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DHEA can raise it somewhat. The most reliable method is to supplement E2 directly though, crazy as it sounds. Your clinic will almost certainly help if you want to go that route, or you can procure it yourself from sources that cater to the trans market: Home - DIYHRT.Market I like injections...

Just to be clear, I'm not advocating for abnormally high estradiol levels. When I was talking about honesty around trade-offs, I meant being clear-eyed about the likely damage of inhibiting aromatase. Some people have the idea that if you modestly and carefully inhibit aromatase, just the...

Friends don't let friends start with subq. https://www.amazon.com/dp/B0CXF7V7BV 5/8" into the delt, ventroglute or quad. Lower dose isn't a bad idea either if your initial reaction is so unpleasant.

That's totally fair, as long as we are being honest about the tradeoffs we're making.

Please give this one a watch, and then tell me, in what scenario outside of possibly ER+ breast cancer are you going to improve anyone's health (man or woman) by inhibiting aromatase (even a little bit)?

Yes, that sounds plausible that it could, but inhibiting aromatase will not optimize for libido or health if these are important goals.

I don't understand how anastrozole brain penetration is relevant to our discussion, which has not been focused at all on anastrozole. What point were you trying to make? This approach to TRT protocol design is meant to optimize sexual function, not anabolism / body composition. Much higher...

In my case, and with my current SHBG of high 30's (as critical for context when interpreting E2 as it is for T), I think that translates to an e2 of less than 40. You don't actually need any labwork to determine that though. You would simply start with hCG at a target dose, start with...

Berberine is very similar to metformin in its metabolic effects. I think it's reasonable to start with berberine and see how you do with that. I would probably experiment with metformin also at some point to compare effects and tolerability if you'll be using one of these long-term. With...

Dr. Anawalt won handily. Dr. Handelman's fixation on difficulties with measuring free testosterone did nothing to dispute the validity of the free hormone hypothesis. He had no answer to the numerous human epidemiologic studies which support it.

Yes, but the negative feedback from oral native testosterone is minimal to begin with. We have internal data showing, on average, men's LH only dropped by 0.8 IU/L (non-significant and within margin of error) when using a single 600 mg dose of native oral T daily. Yes, it certainly is, unless...

Very interesting result with the test suspension results. I think there are a percentage of men that do maintain long-term libido on testosterone alone, another group that maintains it long-term with hCG, and I would imagine the fraction that cannot maintain libido despite the combination is...

Mine is also like this (lower end FT4, midrange FT3) and past experiments with supplementing thyroid hormone only made me feel worse. Knowing what I know now, I never would have messed with it at all.

These are not good. You are right on the line of metabolic syndrome with these values (HDL <= 40 and Triglycerides >= 150 is the cutoff), and the Trig/HDL ratio of 3.4 is associated with significantly elevated CVD risk, regardless of your LDL. We had a great discussion on this in a recent...

This, because free T3 is what matters. It would be analogous to supplementing testosterone when your total testosterone is on the low side, even though your free testosterone was at a good level. You don't want high or "optimal" levels of thyroid hormone either - this is associated with a...

I love that you did this experiment and wrote up all of the details for us. Very puzzling results though!

Cortex released a video on this concept of using hCG and DHEA as the foundation of a protocol and then tailoring testosterone dose around that: I have kept going back and forth with hCG myself. I've noticed, now that I have some Janoshik-verified potent hCG (eutrig), if I take 250 iu EOD...

Fasting insulin and lipid panel (HDL and triglycerides specifically). Many of us had sleep issues in the beginning, and water retention is pretty much a given. Most or all of the water retention disappears eventually as you adapt to the new levels. You will certainly be able to find a dose...

That's your fasting glucose, not fasting insulin. You want to see your fasting insulin to determine whether you have insulin resistance. Your lipid panel has some big clues also, between HDL, triglycerides, and their ratio. Insulin resistant men often have a rough time on TRT. They aromatize...

Do you recall what it was?

These free T numbers you are reporting are bogus - likely labcorp direct free T if I had to guess. Your real free T (vermeulen calculation) with 100 mg was 21.8 ng/dL assuming 4.3 albumin, which is a very reasonable level for men on TRT. You have a high SHBG, so this reasonable free T is...

True, but importantly, there's not even a hint in these 20+ studies that looked at effects of TRT on cognition that the lack of GnRH is causing cognitive deficits either. Some trends in that direction would be very persuasive in terms of convincing me to take this GnRH issue seriously. There...

This is quite plausible. Your absolute level of E2 is low, the ratio of T & DHT / E2 is very high, and you have enclomiphene antagonizing estrogen receptors on top of that. I would rather take less of something in this situation than add another compound to increase estradiol. Reducing the...

I've actually been on test cyp for the last couple months and it's working fine for me. 35 mg EOD.

Ran into this article today on CGM benefits in early type 2 diabetes (see attached).

Great suggestions from Guided above. The Clot Thickens is a must read. Chromium can be effective, but can also cause major insomnia in some; watch for that. Time restricted eating, definitely. Avoid seed oils, definitely. Absolutely agree. He actually provided a fasting insulin level in his...

In my opinion, it's more helpful to think about specific target levels, independent of reference ranges, which vary widely from lab to lab. You'll test total testosterone, and you'll need it (together with SHBG) to calculate free testosterone, but free testosterone is where the rubber meets the...

The following review discusses the findings of over 20 studies that investigated the effects of TRT on cognition, in both healthy men, and men with Alzheimer's or other forms of cognitive decline. We might expect worsened cognition if the lack of GnRH is impactful, or an acceleration of...

It sounds reasonable, and might be helpful in some cases.

One more thought I had about GnRH: humans pre-puberty have little/no GnRH secretion, and with varying age of puberty, some will have spent more or less years of their life in this low GnRH state. If the absence of GnRH is harmful then, we might expect later puberty to correlate with increased...

Testosterone with no ester attached.