TRT with no results

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MRHansen

New Member
Hello everyone.
I need your help and guidance on my TRT protocol as it seems to give me no desired benefits.

Im a white male, 43 years old, living in Thailand, have been on self medicated TRT for 8 months now.
I started TRT due to symptoms which is low libido and weak erections.

But first a short background story:
When i was 19 i did a D-bol and Deca only cycle but had to stop it 5-6 weeks in because of serious testes pain in my testes. It felt like someone was stabbing me with icepicks!!! Scary shit so i quit and never touched steroids again only for this reason. Maybe that was a good thing because if that hadnt happende i am pretty sure i would have continued using for many years, as i have always been fascinated by bodybuilding.
After the cycle i didnt have any issues but they started when i was about 23, starting to loose my hair on the scalp and when i was 25 i started with the libido issues, weak erections, not lasting long , eventually lost all lust even i was with a hot girl. Had to rely on cialis and viagra and have ever since.
This brings me to today. I moved to Thailand 1.5 years ago and here it was possible for me to get hold of testosterone from Pharmacys and was excited to start my TRT routine, self medicating though but have researched this topic for years before, so i feel im very well oriented in this matter.

After starting my TRT protocol which consist of 200 mg Test Enanthate every week along with Anazole ( generic Arimidex) 0.5 mg twice a week, i felt eager to start feeling it helping my symptoms. I have learned that it takes app.6 weeks for the body to start showing results but these never came. My first blood test showed Total Test of 1300 and Estrogen at 25 pg/ml. I since tweaked my dosage of test to land in the 900 ish area.

Now to my main question. Last week i did an extensive bloodpanel to find out why my symptoms arent getting better. Still lack of libido, weak erections ( do often have hard morning wood though but i tribute that to the urge to pee/filled bladder)
My blood panel showed the following: Taken on the day of injection, in the morning fasted state.

Total Testosterone : 960 ng/dl ( 249-836)
Free Testosterone 26.7 ng/dl 2.8 %
Bioavailable Testosterone 672 ng/dl 70.10 %
Albumin 4.6 g/dl (3.5-5.20)
SHBG 21.05 nmol/l (18.3 - 54.1)
Estradiol 55.4 pg/ml (25.8 - 60.7 ) Note : The week leading up to the bloodtest i only took 0.5 Anazole, just to see where it would land in this.
Prolactin 15.53 ng/ml ( 4.04 - 15.2 )
Thyroid FT3 3.45 pg/ml ( 2.0 - 4.40 )

An extensive blood panel and very expensive!

As i interpret these numbers , the only thing i would say was out of range was Estradiol at 55, but i didnt feel any different when the level were at 25, which is optimal.

Som im very confused and dont know where to go from here. What can be tweaked?? I know Prolactin can cause my symptoms but i dont think the number is high, even on the higher side but still in the normal range.

I really need qualified advice here guys, hope you can help me out in this matter.

Kind regards. M.
 
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Systemlord

Member
After the cycle i didnt have any issues but they started when i was about 23, starting to loose my hair on the scalp and when i was 25 i started with the libido issues, weak erections, not lasting long , eventually lost all lust even i was with a hot girl.

Hair loss is thyroid related, we need to see a full set of labs for your thyroid. You would then need to retest Free T3 since you can't test Reverse T3 without also testing Free T3. Free T3 increases metabolism and testosterone is metabolized in the liver, TRT cannot work if there are thyroid problems.

TSH
Free T3
Free T4
Reverse T3
Antibodies
 
Last edited:

MRHansen

New Member
Hair loss is thyroid related, we need to see a full set of labs for your thyroid. You would then need to retest Free T3 since you can't test Reverse T3 without also testing Free T3. Free T3 increases metabolism and testosterone is metabolized in the liver, TRT cannot work if there are thyroid problems.

TSH
Free T3
Free T4
Reverse T3
Antibodies

Wow, my Thyroid tested normal as you see from the result above, don't understand the need for further tests please explain
 

MRHansen

New Member
Yes, I just realised there are some more to the complete panel. I will be having another blood test on Thursday, will post lab results as soon as I have them. Thank you
 

MRHansen

New Member
I just wonder if thyroid is the culprit in this because the fattique it also will cause typically I don't have. I think it's in the Prolactin to be honest, but need more feedback on this.
 

equel

Active Member
Split up injections to eod due to low shbg. Try to find caber, start with .25 to see what happends with ur prolactin.
 

equel

Active Member
You definitely don't want to treat Prolactin 15.53 ng/ml ( 4.04 - 15.2 ). Treating at that level will only cause you're more issues.

Source? Ive heard plenty docs threat prolactin in men if its that high cause it can cause libido issues, Ive seen several guys on other forums getting threated at those levels and it brought their libido back in full force.
 

Systemlord

Member
Wow, my Thyroid tested normal as you see from the result above, don't understand the need for further tests please explain

Your thyroid testing is minimal and is missing other important testing. Your Free T3 while good, if Reverse T3 were elevated it could then block Free T3 at the T3 receptors negating a portion of Free T3 causing symptoms of hypothyroidism.
 
Last edited:

Vince

Super Moderator
Prolactinoma - What else can cause elevated prolactin levels?
  • Prolactinomas.
  • Medications (phenothiazines, metoclopramide, risperidone, selective serotonin reuptake inhibitors, estrogens, verapamil)
  • Stress.
  • Pregnancy.
  • Hypothyroidism.
  • Kidney disease.
  • Chest trauma.
1559468702422.png

Pituitary Society - Educational Source for Pituitary Diseases & Disorders › what-e...
What Else Can Cause Elevated Prolactin Levels? - Pituitary Society
 

Charliebizz

Well-Known Member
For what it’s worth. Eating before a prolactin test can raise it. As per Dr. Crisler and it was true for me. I went on caber when I didn’t really need it and it was terrible. I had blunted emotions and intrusive thoughts
 

RoneTone

Member
Low SHBG is strongly associated with insulin resistance/metabolic syndrome. Erections are far more than hormones. The health of your endothelium and proper vasodilation is critical for erections (even PDE5 inhibitors can't overcome these).

What is your A1C? GGT? Have you done an insulin survey or OGTT? Have you tested for fatty liver? Google "low SHBG fatty liver" and you will see a long list of studies that show findings like "The presence of nonalcoholic fatty liver disease (NAFLD) is a strong risk predictor for type 2 diabetes (T2D). A reduction in sex hormone-binding globulin (SHBG) is associated with NAFLD"

If you are any where near pre-diabetic, insulin resistant, have any fatty liver, high levels of visceral fat, are overweight, etc., you will struggle with erections no matter your T level.

You can also look into neurotransmitter imbalances. For example too much norepinephrine will kill erections (at least in my case and many others). There are also some studies showing: "It has previously been shown that in normal subjects, physiological elevation of norepinephrine (NE) impairs insulin sensitivity (Si) but does not influence insulin secretion"

Just some food for thought...
 

MRHansen

New Member
Low SHBG is strongly associated with insulin resistance/metabolic syndrome. Erections are far more than hormones. The health of your endothelium and proper vasodilation is critical for erections (even PDE5 inhibitors can't overcome these).

What is your A1C? GGT? Have you done an insulin survey or OGTT? Have you tested for fatty liver? Google "low SHBG fatty liver" and you will see a long list of studies that show findings like "The presence of nonalcoholic fatty liver disease (NAFLD) is a strong risk predictor for type 2 diabetes (T2D). A reduction in sex hormone-binding globulin (SHBG) is associated with NAFLD"

If you are any where near pre-diabetic, insulin resistant, have any fatty liver, high levels of visceral fat, are overweight, etc., you will struggle with erections no matter your T level.

You can also look into neurotransmitter imbalances. For example too much norepinephrine will kill erections (at least in my case and many others). There are also some studies showing: "It has previously been shown that in normal subjects, physiological elevation of norepinephrine (NE) impairs insulin sensitivity (Si) but does not influence insulin secretion"

Just some food for thought...

Ronetone, do i have low SHBG ??
Its in the normal range according to the test.
My AC1 was at my last test 101, so a bit elevated. I have onset level of fatty liver and maybe 15 kilos over weight. I must add that these symptoms of mine was the same when i was younger and slimmer so i doubt it has something to do with it.
Total Cholesterol of 158, it should be under 200.
Thanks for your reply
 

RoneTone

Member
Yes, you're low normal, but I would still say low. And also we can see that you have fatty liver too so the correlation is there. You're likely insulin resistant.

I wouldn't worry about total cholesterol so much as I would high trigs and low HDL. What is your trig value? HDL? High trigs, low HDL is another sign of metabolic syndrome, insulin resistance and a better predictor of health outcomes than LDL/total C (unless these are crazy high or low).

If I were you, I wouldn't be so concerned with hormone levels. Your levels look fine to me. I would get in shape, get lean, get rid of your fatty liver, get your A1C to 5.2. or lower (I'm not sure what you mean by 101? Is that your fasting blood glucose?), make sure your blood sugar is not spiking post meals for hours on end, etc. These are critical components to your health that you must address. T is not a panacea. It will not correct poor metabolic health.

As far as you not having these issue while younger - the damage of insulin resistance/fatty liver takes years to accumulate. If you have elevated A1C, fatty liver, etc., you are damaging your endothelial walls (and killing your erections). I invite you to research this topic heavily. Evaluation of endothelial dysfunction in patients with nonalcoholic fatty liver disease: Association of selenoprotein P with carotid intima-media t... - PubMed - NCBI
 
Last edited:

MRHansen

New Member
Yes, you're low normal, but I would still say low. And also we can see that you have fatty liver too so the correlation is there. You're likely insulin resistant.

I wouldn't worry about total cholesterol so much as I would high trigs and low HDL. What is your trig value? HDL? High trigs, low HDL is another sign of metabolic syndrome, insulin resistance and a better predictor of health outcomes than LDL/total C (unless these are crazy high or low).

If I were you, I wouldn't be so concerned with hormone levels. Your levels look fine to me. I would get in shape, get lean, get rid of your fatty liver, get your A1C to 5.2. or lower (I'm not sure what you mean by 101? Is that your fasting blood glucose?), make sure your blood sugar is not spiking post meals for hours on end, etc. These are critical components to your health that you must address. T is not a panacea. It will not correct poor metabolic health.

Yes its my fasting blood glucose. According to the doctor , prediabetic level starts at 106 so i know i will have to go low carb for a good while. My triglycerides came back at 58 :)
Thank you
 

RoneTone

Member
Yeah, a FBG is better than nothing, but not ideal to see where you fall on the metabolic scale. Get a A1C, do a OGTT or better yet do an insulin survey with your OGTT. That's good on the trigs. Also test your liver with AST, ALT, and GGT.

Still, I think if you have onset fatty liver and are overweight those are the two biggest areas I would focus on to get better erections (and better libido). Your hormone levels look pretty damn good and don't see any glaring issues (except low normal SHBG and personally I would take less T and not use an AI but that's just me). I also agree with another poster that recommend you inject more frequently. I inject EOD and have lowish SHBG like you. I got much better results this way.
 

MRHansen

New Member
Yeah, a FBG is better than nothing, but not ideal to see where you fall on the metabolic scale. Get a A1C, do a OGTT or better yet do an insulin survey with your OGTT. That's good on the trigs. Also test your liver with AST, ALT, and GGT.

Still, I think if you have onset fatty liver and are overweight those are the two biggest areas I would focus on to get better erections (and better libido). Your hormone levels look pretty damn good and don't see any glaring issues (except low normal SHBG).

Thanks. How will fatty liver and over weight counteract good erections? I mean, i do have strong erections sometimes, but tend to go soft after a bit. So my guess is that theres nothing physically wrong wity my package since it can experience this, or how to say it :)
Sure, getting fit and healthy will be good for everything i know, but when younger i was fit and healthy but with same issues.

Thanks
 
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