Eric Peterson
Member
I have been on TRT since 2011. Initially on a compounded creme (MedQuest) switching later to Axiron and for the past year on testosterone cypionate. I started at the typical dose of 100 mg/week. These labs were drawn to evaluate a dose of 160 mg/wk. I inject IM into my glutes. I am 55. I am 5'10" and weigh 168 lbs BMI 24.1, body fat %: 15. I am fit, physically active, and in excellent health.
I am also using 250 IU of HCG 3/week. While I have anastrazole on hand, I generally don't use it unless I have symptoms (nipple itching is generally what I get) but I am having none now.
Problems: 1) I have high SHBG. I understand that the strategy is to inject a higher dose less frequently to overcome the amount that is becoming tightly bound. This was the rationale for increasing my dose. 2) recently I have had problems with delayed orgasm. I have always had a lot of stamina, but it is becoming annoying and is affecting my satisfaction and that of my partners.
Labs (Quest Diagnostics)
Test Total: 1277 ng/dL (250-1100)
Free: 210.7 pg/mL (35-155)
DHT: 143 ng/dL
Estradiol (ultrasensitive) 36 pg/mL (<29)
Prolactin: 7.8 ng/mL (2.0-18.0)
SHBG: 48 nmol/L (10-50)
Hematocrit: 41.2% (38.5-50)
Hemoglobin: 14.2 g/dL
PSA: 1.3 ng/mL
Questions:
1) If I have done my math right, the percentage of free T vs total T is 1.6% which is below the target of 2%. Should I be pushing for 2% or should I be happy that my Free T is above the reference range? How does my high SHBG fit into this picture?
2) I will be meeting with the urologist who manages my TRT on October 10. I am planning to ask about cabergoline. I found a pilot study of 132 patients with delayed orgasm and more than 60% of the patients had a favorable response. TRT was associated with a favorable response. I understand that cabergoline can be associated heart failure and a valvular dysfunction, but I don't know how common this is. Does it seem reasonable to give this a try?
Thanks in advance.
Eric
I am also using 250 IU of HCG 3/week. While I have anastrazole on hand, I generally don't use it unless I have symptoms (nipple itching is generally what I get) but I am having none now.
Problems: 1) I have high SHBG. I understand that the strategy is to inject a higher dose less frequently to overcome the amount that is becoming tightly bound. This was the rationale for increasing my dose. 2) recently I have had problems with delayed orgasm. I have always had a lot of stamina, but it is becoming annoying and is affecting my satisfaction and that of my partners.
Labs (Quest Diagnostics)
Test Total: 1277 ng/dL (250-1100)
Free: 210.7 pg/mL (35-155)
DHT: 143 ng/dL
Estradiol (ultrasensitive) 36 pg/mL (<29)
Prolactin: 7.8 ng/mL (2.0-18.0)
SHBG: 48 nmol/L (10-50)
Hematocrit: 41.2% (38.5-50)
Hemoglobin: 14.2 g/dL
PSA: 1.3 ng/mL
Questions:
1) If I have done my math right, the percentage of free T vs total T is 1.6% which is below the target of 2%. Should I be pushing for 2% or should I be happy that my Free T is above the reference range? How does my high SHBG fit into this picture?
2) I will be meeting with the urologist who manages my TRT on October 10. I am planning to ask about cabergoline. I found a pilot study of 132 patients with delayed orgasm and more than 60% of the patients had a favorable response. TRT was associated with a favorable response. I understand that cabergoline can be associated heart failure and a valvular dysfunction, but I don't know how common this is. Does it seem reasonable to give this a try?
Thanks in advance.
Eric
