I'd go back to the endo. I'm 69 and scored high TT and FT (in excess of the normal range) on 84 mg T enanthate. I then had a TIA, which many suggest could be related to excess T from TRT for older men. Realizing that I was playing with fire, I've since reduced my dose, which still leaves me with benefits, but not as many as what I had at the higher doses. Needless to say, I think it's foolhardy to suggest that you should dose "until you feel your best".
Wow! That wasn't even a very high dose compared to a lot who've posted here. Were your levels significantly above normal range?
I suspect older men (like me, and perhaps you) have a slimmer margin for error. If any body-system can't keep up with the extra drive that hormones provide, something's going to break down.
Thanks for sharing your experience.
I suspect older men (like me, and perhaps you) have a slimmer margin for error. If any body-system can't keep up with the extra drive that hormones provide, something's going to break down.
Thanks for sharing your experience.
Exactly. And in layman's terms . . . because many men, especially older men, have compromised "this and that", juicing yourself with excess hormones will/can backfire in ways that you're guaranteed not to like.
At my highest 84mg/wk dose, measured in the trough, my TT was 29.5 (8.4-28.8) and FT was 744 (179-475) (!). I feel the high FT may have given me AFib, which then resulted in the TIA.
Look, I made a superman list of all my goals that I wanted to achieve before I started TRT. Sometimes, when I get a little down about things, I read that list and have a good laugh. I've reached about 30% of what I wanted, and in my case it's good enough for me. In the year that I've been on it I lost 30 lbs, built up some good muscle, and increased my stamina some, meaning I fatigue less. That's it, I still have ED problems, my back still hurts, I still have arthritis and my mind isn't as quick as it used to be. But I've become very realistic about things, and am content with what I have.
I now take 63mg/wk TE (9mg/day taken every 4 days); it still leaves me with a FT just above the limit, but I'm content with it and what it does for me. I wouldn't go back. Now if I can just get off these blood thinners . . .
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Systemlord
Member
So ignore what your body is telling you and base everything off a lab test?
Let me put it another way, the goal of treatment is about making the lab number look good and instead of how you feel?
Do you agree with this statement?
Short term gain vs long term pain. C'mon Systemlord, there are limitations to every statement; for example, can a chronic pain sufferer be allowed to dose until "they feel their best"? If so, you know what happens . . .
You need both forms of feedback; you need to listen to what your body tells you in conjunction with what the tests are saying. I felt great on a higher dose of T, but the tests were indicating that I was too high, so I cut back, and I'm thankful that I did. It's still speculation as to whether my TIA was caused by excessive exogenous T levels . . . but it might have been, and if I had ignored the lab results, then maybe I would have had a full blown stroke.
You need both forms of feedback; you need to listen to what your body tells you in conjunction with what the tests are saying. I felt great on a higher dose of T, but the tests were indicating that I was too high, so I cut back, and I'm thankful that I did. It's still speculation as to whether my TIA was caused by excessive exogenous T levels . . . but it might have been, and if I had ignored the lab results, then maybe I would have had a full blown stroke.
Guided_by_Voices
Well-Known Member
Independent of who your doctor is, if you're going to raise your dose, do it slowly enough so that you can assess the impact. I agree with dosing twice per week, but if you raise the total, going up by 10mg per month seems like a reasonable progression so that you have a chance to identify a sweet-spot if you hit one. Going up all at once has numerous issues, not the least of which is overloading your body's set-points and feedback loops.
That is, essentially, what I messaged my doctor. I'm waiting for a reply.
I want to split my current dose in half, see how that feels after a suitable waiting period, then try HCG.
As I understand it, only about 60% of TRT patients who've tried HCG actually like it or can tolerate it. Those who like it seem to really like it. Those who don't, really don't. Some have some bad reactions. I'd like to know which camp I'm in. However, I want to make just one change at a time--hence, the waiting period.
If I like it, I can just keep it as part of my protocol--regardless of what subsequent dose-changes I might make with testosterone (up or down).
I want to split my current dose in half, see how that feels after a suitable waiting period, then try HCG.
As I understand it, only about 60% of TRT patients who've tried HCG actually like it or can tolerate it. Those who like it seem to really like it. Those who don't, really don't. Some have some bad reactions. I'd like to know which camp I'm in. However, I want to make just one change at a time--hence, the waiting period.
If I like it, I can just keep it as part of my protocol--regardless of what subsequent dose-changes I might make with testosterone (up or down).
Guided_by_Voices
Well-Known Member
Your plan and reasoning seems sound. An observation however...It sounds like you need to develop the ability to act independently from your Doctor, both for practical reasons (most of us have had to make dozens of tweaks to get to where we are in a good spot which would have been frustrating and close to impossible if all of them were coordinated with a doctor) and for developing a sense of independent responsibility for your health.
I'm fine acting independently in most cases.
Hormone therapy is new to me, so I'm still learning a lot from (1) this site, (2) doctors and (3) observing changes in my own body. Since I just started with a new doctor, I want to stay coupled to his prescription so I can get advice on side-effects and/or dose adjustments. Last week he wrote me my first Rx, which was a huge dose increase + HCG. Since I'm not comfortable with that, I'm letting him know--and proposing a different protocol. I'm hoping he's more flexible than my first endo was.
Hormone therapy is new to me, so I'm still learning a lot from (1) this site, (2) doctors and (3) observing changes in my own body. Since I just started with a new doctor, I want to stay coupled to his prescription so I can get advice on side-effects and/or dose adjustments. Last week he wrote me my first Rx, which was a huge dose increase + HCG. Since I'm not comfortable with that, I'm letting him know--and proposing a different protocol. I'm hoping he's more flexible than my first endo was.
Phil Goodman
Well-Known Member
One option I always throw out for people adjusting their dose, or more so a tip. If you take a lower dose than your doctor recommends you will end up with an emergency stock of your medication, which is important for obvious reasons. I’m of the belief that everyone should have extra medication on hand in case of emergencies or supply chain disruptions. And when it comes to medications like testosterone, simply taking a lower dose than prescribed is probably the easiest way to achieve that goal. If that’s the case you wouldn’t necessarily push for a lower dosage from the doc, but rather just adjust on your end as needed… which kind of ties into the earlier point about working with an experienced professional but also taking some aspects into your own hands.
Guided_by_Voices
Well-Known Member
This is an essential point and one that doesn't get nearly enough emphasis. I'm so used to doing this that I completely missed it but thanks to Phil for bringing it up
Systemlord
Member
You’re making an assumption that there will be pain long-term without any proof. This is unfounded fear.
Update: My doctor was fine with me taking things slowly. Now I'm just waiting for my first shipment of drugs from Empower. My plan is as follows:
My current Test-dose is 75mg/weekly (Xyosted injector pens). I've also started taking 20mg DHEA daily.
I'm going to split my Test-dose in half--that will be 0.19ml per dose (200mg/ml Test-cyp).
I'll take this every 3.5 days (Monday evening and Friday morning).
I don't anticipate this change being very significant, but I will wait at least 6 weeks to settle in on the new protocol. My peak-T will be lower and my trough-T will be higher, so I will have less of a roller-coaster each week. I need to get used to giving myself sub-Q shots and the carrier oil will likely be different, so I need to be alert for new allergic reactions. I will get a blood test (yet again!) for some of the basics (TT/FT/E-2/CBC) after this initial 6-week period.
After that, I'll start the HCG. I've only been on TRT for 7 months, so my testes should start returning to approximately normal size and function in a month (or so). Certainly by then I should know if I can tolerate HCG. I've seen several reports posted here regarding anxiety, headache, digestive issues, etc. so I'll be alert to potential bad reactions. I may also know by then if its going to have positive effects for me--even if they have not yet fully developed. My doctor said my blood levels should stabilize 4-weeks after starting HCG. I'll wait an extra 2 weeks, then get another blood test. I'm particularly interested in any affect on E-2.
After that? Who knows? Maybe everything will be perfect and no further changes will be needed. I will be guided by what my body is telling me. If I want to increase my dose, I'll go up just 20% to 90mg/week (0.22ml). For this change, I'll wait a full 3 months before making any judgements.
Using 20% increases will help me zero-in on my "sweet-spot" (if that exists), and not over-shoot it by too much. It also will allow me to monitor side-effects like excessive E-2 or hematocrit before they get too far out of balance. With this plan it would take me a full year to reach the dose originally prescribed by my doctor (160mg/week!). Given my current blood levels (already fairly high), I seriously doubt I will ever need/want to go to that big a dose.
My current Test-dose is 75mg/weekly (Xyosted injector pens). I've also started taking 20mg DHEA daily.
I'm going to split my Test-dose in half--that will be 0.19ml per dose (200mg/ml Test-cyp).
I'll take this every 3.5 days (Monday evening and Friday morning).
I don't anticipate this change being very significant, but I will wait at least 6 weeks to settle in on the new protocol. My peak-T will be lower and my trough-T will be higher, so I will have less of a roller-coaster each week. I need to get used to giving myself sub-Q shots and the carrier oil will likely be different, so I need to be alert for new allergic reactions. I will get a blood test (yet again!) for some of the basics (TT/FT/E-2/CBC) after this initial 6-week period.
After that, I'll start the HCG. I've only been on TRT for 7 months, so my testes should start returning to approximately normal size and function in a month (or so). Certainly by then I should know if I can tolerate HCG. I've seen several reports posted here regarding anxiety, headache, digestive issues, etc. so I'll be alert to potential bad reactions. I may also know by then if its going to have positive effects for me--even if they have not yet fully developed. My doctor said my blood levels should stabilize 4-weeks after starting HCG. I'll wait an extra 2 weeks, then get another blood test. I'm particularly interested in any affect on E-2.
After that? Who knows? Maybe everything will be perfect and no further changes will be needed. I will be guided by what my body is telling me. If I want to increase my dose, I'll go up just 20% to 90mg/week (0.22ml). For this change, I'll wait a full 3 months before making any judgements.
Using 20% increases will help me zero-in on my "sweet-spot" (if that exists), and not over-shoot it by too much. It also will allow me to monitor side-effects like excessive E-2 or hematocrit before they get too far out of balance. With this plan it would take me a full year to reach the dose originally prescribed by my doctor (160mg/week!). Given my current blood levels (already fairly high), I seriously doubt I will ever need/want to go to that big a dose.
Dang!
I was wandering through old posts looking for information about Nelson’s Ratio for TT and E-2. I stumbled upon an alarming study on Tadalafil. First, some background.
I only have 1 useful (sensitive) blood test for E-2:
E-2 at 75mg Test—sensitive (4/29/25): 29 (< 30) (Quest)
TT/MS at 75mg Test 1102 (250-1100) (Quest)
TT/E-2 Ratio: 38
This is way beyond Nelson’s upper limit of 20. It implies that my TT is too high or my E-2 is too low (or both).
Over this past year, my hormone symptoms have gotten worse, not better, especially over the past 2 months. I currently have very low energy/motivation, no interest in being social, brain-fog, no libido, almost no penile sensitivity and poor sleep.
One cause may be Tadalifil. In mid-April I started taking 5mg/day to improve my ED symptoms and to improve my BPH issues—it helped with both. Today I found this study (posted by Nelson) which showed that taking 10 to 20mg Tadalifil daily causes E-2 to drop nearly in half!!
Questions:
Am I reading this right? That’s a huge drop. Were there any follow-up studies?
Should I stop taking Tadalifil to see if my symptoms improve (even though it is helping my ED and BPH)?
Is there a way to increase E-2?
Thanks for any comments!
I was wandering through old posts looking for information about Nelson’s Ratio for TT and E-2. I stumbled upon an alarming study on Tadalafil. First, some background.
I only have 1 useful (sensitive) blood test for E-2:
E-2 at 75mg Test—sensitive (4/29/25): 29 (< 30) (Quest)
TT/MS at 75mg Test 1102 (250-1100) (Quest)
TT/E-2 Ratio: 38
This is way beyond Nelson’s upper limit of 20. It implies that my TT is too high or my E-2 is too low (or both).
Over this past year, my hormone symptoms have gotten worse, not better, especially over the past 2 months. I currently have very low energy/motivation, no interest in being social, brain-fog, no libido, almost no penile sensitivity and poor sleep.
One cause may be Tadalifil. In mid-April I started taking 5mg/day to improve my ED symptoms and to improve my BPH issues—it helped with both. Today I found this study (posted by Nelson) which showed that taking 10 to 20mg Tadalifil daily causes E-2 to drop nearly in half!!
Questions:
Am I reading this right? That’s a huge drop. Were there any follow-up studies?
Should I stop taking Tadalifil to see if my symptoms improve (even though it is helping my ED and BPH)?
Is there a way to increase E-2?
Thanks for any comments!
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