Med student here. I have been on TRT since 21. Here is what I have learned about ED, libido and hormones.

[Systemlord]

It’s just the way you post.

You simply interpreted my post incorrectly. @Gman86 interpreted my post correctly, it’s about balance.

 

[Charliebizz]

increased estrogen levels can increase TBG (thyroid binding globulin) which can bind to thyroid hormones like SHBG does to sex hormones, and result in less available thyroid hormones to bind and act on receptors. Low thyroid function can also effect libido in a negative way

But what increased the estrogen ? Isn’t it the testosterone ? most guys that visit these forums still do not understand that and are going to take @Systemlord post and see “estrogen is bad for libido“ been around a long time it’s the same story over and over.

 

[Cataceous]

increased estrogen levels can increase TBG (thyroid binding globulin) which can bind to thyroid hormones like SHBG does to sex hormones, and result in less available thyroid hormones to bind and act on receptors. Low thyroid function can also [a]ffect libido in a negative way

However, if thyroid hormones are regulated according to free levels then higher TBG should have little effect, as appears to be the case with free testosterone and higher SHBG.

 

[Systemlord]

most guys that visit these forums still do not understand that and are going to take @Systemlord post and see “estrogen is bad for libido

If new members see my post and interpreted correctly, they will conclude excess hormones can cause problems.

Let’s revisit what I said, “excess estrogen can lead to excess serotonin, which can lead to libido and ED difficulties”.

Your response was, none of this happened to you, which is why I said excess estrogen and excess serotonin “can” lead to problems.

I have no control over someone’s inability to comprehend what’s being written.

 

[Dayman]

However, if thyroid hormones are regulated according to free levels then higher TBG should have little effect, as appears to be the case with free testosterone and higher SHBG.

isnt SHBG also a carrier hormone? i would guess TBG acts on that same principle as well? So in fact having low TBG would actually be a bad thing.

 

[Charliebizz]

If new members see my post and interpreted correctly, they will conclude excess hormones can cause problems.

Let’s revisit what I said, “excess estrogen can lead to excess serotonin, which can lead to libido and ED difficulties”.

Your response was, none of this happened to you, which is why I said excess estrogen and excess serotonin “can” lead to problems.

I have no control over someone’s inability to comprehend what’s being written.

how Can you not see how that post will be interpreted by most ? I was just posting to clear it up we can keep going back and forth but you know exactly what I’m talking about. I’ve had low estrogen and low libido and sky high estrogen and high libido. I’ve had high libido on ssri and off ssri.

 

[Gman86]

However, if thyroid hormones are regulated according to free levels then higher TBG should have little effect, as appears to be the case with free testosterone and higher SHBG.

Studies are one thing, real world effects are another. Studies can say whatever they want, anecdotes can say another, even if it goes against the results of a study. That’s why I put mor weight into real world results, than what studies tell us should be the case

For example, these are my labs while on nothing. Based on these my total test levels, and my correlating SHBG levels on each specific set of labs, studies, and u would say that my free T level should be fine, and that I shouldn’t need HRT. Yet when I had all these labs done, I felt absolutely horrible. Had all the low T symptoms except no libido and/ or erectile dysfunction. Libido wasn’t great when I had all these labs done, but wasn’t in the gutter or anything. Other than sexual function, I felt horrendous. But according to u and madman, I shouldn’t be experiencing such low T symptoms with these labs, and my free T level, according to the formula that we’re supposedly supposed to go by, should be within a healthy range

8-5-15
ON NOTHING (Labcorp)

Total T - 584 (348-1197 ng/dL)

Free T - 7.3 (9.3-26.5)

SHBG - 57.1 ( 16.5 - 55.9).

E2 NOT sensitive - 14.6 (7.6-42.6)

Prolactin - 9 (2.0-18.0)

LH - 3.5 (1.7-8.6)

FSH - 2.3 (1.5-12.4)

TSH - 1.2 (0.450-4.500)

T4 free - 1.15 (0.82-1.77)

T3 free 3.4 ( 2.0-4.4)

DHEA-S 486.0 (138.5-475.2)


11-2-15
ON NOTHING (QUEST)

Total T - 691 (250-1100 ng/dL)

Free T - 73.9 (46.0-224.0)

Bio T - 161.6 (110.0-575.0 ng/dL)

SHBG 45 (10-50)

E2 Sensitive- 25

IGF 1 - 294 (63-373)

DHEA-S - 411 (106-464)

Albumin - 4.7 (3.6-5.1)




8-31-16
ON NOTHING (QUEST)

Total T - 601 (250-1100 ng/dL)

Free T - 54.3 (46.0-224.0)

Bio T - 116.4 (110.0-575.0 ng/dL)

SHBG 53 (10-50)

E2 NOT Sensitive - 23

IGF 1 - 204 (53-331)

DHEA-S - 324 (106-464)

 

[Charliebizz]

Studies are one thing, real world effects are another. Studies can say whatever they want, anecdotes can say another, even if it goes against the results of a study. That’s why I put mor weight into real world results, than what studies tell us should be the case

For example, these are my labs while on nothing. Based on these my total test levels, and my correlating SHBG levels on each specific set of labs, studies, and u would say that my free T level should be fine, and that I shouldn’t need HRT. Yet when I had all these labs done, I felt absolutely horrible. Had all the low T symptoms except no libido and/ or erectile dysfunction. Libido wasn’t great when I had all these labs done, but wasn’t in the gutter or anything. Other than sexual function, I horrendous. But according to u and madman, I shouldn’t be experiencing such low T symptoms with these labs, and my free T level, according to the formula that we’re supposedly supposed to go by, should be within a healthy range

8-5-15
ON NOTHING (Labcorp)

Total T - 584 (348-1197 ng/dL)

Free T - 7.3 (9.3-26.5)

SHBG - 57.1 ( 16.5 - 55.9).

E2 NOT sensitive - 14.6 (7.6-42.6)

Prolactin - 9 (2.0-18.0)

LH - 3.5 (1.7-8.6)

FSH - 2.3 (1.5-12.4)

TSH - 1.2 (0.450-4.500)

T4 free - 1.15 (0.82-1.77)

T3 free 3.4 ( 2.0-4.4)

DHEA-S 486.0 (138.5-475.2)


11-2-15
ON NOTHING (QUEST)

Total T - 691 (250-1100 ng/dL)

Free T - 73.9 (46.0-224.0)

Bio T - 161.6 (110.0-575.0 ng/dL)

SHBG 45 (10-50)

E2 Sensitive- 25

IGF 1 - 294 (63-373)

DHEA-S - 411 (106-464)

Albumin - 4.7 (3.6-5.1)




8-31-16
ON NOTHING (QUEST)

Total T - 601 (250-1100 ng/dL)

Free T - 54.3 (46.0-224.0)

Bio T - 116.4 (110.0-575.0 ng/dL)

SHBG 53 (10-50)

E2 NOT Sensitive - 23

IGF 1 - 204 (53-331)

DHEA-S - 324 (61-1636)

Time to jump in the other thread with @RobRoy and @readalot lol

 

[Gman86]

But what increased the estrogen ? Isn’t it the testosterone ? most guys that visit these forums still do not understand that and are going to take @Systemlord post and see “estrogen is bad for libido“ been around a long time it’s the same story over and over.

I totally see what ur saying. It’s true that E2 does get focused on more than other possible reasons for certain issues, even when there are multiple possibilities as far was what could be causing the issue goes. So I see where ur coming from.

Increased estrogen is obv a general phrase. I just basically meant ”high estrogen“ for that specific person. The level at which E2 is going to cause negative effects with certain things is obv highly individual. But as estrogen increases, it supposedly increases thyroid binding globulin. That’s just what I’ve read. And I assume it happens in a linear fashion. Higher the estrogen, the higher it’s gonna push TBG. Possibly to a point. Really not sure. Just something to consider, that’s all

and from what I read is estrogen that increases TBG, not testosterone. But I could be wrong. And obv testosterone increases estrogen, so I guess indirectly test increases TBG, if u want to look at it that way

 

[Gman86]

isnt SHBG also a carrier hormone? i would guess TBG acts on that same principle as well? So in fact having low TBG would actually be a bad thing.

SHBG isn‘t a hormone, it’s a protein, but that’s nitpicking lol. But yes, it is a carrier protein as far as I know. So I’m pretty sure it does both things. Transports sex hormones, as well as regulates the amount of that hormone that’s available to actually attach to cell receptors. So it does sound like those two things might cancel eachother out, but ime when I had normal total testosterone levels, and a SHBG on the high end of the range, or slightly over, it resulted in me experiencing really bad low T symptoms. So in that specific case, with me personally, the hormone transporting effect wasn’t enough to counteract the lowering of free test effect that the high SHBG was causing

 

[Cataceous]

isnt SHBG also a carrier hormone? i would guess TBG acts on that same principle as well? So in fact having low TBG would actually be a bad thing.

The carrying proteins are analogous, which is why I suggested that varying levels probably don't have much influence on the free levels of the hormones they carry. This is not to gainsay that other problems may arise from high or low levels of the carriers.

...
For example, these are my labs while on nothing. Based on these my total test levels, and my correlating SHBG levels on each specific set of labs, studies, and u would say that my free T level should be fine, and that I shouldn’t need HRT. ...

These three results all seem to yield Vermeulen free testosterone below 10 ng/dL. I do believe that some men can be hypogonadal in the 7-10 ng/dL range, even though it falls within the normal range of some studies. Making the diagnosis is more difficult because many are still ok in this border region.

 

[Charliebizz]

I totally see what ur saying. It’s true that E2 does get focused on more than other possible reasons for certain issues, even when there are multiple possibilities as far was what could be causing the issue goes. So I see where ur coming from.

Increased estrogen is obv a general phrase. I just basically meant ”high estrogen“ for that specific person. The level at which E2 is going to cause negative effects with certain things is obv highly individual. But as estrogen increases, it supposedly increases thyroid binding globulin. That’s just what I’ve read. And I assume it happens in a linear fashion. Higher the estrogen, the higher it’s gonna push TBG. Possibly to a point. Really not sure. Just something to consider, that’s all

and from what I read is estrogen that increases TBG, not testosterone. But I could be wrong. And obv testosterone increases estrogen, so I guess indirectly test increases TBG, if u want to look at it that way

It’s all speculation really. I mean me personally since getting on trt my e2 number has come up from the teens (obviously cause my t levels were low) to the 40-60 range. And my thyroid numbers

I totally see what ur saying. It’s true that E2 does get focused on more than other possible reasons for certain issues, even when there are multiple possibilities as far was what could be causing the issue goes. So I see where ur coming from.

Increased estrogen is obv a general phrase. I just basically meant ”high estrogen“ for that specific person. The level at which E2 is going to cause negative effects with certain things is obv highly individual. But as estrogen increases, it supposedly increases thyroid binding globulin. That’s just what I’ve read. And I assume it happens in a linear fashion. Higher the estrogen, the higher it’s gonna push TBG. Possibly to a point. Really not sure. Just something to consider, that’s all

and from what I read is estrogen that increases TBG, not testosterone. But I could be wrong. And obv testosterone increases estrogen, so I guess indirectly test increases TBG, if u want to look at it that way

well I’ve had low estrogen off trt (obviously due to low t ) and I can tell you that being on trt increased my thyroid levels in blood labs. Specifically ft3. And my e2 typically runs from 40-60.

 

[Gman86]

It’s all speculation really. I mean me personally since getting on trt my e2 number has come up from the teens (obviously cause my t levels were low) to the 40-60 range. And my thyroid numbers

well I’ve had low estrogen off trt (obviously due to low t ) and I can tell you that being on trt increased my thyroid levels in blood labs. Specifically ft3. And my e2 typically runs from 40-60.

See, this is a perfect example of what happens in real life being different than what studies and research tells us should happen. That’s why I personally put so much weight into real life experience and anecdotes and labwork. Thanks for sharing man

 

[4everyoung]

Forget trying to mimic the honeymoon.

Hope you have realistic expectations.

Truth About Testosterone and Your Libido

https://www.yahoo.com/lifestyle/truth-testosterone-libido-185000725.html?soc_src=social-sh&soc_trk=tw&tsrc=twtr As an expert on andrology and sexual dysfunctions, urologist Andrew Y. Sun, M.D., sees plenty of patients who’re struggling with low libido. And most are pretty sure they already...

www.excelmale.com

*Most of them still strongly believe that increasing their testosterone levels will improve their libido

*This hormone isn’t the only biological factor with clear, substantial power over our libidos

*Notably, estrogen, although often characterized as the female sex hormone, plays a major role in maintaining male libido

*Estrogen and testosterone actually balance and support each other in any body

*Complete suppression of estrogen is a surefire way to destroy a man's libido

*Dopamine, serotonin, and oxytocin all play a role in libido, too

*Psychological factors like stress and anxiety can lower a person’s libido, no matter how robust their levels of testosterone, estrogen, or any other biological element may be. So can social factors, like relationship troubles

*Even personal beliefs or values about sex and relationships can have a top-down effect on our bodies

*Libido is very complex, and definitely poorly understood

*Testosterone is a threshold hormone. Our bodies need a certain amount for normal functions, but beyond that, there is not necessarily any additional benefit

*The effects of testosterone on libido are incredibly mixed and complicated

*Any number of chronic or acute health issues can affect libido, directly or indirectly. Notably, conditions including diabetes, kidney and liver diseases, recent weight increases, thyroid disorders, and even sleep apnea can all cause a decrease in testosterone, and thus libido, and that decrease can often be reversed by treating this underlying health issue

*Many common drugs, from antidepressants to anticonvulsants, cancer treatments to contraceptives, and more, can all lower libido themselves

*Focus on improving your exercise regimen, hydration, and sleep hygiene These are the low-hanging fruit of libido health

*The hormone works best for people who have the rest of their health in order

Libido...to titrate up or down while on TRT?

Just wondering if anyone else has had the same experience. I am "self dosing" testosterone cyp. Weekly shallow IM injections of 87.5mg. The first 3-4 weeks were great. Libido and energy took quite a jump. Going in to weeks 5-6 things started slowing down, especially the libido. I have read in...

www.excelmale.com

A pill that could outsell Viagra: New testosterone Rx drug

https://www.americanbazaaronline.com/2022/10/11/testosterone-drug-kyzatrex-hits-market-451261/ Kyzatrex could be a potential blockbuster to treat testosterone deficiency, a severely undertreated disease. Testosterone has been historically perceived as a lifestyle issue for men who want to...

www.excelmale.com

I'm not necessarily trying to mimic the honeymoon.

My drive is now much lower then it was pre-TRT.

I live a healthy lifestyle.

My problem is related to TRT itself.

Back to my actual question...Are there other hormones I need to test besides what are listed inthe OP: Thyroid, Cortisol, Testosterone, DHT, Prolactin, Estradiol?

 

[madman]

I'm not necessarily trying to mimic the honeymoon.

My drive is now much lower then it was pre-TRT.

I live a healthy lifestyle.

My problem is related to TRT itself.

Back to my actual question...Are there other hormones I need to test besides what are listed inthe OP: Thyroid, Cortisol, Testosterone, DHT, Prolactin, Estradiol?

You are missing one of the most important blood markers FT.

Even then what is your current protocol (dose T/injection frequency) and where does your trough TT, FT, and estradiol sit?

Do you know where your DHT and prolactin sit?

Did you get a full thyroid panel/cortisol salivary (4 specimens)?

 

[Systemlord]

My drive is now much lower then it was pre-TRT.

You should have baseline ferritin and again 6 months after starting TRT. TRT can suppress ferritin in some individuals.

In my experience, TRT is much less effective with lower end ferritin <80.

 

[4everyoung]

You are missing one of the most important blood markers FT.

Even then what is your current protocol (dose T/injection frequency) and where does your trough TT, FT, and estradiol sit?

Do you know where your DHT and prolactin sit?

Did you get a full thyroid panel/cortisol salivary (4 specimens)?

Thank you so much! I will definitely look into the FT. I don't believe I ever had that tested.

Current protocol is 50mg Test Cyp, 300iu HCG IM and .12mg Anastrozole and 12.5mg DHEA orally EoD.

My SHBG is low which is why I do EoD...thinking about switching back to ED to try and get those numbers up a bit.

My last DHT test in June was 70 ng/dl

We did Thyroid a while back and it was fairly normal.

 

[4everyoung]

You should have baseline ferritin and again 6 months after starting TRT. TRT can suppress ferritin in some individuals.

In my experience, TRT is much less effective with lower end ferritin <80.

Ok, thank you. I will definitely be getting that tested

 

[Cataceous]

...
Current protocol is 50mg Test Cyp, 300iu HCG IM and .12mg Anastrozole and 12.5mg DHEA orally EoD.
...

All of that EOD? If so way too much testosterone. Was this your doctor's idea? This post could equally well apply to you with your 175 mg TC/week. Be sure to browse the anecdotes suggesting that more testosterone is usually not better.

 

[madman]

Thank you so much! I will definitely look into the FT. I don't believe I ever had that tested.

Current protocol is 50mg Test Cyp, 300iu HCG IM and .12mg Anastrozole and 12.5mg DHEA orally EoD.

My SHBG is low which is why I do EoD...thinking about switching back to ED to try and get those numbers up a bit.

My last DHT test in June was 70 ng/dl

We did Thyroid a while back and it was fairly normal.

Post pre-trt labs.

Always include the assays used/reference ranges

Need to post your most recent labs and we can calculate your FT using your TT/SHBG/Albumin.

Going to take it that you are injecting 175 mg T/week split into EOD injections with an AI thrown in to boot.

Hopefully your most recent blood work was done at true trough (48 hrs) post-injection.

Where does your TT, SHBG, estradiol, RBCs, hemoglobin and hematocrit sit.

175 mg T/week is a fair dose and chances are your trough FT level is too high and you are trying to manage elevated e2 with the use of an AI.

Would be a good idea to get a current thyroid panel.