ClashCityRocker
New Member
I've posted on this forum before, and the feedback has been very helpful.
I'm at 3 months after a 110-day TRT trial earlier this year that was stopped mainly because of adverse sexual side effects (now improved somewhat off-therapy). The other symptoms that caused me to seek TRT in the first place have returned, however, and my labs are slightly worse than before (although in the same ballpark).
I have been down the Grok/ChatGPT rabbit hole, and they both agree I would likely do better on a low-dose daily regime, perhaps transdermal, maybe with an AI (my endocrinologist agreed to follow and respond to E2 this time but flatly refuses to prescribe hCG). I am skeptical, however, and don't want to make my situation worse.
As always, your thoughts and observations are appreciated.
The history, as concise as I could make it:
I'm at 3 months after a 110-day TRT trial earlier this year that was stopped mainly because of adverse sexual side effects (now improved somewhat off-therapy). The other symptoms that caused me to seek TRT in the first place have returned, however, and my labs are slightly worse than before (although in the same ballpark).
I have been down the Grok/ChatGPT rabbit hole, and they both agree I would likely do better on a low-dose daily regime, perhaps transdermal, maybe with an AI (my endocrinologist agreed to follow and respond to E2 this time but flatly refuses to prescribe hCG). I am skeptical, however, and don't want to make my situation worse.
As always, your thoughts and observations are appreciated.
The history, as concise as I could make it:
- 5'9"; 142.4 lb; muscle mass 115 lb; body fat 14.5%; fit but relatively high body fat in legs/glutes. Fertility not desired. No other prescription meds.
- Longstanding symptoms: depressed mood, poor sleep, generalized anxiety, low motivation, difficulty gaining/maintaining quality muscle, overall getting physically softer and psychologically less motivated, despite disciplined lifestyle.
- Very healthy lifestyle: high‑protein whole‑food diet, <3 drinks/month, strict sleep hygiene, resistance training 3×/week, daily walking.
- Remote prolonged prednisone and methotrexate use, stopped at age 40. No chemo/radiation. No history of mumps orchitis, testicular torsion, or cryptorchidism.
- Total testosterone 411 ng/dL (Reference Range: 250-1100 ng/dL)
- Free testosterone 56.8 pg/mL (Reference Range: 35.0-155.0 pg/mL)
- LH markedly elevated ~19.3 mIU/mL (prior) — FSH markedly elevated ~49.9 mIU/mL
- SHBG 51 nmol/L (slightly above RR 10–50)
- Hematocrit 46.8% (RR 38.5–50.0)
- Morning cortisol previously 23.1 mcg/dL (mildly high previously; nondiagnostic)
- Pre-TRT baseline labs similar (465 total T; 68.4 free T; high normal SHBG)
- 110‑day trial of testosterone cypionate (IM/SC) with variable dosing/frequency:
- Initial 80 mg IM weekly → immediate BP spike.
- Average dose over trial ~86.16 mg/week; dosing frequency varied from daily to every 3 days
- Labs at day 31 showed high serum T (78th percentile) and free T (84th percentile), SHBG ~50th percentile.
- Clinical response to TRT trial:
- Muscle gained quickly but paradoxical increase in abdominal fat.
- CNS overstimulation, poor sleep, emotional flattening (stable but blunted affect).
- Marked variability and overall decline in libido and sexual function: decreased genital sensation and intermittent inability to climax.
- BP spike temporally associated with higher initial dose; BP normalized with dose reduction.
- Discontinued TRT due to sexual dysfunction
- After discontinuation he reported feeling markedly better for ~3 weeks (rebound); after 3 month washout sexual function improved while other low‑T symptoms returned.
