Issues on trt, ED and high DHT

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Yobie

New Member
New here and looking for some advice. Desperate for some help.

I'm having major ED issues. I can get it hard some days but then other days can not. If I can get it hard it requires constant stimulation or it goes soft instantly. There also seems to be low sensitivity down there as well.

Libido seems to be hit and miss as well, but generally stil never turn down sex and am still sexually active even if I cant get it up.

Been on trt for about 3 years now and really just got inthis funk about 6-7 months ago. Nothing has really changed within my protocol except hcg I've experimented with on and off.

I'm 34, 200lbs about 9 percent bf and taking test cyp 20mg EOD sub-q. Currently just restarted HCG at 250 2x week to see how that goes, but no change so far. Also just last week hopped on some arimidex to see if I'm just estrogen sensitive.


Lastly really concerned about the high dht as well. Looking to keep my hair :).



Shbg - 26. (10-50)

Estradiol - 32 (<39)

Hemoglobin - 17.6 (13-17)

T4 - 1.3 (.9 -2.2)

TSH - 2.08 (.4 - 4.50)

Test - 504 (250-827)

DHT - 124 (12-65)

Prolactin: 11.4 (2-18)
 
Last edited:
Defy Medical TRT clinic doctor
I'll let other more experienced members chime in on specifics, but from my own experience, when my T and especially Dht went too high, libido went down dramatically. Also, at age 34 with increased Dht, you are going to have a hair problem increasingly over time.
 
New here and looking for some advice. Desperate for some help.

I'm having major ED issues. I can get it hard some days but then other days can not. If I can get it hard it requires constant stimulation or it goes soft instantly. There also seems to be low sensitivity down there as well.

Libido seems to be hit and miss as well, but generally stil never turn down sex and am still sexually active even if I cant get it up.

Been on trt for about 3 years now and really just got inthis funk about 6-7 months ago. Nothing has really changed within my protocol except hcg I've experimented with on and off.

I'm 34, 200lbs about 9 percent bf and taking test cyp 20mg EOD sub-q. Currently just restarted HCG at 250 2x week to see how that goes, but no change so far. Also just last week hopped on some arimidex to see if I'm just estrogen sensitive.


Lastly really concerned about the high dht as well. Looking to keep my hair :).



Shbg - 26. (10-50)

Estradiol - 32 (<39)

Hemoglobin - 17.6 (13-17)

T4 - 1.3 (.9 -2.2)

TSH - 2.08 (.4 - 4.50)

Test - 504 (250-827)

DHT - 124 (12-65)

Prolactin: 11.4 (2-18)

When were labs done and your TT 500s is sub-par even with having an SHBG 26 nmol/L hard to believe your FT level is high enough.

Regardless 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.

You are missing one of the most important tests which are FT!

It is critical that you have it tested as the goal is to follow a protocol (dose T/injection frequency) that will allow you to attain a healthy trough FT level.

The only way to know where your FT truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).

Hard to give feedback when we have absolutely no idea where your FT level sits on such protocol.

I would look into paying for your own set of labs and use Nelson's discountedlabs.

Either of these assays will suffice when it comes to testing FT!

1 Testosterone, Total and Free (NO Upper Limit) plus Hematocrit

2 Testosterone, Total, LC/MS and Free (Equilibrium Ultrafiltration)



Bad move jumping on the AI!

I would not be too concerned with running higher DHT levels.

Androgens and activation of the AR.

Comes down to genetics, the sensitivity of the AR to androgens, and sensitivity of the skin/hair follicles to DHT.

The main point to keep in mind regarding acne or hair loss (genetically prone individuals).....is that DHT is not the sole contributor and it is the general activation of the AR that is responsible.


post#26
 
post#26

Dihydrotestosterone: Biochemistry, Physiology, and Clinical Implications of Elevated Blood Levels

We are reminded of Horton’s admonition some 25 years ago when he concluded that blood levels of DHT provide only a hint of tissue levels and that DHT should be regarded as a paracrine hormone formed and acting primarily within target tissues (39).

The modest increases observed in serum DHT and in the DHT/T ratio observed after TRT are unlikely to be a cause of clinical concern, particularly when viewed in the context of changes observed in these parameters for currently marketed T replacement products and those under development for which DHT data are available. There is no sound current clinical evidence to indicate that elevated DHT concentrations (either short-lived peaks or sustained supraphysiological levels) are associated with risk beyond that known for androgens (most notably, T), including adverse effects on the prostate.
 
This is key!

*blood levels of DHT provide only a hint of tissue levels and DHT should be regarded as a paracrine hormone formed and acting primarily within target tissues (39)
 
I'll get free test done and report back. I appreciate the feedback. I was curious about my test levels being so low based on my weekly protocol and suspect my FT might be low too. I haven't really changed protocol much since starting, and have always been around 500-550 test on trt. The first year I experienced no loss in libido or ed issues.


I'm nervous going any higher with the test dose tho given my dht and estrogen levels currently as those will only increase as well? I'm super nervous to say the least about the possibility of losing my hair as well!! I'll take a further five into your post regarding DHT, but I have seen it many times over expedite hair loss I'm those I've known.

Regardless, I'll report back after further testing. Super appreciative of your guys reply and willingness to help.
 
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