Struggling With TRT: Labs

[JetSpyder]

Thanks everyone for the cordial and quick responses to my 1st post. A little background. I began TRT 2 yrs ago from a Dr. that didn't really know much about it. They tested my total T and it was at 220 (age 33). I began self injections of 200 mg test cyp 1 time per week. The results were great for about 6 months. Strong erections, much more energy and better gym workouts which were all lacking significantly. Then my insurance changed and I had to switch Dr's. I went to a low T clinic and was introduced to people that had no clue what they were doing. They would not write me a script for test at home so I had to come in once a week for a shot. I travel A LOT for work so it was nearly impossible to come in on a weekly basis. They were giving me 200 mg one week. Then 220-250 next time. Charging me $300/mo. After a year of this non sense I switched to another clinic who would send me home with test ( so they said on the phone). They made me pay for a 10 ml vial which they kept and would send me home with 2-3 syringes of 100 mg per syringe. They were charging me $800 for a 10 ml vial. At this time my wife and I decided that it was time to try and have a child. I had previously been on HCG from the other clinic to help with test shrinkage and semen loss. The Dr. that was in charge told me that men do not take HCG, that it is only for women and they would NEVER prescribe HCG. I explained to them how it worked but they wouldn't budge. Needless to say I knew that this was ridiculous but the only Dr. in the city that I heard was knowledgable was a 5 month wait. So I put myself on the wait list. CONTINUED BELOW

 

[JetSpyder]

Finally where I was when I switched Dr's:
My current Dr. is a fertility specialist and is pretty knowledgable about TRT. I went off test for about 2 months during the wait for my appt. I lost a lot of my energy and strong erections. Making a baby is very difficult with no libido or erection. He took blood tests and a semen analysis. Here were the results on 9/2015
Total T - 180 ng/dL
Free T - 4.7 pg/mL
FSH - 0.4 mlU/ml
Semen - 0.6 M/mL
Estrone - 12 pg/mL
Estradiol - 11 pg/mL

I went exclusively on a high dose of HCG for 2 months to try and recoup some of my sperm count. I was taking 1500-2000 IU of HCG 3 times per week for 2 months. The HCG worked and recouped my semen levels to 88.3 M/mL currently. However he was a little skeptical of re administering test cyp for fear of my sperm dropping again. Problem was the HCG did absolutely nothing for my sex drive. I could barely achieve erection (even watching porn). It was a brutal few months of trying to procreate. Never thought I would say that!?! Practice is supposed to be the best part. We then decided to start test again but at a low dose 300 mg once per week combined with 1500 IU HCG 3x week and 1 mg anastrozole 3x week. I have been currently on this dose for about 6 months now and my sperm has remained elevated.
Now to the current problem. About a month ago I lost all interest in sex. I have to watch porn and get off as quickly as possible so I don't lose my half erection. I can ejaculate but it is very difficult to maintain an erection and I have no libido at all. My latest lab results have my test levels back up to a good level. However my estradiol, LH, and FSH are really low. Here are my most current lab results 4/28/16:
Total T - 664 ng/dL
Free T - 21.8 pg/mL
FSH - 0.3 mlU/mL
LH - less than 0.1 mlU/ml
Estradiol - 8 pg/mL

I know it was a lot of writing but any thoughts I would appreciate.

 

[CoastWatcher]

With all due respect, I question your doctor's knowledge of male hormone replacement. Your protocol is, to put it mildly, working against you. A weekly dose of 300mg of testosterone is excessive and 3mg of Anastrozole a week is great - if you are a woman recovering from breast cancer.

Knowledgeable doctors, those who work at the cutting edge of TRT, typically administer frequent small injections (every 3.5 days is somewhat standard) and are very careful to prescribe Anastrozole only when needed. Typical starting dose is 50-60 mg of testosterone twice weekly with no anti-estrogen. Such a protocol will typically see total testosterone in the 900s, if not over 1000. Anastrozole can be added if necessary.

You have suppressed your estradiol to a point that it may well be impacting your libido and erectile function. Your total testosterone is not as high as one would like - do you have your SHBG lab results? You may be taking in 300mg of testosterone, but your SHBG could well be working against single, large doses.

You feel terrible. It isn't your fault, it's due to a bungled protocol that clueless doctors ordered up.

 

[ERO]

Agree with CoastWatcher 100%. Your latest doctor is clueless as well. Guys have fathered children on TRT, often following a protocol of T sots every 3.5 days and HCG at 500IU every other day, as just one example. Many of us on the forum use and recommend Defy Medical. They not only know what they are doing, but charge far less than what you have been paying that clown car of doctors you have had in the past.

 

[Vince Carter]

I'd say the most glaring thing is your Estrogen @ 8, then as Coast and Ero stated, this Dr is not really doing you too many favors but in a vacuum, I'd pull back on the Anastrozole. Also rather bizarre that you're getting 300mg 1x per week but only pulling a trough of 664. If I were you and did just one thing I'd cut back on that Anastrozole. We typically NEVER see any of us taking but maybe .5mg, per week total. Getting 300mg at one-time I'm sure you need an AI as that's a 100mg over what any of us believe is a TRT dose, leaves for excess to aromatize.

 

[Jackie Treehorn]

We then decided to start test again but at a low dose 300 mg once per week combined with 1500 IU HCG 3x week and 1 mg anastrozole 3x week. I have been currently on this dose for about 6 months now and my sperm has remained elevated.
Now to the current problem. About a month ago I lost all interest in sex. I have to watch porn and get off as quickly as possible so I don't lose my half erection. I can ejaculate but it is very difficult to maintain an erection and I have no libido at all. My latest lab results have my test levels back up to a good level. However my estradiol, LH, and FSH are really low. Here are my most current lab results 4/28/16:
Total T - 664 ng/dL
Free T - 21.8 pg/mL
FSH - 0.3 mlU/mL
LH - less than 0.1 mlU/ml
Estradiol - 8 pg/mL

I know it was a lot of writing but any thoughts I would appreciate.

Here we go again...

I am speechless (practically). Looks like your "doctor," and I use that term loosely, has done an excellent job crashing your E2 with an anastrozole dose large enough to kill the wood on a rhinoceros. If that wasn't enough, I really like the "low dose" weekly test injection of 300mg...nice job, "doctor." That must have been fun riding that roller coaster.

Jet,

If you're not running away from this "medical professional" at top speed, I feel sorry for you. He is hurting you, not helping you. Seek the advice of real medical professionals elsewhere. You know where to go.

 

[JetSpyder]

I guess when I wrote this long bitch session I put the wrong numbers for my test. He has me on 100 mg of test a week not the 300 that i incorrectly wrote.

However, thankfully after joining this site and reading articles along with all the helpful posts I realize that he must know much about my estrogen levels. From what I see there has been no need for 1 mg 3x/week of anastrzole. My E levels are extremely low. I stopped taking the anastrzole 2 weeks ago and already I feel better. I split my test dosage to 50 mg twice a week to help boost my E levels back up to a normal level.

 

[JetSpyder]

A couple questions for anyone with a similar experience. I stopped taking anastazole completely.

I would like to increase my test to 75-100 mg twice a week. Does anyone else have experience with fertility on this dosage? I am afraid to increase my test intake with the possibility of reducing my sperm count.

Also I am still on a pretty high dose of HcG (1000 IU) 3x/week. Can I maintain my fertility if I reduce my HcG 1000 IU 2x/week?

What is a good target number for my free T? I see some say mine is still relatively low.

 

[ERO]

I guess when I wrote this long bitch session I put the wrong numbers for my test. He has me on 100 mg of test a week not the 300 that i incorrectly wrote.

However, thankfully after joining this site and reading articles along with all the helpful posts I realize that he must know much about my estrogen levels. From what I see there has been no need for 1 mg 3x/week of anastrzole. My E levels are extremely low. I stopped taking the anastrzole 2 weeks ago and already I feel better. I split my test dosage to 50 mg twice a week to help boost my E levels back up to a normal level.

Good move on your part! You will no doubt feel much better with a more normal E2 levels and with splitting your T dose. It can take a while - up to a few weeks - to return to normal after crashing your E2 that low so you may need to be patient. The time to recover from crashed E2 varies from person to person.

 

[CoastWatcher]

A couple questions for anyone with a similar experience. I stopped taking anastazole completely.

I would like to increase my test to 75-100 mg twice a week. Does anyone else have experience with fertility on this dosage? I am afraid to increase my test intake with the possibility of reducing my sperm count.

Also I am still on a pretty high dose of HcG (1000 IU) 3x/week. Can I maintain my fertility if I reduce my HcG 1000 IU 2x/week?

What is a good target number for my free T? I see some say mine is still relatively low.

Why do you want to increase your testosterone doseage? I would do NOTHING until at least four weeks have passed without estradiol and then I would obtain lab values through Discountedlabs.com. It is a solid rule - any change in protocol, any change at all, means you are standing at the starting line again and need to give serum levels a chance to rebalance.

As as far as fertility, we have a number of members who have impregnated their partners while in TRT. But they had top-flight medical advisors.

 

[Jackie Treehorn]

I stopped taking the anastrzole 2 weeks ago and already I feel better. I split my test dosage to 50 mg twice a week to help boost my E levels back up to a normal level.

Good move...now listen to Coastie and don't increase your test dosage. Do one thing at a time, let everything settle down, and re-draw your labs in about 6 weeks.

With regard to your HCG dosage, have you consulted Defy Medical or someone that knows what they're doing? Most guys are taking somewhere in the neighborhood of 1000IUs per week for backfilling the pathways, and maintaining testicle size. The dosage varies with each patient. For fertility issues, I don't have an answer for you, as you need to talk to a professional like Dr. Saya.