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Which alternative source for topical DHT do you suggest? There aren't exactly a plethora of options. That's the only product I'm aware of that has reliably worked for everyone who used it (including myself and RL friends). 100% DMSO would explain the skin rape though.

If continuous glucose monitors are available over-the-counter where you live, you should wear one for some time. If they aren't available OTC, see if your doctor will prescribe one for you. The minute to minute biofeedback on your glucose levels is invaluable for someone seeking to improve their...

If you liked the results of keto but not the effort involved, I would suggest carnivore is much easier. Twice a day, I throw a salted piece of meat into an air fryer. It cooks for 10-15 min, I put it on a plate, add some fat to correct protein/fat ratio if necessary, done. Perfect metabolic...

New doctor (either local or telemedicine TRT clinic) or go UGL.

Yes, 100% do this. I missed this in the initial post.

This is the type of lower fat, high refined carb, pseudo-healthy diet that most Americans are eating, resulting in 50% of the population being either prediabetic or diabetic. This is the direction you are also heading, unless you make significant course corrections. The ED you are dealing with...

I think you are focused too narrowly on the particulars of your protocol and need to investigate the root cause of your excessive aromatization. Your HDL and triglycerides are abysmal and suggest serious metabolic dysfunction. Insulin strongly promotes the expression of aromatase enzyme. Excess...

Looks like hypogonadal estradiol, which aligns with your symptoms, and which would cause the pituitary to release more LH as it tries to raise estadiol. Testosterone is actually pretty good, but you aren't aromatizing enough. If you want to stay natural and just do something OTC to bump up E2...

Skin becomes inflamed, feels irritated to the touch and breaks out with acne. Fasting glucose, fasting insulin, HbA1c, lipid panel (watch triglyceride:HDL ratio), uric acid (driven up by fructose, both a marker for and cause of metabolic dysfunction), and ALT / AST / GGT (screen for liver harm...

That is overcomplicating things - there is no need. Any change in the T/E2 ratio that occurs when you reduce dose will be minor and very temporary. You'll just throw everything more out of wack by introducing an AI.

I'm sure I would if I bothered to share that. I find doctors totally useless at solving anything there isn't a well known treatment algorithm for, so I see no value in discussing it. You would have better luck with ChatGPT at this point if you want creative medical problem solving.

This is confirmation of what I'm saying here, that OSA is really the larger factor, more so than the testosterone. So, if you want to run more testosterone, attack the OSA harder. And if you want more consistent levels, it is my opinion you'll get that with IM.

I would think E3.5D with IM is going to have peaks large enough to make a significant negative difference. I would not make that move while struggling with hematocrit. How are you tracking the effectiveness of your OSA treatment? I bet there is room for improvement. This is likely the real...

I personally find EOD IM with long esters to be a great compromise of stability and side effect management without having to poke yourself every day. I would be surprised if there were any substantial hematocrit difference between daily SC and EOD IM with cypionate at equivalent doses. Your...

May I suggest injecting into the muscle instead? You may be like many of us, where your subcutaneous tissue is like a black hole that mysteriously makes testosterone disappear.

Probably needs to drop more to make a significant difference in both numbers and symptoms. I would drop 20 mg to 130 mg.

I wouldn't run this experiment personally because I know the seed oil diet causes obvious problems for me. Oxidized LDL might be more sensitive as a marker for this. My most recent hs-CRP is 0.27 mg/L and oxidized LDL is 30 ng/mL on carnivore diet.

I would test one more time to make sure there wasn't a lab error or something. If your testosterone comes back low again, take more. Your first set of labs was quite high for your dose anyway, it would be the second result that makes more sense IMO.

Can you tell us more about your injection method / site / depth? Same vial of test used in both cases?

My overall function still isn't great, but I have had flashes or windows of major improvement, particularly lately while experimenting with adding hCG to my TRT. I'm working on dialing in the combination.

The seed oils your restaurant meals are cooked in are still doing damage even if things look good on the surface. Try a month of home cooked meals, then a month eating out, testing hs-CRP, oxidized LDL, and myeloperoxidase at the end of each month to assess the CVD risks of each lifestyle pattern.

Yes it did.

Some of them disappear, yes. Tolerance builds to the stimulant effects, and associated side effects, including anxiety, fast heart rate, insomnia, etc. Dose-limiting side effects for me have been cognitive impairment with high doses of prop (20+ mg), particularly in the middle of the workday...

I was like this when I first started: a dose of 10 mg prop would nearly cause me a panic attack. Something has changed over time, and it does not affect me like that anymore, even with much larger doses. I can take 30 mg now and only feel a mild uplift of energy and mood. I suspect you would...

Hikma testosterone enanthate is great stuff. When I first started TRT, it was actually the only formulation that I could tolerate well. Over time, I have somehow become more normal and am able to use a variety of formulations. It still holds a fond place in my heart, and we continue to use it...

There is not academically rigorous evidence, but there is overwhelming evidence. Literally overwhelming, in that if I summoned to this thread everyone on just this forum alone who has reported this phenomenon, you will have too many responses to manage. Let alone if I were to take the time to...

I think this is the key to the lower testosterone levels often seen with SC injections. The testosterone is being exposed to a ton of immune cells in the lymphatic system before it is able to reach circulation. It may be eaten by macrophages (either receptor mediated uptake or phagocytosis)...

As many of us have learned the hard way, the reality of subcutaneous injections is often quite different than the rosy picture painted by the studies.

Looks like another DHEA casualty.

No, absolutely not:

Everyone is started on 600 mg, with the option to increase to 800 mg. If you wanted to start at 400 mg, that is something you could work out with your Maximus provider. The effective dosage can also be adjusted by varying the amount of co-ingested fat. For example, 600 mg taken with 20-30 g...