Difficulty finding the right dose

[Pocketman]

I've been on TRT for about 10 years. Every time I read the benefits I realize I've never really experienced them. I wondered if I'm on the right dose. It never helped with depression so I take Wellbutrin. I'm 65 yrs old. I was on 0.7 ml but I started to have some problems. I didn't feel great and I get an erection but I would lose it in the middle of sex. was losing erections Recently I've been on 0.8 ml and I feel a little better sexually. My estradiol is high so I've been prescribed anastrozole. I take half of a 1 mg tablet twice per week
I had blood done recently and here's my results:
Testosterone
Total 1,014.7
Free 33.3

Estradiol 58.9. High
RBC. 6.09 x 10E6/uL
LDL 131mg
Cholesterol 202 mg/dl
Heme A1c 5.9%
These results are crazy, considering I eat a really clean diet. I eat only lean protein, no sugar. Are you complex carbohydrates and healthy fats

 

[Phil Goodman]

A lot of different ways this could go, but my first question would be: why did you take a medication for 10 years if it didn’t provide you with any benefits?

Also, what symptoms are you looking for help with? Testosterone isn’t a magic bullet, but it can have lots of benefits for many people. Whether, and how much, it helps will depend on a lot of different things. But again, what symptoms do you experience that you’re trying to alleviate?

 

[Forty2]

I've been on TRT for about 10 years. Every time I read the benefits I realize I've never really experienced them. I wondered if I'm on the right dose. It never helped with depression so I take Wellbutrin. I'm 65 yrs old. I was on 0.7 ml but I started to have some problems. I didn't feel great and I get an erection but I would lose it in the middle of sex. was losing erections Recently I've been on 0.8 ml and I feel a little better sexually. My estradiol is high so I've been prescribed anastrozole. I take half of a 1 mg tablet twice per week
I had blood done recently and here's my results:
Testosterone
Total 1,014.7
Free 33.3

Estradiol 58.9. High
RBC. 6.09 x 10E6/uL
LDL 131mg
Cholesterol 202 mg/dl
Heme A1c 5.9%
These results are crazy, considering I eat a really clean diet. I eat only lean protein, no sugar. Are you complex carbohydrates and healthy fat

 

[t_spacemonkey]

160mg T in 1 weekly shot + 1mg anastrazole weekly. what a shitty protocol. my e2 is 80 and so what. i feel great no AI.
you need to stop that fcking AI and go by symptoms which might go all away if you adjust dosing to 3x a week or so. fire your doc asap

 

[Forty2]

Your testosterone is on the high end.
A lot of guys feel much better when their testosterone is about half of yours.
If I were you, I'd cut the dose by half and drop the arimidex completely.

 

[madman]

I've been on TRT for about 10 years. Every time I read the benefits I realize I've never really experienced them. I wondered if I'm on the right dose. It never helped with depression so I take Wellbutrin. I'm 65 yrs old. I was on 0.7 ml but I started to have some problems. I didn't feel great and I get an erection but I would lose it in the middle of sex. was losing erections Recently I've been on 0.8 ml and I feel a little better sexually. My estradiol is high so I've been prescribed anastrozole. I take half of a 1 mg tablet twice per week
I had blood done recently and here's my results:
Testosterone
Total 1,014.7
Free 33.3

Estradiol 58.9. High
RBC. 6.09 x 10E6/uL
LDL 131mg
Cholesterol 202 mg/dl
Heme A1c 5.9%
These results are crazy, considering I eat a really clean diet. I eat only lean protein, no sugar. Are you complex carbohydrates and healthy fats

Your still at this I see.

Need to post more thorough labs.

Always include the reference ranges/assays used TT (LC/MS-MS or direct immunoassay), estradiol (LC/MS-MS or direct immunoassay), FT (Equilibrium Dialysis, Ultrafiltration, direct immunoassay or cFT).

Results can be skewed if you are not using accurate assays especially when it comes to free testosterone.

You left out critical blood markers SHBG, hemoglobin and hematocrit.

What is your protocol 160 mg T once weekly or are you still on twice weekly injections which you were following back in May (thread posted below).

So hear are my test results:

Estradiol: 64.2. (since this result, I started taking arimidex .5 mg (1/2. tablet) twice per week Testosterone total: 1,190 Testosterone free: 25.6 What is the best range for best results? I know the estrogen was too high...

www.excelmale.com

Where your labs done at true trough which would be 7 days post-injection if you are injecting 160 mg T once weekly and if you are injecting 160 mg T split twice weekly (every 3.5 days) than your true trough would be 84 hrs post-injection.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

Even without posting the reference ranges your TT is very high which would have your FT high even if you have highish SHBG.

Top it off that your estradiol is high due to the high FT which is why you threw in the AI.

Keep in mind that if these are your TT, FT and estradiol levels at true trough than peak levels will be much higher.

If such is the case then you would easily have room to lower your weekly dose and drop the AI.

Can be a slippery slope when relying on an aromatase inhibitor to try and manage elevated estradiol as in many cases one can easily crash e2 if they are not careful.

Too many end up overmedicating.

The sensible ones are using micro-doses.

Even then there are many that are running way too high a trough FT level and could easily avoid use of an AI by lowering their dose.

Too many still caught up on that more T is better mentality.

Running too high an FT can be just as bad in the long run as having a low FT in many ways.

As I have stated numerous times on the forum we need to tread lightly when trying to manipulate testosterone metabolites estradiol and DHT as they are needed in healthy amounts and are critical to our overall health.

Estradiol and DHT are needed in healthy amounts to experience the full spectrum of testosterones beneficial effects on mood, energy, libido, erectile function, cardiovascular health, brain, bones, tendons, immune system, body composition, and recovery.

*Natural testosterone is viewed as the best androgen for substitution in hypogonadal men. The reason behind the selection is that testosterone can be converted to DHT and E2, thus developing the full spectrum of testosterone activities in long-term substitution

Looking over your labs back in May your were hitting a very high TT 1190 ng/dL and although your FT was a little lower 25.6 than now 33.3 you never stated what method (assay, calculated) was used or the reference ranges.

Again with a very high TT almost 1200 ng/dL your FT would be high even if you had highish/high SHBG.

You threw in the AI to try and manage your elevated estradiol.

Put money on it that your RBCs, hemoglobin and hematocrit were high back in May and on your current protocol!

My reply from a previous thread may give you some insight when it comes to using/relying on testosterone to treat depression/anxiety.

*Although TRT can improve mild depression, anxiety, and overall well-being it is highly doubtful that it will have a big impact on treating MDD.

*Keep in mind that even men with healthy testosterone levels can still suffer from mild, moderate, or severe depression.

Does depression from low testosterone feel different from "regular" depression?

Hi! I been struggling with ptsd and depression for a few years as a result of years of working as a first responder. I sought different ways to fix it however they work temporarily. Two weeks ago I got some blood work done and my testosterone came back low the doctor referred me to a men's...

www.excelmale.com

 

[Systemlord]

Every time I read the benefits I realize I've never really experienced them. I wondered if I'm on the right dose.

Did you ever give any thought to dosage and injection frequency may be the key to improved sexual performance?

An inappropriate injection frequency can lead to a weaker response to T therapy. I don’t respond very well to therapy at all injecting twice weekly, even with 697 ng/dL trough levels. It took me years to figure this out.

 

[Pocketman]

Did you ever give any thought to dosage and injection frequency may be the key to improved sexual performance? As far as dosage I don't feel like it was really helping me lower doses

An inappropriate injection frequency can lead to a weaker response to T therapy. I don’t respond very well to therapy at all injecting twice weekly, even with 697 ng/dL trough levels. It took me years to figure this out.

Yes, I've been doing it twice weekly. I do it on a Thursday and a Sunday. As far as dosage I don't feel like it was helping me with a low dose

 

[Pocketman]

Your still at this I see.

Need to post more thorough labs.

Always include the reference ranges/assays used TT (LC/MS-MS or direct immunoassay), estradiol (LC/MS-MS or direct immunoassay), FT (Equilibrium Dialysis, Ultrafiltration, direct immunoassay or cFT).

Results can be skewed if you are not using accurate assays especially when it comes to free testosterone.

You left out critical blood markers SHBG, hemoglobin and hematocrit.

What is your protocol 160 mg T once weekly or are you still on twice weekly injections which you were following back in May (thread posted below).

So hear are my test results:

Estradiol: 64.2. (since this result, I started taking arimidex .5 mg (1/2. tablet) twice per week Testosterone total: 1,190 Testosterone free: 25.6 What is the best range for best results? I know the estrogen was too high...

www.excelmale.com

Where your labs done at true trough which would be 7 days post-injection if you are injecting 160 mg T once weekly and if you are injecting 160 mg T split twice weekly (every 3.5 days) than your true trough would be 84 hrs post-injection.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

Even without posting the reference ranges your TT is very high which would have your FT high even if you have highish SHBG.

Top it off that your estradiol is high due to the high FT which is why you threw in the AI.

Keep in mind that if these are your TT, FT and estradiol levels at true trough than peak levels will be much higher.

If such is the case then you would easily have room to lower your weekly dose and drop the AI.

Can be a slippery slope when relying on an aromatase inhibitor to try and manage elevated estradiol as in many cases one can easily crash e2 if they are not careful.

Too many end up overmedicating.

The sensible ones are using micro-doses.

Even then there are many that are running way too high a trough FT level and could easily avoid use of an AI by lowering their dose.

Too many still caught up on that more T is better mentality.

Running too high an FT can be just as bad in the long run as having a low FT in many ways.

As I have stated numerous times on the forum we need to tread lightly when trying to manipulate testosterone metabolites estradiol and DHT as they are needed in healthy amounts and are critical to our overall health.

Estradiol and DHT are needed in healthy amounts to experience the full spectrum of testosterones beneficial effects on mood, energy, libido, erectile function, cardiovascular health, brain, bones, tendons, immune system, body composition, and recovery.

*Natural testosterone is viewed as the best androgen for substitution in hypogonadal men. The reason behind the selection is that testosterone can be converted to DHT and E2, thus developing the full spectrum of testosterone activities in long-term substitution

Looking over your labs back in May your were hitting a very high TT 1190 ng/dL and although your FT was a little lower 25.6 than now 33.3 you never stated what method (assay, calculated) was used or the reference ranges.

Again with a very high TT almost 1200 ng/dL your FT would be high even if you had highish/high SHBG.

You threw in the AI to try and manage your elevated estradiol.

Put money on it that your RBCs, hemoglobin and hematocrit were high back in May and on your current protocol!

My reply from a previous thread may give you some insight when it comes to using/relying on testosterone to treat depression/anxiety.

*Although TRT can improve mild depression, anxiety, and overall well-being it is highly doubtful that it will have a big impact on treating MDD.

*Keep in mind that even men with healthy testosterone levels can still suffer from mild, moderate, or severe depression.

Does depression from low testosterone feel different from "regular" depression?

Hi! I been struggling with ptsd and depression for a few years as a result of years of working as a first responder. I sought different ways to fix it however they work temporarily. Two weeks ago I got some blood work done and my testosterone came back low the doctor referred me to a men's...

www.excelmale.com

I had them done at LabCorp. I'm not sure how to tell you what method. I have my blood taken and they sent it to the lab. Surprisingly my hemoglobin and hematocrit were normal. The RBC were high.
I didn't have SHGB done.
I did my injection on a Thursday and had the blood taken Wednesday of the following week. So it was on the 6th day.

 

[Vince]

I've been on TRT for about 10 years. Every time I read the benefits I realize I've never really experienced them. I wondered if I'm on the right dose. It never helped with depression so I take Wellbutrin. I'm 65 yrs old. I was on 0.7 ml but I started to have some problems. I didn't feel great and I get an erection but I would lose it in the middle of sex. was losing erections Recently I've been on 0.8 ml and I feel a little better sexually. My estradiol is high so I've been prescribed anastrozole. I take half of a 1 mg tablet twice per week
I had blood done recently and here's my results:
Testosterone
Total 1,014.7
Free 33.3

Estradiol 58.9. High
RBC. 6.09 x 10E6/uL
LDL 131mg
Cholesterol 202 mg/dl
Heme A1c 5.9%
These results are crazy, considering I eat a really clean diet. I eat only lean protein, no sugar. Are you complex carbohydrates and healthy fats

My short answer would be lower your dose of T add in in HCG and drop the AI.

 

[Pocketman]

How low? I've been on low before and I didn't feel that great. I held more body fat as well. I don't know where to get HCG

 

[Pocketman]

I had them done at LabCorp. I'm not sure how to tell you what method. I have my blood taken and they sent it to the lab. Surprisingly my hemoglobin and hematocrit were normal. The RBC were high.
I didn't have SHGB done.
I did my injection on a Thursday and had the blood taken Wednesday of the following week. So it was on the 6th day.

 

[madman]

Yes, I've been doing it twice weekly. I do it on a Thursday and a Sunday. As far as dosage I don't feel like it was helping me with a low dose

You never even posted up what dose you consider as low let alone where such dose had your trough TT, FT and estradiol level.

Again you need to know where your SHBG sits.

 

[madman]

You had your FT tested using the direct immunoassay (post #12) which is known to be inaccurate.

You need to have your FT tested using an accurate assay (ED or UF) especially in cases of ALTERED SHBG.

Seeing as you reside in the US you have access to the most accurate assays for FT through Labcorp or Quest Diagnostics.

Otherwise for the time being you will need to use/rely upon the cFTV.

 

[madman]

I had them done at LabCorp. I'm not sure how to tell you what method. I have my blood taken and they sent it to the lab. Surprisingly my hemoglobin and hematocrit were normal. The RBC were high.
I didn't have SHGB done.
I did my injection on a Thursday and had the blood taken Wednesday of the following week. So it was on the 6th day.

If you are only injecting once weekly and your blood work was done 6 days post injection than these are where your TT, FT and estradiol levels sit 24 hrs before your true trough (7 days post-injection).

Again you are hitting a very high TT 1042 ng/dL and FT based on the direct immunoassay 6 days post-injection close to true trough.

Your peak TT, FT and estradiol levels are going to be much higher!

 

[Vince]

How low? I've been on low before and I didn't feel that great. I held more body fat as well. I don't know where to get HCG

You may want to start a little too low. It's easier to go up than down. Maybe 40 mg twice a week and 500 iu of HCG twice a week.

cheap HCG (23usd/10k IU) - reliableRX - experience

so after the FDA improved our wellbeing, and made HCG too expensive, i decided to look for alternatives. took the plunge and ordered from an indian pharmacy. Best Online Pharmacy | Buy Prescription Drugs Online - ReliableRx Pharmacy this is obviously a grey area, as this stuff is legal over...

www.excelmale.com

 

[Pocketman]

You may want to start a little too low. It's easier to go up than down. Maybe 40 mg twice a week and 500 iu of HCG twice a week.

cheap HCG (23usd/10k IU) - reliableRX - experience

so after the FDA improved our wellbeing, and made HCG too expensive, i decided to look for alternatives. took the plunge and ordered from an indian pharmacy. Best Online Pharmacy | Buy Prescription Drugs Online - ReliableRx Pharmacy this is obviously a grey area, as this stuff is legal over...

www.excelmale.com

Doing this worries me because I've already been ripped off twice. The one guy took my money then wouldn't ship it until I paid him $200 for insurance. He was going to take the $200 and keep it too.

 

[Pocketman]

If you are only injecting once weekly and your blood work was done 6 days post injection than these are where your TT, FT and estradiol levels sit 24 hrs before your true trough (7 days post-injection).

Again you are hitting a very high TT 1042 ng/dL and FT based on the direct immunoassay 6 days post-injection close to true trough.

Your peak TT, FT and estradiol levels are going to be much higher are you saying it would be that much different 24 hours later? If anything it would probably be lower

If you are only injecting once weekly and your blood work was done 6 days post injection than these are where your TT, FT and estradiol levels sit 24 hrs before your true trough (7 days post-injection).

Again you are hitting a very high TT 1042 ng/dL and FT based on the direct immunoassay 6 days post-injection close to true trough.

Your peak TT, FT and estradiol levels are going to be much higher!

Yes, they probably would be.

 

[Pocketman]

Yes, they probably would be.

I was injecting twice per week but the week before being tested I did the whole thing in one shot. Then I tested 6 days later. I'm probably going to have to keep testing until I get it right. The estradiol is high even while taking anastrozole

 

[Pocketman]

You never even posted up what dose you consider as low let alone where such dose had your trough TT, FT and estradiol level.

Again you need to know where your SHBG sits.

I don't think my doctor tests for that. I asked for Cortisone and he just ignored it. Where can I get that done. Truthfully I've never felt good on it. I've been on a 100 mg, 120 mg, recently 160. At 160 I was getting morning wood