Stripped down protocol to T only. Anyone else on this?

[Green Arrow]

I'd like to hear the community's insights. I've seen some users post about T to E ratio, but I'm not sure how that deal goes. I'm beginning to think my issue was E2 related all along.

Well, it's been just about 5 years on this TRT journey if my memory serves.

A few weeks ago, out of exasperation I dropped everything but Test from my protocol as I felt the financial cost far outweighed whatever marginal benefit I was supposed to be feeling. I also felt at the end there that my penile function/libido were in worse shape than ever. I've struggled with low libido and ED since before starting TRT but apart from the occasional marginal improvement my ED was eventually worse than ever. At the end there I was having issues solo.

At this point I just threw my hands up and got a script for Trimix. While figuring out my appropriate dosage I felt my erections on it still felt a bit "off". In my head they felt like a different kind of erection, if that makes sense. All the while, I was also reading elsewhere that my weekly AI dose was really only appropriate for a guy "on cycle" and only appropriate after experiencing issues.

Since Test and an AI have been the constant in my TRT regimen throughout the years, I decided to drop the AI. My function has definitely improved in this time. TMI here, but I slapped the ham 3 times this afternoon to relieve the urge. No ED pills or Trimix. I'm wondering if I'll have to "refigure" out my Trimix dosage, to avoid that dreaded trip to the ER.

I'm curious if anyone else is on a Test only protocol and how they're faring on it as far as libido/penile function?

 

[Mountain Man]

I've been on test only for 6 months with no issues. I'm with Dr Morganthaler's clinic in Boston and that's their starting protocol for someone my age. Libido is much higher and, although I still use cialis, I need less of it and get a lot more out of the regular dose. Way shorter refractory period. If I develop any issues down the road, I'll ask for HCG or at least inquire at my next visit.

 

[Vince]

I've only used T, HCG and Cialis, very strong libido and good penis sensitivity. I really believe but don't know for sure, that Cialis has added to my penis sensitivity.

 

[Vince Carter]

Im tinkering with the idea of dropping HCG. I was (am) having E problems for quite some time and tried everything, almost everything, to get a handle on it to no avail. I dropped Pregnenolone, dropped, DHEA, reduced my HCG use to 200iu E3.5D, went from EOD to daily injections, nothing worked and had to get on AI. I'm still going thru that and have labs upcoming to see how the AI is working.
But a few of us are thinking of this stripped down TRT, no HCG is what I'm specifically thinking about, TCyp only.

 

[CoastWatcher]

You wrote that an AI has been a constant in your protocol. What was your estradiol level that caused you to adopt it's use?

 

[Green Arrow]

CW, the clinic I got started with started me on an AI about 6 weeks in to TRT. 0.5 mg of Anastrozole that was eventually reduced to 0.25 mg.

This was back in 2013, possibly late 2012 during a once weekly 100 mg of T regimen. My values were only sent to my physician and he'd go over them with me on the phone. He wouldn't send me my results, which I came to think was him trying to avoid having me trying to treat myself. (I was asking a lot of questions) The test we were using was actually the regular e2 test.

 

[CoastWatcher]

CW, the clinic I got started with started me on an AI about 6 weeks in to TRT. 0.5 mg of Anastrozole that was eventually reduced to 0.25 mg.

This was back in 2013, possibly late 2012 during a once weekly 100 mg of T regimen. My values were only sent to my physician and he'd go over them with me on the phone. He wouldn't send me my results, which I came to think was him trying to avoid having me trying to treat myself. (I was asking a lot of questions) The test we were using was actually the regular e2 test.

I'm confident in asserting that you probably never needed an AI. The fact that you're feeling better now, with no AI, well, that tells you something doesn't it?

I hope you are seeking care from a different doctor/clinic now - you received poor care and no respect. You deserve a lot better. Keep us posted.

 

[Green Arrow]

I figured I might not need an AI but thought I'd seek opinions. Really hoping this isn't something that might taper off after some time.

I did switch providers about a year ago. My Total T has come in at around 800 to 840 and my E2 at 20.2 to 20.7 my last few tests, which is why I'm curious about the T to E "theory". If I'm correct, that puts my tested T to E ratios up to this point at 40? That would explain why I wasn't doing so hot under that theory, right?

Before treatment I'd at least get wood from Viagra/Cialis when it came time for sex. Throughout treatment, not so much. Just morning wood the next morning from daily Cialis use. Wasn't worth the expense.

 

[ERO]

I am getting close to dropping everything except for T as well, for basically the same reasons you mentioned. TRT for me has been a long, expensive science project with no benefits and in some ways has left me feeling worse than with untreated Low T. Specifically my libido is gone and I have worse ED now than before starting treatment.

 

[johndoesmith]

I figured I might not need an AI but thought I'd seek opinions. Really hoping this isn't something that might taper off after some time.

I did switch providers about a year ago. My Total T has come in at around 800 to 840 and my E2 at 20.2 to 20.7 my last few tests, which is why I'm curious about the T to E "theory". If I'm correct, that puts my tested T to E ratios up to this point at 40? That would explain why I wasn't doing so hot under that theory, right?

Before treatment I'd at least get wood from Viagra/Cialis when it came time for sex. Throughout treatment, not so much. Just morning wood the next morning from daily Cialis use. Wasn't worth the expense.

How is your E2 so low?

I found an old post of yours, near identical total but significantly higher E2. Did something change since then?

https://www.excelmale.com/forum/showthread.php?6288-Treating-prolactin&p=33663&viewfull=1#post33663

Do you have lab ranges or other more detailed labs? That E2 level is fairly low for an 800 total. I take your current post as ED drugs no longer work, and you suspect low E2 to be the cause, right?

 

[Green Arrow]

That was about the time I switched providers so I wasn't on an AI for a very brief period during the switch. That led to the 42 reading on my initial tests with my new provider. It was also the first time the correct test (sensitive e2) was used. Up to that point I didn't know much about where I should be on any of my lab values. I only knew that I should be concerned with my Total and Free T at that time.

ED drugs have not been effective over the course of my treatment which has led me to believe that perhaps my E2 has been too low throughout the entire course of my treatment.

 

[johndoesmith]

That was about the time I switched providers so I wasn't on an AI for a very brief period during the switch. That led to the 42 reading on my initial tests with my new provider. It was also the first time the correct test (sensitive e2) was used. Up to that point I didn't know much about where I should be on any of my lab values. I only knew that I should be concerned with my Total and Free T at that time.

ED drugs have not been effective over the course of my treatment which has led me to believe that perhaps my E2 has been too low throughout the entire course of my treatment.

Hmm, did you still have the issues you're having now, at the time of the 42 sensitive E2 test?

Also, how long did your E2 stay there? If it was only a week or so, it may need to be a normal level for longer to elicit the effects you're after.

 

[Green Arrow]

I wasn't at that level for very long, and at the time I was really worried about NOT being on an AI. All I'd read was that an AI was needed to avoid gyno on TRT, so I was really concerned with avoiding it. I thought I might be experiencing some gyno. Based on my first follow-up test results I was prescribed an AI. In hindsight, I was looking for what may not have been there or was likely something else. (I'm carrying more body fat than I should and my diet is crap right now)

As of right now, I'm going on 4 weeks without an AI. I'll be staying the course over the next few weeks and will then run some labs.

 

[CoastWatcher]

I wasn't at that level for very long, and at the time I was really worried about NOT being on an AI. All I'd read was that an AI was needed to avoid gyno on TRT, so I was really concerned with avoiding it. I thought I might be experiencing some gyno. Based on my first follow-up test results I was prescribed an AI. In hindsight, I was looking for what may not have been there or was likely something else. (I'm carrying more body fat than I should and my diet is crap right now)

As of right now, I'm going on 4 weeks without an AI. I'll be staying the course over the next few weeks and will then run some labs.

The fear of gynocomastia haunts many guys at the start of their TRT journey. Stay the course, as you wrote, and let us know how things play out. All the best!

 

[johndoesmith]

I wasn't at that level for very long, and at the time I was really worried about NOT being on an AI. All I'd read was that an AI was needed to avoid gyno on TRT, so I was really concerned with avoiding it. I thought I might be experiencing some gyno. Based on my first follow-up test results I was prescribed an AI. In hindsight, I was looking for what may not have been there or was likely something else. (I'm carrying more body fat than I should and my diet is crap right now)

As of right now, I'm going on 4 weeks without an AI. I'll be staying the course over the next few weeks and will then run some labs.

Gyno is like Rome, it wasn't built in a day.

How do you feel now that you're off AI?

 

[Green Arrow]

The main change I've noted so far is morning wood over the last few weeks that I've been off the AI. I haven't used anything besides my EOD T shots in that time. My physical responsiveness in that regard is getting better too. As I wrote before, while taking an AI it got to the point that it was near impossible to get wood even solo. That is no longer the case. I've developed some anxiety from it as I've not attempted sex without ED pills in several months.

I'm currently single, so I'll be giving myself some time to stabilize before I give that a shot, or reintroduce ED meds.

 

[johndoesmith]

The main change I've noted so far is morning wood over the last few weeks that I've been off the AI. I haven't used anything besides my EOD T shots in that time. My physical responsiveness in that regard is getting better too. As I wrote before, while taking an AI it got to the point that it was near impossible to get wood even solo. That is no longer the case. I've developed some anxiety from it as I've not attempted sex without ED pills in several months.

I'm currently single, so I'll be giving myself some time to stabilize before I give that a shot, or reintroduce ED meds.

So it sounds that you have morning wood now, but are still having difficulties achieving an erection when you want to?

Sounds like things are improving!

How about other than erections, such as mood, depression, or joint pain(insert any other specific to you low E2 symptom you experienced)?

 

[Green Arrow]

I would occasionally get joint pains, usually in my knees, elbows and occasionally in my wrists and ankles. Lately I've only had a little lingering pain in my left knee but that is likely due to the cold weather. My other joints feel fine right now.

I want to focus the coming weeks on reducing my stress levels and watching my diet. I've had high blood pressure and cholesterol issues that I want to ensure I get under control going forward. Figure that should positively factor in as well.