TRT patient feeling better after lowering my prescribed dose

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Bentiger07

Member
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 medicine, sports-injury, or genetics related as I easily get high cholesterol despite being very active and eating normal. Even though I ate slightly better than the average American in my past, I now eat EXTRA-healthy to get LDL cholesterol in range. As far as medicine, my dad's a conventional doctor. He often went to his drug cabinet 1st if I was just a little sick, had flareups of severe eczema, or allergies. Docs often prescribed steroid creams/sprays/allergy shots as well. Maybe it effected ED/T. I'd never blame my dad and love him, but as I grew, I learned more. These days, I rely much more on listening to my body, diet, and exercise for health.

It took alot of yrs for me to realize I had low T and estradiol, plus extra years of confusion since my urologists weren't interested in treating. They usually just gave tadalafil which didn't help enough. I eventually found Defy and Dr. Saya. To combat ED, I started AI and clomid first 12.5mg twice daily, and then HCG 350iu daily without success. Clomid raised T levels a lot and HCG barely did. Symptom-wise, no help. Thinking back on those protocols, maybe changing dose and dropping AI may have helped, but that was never tried. About 1-2 yrs ago, I started a prescription of about 62mg of T cyp, 500iu HCG, and 0.3mg AI twice a week. Also, 1 click of 10% T gel to scrotum a day. Bloodwork for that shared in 2nd post. TRT took me into the right direction. I had alot more morning wood, 60% less ED, and slight improvement in libido. While I was happy to see improvement, there was still room for more. The pipes worked maybe on average 4/5 times, and libido only improved slightly.

Around early-mid June, without obtaining doctor's recommendation yet, I started taking 9-10mg of T cyp and 40iu of HCG daily. No more AI and T gel. Changing to daily shots gave more reason to use a smaller needle. I switched to 31g 5/16” needles, as I assume a needle that small won't cause scar tissue. I rotate injections between butt/abs/quads/shoulders. Anyways, I did this protocol because I figured starting low and increasing frequency was a good way to optimize. Change as needed. It was difficult to find how low to start as a daily user because there aren't many I know who inject T+HCG daily. I heard few starting as low as 60mg T cyp once a week and 50IU of HCG daily, so I must be at a decent daily starting point to titrate up. I wanted to focus more on symptoms and a starting point, instead of common protocols/lab numbers. I knew I had aching joints and low-normal SHBG before the latest change. I have to say with this protocol, I feel better. Less ED, more libido, more steady, and as an unexpected bonus, less pain. My muscles feel less stiff. Maybe I do better without AI and higher estradiol.

Everyone's different but for me, my theory is that my original protocol of higher doses and less frequent injections was helpful, but not optimal. Lower doses and more frequent injections is currently working for me. However, I could be wrong. It's not clear if it'll continue to work. Thanks to a sticky thread here, I've learned that T cypionate has a very long half-life, so I'm not at a steady state until after 40 days after changing dose. I'm only 2 or so weeks in. If I see my testicles getting smaller at 40IU HCG daily, then I assume I can just increase that to increase chances of having kids someday. After 40 days, I'll know better if I need increase dosage of T+HCG, or if I can even go lower without ED resurfacing. I'll get bloodwork and doctor's suggestion as well.

That is my experience thus far. If you have any comments, critique, or questions, let me know.
 
Last edited:
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Bentiger07

Member
This is bloodwork while on 62mg T cyp, 500IU HCG,0.3mg AI twice a week, and 1 click of 10% T gel to scrotum a day. I haven't done bloodwork since switching to a daily protocol of lesser dose yet. To be continued...

TESTS RESULT FLAG UNITS REFERENCE INTERVAL LAB

CBC With Differential/Platelet
WBC 6.1 x10E3/uL 3.4 - 10.8 01
RBC 5.65 x10E6/uL 4.14 - 5.80 01
Hemoglobin 16.8 g/dL 13.0 - 17.7 01
Hematocrit 50.2 % 37.5 - 51.0 01
MCV 89 fL 79 - 97 01
MCH 29.7 pg 26.6 - 33.0 01
MCHC 33.5 g/dL 31.5 - 35.7 01
RDW 13.9 % 12.3 - 15.4 01
Platelets 229 x10E3/uL 150 - 379 01
Neutrophils 64 % Not Estab. 01
Lymphs 19 % Not Estab. 01
Monocytes 12 % Not Estab. 01
Eos 4 % Not Estab. 01
Basos 1 % Not Estab. 01
Neutrophils (Absolute) 4.0 x10E3/uL 1.4 - 7.0 01
Lymphs (Absolute) 1.1 x10E3/uL 0.7 - 3.1 01
Monocytes(Absolute) 0.7 x10E3/uL 0.1 - 0.9 01
Eos (Absolute) 0.2 x10E3/uL 0.0 - 0.4 01
Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2 01
Immature Granulocytes 0 % Not Estab. 01
Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1 01

Lipid Panel w/ Chol/HDL Ratio
Cholesterol, Total 160 mg/dL 100 - 199 01
Triglycerides 58 mg/dL 0 - 149 01
HDL Cholesterol 58 mg/dL >39 01
VLDL Cholesterol Cal 12 mg/dL 5 - 40
LDL Cholesterol Calc 90 mg/dL 0 - 99
T. Chol/HDL Ratio 2.8 ratio units 0.0 - 5.0

Testosterone,Free and Total
Testosterone, Serum 827 ng/dL 264 - 916 01
Free Testosterone(Direct) 33.7 High pg/mL 8.7 - 25.1 01
Dihydrotestosterone 59 ng/dL 02
Reference Range:
Adult Male: 30 - 85
Prostate-Specific Ag, Serum
Prostate Specific Ag, Serum 0.6 ng/mL 0.0 - 4.0 01
Roche ECLIA methodology.
Estradiol, Sensitive 25.1 pg/mL 8.0 - 35.0
Sex Horm Binding Glob, Serum 15.0 Low nmol/L 16.5 - 55.9
 
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CoastWatcher

Moderator
I've been injecting enanthate in a daily basis, 16mg every morning, for four years with great success; I couldn't be happier. I only inject 250 of HCG twice weekly, with little enthusiasm, but I am twice your age and all else is in good shape. There are other daily injectors here, and some who didn't find what they were looking for on a daily protocol. It all goes back to how very unique this journey is for each of us. I feel my best when e2 is in the mid-30s; setting aside the anastrozole is a reasonable decision - easy to work estradiol down rather than fighting to bring it up.

I didn't see your SHBG, where does it sit?
 

Bentiger07

Member
Coastwatcher - I agree. Before switching to daily, I read a couple of your posts already and was aware you're on a daily protocol. SHBG results must have got cut off at the end. I edited post: Sex Horm Binding Glob, Serum 15.0 Low nmol/L 16.5 - 55.9

lowe2sucks - It's possible. My SHBG is on the lower end though, so maybe increased frequency helped too, if not the lower dose. Due to t cypionate half-life, I'm not at a steady state yet though until about 40 days after changing protocol. Things could change, but I hope for continued success.

lexer - It's funny you ask that. Hair loss is genetic. I think my healthy lifestyle kept more hair on my head in my later years compared to my older brothers, but in time, I was losing it. Hair loss really accelerated after I saw a urologist for ED. He 1st put me on high doses of DHEA and then high doses of clomid. E2 was high needless to say, and while DHT was never checked, it probably was too. He wasn't interested in treating high E2 so I looked elsewhere. Anyways, on June 11, I actually had an FUT hair transplant done with a popular doctor in NY. No problems so far, but it takes time to see results. However, if I could do it all over again, knowing what I know now, I would have flied to another country to get it done for much cheaper.
 

lexer

New Member
Bentiger07
are these your actual results posted? If so, dht is normal but yet you have hair loss. Did you see dr bernstein?

Testosterone,Free and Total
Testosterone, Serum 827 ng/dL 264 - 916 01
Free Testosterone(Direct) 33.7 High pg/mL 8.7 - 25.1 01
Dihydrotestosterone 59 ng/dL 02
Reference Range:
Adult Male: 30 - 85
Prostate-Specific Ag, Serum
Prostate Specific Ag, Serum 0.6 ng/mL 0.0 - 4.0 01
Roche ECLIA methodology.
Estradiol, Sensitive 25.1 pg/mL 8.0 - 35.0
Sex Horm Binding Glob, Serum 15.0 Low nmol/L 16.5 - 55.9
 

Bentiger07

Member
Its normal in the bloodwork shared under Dr.Saya’s supervision, but as mentioned, hair loss accelerated when a past urologist had me on high doses of dhea and clomid. That probably led to high DHT at that time, plus hairloss is genetic anyways. Before hair transplant, I occasionally used Nizoral and Lipogaine shampoo, because it contains ketoconazole which lessens DHT on the scalp. Now that I got a hair transplant, I may stop using that shampoo.

I went with Dr. Carlos Wesley for hair transplant. I probably wouldnt have mind Dr. Bernstein but I didnt want to visit too many top doctors when I already found one I liked, so I never saw him.
 

lexer

New Member
The fue is very impressive. My friend had it done. He looks great. He said he had no pain during or after his procedure..
how was your experience?
 

Bentiger07

Member
I feel a review would be premature until I give time to see results, but are you considering? If you want to save money and don't mind some inconvenience, getting it done in another country is an option. I didn't know any good doctors out of country until after doing surgery in NY. If you do decide to get it done in NY, I can say Dr. Wesley is busy but has an intelligent and calm personality. He appeared to be on the cutting edge. I cant remember much about the surgery which I guess is a good thing. I usually avoid drugs as much as possible, but they highly recommended I take ambien and vicoden so I listened. Slept through most of it. I chose FUT, mainly due to higher yield. I believe FUE recovery process is only a few days, whereas FUT is a few weeks. Not much pain during surgery, but mild pain sets in the 1st couple days until the stitches are out. Nothing bad. I did get a bit sick after surgery, but I'm better now. Taking vicoden/ambien/antibiotics caused an uncommon but possible reaction. I had 48hrs of hiccups, which led to coughing. I'm better now though.
 

lexer

New Member
Bentiger07
why did you get stitches? The FUE is supposed to be robotic that randomly plucks hairs. My buddy didnt get stitches.
 

Bentiger07

Member
Lexer,
I’m not sure if you missed the part where I said i did FUT or if you dont know what it is. FUT and FUE have their pros and cons. I went with FUT due to more yield (decrease my chances of needing a future hair transplant), plus slightly better cost. But a con of FUT is a thin line of no hair at the back of the head, which cant be seen if hair is long enough to cover it. They take a strip out of the back and stitch it up. If you are considering a hair transplant, I’d recommend learning more about both methods to see what you like more, and also ask what the doctor suggests.
 

lexer

New Member
Sorry, i missed that. Yeah, i also read that FUT renders a better yield. I only need 1000-1200 graphs from what dr bernstein said, and i also where my hair short. Thats why i am a good candidate for FUE. I actually have a decent amount of hair for a 50 year old but the front is starting to recede a little.
 

Bentiger07

Member
That may be fine for you but If you want to go the extra mile, I’d post a picture of your scalp and ask whats recommended on a hair loss forum. Good to get another set of eyes on it. When I did that, all posters pretty much mentioned a lot of doctors are too conservative with the amount of grafts. They said I should get more grafts done than what doc recommended. I shared those responses with my doctor and was able to bump it up by 500 more grafts. I only saw 2 top doctors in NY, and the amount of grafts they recommended was very different.
 
Given your SHBG you should never have been on those starting protocol's to begin with. We're finding more and more of this with the low SHBG guy, me included. At 12mg/D I thought I was using the lowest daily dose. I would strongly recommend that you add to your testing and do "Estradiol, Free" on your next set of labs. I think we're seeing low SHBG = (Very) High Free T, also = (very) high Free Estrogen. Likewise we need to base dose off of Free T and not letting Free T be astronomically high off the lab range and in turn, we need a much lower E2 and Free Estradiol number than the typically recommended 21-30.
 

Bentiger07

Member
Vince,
Thank you. I didn't know testing for Free Estradiol could be useful. I'll include that. Because of T cyp's long half-life, I'm waiting a few more weeks to see if I continue to feel well. Figured I should wait 4-5 weeks before retesting for that same reason.

Naturally, before starting HRT, I was a low T and low E2 guy for years. Since changing to this latest daily protocol with no AI, an unexpected welcoming bonus is my joints hurt less and my muscles feel more loose. I'll consider what you said after seeing where my levels are.

My SHBG results over the past 1-2 years were generally on the high end of low, or low end of normal. As you noticed with lower SHBG guys, free T was usually slightly out or range on high side. My doctor did consider having me take shots more than twice a week but ultimately thought twice a week was fine. I suppose because I mentioned I was feeling progress (now I know that while I was, it may have not been optimal) and because I was dumb enough to ask if I could do 1 injection a week, the doctor kept things as is. By reading more and experimenting a little with daily shots, I now understand and feel that low SHBG guys will generally feel better with more frequent shots.
 

Systemlord

Member
I feel mediocre injecting twice weekly, yet when I start injecting EOD I feel like I'm on a whole other level feeling wise. I've been doing my new EoD protocol for almost 4 weeks and my muscles are harder and have that feel good burn you get when lifting weight, only sitting in my computer chair.

It's not like my numbers were low injecting twice weekly, they were higher than they are now. Weird.
 

Bentiger07

Member
lexer,
Feel free to PM me on your hairloss questions (or if you have a thread somewhere, let me know). I'm glad to help, but it's off topic for this thread.

Did 2800 grafts, but that shouldn't tell you much. Maybe I have more loss than you. I'd post the link of where I shared pics of my scalp on a hair loss forum to give you an idea, but I'm not sure if that's allowed here. You can just search hair loss forums and start a thread with pictures of your scalp. People will help. Always good to get another set of eyes before doing surgery. I had 1 top doctor that wanted to do only 1200, and then a 2nd surgery of 1200 6 months later. From what I've been told, a bad deal to damage tissue twice when not needed. The doctor I actually went with wanted to do about 2300, but I was able to bump him up a bit after sharing responses from a hair loss forum that I should go higher. Power of the internet I guess. How high to go depends on your need, the limit of your donor area, and what the doctor's willing to do. Some doctors try to fit in more than 1 surgery a day.

No, I personally think it doesn't make much sense to take oral propecia for anyone with a severe ED history such as me. Even though topical propecia appears to be fine when it comes to ED, I still stay away from that as well because I wonder about the long-term. There are other options if you don't want to go under the knife (minoxidil/latanoprost with DHT blockers such as ketoconazole, azelaic acid, saw palmetto, etc). I mostly tried minoxidil and ketoconazole. The combination stopped my loss, but didn't cause any noticeable growth. Even if it did help, a part of me still wanted to do surgery. Not the most convenient option to keep buying and apply a minoxidil drug twice a day forever to maintain results.
 
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Bentiger07

Member
Systemlord, I hear ya. Maybe it's all in my head, but I think my physical appearance is already slightly better since I switched 2x/week to daily. I didn't expect that because my total dose is less.

When I used to sit in a chair for awhile, for years, I'd have moderate pain getting up. Recently, not so much. Joints must be doing better. Muscles less stiff.

Praying this lasts. Similar to stories I've read, in the past, I've had inconsistent days where I either felt great or bad. Hopefully, taking shots more frequently brings some consistency.
 
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