Struggling EOD Protocol - Low TRT Levels?

[riverside]

I have been struggling to get better and am on week 9 of TRT. I started with 70mg E3.5D and 200IU HCG EOD for 6 weeks and ran into major E2 spikes. I am currently looking into switching to Dr. Saya at Defy as I am hoping to dial into something that works. Please see my progression below, I am looking forward to your thoughts. I am 35, 6'2" and 200 lbs.

After 6 Weeks TRT and HCG (48 hours after injection on 70mg E3.5D protocol)
E2 = 63 H pg/mL 10‐40
Total T (sensitive) = 712 240 ‐ 950 ng/dL
Total T = 766 240.0 ‐ 950.0 ng/dLFree T = 173.9 46.0‐224.0 0.2‐5.0
Bio T = 377 H ng/dL 72 ‐ 235 ng/dL
SHBG = 20 nmol/L 10 ‐ 57 nmol/L

I switched to an EOD Testosterone protocol at the same weekly dosage (40mg EOD) to try to lower T and switched to 350IU HCG E3.5D. Then was prescribed .25 AI EOD on injection day.

Labs from 10/10, the day before I started Anastrazole that I ordered online myself (Draw 48 hours after injection on 40mg EOD protocol):
Estradiol E2 (sensative) = 100 H < OR = 29 pg/mL
Prolactin (never had this drawn before) = 10 2.0-18.0 ng/mL
THYROID PANEL WITH TSHT3 UPTAKE = 36 H 22-35 % 01
T4 (THYROXINE), TOTAL = 5.0 4.5-12.0 mcg/dL 01
FREE T4 INDEX (T7) = 1.8 1.4-3.8 01
TSH = 1.64 0.40-4.50 mIU/L 01

The 100 E2 freaked me out. I then requested E2 on 10/21 as well as Total T and Cortisol A.M. This is 2 weeks into AI as well (Draw 48 hours after injection on 40mg EOD protocol):
E2 (sensitive) = 33 H < OR = 29 pg/mL
Total T (non sensitive) = 519 250-827 ng/dL
Cortisol A.M. = 16.9 8 a.m. (7-9 a.m.) Specimen: 4.0-22.0

The drop in Total T concerns me as I still haven't had any benefits from TRT. The test was the morning on injection day but for me that is EOD so I would think my levels should be normalized? I am suffering primarily from a complete lack of libido which is leading to ED and problems in the marriage because of it. Other common Low T symptoms as well but libido is my #1. Any thoughts or numbers jump out as problematic at this point? Any help is greatly appreciated.


Here are some bloods from before I started TRT.

Pre TRT:
Total T = 193 ng/dL 241-827
Free T = 3.50 ng/dL 3.70-23.28
SHBG = 33.2 nmol/L 11.0-57.0
E2 = 2.0 &#956;g/24hrs 0.8 &#8211; 7.0
FSH = 0.9 [IU]/L 1.4 - 18.1 mIU/mL
LH = 1.3 [IU]/L 1.5 - 8.1 mIU/mL
DHT = 1.6&#956;g/24hrs 3&#8211;16
TSH = 1.020 uIU/mL 0.350-5.500

 

[CoastWatcher]

How long had you been on your revised injection schedule,mt he one that produced the testosterone value of 519, before you pulled those blood tests? I'm not certain, from your account, how much time had passed. At least four weeks?

 

[riverside]

Yes, 4 weeks exactly.

 

[riverside]

To clarify my current protocol:

40mg Test-C EOD
.25 Adex EOD on injection day
350IU HCG E3.5D

 

[Vince Carter]

I too am having an E problem last one was 88 for me with no real explanation. I started with AI, too, I think you're moving in the right direction ther but wanted to advise on your T...i would bet your SHBG has lowered from that pervious 20. When I was doing EOD I would use 50mg. If you're pulling 519 in a ~48hr trough you need to up your T dosing.

 

[johndoesmith]

When were all of these taken relative to injection?

The test on 10/21 was that with ai? What protocol was that? When was it drawn relative to injection? How long were you on this new EOD protocol for?

 

[riverside]

When were all of these taken relative to injection?

The test on 10/21 was that with ai? What protocol was that? When was it drawn relative to injection? How long were you on this new EOD protocol for?

The first draw was 48 hours after injection on my 70 mg E3.5D protocol which was a total T of 766. The Total T of 519 was 4 weeks in 40mg EOD protocol and was 48 hours after injection.

 

[johndoesmith]

The first draw was 48 hours after injection on my 70 mg E3.5D protocol which was a total T of 766. The Total T of 519 was 4 weeks in 40mg EOD protocol and was 24 hours after injection.

You need consistency with labs, when there are too many variables it makes the information very difficult to interpret.

1.Why are you doing 48 hours then 24?
2. The test on 10/21 was that with AI?

 

[riverside]

You need consistency with labs, when there are too many variables it makes the information very difficult to interpret.

1.Why are you doing 48 hours then 24?
2. The test on 10/21 was that with AI?

Actually I take that back. The second draw was 48 hours after as well, it was my absolute trough on an EOD protocol. Yes, the 10/21 draw was 2 weeks into AI. I edited my original post.

 

[johndoesmith]

Actually I take that back. The second draw was 48 hours after as well, it was my absolute trough on an EOD protocol. Yes, the 10/21 draw was 2 weeks into AI. I edited my original post.

Okay, so the first draw you have when was that taken?

It's a bit confusing so far so don't mind my questions lol.

Did the AI change how you feel? Were there ANY changes in how you felt with all of these different protocols?

 

[riverside]

Okay, so the first draw you have when was that taken?

It's a bit confusing so far so don't mind my questions lol.

Did the AI change how you feel? Were there ANY changes in how you felt with all of these different protocols?

No worries, sorry for the confusion. The first draw was 9/21 and was 6 weeks into my first protocol (E3.5D). Unfortunately, I haven't felt much different in the 9 weeks which has been very frustrating. I would say that I have better morning erections, still not great. Energy, brain fog, and especially libido have continued to struggle and I haven't seen one end of the spectrum or another, it has remained the same.

 

[johndoesmith]

No worries, sorry for the confusion. The first draw was 9/21 and was 6 weeks into my first protocol (E3.5D). Unfortunately, I haven't felt much different in the 9 weeks which has been very frustrating. I would say that I have better morning erections, still not great. Energy, brain fog, and especially libido have continued to struggle and I haven't seen one end of the spectrum or another, it has remained the same.

Oh sorry I meant relative to injection. You should edit the OP with all of this so you can get better advice from people. I've noticed when posts are confusing they get less response.

6 weeks isn't always enough time to notice benefits, but your e2 was high, so that probably would have prevented any regardless.

All of the changes in a short period of time will add to how long it takes for good changes to happen. It's unfortunate but trt is a waiting game, especially with all of the difficulties you have experienced.

 

[riverside]

Oh sorry I meant relative to injection. You should edit the OP with all of this so you can get better advice from people. I've noticed when posts are confusing they get less response.

6 weeks isn't always enough time to notice benefits, but your e2 was high, so that probably would have prevented any regardless.

All of the changes in a short period of time will add to how long it takes for good changes to happen. It's unfortunate but trt is a waiting game, especially with all of the difficulties you have experienced.

Ok, I edited my post with injection times. The first was 48 hours after injection as well.

 

[johndoesmith]

Ok, I edited my post with injection times. The first was 48 hours after injection as well.

Cool. I hate to so particular but it's really important.

Honestly, I imagine your SHBG dropped a lot between 9/21 and the test while on EOD injections.

That and adding in that you have not been on EOD for long enough to stabilize levels could explain the suddenly low test readings.

This seems a bit complicated, and with different tests being ran each time and some missing, it's hard to make any conclusions with missing data, maybe I'm missing something big but hopefully one of the other members will pick up on it.

 

[Vince Carter]

here's a tip if you think it's useful, I try to (and sometimes fail) but when I was doing EOD (and now daily) I know I'll be having my draw @ 0800/0830. I normally shoot @ 0500 out of the shower and getting dressed. What I try to do is the day before i shoot that one @ 8 so the next day I can get a real 24hr trough, in stead of something that is actually ~27hrs. Minor difference but I do try it that way for my labs.

 

[riverside]

Cool. I hate to so particular but it's really important.

Honestly, I imagine your SHBG dropped a lot between 9/21 and the test while on EOD injections.

That and adding in that you have not been on EOD for long enough to stabilize levels could explain the suddenly low test readings.

This seems a bit complicated, and with different tests being ran each time and some missing, it's hard to make any conclusions with missing data, maybe I'm missing something big but hopefully one of the other members will pick up on it.

Are you saying that an EOD protocol will drop SHBG or that TRT continues to drop SHBG and mine might still be falling and therefore metabolizing the Testosterone quicker?

 

[johndoesmith]

Are you saying that an EOD protocol will drop SHBG or that TRT continues to drop SHBG and mine might still be falling and therefore metabolizing the Testosterone quicker?

I don't know that EOD will drop shbg.

I was saying that shbg might have dropped, probably from starting trt, which could explain why you're metabolizing the testosterone quicker.

 

[Vince Carter]

SHBG does tend to lower once you start on t, as a rule, I don't know but it is common.

 

[CoastWatcher]

SHBG does tend to lower once you start on t, as a rule, I don't know but it is common.

True in most cases. But not all. This is TRT, where nothing surprises any of us.