10 Years on TRT and Only Recent Libido Issues

[wes6363]

Hello All,
First, thank you all for you knowledge throughout the years, it has certainly helped. I have used this forum often in the past for questions on topics and I appreciate it. I have never had to post as most of the answers were located in the threads on here, so I will try to make this short for review.

Backstory- Have been on TRT due to cancer since 2015, with generally decent results overall. Over the past 8-12 months, I have been having extreme libido issues, as in zero libido. Protocol was 0.2mL (200mg/mL) every 3 days, which usually put me in the 800-850 TT range (and has been for the past 6 years or so). Labs looked good, so I thought, maybe I need to increase my dose. Doc put me on 0.3mL (200 mg/mL) twice a week, or 0.6mL a week. Unfortunately no change, besides maybe some better gym gains. Other symptoms- motivation slightly less and not quite as much energy. Performance from an intimacy aspect not really an issue, just the drive. Upcoming endo appointment in June.

Supplements- L-Dopa (recent), L-Tyrosine (recent), MV, calcium, DIM (recent). Started the L-Dopa & Tyro as I thought maybe a dopamine issue. No changes but some more energy. No other meds that cause libido side effects.

Rule out- I have tried to rule out everything possible, both with the help of docs and ordering labs myself. Saw a psych and sex therapist just in case, nothing that they could identify. I also do not drink, smoke or anything else recreational. Lifestyle wise, no issues or abnormal stressors and I workout 3-4 times a week.

Labs- These are all recent labs, within the past 30 days.
CBC- all normal
CMP- all normal
Lipid- HDL a little low at 34 and LDL a little high
A1C- 5.3 normal
Total T- 1265
Free T- 27.1 (8.7-25.1)
SHBG- 38.4 (16.5-55.9)
E2- 25 (11-44) 4/8/25
DHEA- 203 (89-427)
FT3/FT4/TSH- normal
PSA- normal
Cortisol Random- 10.6 (no ref)
Prolactin- 8.0 (4.0-26)
IFG1- 164 (72-228)
HGH- 3.82 (<2.47)

That's where I am so far and completely stumped. Besides libido, I overall feel well, but I have no idea why it just gradually disappeared. I'm also curious why my HGH would be elevated, but maybe it was random. I looked through other discussions and felt like this one was different, so I apologize if it seems repetitive to another. Open to any suggestions or ideas that y'all may have. Thanks in advance.

 

[Systemlord]

Your E2 is low in relation to your testosterone. I wouldn’t expect your endo to be very helpful.

You need to get that estrogen level up.

 

[Belekas]

Personally would never use DIM and would be very very careful with Calcium as it needs proper D3 and K2 dose to balance things out else you might be driving all that calcium to wrong areas think atherosclerosis. Also needs a lot more cofactors and proper testing and knowledge to be able to understand and manage all this. Also when you have so many moving parts and esp new ones, figuring out whats happening is next to impossible. Less is more esp when fucking with your own dopamine levels that might mess you up big time and for longer. Usually these experiments go full circle and never yield much long-term benefits if you know what I mean.

 

[SS1LE]

Personally would never use DIM and would be very very careful with Calcium as it needs proper D3 and K2 dose to balance things out else you might be driving all that calcium to wrong areas think atherosclerosis. Also needs a lot more cofactors and proper testing and knowledge to be able to understand and manage all this. Also when you have so many moving parts and esp new ones, figuring out whats happening is next to impossible. Less is more esp when fucking with your own dopamine levels that might mess you up big time and for longer. Usually these experiments go full circle and never yield much long-term benefits if you know what I mean.

Agree here, don't try messing dopamine. My buddy started using those zyn nicotine pouches for a dopamine boost well after a year he decided to quit because he had to use more and more for a benefit. After quitting he had minor depression, fatigue, no libido....took about 5-6 months to level back out. Granted nicotine is stronger on the dopamine pathways than supplements, just be very cautious. Also agree with systemlord, maybe try boosting E2, with some low dose DHEA maybe 10mg daily or very low dose HCG. you don't want to overshoot E2. Also don't try the cabergoline or pramipexole as suggested your prolactin is already low.

 

[Willyt]

Protocol was 0.2mL (200mg/mL) every 3 days, which usually put me in the 800-850 TT range (and has been for the past 6 years or so). Labs looked good, so I thought, maybe I need to increase my dose. Doc put me on 0.3mL (200 mg/mL) twice a week, or 0.6mL a week.

The libido issues started on your old protocol? Increasing the dose to supraphysiologic levels never seems to work and can even make it worse.

 

[Vince]

I also have been on TRT for 10 plus years. My libido and orgasms are still very strong. I do inject 500 iu of HCG every third day.

 

[Seagal]

Rule out overtraining: 1-2 weeks no weight training.

 

[wes6363]

Personally would never use DIM and would be very very careful with Calcium as it needs proper D3 and K2 dose to balance things out else you might be driving all that calcium to wrong areas think atherosclerosis. Also needs a lot more cofactors and proper testing and knowledge to be able to understand and manage all this. Also when you have so many moving parts and esp new ones, figuring out whats happening is next to impossible. Less is more esp when fucking with your own dopamine levels that might mess you up big time and for longer. Usually these experiments go full circle and never yield much long-term benefits if you know what I mean.

Thank you. My last provider suggested the DIM with the new regimen. I can’t say I’ve noticed any difference, but less is more is a good point.

@SS1LE @Systemlord yeah the dopamine was a last ditch effort that I started a month ago. I’ve been doing 5 days on, 2 off. To Belekas’ point as well, I’ll ween off so there isn’t as much going on. I do have an AI on hand, but only take PRN (around 0.5mg arimidex every 4-6 weeks). I imagine my E2 is a little higher since I had that one done a couple of weeks ago.

@Willyt symptoms started around 8-12 months ago on the old protocol and has progressively declined. I started the new protocol 2 months ago or so.

@Vince My PCP does the TRT, so I doubt they’ll give me hCG. She wasn’t sure what to do and referred me to endo, which I don’t think will be a big help either.

@Seagal admittedly, definitely don’t train that hard, although I’d like to say I do lol. I did just take a week off though about 3 weeks ago.

I’ve had low and high E2 several times throughout my TRT journey. This time is just weird to have absolutely no drive. And no symptoms of irritability, emotional, etc. I’ll ween off the unneeded supplements asap.

 

[Vince]

C

Thread 'Experience with HCG from Reliable Rx?'

Feb 18, 2022

Hey guys,

I ordered and received two vials of HCG from reliable. Can anyone share their experiences or vouch for the legitimacy of HCG purchased from them ?

Thanks

• cmatt15
• hcg reliablerx
• Replies: 42
• Forum: Resources and Suppliers

• 

 

[Guided_by_Voices]

Under-eating is also something to rule out.

Beyond all the above, changes in your relationship(s) are also something to consider. Libido has a lot of under-appreciated, difficult-to-control factors such as pheromones that may be in play in some way.

 

[SS1LE]

I would check Vit D, B12. Also possibly magnesium and zinc blood levels.

 

[Warrior]

I've had similar experience with ED, been on TRT for 15yrs. Completely dialed in at 150mg per week 75 2x per week. 500 of HCG, 250 x 2x per week.
Recently having ED issues for no apparent reason?

 

[Guided_by_Voices]

You might also look into nitric oxide supplements via pills (I uses N1o1) or beet root powder. PT-141 my also help.

 

[wes6363]

I would check Vit D, B12. Also possibly magnesium and zinc blood levels.

Adding to my next labs, thank you!

 

[wes6363]

You might also look into nitric oxide supplements via pills (I uses N1o1) or beet root powder. PT-141 may also help.

Thank you. Funny enough, my wife actually has Vyleesi with the same active ingredient as PT-141. Tempted to try it at this point!

 

[Guided_by_Voices]

Thank you. Funny enough, my wife actually has Vyleesi with the same active ingredient as PT-141. Tempted to try it at this point!

I would star with no more that 100-300 micrograms. The commonly used doses are way too high IME. There are other threads here about it and Peptide Sciences carries it.

 

[Guided_by_Voices]

Adding to my next labs, thank you!

Most people are low in all of these, unless you work as a lifeguard, and maybe not even then. You want 50 or higher for Vitamin D. I'm not sure the units on the others but if you're not supplementing you're likely low, and there's no real risk of overdose. You also need to take Vitamin K2 with the D. The lab range for B12 often says you are ok when you're not.

 

[FunkOdyssey]

Supplements- MV

What is MV?

Do you consume stevia?

Do you have anything to track sleep quality and SpO2 (to identify apnea) like an oura ring? How does that look?

You said, "No other meds that cause libido side effects." Are you taking any other medications besides TRT?

 

[Guided_by_Voices]

What is MV?

Do you consume stevia?

Do you have anything to track sleep quality and SpO2 (to identify apnea) like an oura ring? How does that look?

You said, "No other meds that cause libido side effects." Are you taking any other medications besides TRT?

Probably Multi-Vitamin, which makes this a good time to point out a few of the problems with MVs.

- Wrong/incomplete forms: for example, Vitamin E is is usually just alpha tocopherol in MVs
- Low dosage, for example magnesium, potassium, vitamin C and D
- Conflicting nutrients, for example Zinc and Copper
- Lack of key items, such as quercetin and bela glucans, or amino acids such as glycine.
- And most importantly, a false sense of security. Many people take an MV and think this gives them what they need, instead of actually investigating what to take. MVs also ignore situational needs, such as the need for much more Vitamin C if one is fighting off an infections, and options like liposomal vitamin C.

 

[FunkOdyssey]

Probably Multi-Vitamin, which makes this a good time to point out a few of the problems with MVs.

There are many micronutrients in multivitamins that each make me feel like garbage in the high doses they typically use. I often wonder if other people are similarly affected and are not self-aware enough to notice the adverse effects. I've tested all of the nutrients independently and the offenders include:

• Higher than RDA thiamine
• Higher than RDA riboflavin
• Any amount of niacin/niacinamide
• 400 mcg+ methylfolate
• More than 10-20 mg B6
• Any amount of zinc
• Any amount of chromium
• Higher than RDA vitamin E
• Higher than RDA vitamin C
• 5000+ iu retinol
• 2000+ iu Vitamin D

Some of the adverse effects include fatigue, depressed mood, spaciness / brain fog, insomnia, and reduced libido.

I would absolutely include a multivitamin in your list of suspicions if anything is feeling off.