Hi Everyone,
This is my first post on here, just wanted to give an overview of my background and history with ED and no libido.
I'm 45 and have suffered on and off with ED for around 25 years, my low testosterone was flagged up back in my mid 20,s but as it was just within range bugger all was done about it.
After many years of trying this and that I settled on self administrating trt due to no NHS doctors being capable of helping.
Started in June 2025, daily subq injections of test cyp, started at 10mg with 250iu HCG EOD.
Had blood work done every 8 weeks and assessed symptoms.
I've gradually over several months worked up to 17mg per day, which was the first dose after 8 weeks that gave symptoms relief, morning erections started and things started to feel normalish.
Here's the blood work for this dose
Testosterone 34.9nmol
Oestrogen 284. Pmol
Prolactin 262
Free test 0.935
Shbg 21.1
Dhea 6.3
Due to oestrogen and testosterone being out of range I reduced to 15mg per day
And all the morning wood went away and I feel flat as hell.
Blood work now looks like this
Testosterone 28.5 nmol
Oestrogen. 236pmol
Prolactin 260
Shbg 20.9
Dhea 6.3
Iron 36ug/l
Haemocrit 0.501
Red blood cell count 5.61 (4.5-6.5)
Haemoglobin 36mmol
So the question is, do I stay at 15mg and work on reducing oestrogen and potentially start giving blood even though irons a bit low?
It's frustrating that 17mg per day felt great but would only exacerbate issues above
Sorry thats a lot to read
Started in June 2025, daily subq injections of test cyp, started at 10mg with 250iu HCG EOD.
Had blood work done every 8 weeks and assessed symptoms.
I've gradually over several months worked up to 17mg per day, which was the first dose after 8 weeks that gave symptoms relief, morning erections started and things started to feel normalish.
Here's the blood work for this dose
Testosterone 34.9nmol
Oestrogen 284. Pmol
Prolactin 262
Free test 0.935
Shbg 21.1
Dhea 6.3
You never even gave each protocol (dose increase) enough time to truly gauge the effectiveness as 8 weeks is not enough time.
If anything you would need to give it 12 weeks before claiming whether it was a success or failure.
3-4 months would be ideal.
Why?ffggf
When first starting T or tweaking a protocol (dose of T/injection frequency) hormones will be in flux during the weeks leading up until blood levels have stabilized (4-6 weeks TC/TE) due to the PK and it is common for one to experience ups/downs along the way as the body is trying to adjust to the rising T, increased dopamine and lighting up ARs (androgen receptors).
Even then once steady-state is achieved (4-6 weeks TC/TE) it will still take a few more months for the body to adapt to its new set-point and this is the critical time period when on needs to gauge how they truly feel overall regarding relief/improvement of low-T symptoms and overall well-being.
Many make the mistake of tweaking their protocol every 6-8 weeks because they do not feel well which is a bad move as you will. be running around in circles here.
Chasing your tail until the cows come home.
Many still lack the understanding of how exogenous T works.
Also keep in mind when first starting T or tweaking a protocol hematocrit will rise within the first month and the biggest increase will be seen in at the 3-6 month mark and top it off that it can take much longer for blood levels to stabilize.
Every time you jack up your FT by increasing the dose you will have to go through the whole process again as hematocrit will. increase further.
Where your hematocrit sits at 6-8 weeks is not where it will end up in 3-6 months!
As we always say start low and go slow on a T only protocol so you can see where said protocol (dose of T/injection frequency) has your trough TT and more importantly FT, estradiol and critical blood markers RBCs, hemoglobin and hematocrit.
There will always be time to increase the dose if need be or throw in hCG.
Every protocol needs to be given 3-4 months before throwing in the towel.
Keep in mind it will always be easier going up then coming down as you can clearly see.
Again even when decreasing the dose it will take another 4-6 weeks for blood levels to stabilize as your levels are decreasing over the following weeks and it is common for one to experience a bumpy ride especially when it comes to energy, mood, libido and in some cases erectile function as the body is trying to adjust.
Even then once steady state is achieved (4-6 weeks TC/TE) you would still need to give it a few more months for the body to adapt to its new set-point.
Every protocol need to be given a fighting chance before throwing in the towel.
As you can see when you were injecting 17 mg TC daily (119 mg T/week) you were hitting a high TT 1006.6 ng/dL (34.9 nmol/L) especially for someone with lowish SHBG 21.1 nmol/L so it would be a given that your trough FT is very high.
Keep in mind there will be a minimal peak-->trough when injecting daily.
Although TT is important to know FT is what true matters as it is the active unbound fraction of T responsible for the positive effects.
The only way to know where your FT truly sits would be testing it using the most accurate assay the gold standard Equilibrium Dialysis especially in cases of altered SHBG.
If you do not have access which is highly doubtful if you live in the US then you would need to use/rely on the next best testing method the linear law-of-mass action Vermeulen (cFTV) which will give a good approximation.
No one should be using/relying on the known to be inaccurate direct immunoassay.
Seeing as you are living in the UK your FT was most likely tested using the known to be inaccurate direct IA or calculated.
We can easily calculate your FT using the go to cFTV with the online calculator which is available to the general public for free.
If we take your high trough TT 1006.6 ng/dL, lowish SHBG 21.1 nmol/L and Albumin 4.3 g/dL (default) then your trough FT 29.9 ng/dL is very high.
Nothing bad here if you are not experiencing any sides, blood markers are healthy and you feel good overall.
Otherwise you would easily have room to lower your weekly dose and bring down your FT.
Due to oestrogen and testosterone being out of range I reduced to 15mg per day
And all the morning wood went away and I feel flat as hell.
Blood work now looks like this
Testosterone 28.5 nmol
Oestrogen. 236pmol
Prolactin 260
Shbg 20.9
Dhea 6.3
Iron 36ug/l
Haemocrit 0.501
Red blood cell count 5.61 (4.5-6.5)
Haemoglobin 36mmol
So the question is, do I stay at 15mg and work on reducing oestrogen and potentially start giving blood even though irons a bit low?
It's frustrating that 17mg per day felt great but would only exacerbate issues above
You decided to decrease your dose slightly due to elevated T/E and concerns about elevated hematocrit.
Your trough/steady-state FT is. high so it is a given that your estradiol and hematocrit would be driven up.
Again no big deal here if youn are not experiencing any sides, blood markers are healthy and you feel good overall.
The cut-off for hematocrit is 54% and as of now you are only hitting 50% mind you it would have been much higher as you had only given each protocol (increasing dose of T) 8 weeks which is not enough time to see where your hematocrit would have ended up as again the biggest increase will be seen at the 3-6 month mark.
Even then lowering your daily dose from 17 mg--->15 mg T still has you hitting a high trough TT 821.9 ng/dL (28.5 nmol/L) and with a lowish SHBG 20.9 nmol/L your trough FT will still be high.
If we take your high-end TT 821.9 ng/dL, lowish SHBG 20.9 nmol/L and Albumin 4.3 g/dL (default) then your cFTV 24 ng/dL is still high.
If anything you just decreased the dose from 119---105 mg T/week (17--->15 mg daily) so you need to give it more time before convincing yourself that you need to increase your dose again.
Chances. are if your ferritin/iron are low/borderline low that would have a negativeimpact on your energy and mood.
There is no need to donate as your hematocrit not that high and the last thing you want to do is crash your iron/ferritin.
You will open up another can of worms especially when it comes to thyroid!
Would get a full iron panel and decide if you need to take any measure here.
If things do not settle then you easily have room to tweak your protocol further if need be.
