6 months into TRT - minimal effects - no libido - thinking of stopping?

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brookseth

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So I'm going to preface this. Now that I know what I know from researching myself rather than just listening to doctors- I don't think I should have ever been put on TRT.

About 4 years ago I started having massive fatigue, loss of motivation, couldnt bring myself to the gym, couldnt lose weight, total loss of libido, depression, etc etc. Basically every textbook symptom of low T. I am currently 31yrs old.
Doctors at that time ran labs and basically everything looked pretty good. Here is an excerpt from two labs I had back in 2020:


Total Test: 807
SHBG: 52.6
Calc Free T: 136.5
Estradiol: 20.5
Prolactin: 16.9


Total Test: 583
SHBG: 39.4
Calc Free T: 112.6
Follicle Stim: 3.7
LH: 6.3
Prolactin: 14


Going through all of these will be annoying to read - my doctors never used any standardization with doing labs. Some labs were totally missing important items. Some labs were using totally different metrics. Bear with me.
From the 6 or so different labs I had done in 2020-2022, main things that looked the oddest to me were my TSH. Lowest it was on any labs was .55 and highest was 3.05. Looking back at my other labs though everything seems like it WAS actually fine.
At this point in time in 2020 I was put on clomid -took it for a few months - noticed no changes in symptoms - and discontinued. Testosterone numbers did increase over 1200-1400. and went back to the 500-800 range after.

in 2022 I began experiencing even WORSE fatigue and had a 100% complete loss of libido.
Labs done 09/22:
Total Test: 495
Free Test (Dialysis): 76.6
Estrogen Total Serum: 120.1 (no clue why this was even done. Seemingly pointless metric)
TSH: 3.01
T4: 7.8
Free T4 Index: 2.6
DHEA: 248

From here - I was once again put on clomid. Took it for 2 maybe 3 months? Had like a 1 week period of libido and other than that did nothing for my symptoms.
Labs done 12/22: (on clomid)
Total Test: 955
Estradiol: 37.2
TSH: 2.094

From here I was recommended to switch to TRT from clomid.
I was initially told to do 100MG 2x per week by the prescribing doctor. I did this for maybe 1 month until cutting it back myself as I was made aware this is a MASSIVE dose. In the first 2-5 weeks of TRT I felt fantastic though. Great energy, libido, etc etc.
I cut my protocol back to the following:
400iu HCG
50mg Test Cyp
.25 anastrozole
This was taken 2x per week Wednesday and Saturday.

On this protocol I had labs drawn after about 5 weeks
Labs done 3/23:
Total Test: 676.6
Free Test (Direct): 16.6
Estradiol (Sensitive): 20.1
DHT: 79
DHT Free: 7.35
TSH: 1.5
Free T4: 1.18
Free T3: 3.5
DHEA: 280
Prolactin: 11

With this protocol I did not feel any real improvement. Maybe VERY minor but definitely nothing to get excited about. From here I my doctor told me to stick to their routine. and I then moved to the following protocol.
500iu HCG
100mg Test Cyp
.25 anastrozole
This was taken 2x per week Wednesday and Saturday.

With this protocol I felt the best of any - but only pretty good. Had the best bouts of libido, energy, drive for the gym, etc. But it also seemed to start to fade out after the first few weeks of this protocol.

New labs were drawn at the end of 4/23
Total Test: 1260
Free Test: 272.2
Estradiol (Ultra Sensitive): 53
SHBG: 25
TSH: 1.19
Free T4: 1
Free T3: 3.8
DHEA: 194
Prolactin: 9.9

My biggest issue here was that I was having extremely bad chest, shoulder and back acne, and I felt as if my hair was thinning and falling out as well. Also was being somewhat moody.

From here I altered my protocol once again to
500iu HCG
68mg Test Cyp
.25mg Anastrozole (discontinued 2 weeks ago so now none).
This was taken 2x per week Wednesday and Saturday.

I am getting labs done this coming wednesday to see where I am at now.
I do not feel great though. Libido is completely gone again, energy and drive is basically nonexistant. Only real good thing is I do feel like my mood is more stable and also the chest acne is gone, now just shoulder and slight back acne.

I almost feel like I'm chasing my tail here and dont actually need to be on TRT. I also now know that my doctors don't really seem to know what they are doing in this space. So I'm now looking for a better provider and in the meantime relying on my own research and input from you all here.

What are the thoughts? Why do we think I am so fatigued and dont have a libido? and do we think I should just discontinue the TRT (and do a PCT of some sort to get back to natural and see where we are at to start over?) Why do we think I have had some spurts of success with TRT but it is short lived? And also was only in super-physiological range too.


Let me know your thoughts! Also with the labwork, if there is other specific items anyone wants to know values of, there is alot more on these tests - most of it (I believe to be) irrelevant though so I did not include.
 
Last edited:
Defy Medical TRT clinic doctor
This has been discussed plenty of times in very similar fashion as we have a lot of men in the similar situation. First thing we know nothing about whats the most important factor - the context. I'm not sure why people start from the other way around as its what matters the most and as you said you probably never needed TRT in first place, just to man da fuck up and take life in your own hands. Get as healthy as possible, compose a good diet and training plan, optimize sleep hygiene etc and just be religeously dedicated to that for lets say a year or two and then see how you feel, run blood tests, several, and make a sound decision from that, now you will never know.

Another thing is you are/were running a lot of crap like HcG and AI, which do have their own time and place, but def not in your protocol from the get-go. TRT dose is hard to nail on its own and when you have a lot of moving parts it will be next to impossible to know whats giving you what. Think of elimination diet, its very similar. Thats why I like to go by the phrase "less is more" especially when it comes to hormones, drugs, meds, supps, etc.

I would ditch such provider and probably do all myself. So my steps would be simple and as follows- drop the HCG, drop the AI and start say 80mg per week split into 2 injections 40mg each so every 3.5 day or can go every 4 days, to make it a bit simplier. While doing that nail my diet, training and recovery/sleep and try to get healthier, cuz that is your mission going forward. Give it 12wks and re-test to see how your blood levels are looking and then go from there.

If you want to quit I'd do it cold turkey unless you have easy access and not too expensive then maybe some form of PCT but since you havent been on TRT for a long time you should return to baseline without much problem IMHO.

Thats basically it and as the saying goes- too much of a good thing actually becomes a bad thing, so same here. Less is more. Better to start low and go higher with time and effort then start high, suffer, then try this or that, add this or that, blah blah blah, change provider, and still, most likely, at the end of the day you will be fucked and without money. Don't get me wrong there are good/decent providers (I believe) but its your life so everything is on you.

Hope that doesn't go over yuor head.

Hang in there and hope you feel better soon!
 
I was only on AI because that’s what my provider was telling me to do. I stopped taking it now after doing my own research.

If I do decide to drop it, access and cost of PCT isn’t an issue for me.
It’s just a matter of picking what we think the right decision is at this point for the next steps. Altering the protocol more to something more simple or scrapping and see what happens.

Belekas, you recommend dropping the HCG, im curious as to why? Shouldnt the hcg theoretically keep some natural T production and be beneficial to libido?
 
I was only on AI because that’s what my provider was telling me to do. I stopped taking it now after doing my own research.

If I do decide to drop it, access and cost of PCT isn’t an issue for me.
It’s just a matter of picking what we think the right decision is at this point for the next steps. Altering the protocol more to something more simple or scrapping and see what happens.

Belekas, you recommend dropping the HCG, im curious as to why? Shouldnt the hcg theoretically keep some natural T production and be beneficial to libido?
As I have explained you are running too much stuff and have no idea what is effecting you and to what extent, if that makes sense. A lot of folks don't tolerate HCG and its another moving part in the puzzle. Natural production will be shutdown after some time as thats how it goes. First nail the testosterone dose alone and then see if you ever need anything else. Since your levels are still high and you have no libido the steps would be cut the dose, pick a good injection protocol, ditch the HCG and go with test only. Give it time and see how you feel and how your blood levels look like. I work with real results and not theories but if you want you can continue on your journey adding more stuff which in "theory" might help ya, but I wouldn't advise to do so. Been in the game a long time and thats just not my way to handling things especially when it comes to hormones and other meds. Anyway more strenght to you whichever way you will go and let us know how your journey goes or ends.

Peace!

p.s. I'm not an expert with HCG FWIW but you get my point. Also I'm on 75mg/week of test myself and my libido is awesome. To be honest maybe a bit too big as I want to fuck every chick out there younger or older haha lol. So def for me libido is not correlated with high total test/free test numbers, but the opposite seems to be true FWIW at the given moment in time. Some food for thought as well.
 
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Starting out on TRT, hCG ad AI’s is usually a ticket to failure. Mostly hCG can hurt libido and cause a degree of ED. The AI can do the same even with what looks like healthy estrogen.

It’s so much easier to dial-in with TRT in isolation. Sometimes smaller more frequent injections is needed to bring out libido. Also the nature of cypionate and enanthate can be problematic for some men, the near static hormone levels creates overstimulation, similar to guys blasting and cruising, where is sexual parameters can become diminished.
 
It's positive that you making honest assessment of the situation. Lack of T was never your issue with those numbers. If it were me, I would quit cold turkey, power through couple of rough weeks, and let the natural production bounce back. Then start looking elsewhere for root of your problem.

Good luck
 
Things that affect libido:

  • Obesity
  • High blood pressure
  • Diabetes
  • Poor sleep
  • Medications
  • Stress/depression
  • Low testosterone
  • Infections
  • High prolactin
  • Low thyroid hormones
  • Alcohol & drugs
  • Surgery
  • Heart disease
  • High cholesterol
 
"Context" is key. Thanks for posting!
Yes sorry forgot to touch on this.
I don't really have ANY of these factors. I was previously a little over weight but it wasnt anything to be "problematic" and had the same issues while in great shape. Other than that I don't have any other things on that list that would cause the libido issues. TSH, T3 and T4 have always been in range, my A1C is slightly elevated in the 4s but not near diabetes. No meds, surgery, cholesterol, etc etc.

And yea based on the advise you have given I'm either going to just do a further dose reduction to ONLY Test Cyp or maybe totally quit and go back to baseline. Wasn't trying to question you negatively about the HCG just wanted to have a better understanding of why you were recommending to remove.
 
Well today I’m due for my shot, I think I’m going to follow your advise and start with just cutting back to T only and go from there rather than discontinuing right away.
 
Well today I’m due for my shot, I think I’m going to follow your advise and start with just cutting back to T only and go from there rather than discontinuing right away.
Dialing in on TRT can take time, it took me 7 years to figure out my optimal protocol.
 
About 4 years ago I started having massive fatigue, loss of motivation, couldnt bring myself to the gym, couldnt lose weight, total loss of libido, depression, etc etc. Basically every textbook symptom of low T. I am currently 31yrs old.

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So I'm going to preface this. Now that I know what I know from researching myself rather than just listening to doctors- I don't think I should have ever been put on TRT.

About 4 years ago I started having massive fatigue, loss of motivation, couldnt bring myself to the gym, couldnt lose weight, total loss of libido, depression, etc etc. Basically every textbook symptom of low T. I am currently 31yrs old.
Doctors at that time ran labs and basically everything looked pretty good. Here is an excerpt from two labs I had back in 2020:


Total Test: 807
SHBG: 52.6
Calc Free T: 136.5
Estradiol: 20.5
Prolactin: 16.9


Total Test: 583
SHBG: 39.4
Calc Free T: 112.6
Follicle Stim: 3.7
LH: 6.3
Prolactin: 14


Going through all of these will be annoying to read - my doctors never used any standardization with doing labs. Some labs were totally missing important items. Some labs were using totally different metrics. Bear with me.
From the 6 or so different labs I had done in 2020-2022, main things that looked the oddest to me were my TSH. Lowest it was on any labs was .55 and highest was 3.05. Looking back at my other labs though everything seems like it WAS actually fine.
At this point in time in 2020 I was put on clomid -took it for a few months - noticed no changes in symptoms - and discontinued. Testosterone numbers did increase over 1200-1400. and went back to the 500-800 range after.

in 2022 I began experiencing even WORSE fatigue and had a 100% complete loss of libido.
Labs done 09/22:
Total Test: 495
Free Test (Dialysis): 76.6
Estrogen Total Serum: 120.1 (no clue why this was even done. Seemingly pointless metric)
TSH: 3.01
T4: 7.8
Free T4 Index: 2.6
DHEA: 248

From here - I was once again put on clomid. Took it for 2 maybe 3 months? Had like a 1 week period of libido and other than that did nothing for my symptoms.
Labs done 12/22: (on clomid)
Total Test: 955
Estradiol: 37.2
TSH: 2.094

From here I was recommended to switch to TRT from clomid.
I was initially told to do 100MG 2x per week by the prescribing doctor. I did this for maybe 1 month until cutting it back myself as I was made aware this is a MASSIVE dose. In the first 2-5 weeks of TRT I felt fantastic though. Great energy, libido, etc etc.
I cut my protocol back to the following:
400iu HCG
50mg Test Cyp
.25 anastrozole
This was taken 2x per week Wednesday and Saturday.

On this protocol I had labs drawn after about 5 weeks
Labs done 3/23:
Total Test: 676.6
Free Test (Direct): 16.6
Estradiol (Sensitive): 20.1
DHT: 79
DHT Free: 7.35
TSH: 1.5
Free T4: 1.18
Free T3: 3.5
DHEA: 280
Prolactin: 11

With this protocol I did not feel any real improvement. Maybe VERY minor but definitely nothing to get excited about. From here I my doctor told me to stick to their routine. and I then moved to the following protocol.
500iu HCG
100mg Test Cyp
.25 anastrozole
This was taken 2x per week Wednesday and Saturday.

With this protocol I felt the best of any - but only pretty good. Had the best bouts of libido, energy, drive for the gym, etc. But it also seemed to start to fade out after the first few weeks of this protocol.

New labs were drawn at the end of 4/23
Total Test: 1260
Free Test: 272.2
Estradiol (Ultra Sensitive): 53
SHBG: 25
TSH: 1.19
Free T4: 1
Free T3: 3.8
DHEA: 194
Prolactin: 9.9

My biggest issue here was that I was having extremely bad chest, shoulder and back acne, and I felt as if my hair was thinning and falling out as well. Also was being somewhat moody.

From here I altered my protocol once again to
500iu HCG
68mg Test Cyp
.25mg Anastrozole (discontinued 2 weeks ago so now none).
This was taken 2x per week Wednesday and Saturday.

I am getting labs done this coming wednesday to see where I am at now.
I do not feel great though. Libido is completely gone again, energy and drive is basically nonexistant. Only real good thing is I do feel like my mood is more stable and also the chest acne is gone, now just shoulder and slight back acne.

I almost feel like I'm chasing my tail here and dont actually need to be on TRT. I also now know that my doctors don't really seem to know what they are doing in this space. So I'm now looking for a better provider and in the meantime relying on my own research and input from you all here.

What are the thoughts? Why do we think I am so fatigued and dont have a libido? and do we think I should just discontinue the TRT (and do a PCT of some sort to get back to natural and see where we are at to start over?) Why do we think I have had some spurts of success with TRT but it is short lived? And also was only in super-physiological range too.


Let me know your thoughts! Also with the labwork, if there is other specific items anyone wants to know values of, there is alot more on these tests - most of it (I believe to be) irrelevant though so I did not include.
I feel your pain.... I too had extreme fatigue and no motivation. I continued going to the gym but my performance sucked and to please my lady I was injecting trimix to get hard and would pump her through multiple orgasms while I did not pop. I went to bed early did not rest well and woke up at 4am. Napped 2 times a day, even sitting up at my desk. My doctor recommended me for a sleep study which I blew off, but after 6 months finally succumbed and did it. Man my life is back, yes I sleep now with a hose to my nose but my body is getting the oxygen needed to recover and I can say I am back 100%. You may be skeptical but go to your doctor and suggest it, it may bring you back ... good luck
 
I feel your pain.... I too had extreme fatigue and no motivation. I continued going to the gym but my performance sucked and to please my lady I was injecting trimix to get hard and would pump her through multiple orgasms while I did not pop. I went to bed early did not rest well and woke up at 4am. Napped 2 times a day, even sitting up at my desk. My doctor recommended me for a sleep study which I blew off, but after 6 months finally succumbed and did it. Man my life is back, yes I sleep now with a hose to my nose but my body is getting the oxygen needed to recover and I can say I am back 100%. You may be skeptical but go to your doctor and suggest it, it may bring you back ... good luck

Yup. I do small daily injections but I do 200mg/week that helped some of my issues with balancing how I felt. HOWEVER I got mild apnea after starting TRT and a machine made me feel like a million bucks. Sucks for the first week but man you wake up feeling like you can fight a fucking grizzly when you actually get the oxygen you need at night
 
So I'm going to preface this. Now that I know what I know from researching myself rather than just listening to doctors- I don't think I should have ever been put on TRT.

About 4 years ago I started having massive fatigue, loss of motivation, couldnt bring myself to the gym, couldnt lose weight, total loss of libido, depression, etc etc. Basically every textbook symptom of low T. I am currently 31yrs old.
Doctors at that time ran labs and basically everything looked pretty good. Here is an excerpt from two labs I had back in 2020:


Total Test: 807
SHBG: 52.6
Calc Free T: 136.5
Estradiol: 20.5
Prolactin: 16.9


Total Test: 583
SHBG: 39.4
Calc Free T: 112.6
Follicle Stim: 3.7
LH: 6.3
Prolactin: 14


Going through all of these will be annoying to read - my doctors never used any standardization with doing labs. Some labs were totally missing important items. Some labs were using totally different metrics. Bear with me.
From the 6 or so different labs I had done in 2020-2022, main things that looked the oddest to me were my TSH. Lowest it was on any labs was .55 and highest was 3.05. Looking back at my other labs though everything seems like it WAS actually fine.
At this point in time in 2020 I was put on clomid -took it for a few months - noticed no changes in symptoms - and discontinued. Testosterone numbers did increase over 1200-1400. and went back to the 500-800 range after.

in 2022 I began experiencing even WORSE fatigue and had a 100% complete loss of libido.
Labs done 09/22:
Total Test: 495
Free Test (Dialysis): 76.6
Estrogen Total Serum: 120.1 (no clue why this was even done. Seemingly pointless metric)
TSH: 3.01
T4: 7.8
Free T4 Index: 2.6
DHEA: 248

From here - I was once again put on clomid. Took it for 2 maybe 3 months? Had like a 1 week period of libido and other than that did nothing for my symptoms.
Labs done 12/22: (on clomid)
Total Test: 955
Estradiol: 37.2
TSH: 2.094

From here I was recommended to switch to TRT from clomid.
I was initially told to do 100MG 2x per week by the prescribing doctor. I did this for maybe 1 month until cutting it back myself as I was made aware this is a MASSIVE dose. In the first 2-5 weeks of TRT I felt fantastic though. Great energy, libido, etc etc.
I cut my protocol back to the following:
400iu HCG
50mg Test Cyp
.25 anastrozole
This was taken 2x per week Wednesday and Saturday.

On this protocol I had labs drawn after about 5 weeks
Labs done 3/23:
Total Test: 676.6
Free Test (Direct): 16.6
Estradiol (Sensitive): 20.1
DHT: 79
DHT Free: 7.35
TSH: 1.5
Free T4: 1.18
Free T3: 3.5
DHEA: 280
Prolactin: 11

With this protocol I did not feel any real improvement. Maybe VERY minor but definitely nothing to get excited about. From here I my doctor told me to stick to their routine. and I then moved to the following protocol.
500iu HCG
100mg Test Cyp
.25 anastrozole
This was taken 2x per week Wednesday and Saturday.

With this protocol I felt the best of any - but only pretty good. Had the best bouts of libido, energy, drive for the gym, etc. But it also seemed to start to fade out after the first few weeks of this protocol.

New labs were drawn at the end of 4/23
Total Test: 1260
Free Test: 272.2
Estradiol (Ultra Sensitive): 53
SHBG: 25
TSH: 1.19
Free T4: 1
Free T3: 3.8
DHEA: 194
Prolactin: 9.9

My biggest issue here was that I was having extremely bad chest, shoulder and back acne, and I felt as if my hair was thinning and falling out as well. Also was being somewhat moody.

From here I altered my protocol once again to
500iu HCG
68mg Test Cyp
.25mg Anastrozole (discontinued 2 weeks ago so now none).
This was taken 2x per week Wednesday and Saturday.

I am getting labs done this coming wednesday to see where I am at now.
I do not feel great though. Libido is completely gone again, energy and drive is basically nonexistant. Only real good thing is I do feel like my mood is more stable and also the chest acne is gone, now just shoulder and slight back acne.

I almost feel like I'm chasing my tail here and dont actually need to be on TRT. I also now know that my doctors don't really seem to know what they are doing in this space. So I'm now looking for a better provider and in the meantime relying on my own research and input from you all here.

What are the thoughts? Why do we think I am so fatigued and dont have a libido? and do we think I should just discontinue the TRT (and do a PCT of some sort to get back to natural and see where we are at to start over?) Why do we think I have had some spurts of success with TRT but it is short lived? And also was only in super-physiological range too.


Let me know your thoughts! Also with the labwork, if there is other specific items anyone wants to know values of, there is alot more on these tests - most of it (I believe to be) irrelevant though so I did not include.
Do you ever get achy, and especially tired mid to late afternoon? Achy in the elbows, or hands especially? You may have Hashimoto's thyroiditis. Go online, to Discount labs and order a full set of thyroid tests, and get the thyroid antibodies too. The antibodies are particularly important to diagnose the Hashimoto's an autoimmune type of low thyroid. Basically your immune system may be attacking your thyroid gland, and the antibodies sometimes to often accumulate in the joints of hands and elbows making them ache. Sometime's you might also get unexplained aches like the flu. if not Hashimoto's the rest of the thyroid tests will help you figure out if there is a thyroid issue contributing to not feeling well. Because if it's not right, you will still feel like crap, no matter how much T you take or have.
 
What’s your vitamin D level at ?
Most people forget about this.
99% of people can’t get enough vitamin D naturally and this is a big problem that’s missed on most blood tests for trt
 
I feel your pain.... I too had extreme fatigue and no motivation. I continued going to the gym but my performance sucked and to please my lady I was injecting trimix to get hard and would pump her through multiple orgasms while I did not pop. I went to bed early did not rest well and woke up at 4am. Napped 2 times a day, even sitting up at my desk. My doctor recommended me for a sleep study which I blew off, but after 6 months finally succumbed and did it. Man my life is back, yes I sleep now with a hose to my nose but my body is getting the oxygen needed to recover and I can say I am back 100%. You may be skeptical but go to your doctor and suggest it, it may bring you back ... good luck

I guess I never really thought about this. My Oura ring usually shows my blood oxygen at 98-99% always at night so I never considered sleep apnia. Might be a dumb question - but wouldnt lower numbers on blood oxygen indicate that rather than high?



Do you ever get achy, and especially tired mid to late afternoon? Achy in the elbows, or hands especially? You may have Hashimoto's thyroiditis. Go online, to Discount labs and order a full set of thyroid tests, and get the thyroid antibodies too. The antibodies are particularly important to diagnose the Hashimoto's an autoimmune type of low thyroid. Basically your immune system may be attacking your thyroid gland, and the antibodies sometimes to often accumulate in the joints of hands and elbows making them ache. Sometime's you might also get unexplained aches like the flu. if not Hashimoto's the rest of the thyroid tests will help you figure out if there is a thyroid issue contributing to not feeling well. Because if it's not right, you will still feel like crap, no matter how much T you take or have.

I've been tested for Hashimotos before and was told no. I've been checked out by 3 different endocrinologists and all basically said I'm fine (even though one of them was with a TSH over 3 which we all know isnt actually fine). I had one who did an ultrasound on my thyroid and said there was small lumps, tested for hashimotos through bloodwork - came back negative and he basically said not to worry about it. Maybe I should be looking into this once again though.



What’s your vitamin D level at ?
Most people forget about this.
99% of people can’t get enough vitamin D naturally and this is a big problem that’s missed on most blood tests for trt

Pretty sure they are good. I remember being low at sompoint on bloodwork years ago but since have been supplimenting D every day, 10k IU as well. I'll get them done on my next batch of bloodwork but I'm fairly certain that I am good with my supplementation at very least.
 
Beyond Testosterone Book by Nelson Vergel
Things to consider:
- potential history of SSRI use; 5ARi use (finasteride)
- progesterone, dhea, pregnenolone supplementation
- gut health (bowel movement frequency, stool appearance)
- overall metabolic, mitochondrial health, immune system function (notice any infections anywhere on the body?)
- "standard" supplements: magnesium, zinc, vit d/k2 ...

To name a few. Anything you havent really put much thought into?
 
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