6 weeks on TRT, weak erections

[Tad1979]

Hi there,
I am currently on the following TRT regime:
150 mg testosterone cypionate once/week
0.5 mg, increased this week to 1 mg, Arimidex, once/week
500 iu HCG once/week

Labs were checked twice before starting, and are being checked every five weeks, and so far my labs have been as follows:
Labs prior to starting TRT (Labcorp)
Total serum testosterone 243 (one week later came back as 128) range 264-916
Free testosterone 9.3 (one week later, 7.1) range 8.7-25.1
SHBG 18.9 range 16.5-55.9
Estradiol 11.1 range 7.6-42.6

After five weeks on TRT
Total serum testosterone 849
Free testosterone 25
SHBG 14.6
Estradiol 43.7

Things have been going so much better since starting treatment, but the past week and a half there has been a change - I went from very satisfying, healthy erections that I could hang a hat on, to soft, weak erections that can rarely support the weight of my appendage. My sense of arousal is still there and strong, unlike prior to starting TRT. Could this be related to my increased Estradiol? My provider increased my Arimidex - how soon should I expect this to be able to be resolved if this is indeed the problem? Thanks for any insight.

 

[Vince]

I would think your poor erections are coming from low estradiol levels. Using too much Arimidex

 

[Vince]

I see you were a low shbg guy, which means more frequent injections. Every other day or everyday would help a lot.

 

[MarkM]

I'm in agreement with Vince. One weekly injection of 150 mg is too large of a dose for your SHBG and the 1 mg of anastrozole, a rather large dose, has problem done a number on your estradiol. Why don't you back off the anastrozole, at least to where you where before and see it that helps you. If you changed your injection protocol it is possible that you might not even need an AI.

 

[Vince Carter]

I agree with most of my friends here...smaller more frequent injections, dosing should be based off of Free T max lab range or a little over that. Cyp Dosing should based on the SHBG absolultely include "Estradiol Free" every time along with The LC/MS/MS test.
E2 probably needs to be in close proximity to the SHBG value.

 

[Sean Mosher]

Based on that range it looks like you didn't use the LCMS/MS sensitive estradiol test.
So your actual e2 maybe way too low.

 

[Tad1979]

Thanks for all the feedback. The lab forms state the Estradiol test was the "ROCHE CLIA methodology". When I started, I had actually asked about twice per week injections as I'd read folks have better outcomes.

I'm in the process of searching out better options for providers. I'm in an area of Iowa where EVERYTHING goes through a particular healthcare system, and despite being badly symptomatic, I've been told everything is "normal" for almost two years. Despite the issue prompting this thread, I feel more like myself than I have in ages and wish I could have gotten TRT rolling back when I first went to my primary physician. I got desperate enough to go in to a local T clinic, and they're only open three days per week, so once per week injections is what they offer. I'm hoping now that I've been established as a TRT patient, I can eventually find a doctor who will be willing to take over care and help me customize my protocol more. I guess worse case scenario I can talk to the clinic about holding the Arimidex - unless that would lead to worse complications? (I'm most worried about breast enlargement)

 

[Vince]

Check one of our advertisers. Defy or Prime Body.

 

[Tad1979]

I’ll need to check out Prime Body. It doesn’t look like Defy is a financially viable option for me.

 

[Vince Carter]

You won't find a cheaper spot than Defy. Labs are what can kill ya in TRT though you can work around it with insurance if you have it.

 

[Tad1979]

That’s rather the issue - Defy doesn’t take insurance. I mean, they don’t seem badly priced for the service but I’m a father of two with a disabled spouse - right now insurance is covering most of my TRT. Thank you though. The responses have been helpful whether it seems that way or not, and I’m grateful.