Chasing the sweet spot

wemmington · May 31, 2016

You Gonna Learn Today said:
I have a question/idea about chasing that sweet spot, mostly all of us look to experience. Since I started TRT, I've only felt that feeling twice. The first time was when I first switched from 200mg TCyp every two weeks to 200mg once per week. But then I didn't feel it after the first 2 days. Then, after I switched to 100mg TCyp E3.5D, I felt it again. Again, though, only for about 2-3 days.

Since then, I've been chasing that same feeling and haven't been able to feel it again. It seems like I take one step forward then 2 steps back.

Anyhow, my question is, would it be a good idea to go get labs immediately when I'm feeling that spot again to see what my levels are at at that same moment then chase THAT number? Atleast doing it that way, I'm not chasing a magical number I don't know, I'm chasing that specific number.

Is that a feasible idea? Also, does anyone know if Defy is willing to order labs that same day or if it's possible to get labs taken with that short notice?

I also had a sweet spot for a couple days just after I started clomid and what you're talking about is exactly what I plan to do. I figure if I feel 100% and get labs the same day then I just need to aim for those numbers. If it doesn't work then i'm only out a few bucks for the labs. I want the sweet spot back!

You Gonna Learn Today · May 31, 2016

wemmington said:
I also had a sweet spot for a couple days just after I started clomid and what you're talking about is exactly what I plan to do. I figure if I feel 100% and get labs the same day then I just need to aim for those numbers. If it doesn't work then i'm only out a few bucks for the labs. I want the sweet spot back!

Yup, I'm with you on that one. I think it would be very interesting to see what my numbers look like at that very moment when I've got that SUPERMAN feeling. Again, I don't want anyone getting me wrong on this. I feel a LOT better now that I'm on TRT, but those special days were nothing short of amazing. I would love to get back to that same exact level again, though! That's definitely worth a few bucks to me, for sure!

CoastWatcher · May 31, 2016

You Gonna Learn Today said:
Yup, I'm with you on that one. I think it would be very interesting to see what my numbers look like at that very moment when I've got that SUPERMAN feeling. Again, I don't want anyone getting me wrong on this. I feel a LOT better now that I'm on TRT, but those special days were nothing short of amazing. I would love to get back to that same exact level again, though! That's definitely worth a few bucks to me, for sure!

Remember, in the early stages of TRT natural production of testosterone (even the little that a hypogonadal man may be producing) has yet to be fully shut down. There is a point that the exogenous testosterone and the body's natural/endogenous testosterone sync and create higher levels of testosterone, levels not felt in some time. After a prolonged period of hypogonadism, years in many cases, the patient feels an unexpected dopamine surge...pure bliss. But likely temporary. Natural production ceases and the dialing-in process gets underway.

On TRT I feel better than I have in years - I have consistent lab values. But it did take time to arrive there. It is worth it.

Dr Justin Saya MD · May 31, 2016

CoastWatcher said:
Remember, in the early stages of TRT natural production of testosterone (even the little that a hypogonadal man may be producing) has yet to be fully shut down. There is a point that the exogenous testosterone and the body's natural/endogenous testosterone sync and create higher levels of testosterone, levels not felt in some time. After a prolonged period of hypogonadism, years in many cases, the patient feels an unexpected dopamine surge...pure bliss. But likely temporary. Natural production ceases and the dialing-in process gets underway.

On TRT I feel better than I have in years - I have consistent lab values. But it did take time to arrive there. It is worth it.

Coast has it right...especially the DOPAMINE RUSH. I call it the Honeymoon period. Some patients have an exaggerated semi-euphoria during that initial phase. As the body REBALANCES itself (the body ALWAYS seeks homeostasis) including neurotransmitter levels, things usually "come back to earth".

However, as many have already stated, one should still end up long-term in a much better place physically and emotionally than when they were truly hypogonadal. Some guys have re-created the "Honeymoon" phase by discontinuing their TRT (intentionally or due to extraneous circumstances) for several months and then resuming. Obviously, for many reasons this wouldn't be an ideal approach for health nor quality of life purposes (in effect trading a few months of hypogonadal misery for a couple weeks of honeymoon).

PAUL-E · Jun 1, 2016

Maybe I was just lucky my honeymoon period was a few months if that's what it was. What are your thoughts on cabergoline as it is a dopamine agonist would it help or would the offsetting prolactin be counter productive?

ERO · Jun 1, 2016

Cabergoline is only warranted if your prolactin is well above the normal range. With prolactin, too low is as bad as being too high.

PAUL-E · Jun 1, 2016

Thanks I just found this https://www.excelmale.com/forum/showthread.php?4266-Cabergoline-kills-sex-drive

You Gonna Learn Today · Jun 1, 2016

Wow, this is further proof that many of us continue to learn more and more with responses such as those by CoastWatcher and Dr. Saya. I greatly appreciate your responses, along with the others as well.

TRT has definitely improved my quality of life to this point, but it sounds like my sweet spot/honeymoon period may not ever be reached again

. Feeling a million times better than before TRT, I will absolutely not stop and restart to feel the honeymoon period again. It was a great feeling, but definitely not worth feeling like crap like I used to before TRT and dealing with the emotional rollcoaster I was on.

Again, thanks everyone for your responses! I learned something new....again!

trt4me · Jun 1, 2016

DOPAMINE or simple test level?

Dr Justin Saya said:
Coast has it right...especially the DOPAMINE RUSH. I call it the Honeymoon period. Some patients have an exaggerated semi-euphoria during that initial phase. As the body REBALANCES itself (the body ALWAYS seeks homeostasis) including neurotransmitter levels, things usually "come back to earth".

However, as many have already stated, one should still end up long-term in a much better place physically and emotionally than when they were truly hypogonadal. Some guys have re-created the "Honeymoon" phase by discontinuing their TRT (intentionally or due to extraneous circumstances) for several months and then resuming. Obviously, for many reasons this wouldn't be an ideal approach for health nor quality of life purposes (in effect trading a few months of hypogonadal misery for a couple weeks of honeymoon).

I had thought this was simply from a high test level because when you first start trt your body is still producing and hasn't shut down yet thus giving you a high test level probably with a good e2 level as it may not have risen yet ? Also since the body is still producing LH there is also that.
Then I heard that it is the acceleration phase vs the actual levels.
Now I am reading DOPAMINE levels are the cause.

When I had this years back when I first started TRT, it was insane (libido,erections)for a few days, and my dreaded problem of low sensitivity was gone. Then of course gone.
While I wouldnt want to be like that all the time (sex 4 times a day) I'm surprised we haven't found how to just get closer to this.
I was off trt once for around 8 months and then starting again didn't have this amazing 3 days. That did surprise me.

Can DOPAMINE levels be tested and worked on reliably?

Dr Justin Saya MD · Jun 1, 2016

trt4me said:
I had thought this was simply from a high test level because when you first start trt your body is still producing and hasn't shut down yet thus giving you a high test level probably with a good e2 level as it may not have risen yet ? Also since the body is still producing LH there is also that.
Then I heard that it is the acceleration phase vs the actual levels.
Now I am reading DOPAMINE levels are the cause.

When I had this years back when I first started TRT, it was insane (libido,erections)for a few days, and my dreaded problem of low sensitivity was gone. Then of course gone.
While I wouldnt want to be like that all the time (sex 4 times a day) I'm surprised we haven't found how to just get closer to this.
I was off trt once for around 8 months and then starting again didn't have this amazing 3 days. That did surprise me.

Can DOPAMINE levels be tested and worked on reliably?

Dopamine levels can be tested, the problem is the test is checking PERIPHERAL dopamine levels (i.e. from a blood draw -> dopamine levels in the systemic circulation). However, where the dopamine REALLY matters is in the CNS (brain), specifically the neuronal synapses.

PAUL-E · Jun 1, 2016

Dr Justin Saya said:
Dopamine levels can be tested, the problem is the test is checking PERIPHERAL dopamine levels (i.e. from a blood draw -> dopamine levels in the systemic circulation). However, where the dopamine REALLY matters is in the CNS (brain), specifically the neuronal synapses.

Very interesting, so do you believe trial and error is sometimes the best option in certain cases?

Helboi · Jun 1, 2016

Dr Justin Saya said:
Coast has it right...especially the DOPAMINE RUSH. I call it the Honeymoon period. Some patients have an exaggerated semi-euphoria during that initial phase. As the body REBALANCES itself (the body ALWAYS seeks homeostasis) including neurotransmitter levels, things usually "come back to earth".

However, as many have already stated, one should still end up long-term in a much better place physically and emotionally than when they were truly hypogonadal.

This has absolutely been my experience. I definitely felt euphoric every time it was shot day when I started over a year ago with once a week shots. I'm now on every other day shots and I don't feel "shot day rush" anymore, just steady, solid equilibrium which for me IS euphoric compared to my life when I was hypogonadal. It's been incredible for the treatment of my mood disorders.

Dr Justin Saya MD · Jun 1, 2016

PAUL-E said:
Very interesting, so do you believe trial and error is sometimes the best option in certain cases?

I don't favor the term trial and error as it has an "experimental" vibe...however ADJUSTMENTS as a therapeutic trial are often informational and any "errors" are always useful information in and of themselves.

CoastWatcher · Jun 1, 2016

trt4me said:
I had thought this was simply from a high test level because when you first start trt your body is still producing and hasn't shut down yet thus giving you a high test level probably with a good e2 level as it may not have risen yet ? Also since the body is still producing LH there is also that.
Then I heard that it is the acceleration phase vs the actual levels.
Now I am reading DOPAMINE levels are the cause.

When I had this years back when I first started TRT, it was insane (libido,erections)for a few days, and my dreaded problem of low sensitivity was gone. Then of course gone.
While I wouldnt want to be like that all the time (sex 4 times a day) I'm surprised we haven't found how to just get closer to this.
I was off trt once for around 8 months and then starting again didn't have this amazing 3 days. That did surprise me.

Can DOPAMINE levels be tested and worked on reliably?

You are reading that the dopamine surge is the cause because it is - but your impression that the dopamine is resulting from exogenous and endogenous testosterone being present in a hypogonadal man at a reasonable level for the first time in a long time is correct. It is fleeting, however!

Here is a thread, started by Nelson, on dopamine and sex drive.

https://www.excelmale.com/forum/showthread.php?4079-Dopamine-Prolactin-and-Sex&highlight=Dopamine

PAUL-E · Jun 1, 2016

Dr Justin Saya said:
I don't favor the term trial and error as it has an "experimental" vibe...however ADJUSTMENTS as a therapeutic trial are often informational and any "errors" are always useful information in and of themselves.

That's one of the many reason you are a professional. When I first started learning more about HRT I thought this isn't so complicate but the more I learned the more I realized how complicated it is (at least for me) everything must be in balance to make a finely tuned symphony.

trt4me · Jun 1, 2016

Dr. Saya,
So is dopamine something you try to treat?

What is happening to dopamine in this case or trt: is it attaining a new level for a brief period of time and then regresses or does the body just become quickly desensitized to this new level?

I wonder if its both which might explain why i never got the same effect after being off trt for many months even though I was at baseline for some time.
I think there is alot to this as everyone knows that stress can kill sex so maybe people should pay more attention to this subject.

Dr Justin Saya MD · Jun 1, 2016

trt4me said:
Dr. Saya,
So is dopamine something you try to treat?

What is happening to dopamine in this case or trt: is it attaining a new level for a brief period of time and then regresses or does the body just become quickly desensitized to this new level?

I wonder if its both which might explain why i never got the same effect after being off trt for many months even though I was at baseline for some time.
I think there is alot to this as everyone knows that stress can kill sex so maybe people should pay more attention to this subject.

The two BIGGEST libido killers even for guys on TRT are...stress and poor sleep, which not coincidentally often go hand-in-hand.

I wouldn't go as far as the body becoming "desensitized" to dopamine, but maintaining elevated levels (endogenously) is often not sustainable due to the constant re-balancing (read "homeostasis-seeking").

For some interesting insight on dopamine, go do some reading on porn-induced ED.

HarryCat · Jun 1, 2016

Helboi said:
This has absolutely been my experience. I definitely felt euphoric every time it was shot day when I started over a year ago with once a week shots. I'm now on every other day shots and I don't feel "shot day rush" anymore, just steady, solid equilibrium which for me IS euphoric compared to my life when I was hypogonadal. It's been incredible for the treatment of my mood disorders.

I was seeing an endo once who said he had some patients who actually preferred an every 2 week injection schedule because of the euphoric rush they would get after an injection. To each his own I guess.

trt4me · Jun 2, 2016

agree

Dr Justin Saya said:
The two BIGGEST libido killers even for guys on TRT are...stress and poor sleep, which not coincidentally often go hand-in-hand.

I wouldn't go as far as the body becoming "desensitized" to dopamine, but maintaining elevated levels (endogenously) is often not sustainable due to the constant re-balancing (read "homeostasis-seeking").

For some interesting insight on dopamine, go do some reading on porn-induced ED.

I couldn't agree with you more on stress and sleep, which are my worst two areas and yes one feeds the other and becomes a cycle.
I know about the porn thing and its obvious when the brain is expecting certain imagery and doesn't get it, it basically says "ill wait for it" .

So I assume that you would would agree that dopamine is best managed through lifestyle choices rather than trying to find a number?

It would be great to see some rough percentages of men you treat for sexual issues and what the solution ended up being in the end for you. Like an order of precedence on what to correct.
something like:
libido loss 75% sleep and stress
erection 50% trt and so on

Thanks for all your replies on these forums, (im already a patient) but its amazing how defy and your associates can be so far ahead of the local drs including endos

Vince Carter · Jun 2, 2016

HarryCat said:
I was seeing an endo once who said he had some patients who actually preferred an every 2 week injection schedule because of the euphoric rush they would get after an injection. To each his own I guess.

Im sure they were getting 200mg which of course has some kind of rush to it but then the crash from 7-14 days is probably brutal, too.

Chasing the sweet spot

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