One Year of TRT - Input Welcome

Not sure if I should start a new post or try to bump this. I now have an extra year under my belt and its been an interesting ride. I could use some advice on next steps as I have struggled to find the right approach. Here is an update on my labs and what I've gone through. First of all I DON'T take an AI. I've never needed it. My testosterone does not seem to convert well to e2. My e2 remains low.

For most of 2017 I was on the following protocol. Overall. Decent experience. Much better than PreT. Ran into acne and some other minor side effects. But definitely not dialed in. Felt tired at times. Libido would go away, etc..

140mg Test CYP weekly
200 iu hcg twice per week
NO AI

Labs taken at trough
TT - 480 (300 - 1080)
FT - 95 (33 - 106)
E2 - 11


Labs taken one day after shot
TT - 1230 (300 - 1080)
FT - 109 (33 - 106)
E2 - 32

As you can see. Big swings here. And never really felt dialed in. So I switched to twice weekly shots, again.

Test Cyp: 70mg Sunday Morning and 70mg on Wednesday night
200iu hcg: Tuesday and Friday
NO AI


Trough:
TT - 466 (300 - 1080)
FT - 78 (33 - 106)
E2 - 12 (10 - 42)


Peak:
TT: 810 (264 - 916)
FT: 19.3 (8.7 - 25.1)
DHT : 52 (30 - 85)
E2: 17 (8 - 35)

Some other labs. These are very consistent and have had no major swings except for some lower movement with Vitamin D occasionally.
Sometimes the Vitamin D will lower to the high 20s. Tried supplementing but got heart palpitations and crazy side effects.
SHBG - 24 (11 - 80)
Cortisol 20 - (Morning blood test)
Vitamin D - 42 (20 - 50)
17OH Hydroprogestrone 286 - (45 - 203)
DHEA - 327 (80 - 560)




SO....here is where I'm at with this protocol. In general, pretty consistent morning wood. Decent libido consistently. Good energy. More or less I feel pretty good. BUT, about every three weeks I get a day or two of crazy symptoms that I believe are from low e2. Joint pain, insomnia (mainly can't sleep because my joints), no energy, fatigue is so bad I can barely get to work, no libido, brain fog, in general just brutally terrible. I had the symptoms when I had the blood draw for the peak on the E3.5D above. TT 810 and E2 17. Then I slowly get out of it and the next T show seems to help. Based on my SHBG you'd think that the twice per week shots would make sense. BUT, this crash that I get every few weeks is bad. HCG seems to have no impact on my e2. I'm wondering if I should up my test cyp dose? Or maybe should I do a higher dose and inject E5D. Like 120mg E5D? I am clearing the testosterone fast. Its not converting to e2 or dht for that matter. Whats strange is that my trough on the E3.5D and E7D is about the same but I only get the low e2 symptoms when I'm E3.5D. Most people on here have the opposite. I've scoured the web and these forums for hours and there don't seem to be many people that struggle with high t, low e2 WITHOUT an ai. I got some advice to up my dose and that seems to make sense. Then another guy mentioned lowering the dose. So i don't know. Would love some help. I feel like I'm close but just can't get there.

It's interesting that you said you were't able to take HCG for a week due to work, and you said that week was the best you had felt. Do you think HCG might be causing the inconsistency? I only ask because I realized my brain fog got increasingly worse when I started a new bottle of HCG recently. After my next blood draw in a week or so I'm going to try and cut out HCG for like a week or two and see if it has any positive effect on my brain fog/ well being.

Yeah, HCG has never given me the amazing well being that many talk about. I take to keep the testes from shriveling up. I'm going to drop that for 6 weeks and up my test cyp dose and see how that goes. I've learned all too well that each person is different. My low e2 is what I don't understand. I went back and looked at more labs last year and I had a trough reading of TT 412 and e2 7. No AI of course. Seems like everyone is trying to keep their e2 from going too high and I'm experiencing the opposite. I've heard trying DHEA or HCG to help boost e2. Neither worked for me. When I boosted my Hcg last year I got bad acne but still had the lowish e2. Didn't notice much difference with DHEA supplements.

Somedude as you probably know, estrogen follows testosterone. If you increase the amount of testosterone you're injecting and have higher numbers your E2 will also be higher. Personally I think your level of testosterone is just too low.

Your numbers look great ! How old are you? Any hair loss ?
This is something very important for everyone to remember though, no matter how good or how high your dosage is, you will always encounter some days where you may feel tired or have a low libido. I am quite certain that when each of us were 18 and had sky high T levels, we had experienced days where libido wasnt very high or we had low energy. No one, and i mean no one, has a high libido and great energy every day. Thats just not how life works.
you need to look at your “ overall improvement”. the big problem with T replacement is everyone gets overly hyper focused on T levels and how they feel. If your T levels are in a good range and you still feel tired all the time and still have no libido, guess what? Its not your T levels.

I agree with Vince, you need more testosterone. The reason you feel better on one large dose compared to twice weekly is the bigger shot increases your E2 whereas 2 smaller shots doesn't. Always get labs just before your injection. In your trough. Your trough numbers are simply too low. If HCG does nothing for you drop it and fine tune your testosterone level. You want to get your Free T towards at the top of the range in order to feel good. Because of your low E2 you may find one bigger shot per week is best. This is not an unusual protocol if you have low E2.

I’m in the same boat kind of. I want to see if dropping HCG will help with my brain fog, but I need it as well to prevent testicular atrophy as well as maintain a tiny bit of fertility if possible. My plan is to drop it for a couple weeks to see if I feel better without it, and then if I do notice a decrease in brain fog, I can maybe add it back in just at a much lower dose. Im hoping it’s just a dosage issue with me and HCG. Going by all ur updates u seem to have been feeling better when u lowered ur HCG. I’m hoping the same ends up happening for me. Cuz cutting HCG out all together just doesn’t seem like an option if testicular atrophy is a concern

Gman86 said:

I’m in the same boat kind of. I want to see if dropping HCG will help with my brain fog, but I need it as well to prevent testicular atrophy as well as maintain a tiny bit of fertility if possible. My plan is to drop it for a couple weeks to see if I feel better without it, and then if I do notice a decrease in brain fog, I can maybe add it back in just at a much lower dose. Im hoping it’s just a dosage issue with me and HCG. Going by all ur updates u seem to have been feeling better when u lowered ur HCG. I’m hoping the same ends up happening for me. Cuz cutting HCG out all together just doesn’t seem like an option if testicular atrophy is a concern

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Yeah, it might be worth a shot. How are your numbers? I'm going to drop the HCG and switch to the bigger weekly dose. I'm going to go 100mg test cyp E5D. I know my peak on 100mg is in the 1100 to 1200 range. That should raise my e2 and put me in a good spot. After dialing in the test cyp I'm going to take another look at HCG for the same reasons you have. I might try the small daily dose of 100iu and see how that works.

Thanks ratbag and vince! Yeah, thats my plan. Will run that for 6 weeks and see how I feel. Will report back.

I hear you, lexer. Definitely got into early trouble constant chasing numbers. In this case, its more than just a "bad day". I'm fine with those and they happen. When I get this "mini crash", my join pain on a scale of 1 to 10 is a 7. Not trying to whine but it makes getting through the day pretty difficult. Plus the insomnia which I think is me just being unable to sleep because the join point is so bad. And that is what I thought was strange. My numbers are great with just e2 slightly low and my trough tt pretty low. So I'm excreting pretty fast.

Hey all, I thought I'd report back. The last five weeks I upped my dose and dropped the HCG. I'm currently doing 80mg test cyp E3.5D. So 160mg for the week. I've had two tests:

The day after the shot:
TT: 910 (264 - 916)
FT: 21 (8.7 - 25.1)
E2: 19 (8 - 35)

The day of the next shot (but before the shot)
TT: 840
FT: 20
E2: 20

I'd say most people would be thrilled with these numbers. My numbers seem pretty consistent so I'm not getting the big spikes. However, here's where I'm at. Mild insomnia, sweating heavily throughout the day, literally could not get an erection for about 4 days straight, no libido, etc... I think its time to go back to the drawing board and at this time its clear that testosterone is not the only thing at play for me. I do find it strange how my e2 stays in the low mid range even without an AI. I'm not sure if that has something to do with this or not.

I will also mention that I take vyvanse. If I didnt have that I wouldn't be able to get through some days.

BTW - I'm 36

I will make one more comment.....I rarely see anyone complaining about gels or creams. Typically people arrive here when things are not working. I'm sure there are plenty that have had issues with gels as well but wondering if giving that a shot might help.

somedude said:

I will make one more comment.....I rarely see anyone complaining about gels or creams. Typically people arrive here when things are not working. I'm sure there are plenty that have had issues with gels as well but wondering if giving that a shot might help.

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couple of things, and I suck at typing so bear with err.

I have been running this race since Jan 2015. Andro Gel first, and after about 9 months I was feeling awesome, 99%. New DR is going to fix me, I should have run out of his office at that point, and starts me on clomid. Total failure. Weight gain, night sweats........ Dropped the douche bag, and back on Androgel March 16. July I was down 25 lbs, and felt great. Erections were off some, and I was at 1500T, looking back after finding this site and learning a lot, my E was probably through the roof also. New doc starts me on cream, only at a very low dose. Regain weight, low libido, soft wood, symptoms return. Over the next year and a half I repeated this 3 month cycle. Up dosage a little, feel great for a couple of weeks, crash and then wait for the end of the three months to come so we can test T and up dosage. Fast fwd 18 months, and I talk to a new doc my ART guy suggested. First visit she says double the cream dosage. Felt great, and we switched to 200mg C once a week. I had already been learning a couple of weeks by then from Excel, so I split my dose into E3.5D. I added Hcg, and around four weeks after starting. I am bloated, and I cant get rid of it no matter what I try. Woods good, but not great. I was trying to find my HCG dose, and was trying out different doses, that I see posted. Settled in on 150iu HCG, and 22+/- mg T daily injection for last four weeks.

I think you have a lower SHBG, it runs about the same place as mine. I have had some of the same symptons as you, not all though. Thus with a lower SHBG I switched to daily injections, if SHBG was higher it would require less frequent injections. After daily injections for weeks , wood gets bettor, but I am still bloated. I also need a nap in the afternoon. Last week I cut out my DHEA dose of 25mg 2xD, and after one week still bloated. Four days ago I cut out the HCG. It has a short half life so I figured any changes would be quick. It was. My bloat is down a lot. In three days I am down 5lbs in water weight. My erections are firmer, and I am starting to feel great. So, I am going to wait a month before trying HCG again, and see what happens.

Having said all that, and probably confusing the hell out of you .......

I agree with the others your T is to low, also try injecting more often.
Stay off the HCG for awhile.
Looking back I had the best success so far with Andro Gel. I am just an impatient bastard, and overdid it on my second go round with it. I do believe though that once I get the injection dialed in it will out shine the gel, but hey YMMV. I loved the Gel.

Hey blackebob, I can definitely relate. I might up the dose sightly and see if that helps. I might also try a gel. I'm a few months away from my next appt though. Do you have to do any sort of taper from the test cyp to gel? Or could you just take your last shot, what a week or so and then start the gels? I do IM injections. I'd definitely want to switch to sub q if went t daily or eod injections. Is there any special advice for sub q? The only reason I've hesitated going to sub q is that most people say that sub q can lower e2 and I don't want my e2 to go any lower.

I dont think 5/8" in my delt is sub q. lots of guys use insulin pins,
If you switch to gel I would start it on injection day. You dont have to crash to switch.

somedude said:

I will also mention that I take vyvanse. If I didnt have that I wouldn't be able to get through some days.

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And there you go, Vyvanse is known to destroy a guys erections. You have a choice to make, what's more important to you, erection and a sex life or concentration?

I chose a sex life.