Hello all:
I have been on the TRT train for 7 weeks now after a few months of research (much of which was done on this fantastic website!). I am 43 and for about the last year and a half I have been experiencing symptoms (lethargic, weight gain, crappy erections, low libido, loss of muscle mass, etc.). I had a testosterone blood test with a GP who flat out refused to test me for anything other than total, free testosterone and SHBG ("We don't test estrogen levels unless there is a problem with the testosterone level"). Total testosterone came in at 388 ng/dl, free testosterone at 65.9 pg/ml, and SHBG at 23 nmol/L. Not happy, I jumped over to the experts at Defy.
My initial lab results with Defy before beginning treatment (11/29/19):
Total Testosterone: 334 ng/dl
Free Testosterone (Direct): 12.0 pg/ml
DHT: 17 ng/dl
DHEA - Sulfate: 169.1 ug/dl
TSH: 1.570 ulU/ml
LH: 4.4 mlU/ml
Prolactin: 17.6 ng/ml
PSA: 0.8 ng/ml
Estradiol (Sensitive): 16.2 pg/ml
SHBG: 17.6 nmol/L
I was put me on the following protocol:
T cyp 200 mg/ml - 0.32md IM/SQ twice a week (3.5 days)
HCG 6,000 IU - 40 units SQ twice a week (3.5 days)
I had also been a long-time user of Propecia for about 18 years (which worked great for my hair, didn't notice any sexual side effects - well, I guess except for the past year and a half), which I had stopped for a few weeks already before the blood tests. I haven't gone back to it. I'll take great sex and libido over hair at this point.
I was advised that the SHBG would be challenge that would probably require more frequent injections, and that we'd see if my DHT level would rise given some of the post-finasteride syndrome reports and my long-time use of the drug. It was mentioned that testosterone cream on the scrotum could help rectify that issue if we needed it.
I wasn't due for labs until March, but I am impatient so got a set at the 6-week mark (1/29/2020) as that is when things can start to stabilize. Here are the results, which were taken about 73 hours after my last injection.
Total Testosterone: 486 ng/dl
Free Testosterone (Direct): 15.7 pg/ml
DHT: 35 ng/dl
DHEA - Sulfate: 168.6 ug/dl
TSH: 1.040 ulU/ml
Prolactin: 9.1 ng/ml
PSA: 1.4 ng/ml
Estradiol (Sensitive): 42.5 pg/ml
SHBG: 15.0 nmol/L
Overall, I have felt some improvements. The biggest is joint pain - I have had nagging shoulder pain for a few years that went away almost immediately, which I attributed to correcting a low estrogen issue. I felt really good in week 2, better libido, sexual function, sensitivity. I felt ok (and overall better) for the next few weeks, but the last 2 weeks not so much. Libido has taken a dive, as has sexual function and sensitivity.
I attribute that to my rising estrogen levels. I think I may have hit a sweet spot in week 2, but now I've blown past it. I have definitely felt the highs and lows between injections and felt almost immediately that I'd be better off on more frequent injections (every day would honestly be fine with me if it works). Honestly, I expected my total/free testosterone to be much higher, but I view my rising DHT as encouraging and hopefully that will get near the higher end if we can get the testosterone higher. I have felt a little better overall using SubQ rather than IM (I get a nice rush from IM for about 24 hours or so, but then can feel it crashing, whereby SubQ seems to be more level - if I could get the rush that I get from IM all the time, though, I'd take that!).
I will set up an early call with Defy to see if I can perhaps switch to EOD or daily injections (which hopefully will stop the highs/lows and get the estrogen under control), but I am interested in anyone's thoughts/suggestions. Sexual function and libido are my primary concerns at the moment.
Thanks,
TLawyer
I have been on the TRT train for 7 weeks now after a few months of research (much of which was done on this fantastic website!). I am 43 and for about the last year and a half I have been experiencing symptoms (lethargic, weight gain, crappy erections, low libido, loss of muscle mass, etc.). I had a testosterone blood test with a GP who flat out refused to test me for anything other than total, free testosterone and SHBG ("We don't test estrogen levels unless there is a problem with the testosterone level"). Total testosterone came in at 388 ng/dl, free testosterone at 65.9 pg/ml, and SHBG at 23 nmol/L. Not happy, I jumped over to the experts at Defy.
My initial lab results with Defy before beginning treatment (11/29/19):
Total Testosterone: 334 ng/dl
Free Testosterone (Direct): 12.0 pg/ml
DHT: 17 ng/dl
DHEA - Sulfate: 169.1 ug/dl
TSH: 1.570 ulU/ml
LH: 4.4 mlU/ml
Prolactin: 17.6 ng/ml
PSA: 0.8 ng/ml
Estradiol (Sensitive): 16.2 pg/ml
SHBG: 17.6 nmol/L
I was put me on the following protocol:
T cyp 200 mg/ml - 0.32md IM/SQ twice a week (3.5 days)
HCG 6,000 IU - 40 units SQ twice a week (3.5 days)
I had also been a long-time user of Propecia for about 18 years (which worked great for my hair, didn't notice any sexual side effects - well, I guess except for the past year and a half), which I had stopped for a few weeks already before the blood tests. I haven't gone back to it. I'll take great sex and libido over hair at this point.
I was advised that the SHBG would be challenge that would probably require more frequent injections, and that we'd see if my DHT level would rise given some of the post-finasteride syndrome reports and my long-time use of the drug. It was mentioned that testosterone cream on the scrotum could help rectify that issue if we needed it.
I wasn't due for labs until March, but I am impatient so got a set at the 6-week mark (1/29/2020) as that is when things can start to stabilize. Here are the results, which were taken about 73 hours after my last injection.
Total Testosterone: 486 ng/dl
Free Testosterone (Direct): 15.7 pg/ml
DHT: 35 ng/dl
DHEA - Sulfate: 168.6 ug/dl
TSH: 1.040 ulU/ml
Prolactin: 9.1 ng/ml
PSA: 1.4 ng/ml
Estradiol (Sensitive): 42.5 pg/ml
SHBG: 15.0 nmol/L
Overall, I have felt some improvements. The biggest is joint pain - I have had nagging shoulder pain for a few years that went away almost immediately, which I attributed to correcting a low estrogen issue. I felt really good in week 2, better libido, sexual function, sensitivity. I felt ok (and overall better) for the next few weeks, but the last 2 weeks not so much. Libido has taken a dive, as has sexual function and sensitivity.
I attribute that to my rising estrogen levels. I think I may have hit a sweet spot in week 2, but now I've blown past it. I have definitely felt the highs and lows between injections and felt almost immediately that I'd be better off on more frequent injections (every day would honestly be fine with me if it works). Honestly, I expected my total/free testosterone to be much higher, but I view my rising DHT as encouraging and hopefully that will get near the higher end if we can get the testosterone higher. I have felt a little better overall using SubQ rather than IM (I get a nice rush from IM for about 24 hours or so, but then can feel it crashing, whereby SubQ seems to be more level - if I could get the rush that I get from IM all the time, though, I'd take that!).
I will set up an early call with Defy to see if I can perhaps switch to EOD or daily injections (which hopefully will stop the highs/lows and get the estrogen under control), but I am interested in anyone's thoughts/suggestions. Sexual function and libido are my primary concerns at the moment.
Thanks,
TLawyer