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Okay. Noted.

You're obsessing over E2 results that you don't even have yet. The liver is not the sole source of aromatization.

https://academic.oup.com/jcem/article/91/11/4669/2656842/Differences-in-the-Apparent-Metabolic-Clearance Clearance of testosterone decreases as SHBG increases. Free hormone hypothesis vs free hormone transport hypothesis. It's easier to understand the free hormone hypothesis, which is why...

Yeah man, I understand where you're coming from, but chronic pain, stress, opiates, and anastrozole are probably the world's biggest libido killers with only Mom's voice being more effective at killing libido. Dopamine Desensitization is broscience speculation without any real sources...

I'd say your E2 is crashed. You strike me as a low E2 guy, and you're on 3 MILLIGRAMS OF ANASTROZOLE PER WEEK. That is an ENORMOUS dose. Period. The other problem is that you're on vicodin, xyrem, and monstrous doses of AI. I assume the xyrem is because you have Narcolepsy, so you're never...

So you have labs done months apart, and you think the change in labs is what caused the differences? You'll need to add more details, time taken relative to injection, protocol, lab ranges, and your other labs. Roche is the standard test, which is not intended for men. If your E2 is <6...

"Within range" is the same as normal, it tells us nothing. I'm not sure what you're asking us to do here really.

I seriously can't stop laughing at this. I mean, wow. OP, you're expecting things to happen WAY too quickly. There's a delay between when you make a change and when you feel it's benefits. E2 is a steroid hormone that binds to nuclear receptors. It takes TIME to work. I agree with Vince...

Levels from years ago mean nothing now, and get out of the habit of using the word "normal" when referring to lab tests, there isn't a more useless word when it comes to labs. I doubt this is from TRT. Platelets, I am not sure about. Get your "normal" B12 and folate levels tested again.

Give Defy a call. I know that prime body is about $200 a month so you're already paying for your care. They'll explain what's needed and such. I use them, and a lot of others on here do as well.

Post the rest of your labs. Looks like macrocytosis without anemia, or with, not really enough info to tell. Do you drink alcohol? You should get your B12 and folate levels checked. Both deficiencies can cause this.

You can do that here as far as I know. If the moderators feel it's appropriate they'll move it.

I legitimately laughed out loud. Spot on. So few words.

Morning erections can be improved from the rapid acting vasodilatory proprieties of testosterone. Anything else is placebo. My personal theory is that a lot of guys experience a placebo effect improving mood right away from the sheer power of injecting, that tapers off before the actual...

If your doctor believes that hCG can be used for weight loss, you're going to the wrong doctor.

I remember reading about testosterone having an affect on TBG and CBG possibly down regulating it. So while not directly I do think it has an indirect effect on other hormone systems. Plus testosterone is purported to act as a corticosteroid receptor antagonist.

If your labs are recent, there's no need to reorder the ones you already have. I believe it's under 2 months for them to accept.

I only asked about primary. I agree with you on everything else.

Would you say it's still inappropriate even if the guy has profound primary hypogonadism? If so that's rather restrictive.

It's all going to depend on your labs, total testosterone is like knowing someone's weight. If I'm 150lbs, am I healthy? Depends if I'm 5'8 or 6'5. Clomid is going to be strongly pushed due to your age and because you want to maintain fertility, there really isn't a better option for someone...

So you had face flushing just once and it was after eating a large meal? What did you eat? Was it spicy? Did you have alcohol? Everyone gets flushed from time to time, and guys will attribute anything and everything to TRT, but if this is the FIRST time in 4 months that you've had flushing...

I don't think clomid would be a great idea for you, for a few reasons. LH is mid range with total testosterone fairly low(really low when you consider that your high SHBG is artificially inflating your total testosterone level) and your SHBG is fairly high and clomid will only increase this...

You... just used cosmopolitan as a source?

He has said that he does it when all else fails. That's from memory though.

I love the "oh and by the way I'm on methadone, oxycontin, and amphetamines". You don't think that had any relevance?

It might say it was reran for verification or the doctor didn't forward the results right when they received them.

Tuesdays and Thursdays.

If low testosterone is the sole cause of ED it will help significantly. The thing is though, most guys posting on here have other medical conditions or medications contributing to ED that they aren't mentioning. They attribute their ED to low test and expect TRT to fix everything.

I wouldn't recommend having E2 ran on its own. It'll be less interpretable than if you have total and free ran with it, because say E2 is super low, is that because you're a low aromatizer? Or because testosterone suddenly dropped? Each will have different meanings. With just E2 on its own...

Have you had E2 tested? I assume not. E2 and SHBG will be your most likely causes. Free testosterone tests aren't the best for reliability.

SHBG is a transport protein. It shuttles testosterone around to the places it needs to be, not just binds testosterone up making it useless. There is the free hormone hypothesis vs the free hormone transport hypothesis which is exactly what you just said, is free testosterone the only hormone...