Add back hCG and T4?

[osirisrisen]

I've been working with HRT for about 6 years now and have been on/off many different approaches, too many to list initially. However, here are my my recent labs and I'd like some feedback. Thanks!



Stopped all thyroid meds for a while.
On Fortesta 5 pumps
No other meds

Blood draw 9 hours after Test Gel application

Total Test 684 (250-1100)
Free Test 130 (35-155)
e2 (reg test, lab did wrong one) 23
DHEA 376 (61-1636)
PSA 0.52 (0 - 4.0)

TSH 1.71 (.35-4.94)
T4 Free 0.9 (0.7-1.5)
Total T3 1.1 (0.6 - 1.6)

Energy is ok. Libido is hit or miss.

Should I re add t4 (Natural thyroid and t3 in general gives me issues, even with cortisol)? DHEA?
What about HCG?

What do you all see?

 

[ERO]

Your E2 *may* be too low to have a good libido if its only 23 on the regular test - that test typically overstates the true level in men. 684 total T is decent but not great. Kind of mid-range where the best TRT docs typically want to get you past mid-range and into the upper quartile.

Others here are much more knowledgeable about thyroid and I am sure they will chime in.

 

[osirisrisen]

Your E2 *may* be too low to have a good libido if its only 23 on the regular test - that test typically overstates the true level in men. 684 total T is decent but not great. Kind of mid-range where the best TRT docs typically want to get you past mid-range and into the upper quartile.

Others here are much more knowledgeable about thyroid and I am sure they will chime in.

I have always been a low e2 guy, so you're point is probably right. As for the midrange t level, this too concerns me. I've done shots before and can easily get into the 1000 range, e2 still around 20 and have zero libido and erections. Gels give me the dht boost and "usually" better erections. However, shots give me better workouts and I look more muscular on them...for some reason women are much more drawn to me too.

Wondering if just upping the gel by a pump or so would get me around 800-900?

 

[ERO]

its probably worth trying for 4 weeks and then testing again as long as the increased amount won't jam you up with your insurance or your prescription or whatever.

I am a guy that has been on TRT for 5 years and it has never done much good for my libido either, so I can definitely relate. I used to have a very high libido from puberty until my mid-40s so I know what it (used to) feel like.

 

[CoastWatcher]

You wrote you have been on and off different TRTapproaches/protocols. How long you mean been following the one you are currently following?

 

[Vince Carter]

You can use a little, say 10-15mg oral tablet to try and get your E2 to come up a bit, I agree with others that 23 is probably to low, the sensitive test would probably show around 15 (informed guestimation). The DHEA oral pass through the liver can convert, some, to E2.
Otherwise yes, I'd do HCG 500iu 2x a week for starters and you're low on T4 so ya, give that a try, too.

 

[osirisrisen]

You can use a little, say 10-15mg oral tablet to try and get your E2 to come up a bit, I agree with others that 23 is probably to low, the sensitive test would probably show around 15 (informed guestimation). The DHEA oral pass through the liver can convert, some, to E2.
Otherwise yes, I'd do HCG 500iu 2x a week for starters and you're low on T4 so ya, give that a try, too.

Sounds good, and I agree. Going to try:

1. 50mcg t4
2. HCG 500 2x week
3. 25mg DHEA
4. 6 pumps T Gel