Bloodwork looks ok but Libidio is still low?!

[kram22]

I'm currently on 85mg of Test cyp twice per week, 90mg of Armour Thyroid daily, .5mg of Anastrozole twice per week and HCG 500IU twice per week. After a great boost in my libido when I first started TRT over a year ago that only lasted a few weeks I've never been able to get my libido back to that level. Its now just as bad as it was before I started TRT. Any suggestions on what I can do because its driving me crazy?

Labs
T4,FREE - 0.8 Range: 0.8-1.8 - ng/dL
T3,FREE - 3.9 Range: 2.3-4.2 - pg/mL
TSH - 1.48 Range: 0.40-4.50 - mIU/L
PSA,TOTAL - 0.5 Range: <=4.0 - ng/mL\
CORTISOL,TOTAL,SERUM - 16.0 Range: - mcg/dL\
ESTRADIOL - 18 Range: < OR = 39 - pg/mL
TESTOSTERONE,TOT,LC/MS/MS 1782 H 250-1100 (ng/dL)
TESTOSTERONE,FREE 258.4 H 35.0-155.0 (pg/mL)
VITAMIN D,25-OH,TOTAL,IA - 80 Range: 30-100 - ng/mL
C-REACTIVE PROTEIN - <0.1 Range: <0.8 - mg/d
PROLACTIN, SERUM -12.1 Range: 4.0-15.2 - ng/mL
FSH(FOLLICLESTIM.H- 0.1 Range: 1.5-12.4
LH(LEUTINIZINGHORM- <0.1 Range: 1.7-8.6 -mIU/mL
GROWTH HORMONE-i.i Range: <3.0 -ng/mL
CHOLESTEROL - 200 Range: <200 - mg/dL Flag: H
HDL CHOLESTEROL -77 Range: >40 - mg/dL
LDL/HDLRATIO-1.47 Range: <3.56
•LDL CHOLESTEROL - 113 Range: <100 - mg/dL Flag: H
TRIGLYCERIDES-51 Range: <150 -mg/dL
GLUCOSE - 138 Range: 65-139 - mg/dL
SODIUM - 136 Range: 135-146 - mmol/L
POTASSIUM - 4.1 Range: 3.5-5.3 - mmol/L
CHLORIDE - 100 Range: 98-110 - mmol/L
CARBON DIOXIDE - 25 Range: 19-30 - mmol/L
UREA NITROGEN - 12 Range: 7-25 - mg/dL
CREATININE - 1.06 Range: 0.60-1.35 - mg/dL
BUN/CREAT RATIO- 9.2 Range: 10.0-28.0
CALCIUM - 9.4 Range: 8.6-10.3 - mg/dL
PROTEIN, TOTAL, SERUM - 7.0 Range: 6.1-8.1 - g/dL
ALBUMIN - 5.0 Range: 3.6-5.1 - g/dL
GLOBULIN,CALCULATED - 2.0 Range: 1.9-3.7 - g/dL
A/G RATIO - 2.5 Range: 1.0-2.5 - calc
BILIRUBIN,TOTAL - 0.9 Range: 0.2-1.2 - mg/dL
ALKALINE PHOSPHATASE - 60 Range: 40-115 - U/L
AST - 32 Range: 10-40 - U/L
ALT - 22 Range: 9-46 - U/L
EGFR NON AFR AMERICAN - 83 Range: >=60 - mL/min/1.73m2
EGFR AFRICAN AMERICAN - 96 Range: >=60 - mL/min/1.73m2
WBC - 2.7 Range: 3.8-10.8 - Thous/mcL Flag: L
RBC - 4.85 Range: 4.20-5.80 - Mill/mcL
HEMOGLOBIN - 15.6 Range: 13.2-17.1 - g/dL
HEMATOCRIT - 45.5 Range: 38.5-50.0 - %
MCV - 94.0 Range: 80.0-100.0 - fL
MCH - 32.2 Range: 27.0-33.0 - pg
MCHC - 34.3 Range: 32.0-36.0 - g/dL
RDW - 13.7 Range: 11.0-15.0 - %
PLATELET COUNT - 133 Range: 140-400 - Thous/mcL Flag: L
MPV - 10.0 Range: 7.5-11.5 - fL
TOTAL NEUTROPHILS,% - 65.0 Range: 38-80 - %
TOTAL LYMPHOCYTES,% - 25.8 Range: 15-49 - %
MONOCYTES,% - 5.9 Range: 0-13 - %
EOSINOPHILS,% - 2.9 Range: 0-8 - %
BASOPHILS,% - 0.4 Range: 0-2 - %
NEUTROPHILS,ABSOLUTE - 1755 Range: 1500-7800 - Cells/mcL
LYMPHOCYTES,ABSOLUTE - 697 Range: 850-3900 - Cells/mcL Flag: L
MONOCYTES,ABSOLUTE - 159 Range: 200-950 - Cells/mcL Flag: L
EOSINOPHILS,ABSOLUTE - 78 Range: 15-500 - Cells/mcL
BASOPHILS,ABSOLUTE - 11 Range: 0-200 - Cells/mcL

 

[PAUL-E]

Are you taking any other medications even non prescription?

 

[kram22]

Are you taking any other medications even non prescription?

I'm diabetic so I use Insulin and I also take some Vitamins daily, Zinc,B-Complex, Vitamin-D, Cod Liver Oil. I'm thinking of adding some Aimos Acids as well like L-Citrulline, L-Arginine and Acetyl L-Carnitine to see if that helps.

 

[ERO]

Your symptoms are not uncommon, and I can completely relate as TRT has never done anything for my low libido, either.

If your E2 test was not the sensitive test for men, it may be that your E2 is too low (for you - we are all different) and that reducing your AI dosage could help you libido. Low E2 kills libido faster than high E2 and 0.5 mg of AI twice weekly is a pretty hefty dose.

 

[kram22]

I originally started with .5 AI per week and libido wasn't any better...Estradiol was 32 at that time.

 

[ERO]

That could still be on the low side for you - was it the sensitive or the regular test? Have you ever had high E2 symtoms?

 

[kram22]

Only once when i was taking I was mistakenly taking higher dose of Test then prescribed. Also i tried stopping the AI for awhile and lost morning wood completely so I went back to it. None of this ever really help Libido though...was always pretty weak except for when I first started TRT.

 

[Vince]

TESTOSTERONE,TOT,LC/MS/MS 1782 H 250-1100 (ng/dL)
TESTOSTERONE,FREE 258.4 H 35.0-155.0 (pg/mL)
GLUCOSE - 138 Range: 65-139 - mg/dL
Looks like your T levels are pretty high, people have told me when their T levels are too high. They lose their libido, I don't know if this is true, I never had my levels that high.
Need an A1C test for average blood glucose levels over several months, are you diabetic.

 

[kram22]

Yes I'm Diabetic for 17yrs but keep very tight control..My A1C is always between 5-6...last time i had it tested it was 5.7. I'm in pretty good shape, eat healthy and exercise 4-5x weekly.

 

[PAUL-E]

Do you know your DHT, GH, and IGF-1 levels?

 

[kram22]

Do you know your DHT, GH, and IGF-1 levels?

GROWTH HORMONE-i.i Range: <3.0 -ng/mL...don't know the DHT and IGF-1 levels

 

[kram22]

GROWTH HORMONE- 1.1: <3.0 -ng/mL...don't know the DHT and IGF-1

 

[PAUL-E]

DHT is linked to libido https://thinksteroids.com/steroid-profiles/dht/
IGF-1 can be a good indicator of GH levels since GH varies so much during the day, seems like most people who are low in GH and get HRT for it notice improved libido.
also progesterone if high can effect it negatively.

Enhancing DHT via the use of HCG, compounded testosterone creams applied to the scrotum, DHT gel (not available in the US) and Proviron (not available in the US) are great ways to increase sex cravings in men.

A peptide PT-141 has also shown some benefits but it never worked for me.

https://www.excelmale.com/forum/showthread.php?6645-I-could-use-some-advice-for-improving-libido

Your symptoms are not uncommon, and I can completely relate as TRT has never done anything for my low libido, either.

This can also be true everyone is different. I am still learning myself but there are a lot of members on here that are very knowledgeable and give good advise in my opinion.

 

[John O'Connor]

Are you still with Dr. Saya from Defy?

I'm guessing - but based on your previous posts from last year, when SHBG was very high, and this libido problem was ongoing. Why don't you try approaching this in the opposite way you are currently approaching it?

Also - why are all of your Estradiol tests the non-sensitive version? From your very 1st post, people have been telling you to get the Estradiol sensitive (LabCorp) or Ultrasensitive (Quest) version.

Same for checking DHT - this is not the 1st time people suggested checking that.

If I were you I'd cut my testosterone dosage by 75% and try to live in the 400-500 range (for a couple months as an experiment). Everyone is unique, and what works for one person (600-1000) or (1000-1500) does not work for others. Normally people who do get up above 1200 do it over the course of years, trying to optimize their levels. You went there in a couple months - and have struggled ever since.

Your Free T isn't even close to the normal range.
TESTOSTERONE,TOT,LC/MS/MS 1782 H 250-1100 (ng/dL)
TESTOSTERONE,FREE 258.4 H 35.0-155.0 (pg/mL)

And your only SHBG numbers were through the roof.
79 (10-57) on 2/18/2015

When did you first start TRT (date)?
What was your body fat % before starting TRT, and what is it now?

 

[Jackie Treehorn]

Kram,

First off, you need to get the correct E2 test performed. You need the sensitive E2 panel, not the regular estradiol test...that is for women. I'll bet that your sensitive E2 levels are <10, and that is killing your libido.

Your anastrozole dosage is huge, for lack of a better word. I would try backing that off to .15mg or .25mg BIW, and see what happens.

Secondly, your total test and Free test levels are through the roof. I don't know when you performed your blood draw, so I'm assuming that it was at the trough. If so, I think your dosage of test is too high. That is another variable that you can adjust, after consulting your doctor. Just make sure that you're not adjusting too many variables before your next blood test. I would only change one variable at a time. That way you know if it was the culprit or not.

Good luck to you.

 

[GA8314]

It MAY be that your are simply too high in fT and TT.... I've been at very very high levels, and I can tell you that it's not the best for sexual function. Yes, my libido was pretty decent, but erections and sensitivity were not optimal on supra physiological doses.

While I understand you may not be taking a typical "supra physiological" dose, your numbers ARE very high. This may not be your "sweet spot", so consider lowering your dose and see what happens.

 

[kram22]

Are you still with Dr. Saya from Defy?

I'm guessing - but based on your previous posts from last year, when SHBG was very high, and this libido problem was ongoing. Why don't you try approaching this in the opposite way you are currently approaching it?

Also - why are all of your Estradiol tests the non-sensitive version? From your very 1st post, people have been telling you to get the Estradiol sensitive (LabCorp) or Ultrasensitive (Quest) version.

Same for checking DHT - this is not the 1st time people suggested checking that.

If I were you I'd cut my testosterone dosage by 75% and try to live in the 400-500 range (for a couple months as an experiment). Everyone is unique, and what works for one person (600-1000) or (1000-1500) does not work for others. Normally people who do get up above 1200 do it over the course of years, trying to optimize their levels. You went there in a couple months - and have struggled ever since.

Your Free T isn't even close to the normal range.
TESTOSTERONE,TOT,LC/MS/MS 1782 H 250-1100 (ng/dL)
TESTOSTERONE,FREE 258.4 H 35.0-155.0 (pg/mL)

And your only SHBG numbers were through the roof.
79 (10-57) on 2/18/2015

When did you first start TRT (date)?
What was your body fat % before starting TRT, and what is it now?

I started with Defy 12/2014 and I'm still with Defy but when i asked Dr.Saya about getting the sensitive E test done he told me it wasn't necessary. I've been getting these Labs done through my regular doctor so my insurance will cover the costs but there are certain test they won't do for me. I'm seeing another doctor and will try to get the sensitive E, DHT, SHBG, DHEA and Pregnenolone tests done..If i can't i'll just have to pay out of pocket for them. I've never had my bodyfat checked but i'm in pretty good shape. I'm 47yr old. 6'4. 200lbs.

 

[kram22]

Kram,

First off, you need to get the correct E2 test performed. You need the sensitive E2 panel, not the regular estradiol test...that is for women. I'll bet that your sensitive E2 levels are <10, and that is killing your libido.

Your anastrozole dosage is huge, for lack of a better word. I would try backing that off to .15mg or .25mg BIW, and see what happens.

Secondly, your total test and Free test levels are through the roof. I don't know when you performed your blood draw, so I'm assuming that it was at the trough. If so, I think your dosage of test is too high. That is another variable that you can adjust, after consulting your doctor. Just make sure that you're not adjusting too many variables before your next blood test. I would only change one variable at a time. That way you know if it was the culprit or not.

Good luck to you.

I'll try that and will also make sure I get all those tests done....Thx

 

[John O'Connor]

I started with Defy 12/2014 and I'm still with Defy but when i asked Dr.Saya about getting the sensitive E test done he told me it wasn't necessary. I've been getting these Labs done through my regular doctor so my insurance will cover the costs but there are certain test they won't do for me. I'm seeing another doctor and will try to get the sensitive E, DHT, SHBG, DHEA and Pregnenolone tests done..If i can't i'll just have to pay out of pocket for them. I've never had my bodyfat checked but i'm in pretty good shape. I'm 47yr old. 6'4. 200lbs.

FYI, DHEA is the supplement many people take. DHEA-S is the test, (S = sulfate). Just so you order that correctly when you have it checked.

I asked about the body fat, to get an understanding of the physical improvements and gains in strength you have experienced since going from low T levels to, the upper end T levels (1700+). I'm guessing the difference is quite dramatic - as we all want when we start TRT. The issue is, mentally we convince ourselves that more is better.

But as many have discussed above - its not always better. Everyone is unique in how they respond to TRT.
As GA8314 states - your current levels are very high, and this may not be your "sweet spot".
.
https://www.excelmale.com/forum/sho...G-necessary-on-testosterone-replacement/page7

Go to page 6 & 7 of this thread and see the amazing difference JQ88 experienced by getting rid of the AI, and lowering his dose and increasing his dosing frequency.

JQ88 on 4/7/16: "Flushed the ADEX down the toilet. Dropped from 100mg twice a week to 42mg EoD.
Feeling so out of it. Brain fog. Tired."

And on 4/14/16: "best I've felt in a long time. Energy improved mental alertness was even able to get a decent erection with Cialis."... "Thanku guys for begging me to stick with something. 42mg EOD NO AI." ... "I'm liking the face I see in the mirror a little bit more. That Anastrozole really ****ed me up cause I used it unwarranted. Cautiously feeling really hopeful... That was a two year disaster guessing with AI's. Really created a lot of stress... I'm hoping this marks the end of that. "

Also note Coastwatcher's dosage & injection schedule
"I inject 16mg daily (cypionate), 250 of HCG, down dramatically, twice a week."
and he later states, "My E2 had climbed slightly when I was injecting every 3.5 days. Never having used an AI, and wanting to avoid one if I could, my doctor and I moved to daily injections. I've injected every day since the first of July, never having missed a shot, and my total testosterone clocks in at 929, my E2 at 25. Speed is right - any problems you encounter can be dealt with."

There are so many stories like this out there - but making these adjustments takes patience. You may feel like crap initially, but its the only way to find your true "sweet spot", and stop the year-long madness you've experienced. Hopefully this gives you a change in perspective. Good luck!

 

[kram22]

FYI, DHEA is the supplement many people take. DHEA-S is the test, (S = sulfate). Just so you order that correctly when you have it checked.

I asked about the body fat, to get an understanding of the physical improvements and gains in strength you have experienced since going from low T levels to, the upper end T levels (1700+). I'm guessing the difference is quite dramatic - as we all want when we start TRT. The issue is, mentally we convince ourselves that more is better.

But as many have discussed above - its not always better. Everyone is unique in how they respond to TRT.
As GA8314 states - your current levels are very high, and this may not be your "sweet spot".
.
https://www.excelmale.com/forum/sho...G-necessary-on-testosterone-replacement/page7

Go to page 6 & 7 of this thread and see the amazing difference JQ88 experienced by getting rid of the AI, and lowering his dose and increasing his dosing frequency.

JQ88 on 4/7/16: "Flushed the ADEX down the toilet. Dropped from 100mg twice a week to 42mg EoD.
Feeling so out of it. Brain fog. Tired."

And on 4/14/16: "best I've felt in a long time. Energy improved mental alertness was even able to get a decent erection with Cialis."... "Thanku guys for begging me to stick with something. 42mg EOD NO AI." ... "I'm liking the face I see in the mirror a little bit more. That Anastrozole really ****ed me up cause I used it unwarranted. Cautiously feeling really hopeful... That was a two year disaster guessing with AI's. Really created a lot of stress... I'm hoping this marks the end of that. "

Also note Coastwatcher's dosage & injection schedule
"I inject 16mg daily (cypionate), 250 of HCG, down dramatically, twice a week."
and he later states, "My E2 had climbed slightly when I was injecting every 3.5 days. Never having used an AI, and wanting to avoid one if I could, my doctor and I moved to daily injections. I've injected every day since the first of July, never having missed a shot, and my total testosterone clocks in at 929, my E2 at 25. Speed is right - any problems you encounter can be dealt with."

There are so many stories like this out there - but making these adjustments takes patience. You may feel like crap initially, but its the only way to find your true "sweet spot", and stop the year-long madness you've experienced. Hopefully this gives you a change in perspective. Good luck!

Thanks for all the info...I really appreciate it.