I'm currently using Maximus oral-t, and I haven't really felt any benefit after 3-months of use. I'd like to try the Test Prop, mostly because I'm concerned about E2 levels as I am a high aromatizer, and I don't want to be on an AI.

busydad said:

I'm currently using Maximus oral-t, and I haven't really felt any benefit after 3-months of use. I'd like to try the Test Prop, mostly because I'm concerned about E2 levels as I am a high aromatizer, and I don't want to be on an AI.

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What are your levels? Why do think prop is going to solve your issues?

Some info in these two pages: Testosterone Propionate Discontinued by all pharmacies - Excel Male Health Forum

busydad said:

I'm currently using Maximus oral-t, and I haven't really felt any benefit after 3-months of use. I'd like to try the Test Prop, mostly because I'm concerned about E2 levels as I am a high aromatizer, and I don't want to be on an AI.

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The lab work you posted earlier and the lack of improvements from oral testosterone are suggesting that low testosterone is not your problem. It's not impossible that your elevated E2/T ratio is contributing to issues. If you can lose more weight then that is the preferred way to reduce the ratio. Otherwise you might as well test the hypothesis with a short trial of AI use. The main thing is to go into it knowing how potent these drugs are; it is very easy to crash estradiol. For example, with anastrozole a cautious approach is to start with 20 µg daily or 40 µg EOD. Self-compounding is pretty simple because you can dissolve anastrozole in ethanol—e.g. vodka—and dose by volume.

none! reason I went UGL. because Tprop gave me by far best results.

These are my labs from September before starting the Oral-TRT. This is very similar to what my labs have always looked like. I have had "some" benefit from the Oral-TRT. I no longer have a midafternoon crash, and I've started to have morning erections again which I haven't had for years. I guess I expected my libido to come back, and to actually feel a difference in focus, etc. I'm 5' 11" and about 220 lbs. I'd like to lose another 15-20 lbs, but I don't believe that would really help my E2 much, as I've lost about 60 lbs. over the past 3 years and my E2 has barely budged.

busydad said:

I'm currently using Maximus oral-t, and I haven't really felt any benefit after 3-months of use. ...

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busydad said:

... I have had "some" benefit from the Oral-TRT. I no longer have a midafternoon crash, and I've started to have morning erections again which I haven't had for years. I guess I expected my libido to come back, and to actually feel a difference in focus, etc.

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It's challenging to give advice while the story is shifting. The return of morning erections is significant and suggests you should continue with the oral testosterone. You're unlikely to do much better with propionate, although you might enjoy a short-lived honeymoon period. With respect to mitigating the effects of high estradiol, oral testosterone substantially boosts DHT, which reduces estrogenic activity. You should also try to avoid more-is-better thinking. Necessary levels of testosterone for good sexual function are not all that high. Libido is very complex, and involves a lot more than testosterone. A modest level of testosterone is necessary, but not sufficient for good libido. In some cases too much testosterone is actually detrimental to libido, likely due to negative effects on other hormones and neurotransmitters. A lack of focus is even more nebulous, and may have little to do with testosterone.

Cataceous said:

It's challenging to give advice while the story is shifting. The return of morning erections is significant and suggests you should continue with the oral testosterone. You're unlikely to do much better with propionate, although you might enjoy a short-lived honeymoon period. With respect to mitigating the effects of high estradiol, oral testosterone substantially boosts DHT, which reduces estrogenic activity. You should also try to avoid more-is-better thinking. Necessary levels of testosterone for good sexual function are not all that high. Libido is very complex, and involves a lot more than testosterone. A modest level of testosterone is necessary, but not sufficient for good libido. In some cases too much testosterone is actually detrimental to libido, likely due to negative effects on other hormones and neurotransmitters. A lack of focus is even more nebulous, and may have little to do with testosterone.

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I should have been clearer in my first post. I guess I expected more, especially when you read stories of folks feeling a night and day difference.

busydad said:

I should have been clearer in my first post. I guess I expected more, especially when you read stories of folks feeling a night and day difference.

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@madman has some excellent posts explaining the mechanics of honeymoon periods. When you read men's accounts of these periods you might think TRT is a panacea. The problem is that often the post-honeymoon let-downs are reported in different threads, so you might miss the reality of TRT. The experience also depends on the severity of your hypogonadism. If it's bad then you might be pretty happy with TRT in spite of the occasionally rocky road. However, if you were borderline then the tradeoffs may not seem to be worth it.

Has anyone at Maximus suggested trying some enclomiphene with your oral testosterone? I ask because they have demonstrated that one can achieve HPTA activation under these circumstances. This is intriguing, because I think some of the problems associated with TRT are related to the loss of hormones seen in HPTA shutdown. The drawbacks to enclomiphene are in the lack of long-term experience with this drug and the potential for blocking off-target estrogen receptors. However, you seem to have prodigious estrogenic activity, so you might even benefit from a modest reduction therein. If you go this route then I would encourage a low-and-slow approach to dosing.

busydad said:

I should have been clearer in my first post. I guess I expected more, especially when you read stories of folks feeling a night and day difference.

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Cataceous said:
It's challenging to give advice while the story is shifting. The return of morning erections is significant and suggests you should continue with the oral testosterone. You're unlikely to do much better with propionate, although you might enjoy a short-lived honeymoon period. With respect to mitigating the effects of high estradiol, oral testosterone substantially boosts DHT, which reduces estrogenic activity. You should also try to avoid more-is-better thinking. Necessary levels of testosterone for good sexual function are not all that high. Libido is very complex, and involves a lot more than testosterone. A modest level of testosterone is necessary, but not sufficient for good libido. In some cases too much testosterone is actually detrimental to libido, likely due to negative effects on other hormones and neurotransmitters. A lack of focus is even more nebulous, and may have little to do with testosterone.

busydad said:

These are my labs from September before starting the Oral-TRT. This is very similar to what my labs have always looked like. I have had "some" benefit from the Oral-TRT. I no longer have a midafternoon crash, and I've started to have morning erections again which I haven't had for years. I guess I expected my libido to come back, and to actually feel a difference in focus, etc. I'm 5' 11" and about 220 lbs. I'd like to lose another 15-20 lbs, but I don't believe that would really help my E2 much, as I've lost about 60 lbs. over the past 3 years and my E2 has barely budged.

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These are my labs from September before starting the Oral-TRT. This is very similar to what my labs have always looked like.


I already let you know that in order to know where your FT truly sits you would need to have it tested using the most accurate assay the gold standard Equilibrium Dialysis especially in cases of altered SHBG!

Finally out of all the previous labs you have posted in your other threads on the forum this is the only one where you used the most accurate assay to test the most critical blood marker free testosterone!






Reference range 5.25-20.7 ng/dL for healthy young natty males.

A top-end FT 20.7 ng/dL would be what we call those outliers!

This is a daily short-lived peak to boot!


Males (adult):

20-<25 years: 5.25-20.7 ng/dL

45-<50 years: 4.26-16.4 ng/dL






Even with a descent TT 489 ng/dL and highish SHBG 43.7 nmol/L your FT 12.1 ng/dL tested using the most accurate assay the gold standard Equilibrium Dialysis through Mayo Clinic is still healthy and far from low.

You have healthy LH/FSH levels to boot!

Your FT level does not even fall in what would be called the grey zone 5-9 ng/dL where some men may experience symptoms of low-T.

FT <5 ng/dL would be considerd low.

FT 5-9 ng/dL would be considered the grey zone where some men may experience symptoms of low-T.

FT 10-15 ng/dL would be healthy.

FT 20-25 ng/dL would be high-end/high!

Your mFT using the most accurate gold standard ED assay 12.1 ng/dL is healthy.

Most in the know would treat a man that has a FT 5-9 ng/dL (grey zone) territory along with symptoms of low-T.

Most of those run of the mill dime a dozen T-clinics would treat you in a heartbeat as many of them tend to push that more T is better mentality bulls**t!

Even in cases where one has a descent FT but not optimal so they say!

Top it all off that many of those run of the mill T-clinics, clueless doctors and so called TRT specialists do not even test free testosterone using the most accurate assays.

Many of them use/rely on the known to. be inaccurate direct immunoassay which tends to underestimate.

Look over the median mFT using a standardized state of the art ED assay for healthy young natty males age 18-29 yrs.

If anything your FT would be sitting at the mean of a healthy young natty male.

Those outliers hitting that short-lived daily peak FT 25.3 ng/dL would be those that fall in the 95th percentile!

Again this is a short-lived daily peak to boot!

Yes even if you jumped on T and pushed your FT level higher it is far from a given that it will fix your libido issues.




*Serum samples were analyzed from healthy men participating in the SIBLOS/SIBEX and EMAS studies, both population-based cohort studies

* mFT levels were measured in 867 men using ED LC-MS/MS as previously reported (1). Subsequently, 95% reference ranges were determined using the non-parametric method


Reference: 1. Fiers T, Wu F, Moghetti P, Vanderschueren D, Lapauw B, Kaufman JM. Reassessing Free-Testosterone Calculation by Liquid Chromatography–Tandem Mass Spectrometry Direct Equilibrium Dialysis. J Clin Endocrinol Metab. 2018;103(6). doi:10.1210/jc.2017-02360




We present 95% mFT age-stratified reference ranges. These reference ranges show an expected, decreasing trend of mFT with aging. Lower limits and median mFT decrease at a remarkably stable rate of, on average, 12% per decade up into the 6th decade of life. However, in the upper limit, a marked decrease of 25% occurs after 39 years, followed by smaller decreases of 6% per decade in older age categories.




Conclusion

We have determined mFT reference ranges in healthy men aged 18 to 69. These reference ranges are a first step to improving the framework for further development and integration of free testosterone measurements and calculations in clinical practice.