Secondary symptoms not improved

[goga]

I am on 25mg T Enanthate SubQ EOD. I've been on TRT for about 18 months now.
After almost a year I regained libido to some extent and my erectile function improved, but I have not improved otherwise. I am not calmer, not less depressed, do not have self-confidence, my memory has not improved. I am still poor in areal orientation.
Has anyone had the same unusual situation? As I know, "secondary" symptoms improve earlier.
I am considering quitting TRT because of that

 

[Vince]

Not that it really matters, I believe you are primary not secondary. I looked back at some of your old threads and before starting trt, your LH was above 15.

 

[goga]

Right, I have a primary deficiency case. Under "secondary"I meant non-sexual symptoms.
TRT and hypertension

 

[Vince]

Right, I have a primary deficiency case. Under "secondary"I meant non-sexual symptoms.
TRT and hypertension

Thanks for clarifying

 

[Gman86]

What’s your labs look like? You’re on quite a small dose. On a recent video, Dr. Nichols talks about “testosterone resistance”, and for some guys needing more testosterone than they used to, mostly likely due to external estrogens all around us. He also said that even if their numbers look good, sometimes they require higher testosterone numbers to feel optimal. Would you being on too low of a dose be a possibility to why your symptoms haven’t fully resolved? What does your DHEA-S look like?

 

[goga]

Estradiol 29 pg/ml (7-43), Free T 18 pg/ml (1-28), T 4 ng/ml (3-8). SHBG 28.8 nml/l (17-77)

 

[goga]

I have been on more than 100mg per week and felt worse

 

[Gman86]

Really? Huh. I would imagine it was E2 related. Your SHBG is fairly low at 28, and your E2 is already at 29. So ya, raising your dose would probably put your E2 into territory where you might need an ai. Have you ever tried raising your testosterone level higher while taking an ai at the same time?

I have a high SHBG, so I require a total testosterone of around 1600+ to reach the optimal free testosterone range. And it brings my E2 way up, and without an ai I just don’t feel my best. So for me, it seems like I have to raise testosterone pretty high, which consequently requires me to use an ai. So maybe that’s an option for you as well. You wouldn’t need my level of testosterone, but possibly you can dial yourself in at a higher testosterone level and a tiny dose of ai

 

[goga]

yes, but how can I take AI if I don't know my Sensitive E2? and, in particular, how would I know my AI dosage? Regular E2 is said to be meaningless here

 

[Gman86]

The way to do it without getting labs done constantly is to raise your testosterone dose first. With your free T being 18, and the top of the range being 28, I personally would increase your dose to at least 32mg EOD. Then what you do is take that dose without an ai until you start feeling worse. When that happens, start by taking an extremely low dose of ai. Something like 0.25mg of anastrozole once every 7 days. Anastrozole reaches steady state in 10 days, so just take that dose of ai for at least 10 days. If it doesn’t help, increase the frequency to 0.25mg once every 6 days. And wait 10 days to see if it helps. If it still didn’t help, increase to 0.25mg once every 5 days. And keep going like that until you notice some improvement. Then after it’s been around 40 days since you increased the testosterone dose, you can then go ahead and get labs done. After 40 days the testosterone should of reached a steady state. Then check the labs to see if the testosterone dose was enough to get your free T closer to the top of the range, and to see where your E2 sits.

And of course if you increase your testosterone dosage and don’t ever feel worse, don’t even take an ai. Just wait at least 40 days and get some labs done to see where everything is.

Also, this is just the way to do it if you want to try increasing your testosterone dose as a means to eliminate symptoms. You could also look into other factors, like your DHEA-S level, optimizing diet, exercising more and seeing if pregnenolone helps.