Can an 1150 Total T crash your libido?

[stx358]

Good day all. New site member here. I'll try to make it concise. I am a recent TRT patient. Initial numbers were total = 400, free = 8, estradiol = 15. Physician diagnosed me with low T based on low estradiol, low free and symptoms. I am 47, fit, good BMI, normal cholesterol, normal BP.

Initial dose was 40 mg test cyp injected twice per week. After 2 months total = 550, free = 9.

Doctor titrated to 100 mg test cyp twice per week. Last numbers (after 4 weeks) total = 1150, free = 21, estradiol = 45.

I experienced improvement in ED and libido symptoms initially on the smaller dose which subsided. Since going up to the 200mg/week dose my libido and erectile function have crashed. Also taking Cialis 5 mg every day.

Is that total T crashing my libido? Would HCG be worth a try?

Many thanks for any help folks - very frustrated at this point.

 

[Vince Carter]

80 mg to 200mg...quite an interesting Dr you have there. Besides that...your Estradiol testing is probably wrong, too, can you post the lab ranges that were associated with the E testing? There's only one test that is for males, you labs should read something like "LC/MS/MS"...anything else is wrong. Though I do not think that a 45 is high, what often happens, but not in every guy, the sensitive test is going to read lower.

 

[CoastWatcher]

Good day all. New site member here. I'll try to make it concise. I am a recent TRT patient. Initial numbers were total = 400, free = 8, estradiol = 15. Physician diagnosed me with low T based on low estradiol, low free and symptoms. I am 47, fit, good BMI, normal cholesterol, normal BP.

Initial dose was 40 mg test cyp injected twice per week. After 2 months total = 550, free = 9.

Doctor titrated to 100 mg test cyp twice per week. Last numbers (after 4 weeks) total = 1150, free = 21, estradiol = 45.

I experienced improvement in ED and libido symptoms initially on the smaller dose which subsided. Since going up to the 200mg/week dose my libido and erectile function have crashed. Also taking Cialis 5 mg every day.

Is that total T crashing my libido? Would HCG be worth a try?

Many thanks for any help folks - very frustrated at this point.

When were these labs drawn relative to your injection? Were both pulled just prior to a scheduled shot? You mention twice per week, every 3.5 days? What is your SHBG?

 

[Vettester Chris]

IMO, libido and other wellness attributes are dependent on many areas of the endocrine system being in balance. A nice bump in test sounds good at a glance, but if areas, say like adrenals and thyroid are not in-tune, it can trigger counterproductive reactions as way to achieve homeostasis.

Your free test at a glance reflects a lower SHBG level (?), and maybe your body is telling you to back it down? HCG will only add more testosterone to your body, and then you also have more E2 to deal with, and from a intra-testicular standpoint it could present a more problematic challenge to manage.

 

[stx358]

SHBG is 51
I inject Monday and Thursday and test was drawn Thursday morning before my injection.
Thanks

 

[Systemlord]

I agree with Vettester Chris, I believe going from 80mg to 200mg probably forced your SHBG downward creating high FT which sounds good on paper but the truth ends up quite different. SHBG testing will allow your doctor to decide which protocol is likely going to succeed and which ones will fail. Low SHBG you will do better on smaller more frequent injections and larger injections to suppress high SHBG levels.

You went from a protocol designed for low SHBG guys to a protocol for those with high levels of SHBG and now you feel like everything has crashed. This is exactly what happened to me when I started out on high doses, I felt worse than before TRT, it wasn't until my dose was lowered injections became more frequent that I started to feel better.

You need to find a new doctor because the one you currently have doesn't know what he's doing.

 

[Vettester Chris]

SHBG is 51
I inject Monday and Thursday and test was drawn Thursday morning before my injection.
Thanks

My bad, on your opening post, I mistakenly took your Total Serum as 1,150 and Free Test at 400. Sorry for burning through it fast! Yeah at 400ng/dl and 8 Free test, you're at 2%.

 

[Systemlord]

SHBG is 51
I inject Monday and Thursday and test was drawn Thursday morning before my injection.
Thanks

You require moderate doses of testosterone, that SHBG is getting on the high side of the range. Note almost everyone goes through the TRT honeymoon phase when they first start TRT, for Some it lasts few weeks and others days and then your HPTA shuts down. It could literally take months for you to start feeling changes and feeling like your old self. But for this to happen you need a doctor that knows what he's doing, most growing patient and give up thinking that TRT is failed them when in fact it is the doctors who have failed them.

 

[Miguel99]

Maybe you should give it time (8-12 weeks) so it stabilize?
I got the best advice from Coastwatcher, be patient and dont change your protocol before after 3 months. Works for me

Sorry about spelling and so, not from an english speaking country

 

[Starplex]

Agree with others, give it some time to settle out before making to many changes. Might also consider where your DHEA levels are at. Do you need to supplement this area? I saw what I think is an improvement after I added DIM to my protocol, but I realize that doesn't work for everyone.

 

[lowe2sucks]

it's possible.. a lot of men feel better on lower doses like 80-100mg per week then on higher doses. I can imagine 200 maybe very supressive on your whole hpta and can work against you. but give it more time your doc probably has a reason he put you on 200mg as for now

 

[JMP]

I personally don't see any logical reason to go straight from 80 mg to 200. That's a recipe for failure in my opinion. 80mg to 100 or even 120mg, but not straight to 200. You are just asking for problems.

 

[Vince Carter]

it's possible.. a lot of men feel better on lower doses like 80-100mg per week then on higher doses. I can imagine 200 maybe very supressive on your whole hpta and can work against you. but give it more time your doc probably has a reason he put you on 200mg as for now

T is suppressive, there's not a little or "very".

 

[Vince Carter]

I personally don't see any logical reason to go straight from 80 mg to 200. That's a recipe for failure in my opinion. 80mg to 100 or even 120mg, but not straight to 200. You are just asking for problems.

That's what I went to right away as such a massive change at one time, a low rather innefective dose wasn't working that well so he took a sledgehammer to it.

 

[Vitamin_C]

IMO, libido and other wellness attributes are dependent on many areas of the endocrine system being in balance. A nice bump in test sounds good at a glance, but if areas, say like adrenals and thyroid are not in-tune, it can trigger counterproductive reactions as way to achieve homeostasis.

Your free test at a glance reflects a lower SHBG level (?), and maybe your body is telling you to back it down? HCG will only add more testosterone to your body, and then you also have more E2 to deal with, and from a intra-testicular standpoint it could present a more problematic challenge to manage.

This is accurate. I crashed my E2 and was going through a lot of stress at the same time with relationships and school. With the low E2 and stress, my anxiety came back strong and I felt like my adrenals were pumping out cortisol 24/7. My DHEA levels dropped about 400 points which made me suspect adrenal fatigue. My estrogen recovered but I still have some anxiety and erectile strength and libido are not 100% but I would rate them at about 90% and improving. My total test and free test are both high but the adrenal issues are messing up homeostasis. I also am developing some chronic pain and tendinitis in my elbows which has hampered me in the gym. I was on 500mg+ caffeine per day for years as a night shift worker, crashed E2 + stress+ stimulants and my adrenals said enough. Once I fix my adrenals I'll be back to 100%. The good thing is at least being on Testosterone I don't have to worry about hypogonadism from under-performing adrenals.

In your case specifically, I would look at your estrogen levels with that total T.

 

[stx358]

My doctor is now asking me to reduce my dose back down to 40mg twice a week, but add 250 IU HCG injected on the same days. Does HCG really create that much endogenous test production? On 40 mg I was in the mid 500's for total T. These were my numbers after 2 months on 40 mg twice a week which is why he took me up to 100mg twice a week.

Dehydroepiandrosterone
sulfate (μg/dL) 219


Estradiol (pg/mL) 34.4


Human sex hormone-
binding globulin (nmol/L) 51


Testosterone (ng/dL) 561


Free Testosterone (ng/dL)
(calculated) 8.96

 

[CoastWatcher]

My doctor is now asking me to reduce my dose back down to 40mg twice a week, but add 250 IU HCG injected on the same days. Does HCG really create that much endogenous test production? On 40 mg I was in the mid 500's for total T. These were my numbers after 2 months on 40 mg twice a week which is why he took me up to 100mg twice a week.

Dehydroepiandrosterone
sulfate (μg/dL) 219


Estradiol (pg/mL) 34.4


Human sex hormone-
binding globulin (nmol/L) 51


Testosterone (ng/dL) 561


Free Testosterone (ng/dL)
(calculated) 8.96

If exogenous testosterone is being administered, endogenous production is shut down. HCG is used as an adjunctive medication in a protocol to sustain testicular vitality and support upstream hormone production.

Your doctor is is making this up as you go along. With a SHBG levels over 50 you face challenges that small injections twice weekly won't overcome. Still, you were injecting a whopper of a dose and felt miserable. So...you go back to the smaller dose where you felt miserable. What was his reasoning for this?

Was your estradiol measured with the LC, MS/MS lab test (the sensitive test)? If you don't know, post the range associated with the test as it will be a dead giveaway.

You need better care.

 

[Vitamin_C]

My doctor is now asking me to reduce my dose back down to 40mg twice a week, but add 250 IU HCG injected on the same days. Does HCG really create that much endogenous test production? On 40 mg I was in the mid 500's for total T. These were my numbers after 2 months on 40 mg twice a week which is why he took me up to 100mg twice a week.

Dehydroepiandrosterone
sulfate (μg/dL) 219


Estradiol (pg/mL) 34.4


Human sex hormone-
binding globulin (nmol/L) 51


Testosterone (ng/dL) 561


Free Testosterone (ng/dL)
(calculated) 8.96

He should have bumped you to 100mg a week, 200mg a week is the upper limit dose so he went from a very conservative dose to a very high dose. With your SHBG at 51, you should suggest to your doctor a once per week protocol shot every 7 days. You need to make sure your E2 is the sensitive test, more accurate for men.

 

[stx358]

This is the range on the estradiol - not sure if this is the sensitive assay or not - 25.8 - 60.7

 

[cleverusername]

My doctor is now asking me to reduce my dose back down to 40mg twice a week, but add 250 IU HCG injected on the same days. Does HCG really create that much endogenous test production? On 40 mg I was in the mid 500's for total T. These were my numbers after 2 months on 40 mg twice a week which is why he took me up to 100mg twice a week.

It has been said by Dr Crisler that the HCG should be injected one day before the Test C injections now. He linked a paper to this somewhere in the forum.

I also agree with everyone else, 40mg twice a week to 100mg twice a week is a HUGE jump!