delts/VGs, draw/inject using 29G 1ml. Get labs in ~8 weeks...

www.excelmale.com

TRT patient feeling better after lowering my prescribed dose

Hey Guys, Hope all's well and Happy 4th! I'm looking for feedback. As a young male battling ED and low T, hopefully sharing my experience on what worked helps someone too. Almost 32 now and I use to have severe ED as long as I can remember, maybe late teens. No clue on cause. Maybe it's...

www.excelmale.com

Dose Change Side Effects

Hi guys, I just switched to a daily protocol of 24mg after spending a few weeks on 100mg E3D. This E3D protocol kicked the shit out of me, I dont think I respond well to having so much T at one time. The anxiety and thoughts were nightmarish plus the lethagy is real. Is there anything that...

www.excelmale.com

 

[AndroChishti]

Thanks for the feedback everyone, I will implement the changes in protocol advised by @Nelson Vergel and @Cataceous.

On progesterone, is it fine or is it high enough to cause problems ?

 

[DS3]

I'd missed that your lab work was taken at the lower dose rate. As far as I can tell you never gave yourself a chance to experience normal testosterone levels. The lab results do not reflect a "low dose". They show that 105 mg per week (of cypionate?) is approaching double the testosterone that's normal for your physiology. Upon seeing that you should have titrated down to 20 mg EOD instead of up to 50. It's not too late to rectify that, but it will take time and may not feel so good until you've been at a normal level for some months. It's not surprising that you're doing well at the gym. That's the one thing excessive testosterone is good for. But for most other things, more than natural is rarely better.

Read some posts from other guys who came to see that more is not better:

Anyone combine injections and cream? How do you feel?

I’m a long term TRT patient, 39 years old. I’ve been on cypionate and inject a total of 154mg weekly in EOD subQ shots of 44mg each. I have been doing some thinking about the potential benefit of keeping dosing the same but experimenting with using a low cypionate base around 80-100mg weekly...

www.excelmale.com

Anyone combine injections and cream? How do you feel?

I’m a long term TRT patient, 39 years old. I’ve been on cypionate and inject a total of 154mg weekly in EOD subQ shots of 44mg each. I have been doing some thinking about the potential benefit of keeping dosing the same but experimenting with using a low cypionate base around 80-100mg weekly...

www.excelmale.com

Anyone combine injections and cream? How do you feel?

Interesting anecdote. I’m curious what what your SHBG and current protocol are? @JoeMatts im curious for this as well

www.excelmale.com

First labs after starting TRT - WOW!

My hematocrit was 0.55 with a normal range of 0.40 to 0.54. It is only slightly too high. My doctor didn't seem concerned about it. I'll post my full labs in the future. Very much appreciate your feedback. I'm also a bit confused how a dose of 120mg/week can have such a dramatic effect. It...

www.excelmale.com

Hello, 60yo starting TRT.

Hi All. I'm 60yo, lucky with relatively few health problems so far. Total T 350-400. After about a year of research/consideration, about to start TRT, plan is just Test C, 150mg per week separated into two subq injections/week into delts/VGs, draw/inject using 29G 1ml. Get labs in ~8 weeks...

www.excelmale.com

Have you ever DECREASED your dose?

Hey guys. I've only been on TRT for about 9 months. I'm on Test Cyp 100 mg Q3.5d with 350iU of HCG IM. I recently (this week) lowered my Anastrozole from 0.5 mg on injection days to 0.25mg to see how it will effect me (side effects, changes in libido, and also then lab values). ****I'm happy...

www.excelmale.com

Hello, 60yo starting TRT.

Hi All. I'm 60yo, lucky with relatively few health problems so far. Total T 350-400. After about a year of research/consideration, about to start TRT, plan is just Test C, 150mg per week separated into two subq injections/week into delts/VGs, draw/inject using 29G 1ml. Get labs in ~8 weeks...

www.excelmale.com

TRT patient feeling better after lowering my prescribed dose

Hey Guys, Hope all's well and Happy 4th! I'm looking for feedback. As a young male battling ED and low T, hopefully sharing my experience on what worked helps someone too. Almost 32 now and I use to have severe ED as long as I can remember, maybe late teens. No clue on cause. Maybe it's...

www.excelmale.com

Dose Change Side Effects

Hi guys, I just switched to a daily protocol of 24mg after spending a few weeks on 100mg E3D. This E3D protocol kicked the shit out of me, I dont think I respond well to having so much T at one time. The anxiety and thoughts were nightmarish plus the lethagy is real. Is there anything that...

www.excelmale.com

Given that Free T is what we are looking actual compared to TT in determining how physiological a dosing protocol is, with a Free T of 30 pg/ml, @AndroChishti is just barely over the top of the reference range (26 pg/ml typically being the top). This seems hardly qualifiable as ‘double the testosterone’ for his physiology (which we actually do not know what is normal for his younger, ideal physiological T levels).

I am missing where he says these blood tests were the results of a lower dosage than the stated 50 mg T EOD and 1500 IU HCG MWF, but even if they were, a significant dose decrease (lower than what Nelson has recommended) may not be the answer to helping him feel better, as it has not with me nor many guys even on this forum that use 100+ mg per week.

 

[Cataceous]

Given that Free T is what we are looking actual compared to TT in determining how physiological a dosing protocol is, with a Free T of 30 pg/ml, @AndroChishti is just barely over the top of the reference range (26 pg/ml typically being the top). This seems hardly qualifiable as ‘double the testosterone’ for his physiology (which we actually do not know what is normal for his younger, ideal physiological T levels).
...

Since he didn't provide the range for free testosterone we don't know what it is. Different labs can be wildly different. Additionally, the test is more likely to be a direct method based on immunoassay, which should not be used at all because the method is so inaccurate. The free T calculators are suggesting quite high free testosterone, and that's using only 1,000 ng/dL for total T, when in fact it could be much higher.

...
I am missing where he says these blood tests were the results of a lower dosage than the stated 50 mg T EOD and 1500 IU HCG MWF, but even if they were, a significant dose decrease (lower than what Nelson has recommended) may not be the answer to helping him feel better, as it has not with me nor many guys even on this forum that use 100+ mg per week.

"Bloodwork : (After 3 months on TRT)"
"For the first 3 months, I was on low dose trt and no hcg."
"I started with 30mg EOD"

...
On progesterone, is it fine or is it high enough to cause problems ?

This is something to retest/revisit after you have achieved physiological levels of testosterone for some months.