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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
40 and lean, been on TRT for a while but only feel dialed in when making changes
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<blockquote data-quote="Flimpy" data-source="post: 221952" data-attributes="member: 38524"><p>Hi everyone, I’m having a difficult time getting dialed in and I’m hoping I can get some insight from all of you. </p><p></p><p>I’m 40, lean (15% BF) and exercise 3-4 times a week. My main challenge has been ED, erection quality, ability to maintain an erection and nipple pain. I try to be as objective as possible about this so I log my libido, nocturnal erections, and how long I can maintain an erection every day. My main signal has been nocturnal erections in the hope that it rules out most other aspects of life’s distractions. Consistently I’ll have issues with ED and no nocturnal erections, so I make a change, and within a few weeks I go through a great period of good nocturnal erections and strong daytime erections for sex (with PDE5i). However, inevitably without fail, things suddenly drop off and all the benefits go away. I also often have nipple pain, with a lump under both nipples. It’s important to note that I had bad nipple pain during puberty, and unfortunately with no sex ed I didn’t know what was happening and I did squeeze my nipples enough to have fluid discharge. I suspect my nipples are sensitive to hormones now. </p><p></p><p>Over the past few years I've tried many different protocols under advisement with my doctor. As high as 140mg per week (70 e3.5d) to where I’m at now 70mg per week (20mg eod). Right now I’m feeling very calm, mentally much sharper, BP is in a great place, I’m exercising a few times a week, sleep is great, and energy is great. Other than erections and some occasional nipple pain, I’m feeling great right now (including libido, gym performance, etc). My current protocol:</p><p></p><p>Testosterone Cyp: 20mg eod (total of 70mg per week)</p><p>Pregnenolone: 10mg ED - this drastically improved my memory</p><p>Multivitamin: ED</p><p>Vitamin D & K: ED</p><p>Magnesium: ED</p><p>Metamucil: 1-2 times per day</p><p>Creatine: ED</p><p>Daily Cialis: 5mg (recently added, worked great for a while but stopped working, did not cause a change in E2)</p><p></p><p>I’ve tried higher doses, but that caused nipple pain. I tried adding in t-scrot and had <strong>CRAZY</strong> nocturnal erections for a while, but they eventually faded. It also spiked my cholesterol to an unhealthy level (LDL ~125 and I have genetically high lipoprotein-little-a so I need to be careful). My latest labs (quest), without any aromatase inhibiter are:</p><p></p><p>E2 Sensitive: 28pg/Ml <— despite this I had nipple pain and ED</p><p>Total T: 643 ng/dL</p><p>Progesterone: <0.5 ng/mL</p><p>AM Cortisol: 21.5 mcg/dL</p><p>SHBG: 42 nmol/L</p><p></p><p></p><p>In the past I’ve also tested:</p><p>DHEAS: Typically 205-230</p><p>IGF-1: 142 ng/mL</p><p>Prolactin: 5.2 ng/ML</p><p>Free T3: 4.0 pg/mL (but on occasion is lower around 3.4-3.8, not sure if it’s due to time of day or meds)</p><p>Free T4: 1.2 ng/dL</p><p>TSH: 1.07 (although this is sometimes over 2)</p><p>Reverse T3: 17 ng/dL</p><p></p><p></p><p>I’m not a fan of taking aromatase inhibitors which is why I’m taking my testosterone EOD. Despite that, I still get deep nipple pain. Not just burning or itching, but deep pain with a lump behind my nipples. It gets almost intolerable if I let it sit for too long. My SHBG seems to be fluctuating a lot, and I think it’s SHBG adjusting that eventually leads to my erection and nipple problems. When I added daily testosterone scrotal cream (1 click) to my current protocol, my E2 jumped to ~34-38 and SHBG went to 34. DHT also went way above range to 185 ng/dL (ref: 12-65) and caused my LDL to spike. I also tried EOD testosterone scrotal cream and on the off day my E2 was down to 19 without any AI and my SHBG was at 28. I felt best during this time, but was worried about lipids. </p><p></p><p></p><p>My current thought is to add back in EOD testosterone scrotal cream, maybe a smaller dosage, and keep an eye on lipids. <strong>I recently discovered the ultimate adrenergic control of erections, and can try some of the meds mentioned there (doxazosin, yohimbe, etc). This is particularly intriguing because sometimes when I have nocturnal erections, they fade extremely fast upon waking (other times my erection sticks around).</strong></p><p></p><p></p><p>My main questions are:</p><ul> <li data-xf-list-type="ul">Has anyone else noticed that they feel best during a change of protocol that then fades?</li> <li data-xf-list-type="ul">Should I be trying anything else?</li> <li data-xf-list-type="ul">Is progesterone too low?</li> <li data-xf-list-type="ul">Should I try nolvadex or have gyno surgery?</li> </ul><p></p><p>I’ve not tolerated HCG well and not currently taking it, but one remaining option would be to take that for a while to kick start my testicles and then stop TRT to see if that works out better. For each of these changes I’ve tried to make one change at a time, and give it 6-8 weeks, but inevitably things end up worse again. </p><p></p><p></p><p>I appreciate any help and comments.</p></blockquote><p></p>
[QUOTE="Flimpy, post: 221952, member: 38524"] Hi everyone, I’m having a difficult time getting dialed in and I’m hoping I can get some insight from all of you. I’m 40, lean (15% BF) and exercise 3-4 times a week. My main challenge has been ED, erection quality, ability to maintain an erection and nipple pain. I try to be as objective as possible about this so I log my libido, nocturnal erections, and how long I can maintain an erection every day. My main signal has been nocturnal erections in the hope that it rules out most other aspects of life’s distractions. Consistently I’ll have issues with ED and no nocturnal erections, so I make a change, and within a few weeks I go through a great period of good nocturnal erections and strong daytime erections for sex (with PDE5i). However, inevitably without fail, things suddenly drop off and all the benefits go away. I also often have nipple pain, with a lump under both nipples. It’s important to note that I had bad nipple pain during puberty, and unfortunately with no sex ed I didn’t know what was happening and I did squeeze my nipples enough to have fluid discharge. I suspect my nipples are sensitive to hormones now. Over the past few years I've tried many different protocols under advisement with my doctor. As high as 140mg per week (70 e3.5d) to where I’m at now 70mg per week (20mg eod). Right now I’m feeling very calm, mentally much sharper, BP is in a great place, I’m exercising a few times a week, sleep is great, and energy is great. Other than erections and some occasional nipple pain, I’m feeling great right now (including libido, gym performance, etc). My current protocol: Testosterone Cyp: 20mg eod (total of 70mg per week) Pregnenolone: 10mg ED - this drastically improved my memory Multivitamin: ED Vitamin D & K: ED Magnesium: ED Metamucil: 1-2 times per day Creatine: ED Daily Cialis: 5mg (recently added, worked great for a while but stopped working, did not cause a change in E2) I’ve tried higher doses, but that caused nipple pain. I tried adding in t-scrot and had [B]CRAZY[/B] nocturnal erections for a while, but they eventually faded. It also spiked my cholesterol to an unhealthy level (LDL ~125 and I have genetically high lipoprotein-little-a so I need to be careful). My latest labs (quest), without any aromatase inhibiter are: E2 Sensitive: 28pg/Ml <— despite this I had nipple pain and ED Total T: 643 ng/dL Progesterone: <0.5 ng/mL AM Cortisol: 21.5 mcg/dL SHBG: 42 nmol/L In the past I’ve also tested: DHEAS: Typically 205-230 IGF-1: 142 ng/mL Prolactin: 5.2 ng/ML Free T3: 4.0 pg/mL (but on occasion is lower around 3.4-3.8, not sure if it’s due to time of day or meds) Free T4: 1.2 ng/dL TSH: 1.07 (although this is sometimes over 2) Reverse T3: 17 ng/dL I’m not a fan of taking aromatase inhibitors which is why I’m taking my testosterone EOD. Despite that, I still get deep nipple pain. Not just burning or itching, but deep pain with a lump behind my nipples. It gets almost intolerable if I let it sit for too long. My SHBG seems to be fluctuating a lot, and I think it’s SHBG adjusting that eventually leads to my erection and nipple problems. When I added daily testosterone scrotal cream (1 click) to my current protocol, my E2 jumped to ~34-38 and SHBG went to 34. DHT also went way above range to 185 ng/dL (ref: 12-65) and caused my LDL to spike. I also tried EOD testosterone scrotal cream and on the off day my E2 was down to 19 without any AI and my SHBG was at 28. I felt best during this time, but was worried about lipids. My current thought is to add back in EOD testosterone scrotal cream, maybe a smaller dosage, and keep an eye on lipids. [B]I recently discovered the ultimate adrenergic control of erections, and can try some of the meds mentioned there (doxazosin, yohimbe, etc). This is particularly intriguing because sometimes when I have nocturnal erections, they fade extremely fast upon waking (other times my erection sticks around).[/B] My main questions are: [LIST] [*]Has anyone else noticed that they feel best during a change of protocol that then fades? [*]Should I be trying anything else? [*]Is progesterone too low? [*]Should I try nolvadex or have gyno surgery? [/LIST] I’ve not tolerated HCG well and not currently taking it, but one remaining option would be to take that for a while to kick start my testicles and then stop TRT to see if that works out better. For each of these changes I’ve tried to make one change at a time, and give it 6-8 weeks, but inevitably things end up worse again. I appreciate any help and comments. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
40 and lean, been on TRT for a while but only feel dialed in when making changes
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