Erection Issues/Help
- Thread starter Milkman13
- Start date
If you're on 200 mg T cypionate a week in two doses then I'd cut it in half, just as @Mark Saur said. Reread his post, the advice is good. You will probably feel bad at first with the reduction; it takes time to readjust to more normal levels, but it's worth it. Retest in a couple months and let us know how it's going.
Systemlord
Member
I would decrease your dosage to 120mg which should decrease your testosterone and estrogen levels substantially and greatly decreasing the reliance on the AI.
If I were you since your SHBG is very low, to decrease the impact TRT has on it I would consider a daily or EOD protocol. In this case I would decrease the dosage further to around 100mg weekly.
You also might be able to decrease aromatization injecting these smaller doses more frequently and not needing the AI at all.
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Lookingforward
Member
I find this thread interesting. Is it just me? Shouldn't this guy fire his doctor before he gets more screwed up? Maybe go see someone who knows how to help him? I know you guys are super experienced and could probably treat him through these post but dam! This stuff is has too many variables and interactions....I think Milkman needs a good doctor.
Lookingforward
Member
Maybe I am missing something. However, when a "professional" clearly doesn't spend the time or address the issues (order the right test/collect the necessary data) you are paying them to.....they are either not interested or incapable. This isn't a computer purchase, it's your life!
Just an update. Two weeks later after changing my dosage to 120mg a week the doctor called me back to see how I was feeling. Tired obviously probably from the dosage change. He said he was afraid of that and had me change it to 160mg a week with everything else kept the same.
I am still very tired and erections suck. Does anyone think that’s too much AI for that dose? Maybe switch to Hcg too?
thoughts?
I am still very tired and erections suck. Does anyone think that’s too much AI for that dose? Maybe switch to Hcg too?
thoughts?
I think it would be better for you to inject only 100 mg per week as people here said. AI can cause problems for you.
madman
Super Moderator
Bad move on his part and someone should have explained to you that when starting trt or tweaking a protocol (dose T/injection frequency) hormones will be in flux during the following weeks until blood levels stabilize (4-6 weeks) and it is common for many to experience ups/downs during this transition (energy/mood/libido/erections) as the body needs time to adjust.
Top it all off that once blood levels have stabilized (4-6 weeks) it will take the body 2-3 months to adapt to those new levels and this is the critical time period when one should gauge how they truly feel overall regarding relief/improvement of low-t symptoms.
madman
Super Moderator
From my reply post #11
You are missing two of the most important tests on your lab work.
FT and SHBG.
Have no idea where your SHBG sits but with a very high TT 1500ng/dL you can rest assured that your FT level is high and even then if these labs are true trough then your peak TT/FT/e2 levels will be much higher.
You are being over-medicated as 200 mg/week (100 mg every 3.5 days) is a whopping dose and many would never need such a dose to achieve a healthy FT level.
Top it off that you are taking an AI to control your elevated e2 which is a result of your very high TT level which would have your FT very high and again if these are trough levels then a TT 1500 is way too high (twice weekly injections).
Even then I would be more concerned with where your FT level sits as although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the beneficial effects.
You need to have your FT tested let alone SHBG.
Regarding FT you need to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration if you want to know where it truly sits on such protocol (dose T/injection frequency).
Use Nelsons discountedlabs.
Either assay will suffice!
1 Testosterone, Total and Free (NO Upper Limit) plus Hematocrit
2 Testosterone, Total, LC/MS and Free (Equilibrium Ultrafiltration)
Bet your FT will be very high even if your SHBG is on the higher end.
You would most likely fair much better lowering your dose as you may very well be able to drop the AI let alone feel much better.
The horrible protocol you have been put on.....high dosed T, an aromatase inhibitor, and top it off that your doctor has no f**king idea what he is doing prescribing you gonadorelin which will not replace hCG and injecting such a dose 2 times weekly is pointless!
My current protocol is as follows:
200mg of test Cyp split into 2 injections
100mcg of Gonadorelin 2 times a week
.5mg of Armidex on day of injections
-------------------------------------------------------------------------------------------
Your doctor is an idiot.
*Started you on a whopping dose of T
*Throws you on an AI as he clearly knows that a whopping dose of T 200 mg/week (100mg every 3.5 days) will surely have your TT/FT/estradiol levels through the roof
*Prescribed Gonadorelin twice weekly to replace hCG.....lol
*Follow up labs missing critical tests Free Testosterone and SHBG
*Switches your protocol 2 weeks after you started (120mg/week--->160 mg/week)..... let's just up the dose again.....unreal.
madman
Super Moderator
Prior to the dosage change I had j my y SHGB tested and it was 12.
Just noticed that.
This makes matters much worse as having such a low SHBG 12nmol/L with a whopping TT 1460 ng/dL (which was most likely your trough) would have your FT/e2 level through the roof let alone your peak TT/FT levels (8-12 hrs) post-injection would be much higher!
Bet if you had your FT tested let alone using an accurate assay (Equilibrium Dialysis or Ultrafiltration) that your FT would have been through the roof.
Knowing now that your SHBG is absurdly low than you would most likely fair much better injecting a lower dose of T daily or EOD and keeping your overall weekly dose much lower as in 100-120 mg/week than retesting (using accurate assays) once blood levels stabilize (4-6 weeks) to see where said protocol (dose T/injection frequency) has your trough TT/FT/e2 levels.
You would easily be able to achieve a healthy FT running a much lower TT.
Should have at least stuck with the 120 mg/week dose (60 mg every 3.5 days) as I would put money on it that seeing as your doctor jacked it back up to 160 mg/week (80 mg every 3.5 days) such dose will still have your FT/e2 very high.
You definitely would be much better off using a lower overall weekly dose of T and strongly consider splitting your weekly dose and injecting daily or EOD seeing as you have low SHBG.
madman
Super Moderator
Also, keep in mind that dropping your dose from a whopping 200 mg/week--->120 mg/week is a huge drop (80 mg esterified T), and lowering your T dose drastically will be much harder as you would have been in for a bumpy ride (energy/mood/libido/erections) during the transition as hormones will be in flux during the weeks leading up until blood levels stabilize.
Many can feel unwell during the transition as the body needs time to adjust.
Coming down in T dose will always be harder than going up!
Many can feel unwell during the transition as the body needs time to adjust.
Coming down in T dose will always be harder than going up!
Wow Madman thank you for all your reply's and all the great information. When they found out my SHBG was low I felt like they were unsure how to address it. I had researched and found that more frequent injections was better in my case like you stated. I just did not want to change things on my own.
Would you think getting back on Hcg would be beneficial as well?
So let’s say I do an EOD protocol and drop the AI. 150mg a week to start so I don’t do these huge drops. Shallow IM with an insulin syringe?
When referring to every other day, would it go like this:
week 1 Monday Wednesday Friday Sunday
Week 2 Tuesday Thursday Saturday
repeat?
Would you think getting back on Hcg would be beneficial as well?
So let’s say I do an EOD protocol and drop the AI. 150mg a week to start so I don’t do these huge drops. Shallow IM with an insulin syringe?
When referring to every other day, would it go like this:
week 1 Monday Wednesday Friday Sunday
Week 2 Tuesday Thursday Saturday
repeat?
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If a doctor doesn't understand that you need to wait 4-5 weeks at a minimum before judging the success or failure of a T dose change then he/she is not someone that should be a TRT provider. For real.
Yes. Estrogens tend to raise SHBG, while androgens tend to lower it.
Does it raise in any particular form? So if I stopped the AI and estrogen rises it should rise too?
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