Advice on sustanon protocol and libido

Can anyone offer some advice on my protocol please. Aside from low T otherwise fit and healthy late 30s male.

Lab values below are from sustanon 250 @ 125mg per week split into 2 doses (62.5mg Mon and Thu). Bloods were drawn on a Monday morning before injection.

Testosterone - 19 (7.60 – 31.40)
Fee testosterone (calculated) - 0.597 (0.30 – 1.00)
17-beta oestradiol - 91.8 (0.00 – 191.99)
SHBG - 18.4 (16.00 – 55.00)
Prolactin* - 334 (86.00 – 324.00)

I have also used hCG M/W/F from 100-150ius, but had not taken hCG prior to these blood tests.

E2 test is not sensitive assay (not available).

Problems at this dosage were lowish energy but mainly low libido and low EQ. I am trying a few supplements for the prolactin, but looking for any other advice on changes I could make to improve sexual effects. Should I increase T &/or hCG dosage, or is there something else you would recommend?

Thanks for any help.

With an SHBG as low as this you might benefit from more frequent injections

Low SHBG guys tend to not hold on to their testosterone well and benefit from more frequent injections, your SHBG is the same as mine and I seemed to start benefiting greatly injecting more frequently. This is when libido and erections started for me.

It could be that you just haven't been on TRT long enough yet, it can take many months to a year or more to feel the full effect of TRT.

Your E2 is likely lower do to female E2 test, you could use a dosage increase.

How long have you been on TRT?

I’ve been on TRT for just under a year and results have been inconsistent, pretty up and down with how I feel but it’s only been recently (last 2-3 months) I’ve had any trouble with sexual issues.

My doctor has said I’m ok to increase dose if I want to.

I would prefer not to have to have to increase frequency just because the sustanon comes in the single use amps so splitting it properly is awkward but I can always backfill some insulin syringes. I guess with my shbg that’s what I might be better doing.

Lots of guys have thyroid issues and TRT requires optimal thyroid hormones to work, TRT attempts to restore metabolic rates and if thyroid can't keep up you feel mediocre.

It could be that your dosage just isn't enough for your biology, your levels are mediocre. State healthcare systems will likely not run these tests do to costs involved, you have a battle on your hands.

Your doctor is failing to act based on the levels you're hitting, suggests he's clueless. He should be taking charge of your treatment and is instead delegating to you, "would you like a dosage increase". He likely doesn't have the knowledge to balance your hormones if he's perfectly alright with mediocre levels. Terrible!

We see this all the time, most doctors struggle with understanding TRT and the lack of action is telling.

Not having access to proper E2 testing is a huge disadvantage! We have no idea where your E2 levels are and that could be the problem. E2 levels are probably low, dosage increase is your best move.

Test:
1. TSH
2. Free T3
3. Reverse T3
4. Free T4
5. Antibodies

Systemlord, you are right. Getting good medical care for something like this is hard battle, I'm just doing my best to work with what I've got.

The only thyroid labs I have are below. None of the doctors I've seen on this journey have been interested in discussing my thyroid, they all said it's fine.

FREE T3 - 5.22 pmol/L (3.10 - 6.80)
FREE THYROXINE - 14.4 pmol/L (12.00 - 22.00)
THYROID STIMULATING HORMONE - 2.77 mIU/L (0.27 - 4.20)

I'm thinking of increasing my sustanon dose to 50mg EOD for 175mg per week average, but if anyone has any other suggestions I'd love to hear them.

Is hCG dosing similar to testosterone in low SHBG men, in that with low SHBG smaller, more frequent shots are better?

For low shbg guys, most do better with frequent injections. Many do daily injections using an Easy touch 29g 1/2" or a 27g 1/2" syringe doing shallow IM or Sub-Q injections.

You honestly have one of the lowest SHBG levels I've ever seen. Ya you should be on EOD injections minimum. The body does much better with less fluctuations. ED would probably be best for someone with such a low SHBG, but due to inconvenience, EOD should be ok if u can't do ED

I believe you will burn through HCG just as fast, but not 100% sure. Either way Dr. Crisler seems to swear by daily HCG injections. Me personally, have always had a lot of success with EOD as far as HCG goes. So EOD with both Test and HCG should be a good protocol to try next. I also don't think you would need to even increase dosage if u went to EOD. You'd probably find your numbers on the high end of normal during your next blood test while on EOD at 125mg/ week. And if HCG is part of your protocol, no sense of stopping it before the blood test

Have to remember he's using Sustanon and not CYP so some of the usual ^ advice isn't going to play for MDF.

His E is probably too high for his SHBG.

Thanks for the comments everyone.

I know my SHBG is low but I was under the impression it wouldn't be considered 'super-low' as it's still inside the reference range, and I've seen posts from guys with single-digit numbers. Those things made me think mine was more low-normal. But perhaps not.

Vince, thanks for chiming in. I'm really intrigued by your comments. Would you mind expanding please? Are you saying sustanon isn't suitable for high-frequency dosing? If not, are you able to suggest what schedule might be better?

While I was doing some reading I came across this thread where member maxadvance said he got good results with sustanon on twice per week (higher dose than mine) with lower SHBG than me. Now I don't know what to think is best with regards to frequency in my situation.

MDF said:

Thanks for the comments everyone.

I know my SHBG is low but I was under the impression it wouldn't be considered 'super-low' as it's still inside the reference range, and I've seen posts from guys with single-digit numbers. Those things made me think mine was more low-normal. But perhaps not.

Vince, thanks for chiming in. I'm really intrigued by your comments. Would you mind expanding please? Are you saying sustanon isn't suitable for high-frequency dosing? If not, are you able to suggest what schedule might be better?

While I was doing some reading I came across this thread where member maxadvance said he got good results with sustanon on twice per week (higher dose than mine) with lower SHBG than me. Now I don't know what to think is best with regards to frequency in my situation.

Click to expand...

I was reminding those that are chiming in that they're talking about Cyp and that use of Sustanon is different than what we have experience with. You probably do need a more frequent injection schedule I'm just unsure how to extrapolate the Cyp that we use to your use of Sustanon. If maxadavance has some experience you might PM him and see how that's working for him.

Vince Carter said:

I was reminding those that are chiming in that they're talking about Cyp and that use of Sustanon is different than what we have experience with. You probably do need a more frequent injection schedule I'm just unsure how to extrapolate the Cyp that we use to your use of Sustanon. If maxadavance has some experience you might PM him and see how that's working for him.

Click to expand...

Got it. Thank you.
Can't PM yet, not enough posts.

Update:

Since posting this thread I have started smaller, more frequent injections. For just over a week I have been on the following:

30mg sustanon EOD (105/wk)
100iu hCG daily

Felt some improvements pretty much straight away. Energy and mood up and consistent. Erections and libido good as well.

Yesterday was about day 9 and felt pretty tired all day and sexual function seemed to drop off as well, but I was a bit short on sleep which might have contributed. Back feeling more alert again today but lacking downstairs still.

Too early to make any assumptions I guess but all comments welcome. Thanks.

MDF said:

Update:

Since posting this thread I have started smaller, more frequent injections. For just over a week I have been on the following:

30mg sustanon EOD (105/wk)
100iu hCG daily

Felt some improvements pretty much straight away. Energy and mood up and consistent. Erections and libido good as well.

Yesterday was about day 9 and felt pretty tired all day and sexual function seemed to drop off as well, but I was a bit short on sleep which might have contributed. Back feeling more alert again today but lacking downstairs still.

Too early to make any assumptions I guess but all comments welcome. Thanks.

Click to expand...

Tell us how you feel in 5 weeks, it takes 4-6 weeks for bloods to stabilize.

Systemlord said:

Tell us how you feel in 5 weeks, it takes 4-6 weeks for bloods to stabilize.

Click to expand...

Yes, going to stick with T dosage for next 4-5 weeks then assess again. I'm thinking of pulling the hCG back to EOD though, I think 100 every day might be too much for me.

Sorry to bump this ol thread. But how are u doing mdf? What protocol are u on now?

Abuser200 said:

Sorry to bump this ol thread. But how are u doing mdf? What protocol are u on now?

Click to expand...

Last seen May 30, 2018. Hopefully he'll get an email and respond.