I'm a guy with natural levels in the low 300s. I suffer from low libido, ED, low muscle mass, brain fog, no motivation, etc.
Back in 2022, I tried TRT for the first time, a dose of 150mg split into twice per week. I felt the effects within the first few weeks and I felt incredible, elevated mood, increase in muscle, very hard erections, etc. Weeks later, I started developing high heart rate, panic and anxiety, and talked to my
TRT doctor what's going on. He told me to lower the dose but I still had issues. I quit TRT cold turkey (I had no knowledge about high E2 and thought I was dying) and my baseline was restored back to 325 ng/dl months later. (Mid-2022)
Fast forward, 2024-2026, I am a shell of myself with no drive, energy, limp dick. It is humiliating. Keep in mind, I am a skinny guy with GI issues for 10 years. My doctor chalked up my digestive issues to IBS but I later did a breath test and found out I have high hydrogen levels in my small intestine (SIBO). I decided to try TRT again since antibiotics failed me.
I have tried daily cypionate, twice per week, and even esters like Propionate. I got labwork done and it would show my levels around 900-1000 with good free T. Yet I feel nothing, even when taking an AI on and off. I wanted the benefits I initially got in 2022, even went back to my old 150mg dosage and nothing. If anything, despite my high testosterone, TRT causes me to even lose more muscle. I became weaker. I got off again and months later my natural test returned to baseline. My muscles slightly increased. What is going on? It is like my androgen receptors are rejecting synthetic testosterone? Why would it make me smaller and not feel anything? Limp dick and low libido still there. I miss the hard erections I got in 2022...it's like I have Post Finasteride Syndrome yet I have not taken anything like that or any SSRIS.
What do I do? What is the solution for guys like me where the receptors don't seem to function? Do I try proviron? Encomiphine? The cream? Why did TRT work for me initially years ago with good muscle gain, very hard erections, super high libido, good mood, etc? Why does TRT make me weaker now?
I dropped my labs below to see if it helps (140 mg daily cyp per week) was my recent labwork.
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Back in 2022, I tried TRT for the first time, a dose of 150mg split into twice per week. I felt the effects within the first few weeks and I felt incredible, elevated mood, increase in muscle, very hard erections, etc. Weeks later, I started developing high heart rate, panic and anxiety, and talked to my TRT doctor what's going on. He told me to lower the dose but I still had issues. I quit TRT cold turkey (I had no knowledge about high E2 and thought I was dying) and my baseline was restored back to 325 ng/dl months later. (Mid-2022)
When you first started T-therapy your starting dose was too high off the hop.
Such dose most likely had your trough TT and more importantly FT too high
Judging by your recent lab results on the slightly lower dosed protocol 140 mg T split 70 mg twice-weekly which has your FT level sky-high you were clearly overmedicated off the hop.
The standard starting dose is 100 mg T/week or better yet 50 mg T twice-weekly.
Most men on TTh are injecting 100-200 mg T/week whether once weekly or split into more frequent injections.
The majority of men can easily hit a healthy/high trough FT injecting 100-150 mg T/week especially when split into more frequent injections.
As always yes there are some outliers who may need the high-end dose 200 mg T/week but its far from common as in very rare!
Such dose would easily have the majority of men overmedicated.
On the other end of the spectrum there are some men who can achieve stellar levels injecting <100 mg T/week especially when split into kore frequent injections.
The reason you felt so good off the hop is because you were experiencing what we call the honeymoon period where one will see an increase in libido, nocturnal/spontaneous erections and a euphoric like state due to increased dopamine, rising T and AR (androgen receptors lighting up).
Unfortunately this is a short-lived/temporary state as the body will eventually adapt to its new-set point where things tend to wane more in what we would call the norm.
It is a myth that you will maintain a long-term raging libido/rock hard erections when using exogenous T.
When first starting TTh or tweaking a protocol T levels will increase over the following weeks until blood levels have stabilized (4-6 TC/TE) due to the PK and it is common for one to experiences ups/downs during the transition as the body is trying to adjust.
The first 6 weeks means nothing when looking at the bigger picture here.
Even then once steady-state is reached (4-6 weeks TC/TE) it will still take a few more months for the body to adapt to its new-set point and this is the critical time period when one needs to gauge how they truly feel overalll regarding relief/improvement of low-T symptoms.
Every protocol needs to be given a fighting chance 12 weeks before claiming it was a success or failure.
Many still lack the understanding of how exogenous T works and end up making the grave mistake of tweaking the protocol to soon (6-8 weeks) because they do not feel well only to end up chasing their tail indefinitely.
Another big mistake is starting on too high a dose which can have many feeling good off the hop only to end up being let down months later as running too high a trough/steady-state FT can be just as bad in many ways as running to low a FT especially the it comes to libido, erectile function and mood.
Hammering the s**t out of your dopamine is the last thing you want to do here.
T has a tonic effect on the CNS and can easily make on feel amped up/anxious.
Not everyone can handle high T especially if they have blown past their natty genetic set-point.
All that should really matter here is the dose one needs to achieve a healthy trough FT which will result in relief/improvement of low-T symptoms and overall well-being.
Unfortunately many are overmedicated on T especially from the get-go!
Yes symptom relief is what truly matters but when it comes to what FT level is needed one needs to keep in mind the overall goal would be to use the least amount in order to feel well while at the same time minimizing sides and keep blood markers healthy long-term.
The goal here would be to target the lowest effective dose that relieves symptoms and restores physiologic--->high-normal Free T trough levels (15-25 ng/dL).
Critical to pay attention to ones injection frequency/trough FT as there is going to be a big diffrerence between one hitting a high-end/high trough FT injecting daily vs twice-weekly vs once weekly
There is also going to be a big difference in what FT level is achieved running a high-end/high TT in a man with low vs normal vs high SHBG!
I have tried daily cypionate, twice per week, and even esters like Propionate. I got labwork done and it would show my levels around 900-1000 with good free T. Yet I feel nothing, even when taking an AI on and off. I wanted the benefits I initially got in 2022, even went back to my old 150mg dosage and nothing. If anything, despite my high testosterone, TRT causes me to even lose more muscle. I became weaker. I got off again and months later my natural test returned to baseline. My muscles slightly increased. What is going on? It is like my androgen receptors are rejecting synthetic testosterone? Why would it make me smaller and not feel anything? Limp dick and low libido still there. I miss the hard erections I got in 2022...it's like I have Post Finasteride Syndrome yet I have not taken anything like that or any SSRIS.
Again you experienced what we call the honeymoon period which is short-lived and temporary.
Eventually months in the body will always adapt to its new set-point and things will tend to wane more in the norm. especially when it comes to libido and erections.
When starting TTh you are going from a hypogonadal state--->high or very high trough/steady-state FT levels in most cases.
Forget how you feel when starting exogenous T let alone tweaking a protocol (increasing the dose of T) as the first 6 weeks means nothing when looking at the bigger picture.
No way you should be losing muscle if you are achieving a healthy let alone high trough/steady-state FT.
If you were not taking in enough protein or your daily caloric intake was low then one can easily lose muscle.
I dropped my labs below to see if it helps (140 mg daily cyp per week) was my recent labwork.
How many days post-injection were your labs done?
We always want to test at the true trough (lowest point) before your next injection which in your case would be 3.5 days (84 hrs) post-injection seeing as you are injecting 140 mg T/week split 70 mg every 3.5 days.
Forgive me. but your labs are a mess.
Again have no idea how many days post-injection you had your blood work done but you are hitting an absurdly high TT 1426 ng/dL for someone with a low SHBG 14.6 nmol/L which means it would be a given that your FT would be absurdly high as in 40-50 ng/dL.
FT <5 ng/dL would be considerd low.
FT 5-9 ng/dL would be considered the grey zone where some men may experience symptoms of low-T.
FT 10-15 ng/dL would be healthy.
FT 20-25 ng/dL would be high-end/high!
Your FT is well beyond high as in ridiculous.
Seeing as you have low SHBG you can easily get away with a trough TT 550-870 ng/dL in order to achieve. a healthy/high trough FT 15-25 ng/dL.
This is a given.
Although TT is important to know FT is what truly matters as it is the active unbound fraction of T responsible for the positive effects.
Unfortunately you never had your FT tested using an accurate assay as it was done using the known to be inaccurate direct immunoassay which tends to underestimate in many cases or be out to lunch!
The only way to know where your FT truly sits would be testing it using the most accurate assay the gold standard Equilibrium Dialysis especially in cases of altered SHBG.
If you do not have access to such highly doubtful unless you live outside of the US then you would need to use/rely on the next best method which would be the calculated linear law-of-mass action Vermeulen (cFTV) which will give a good approximation.
Your estradiol is high because your FT is absurdly high.
Another marker that stands out here is your prolactin is high which can easily kill one's libido/mood.
Look over all the threads in post #3.
Testosterone libido and erectile function.
Eye opener for most!
14:20-16:47 (erections/erectile dysfunction)
You need 5 things to get a good erection:
1. good blood flow
2. good nerves
3. good testosterone levels
4. neurotransmitters/arousal
5. state of mind
Testosterone might not do as much for your libido as people think it does. Here's what this hormone does and doesn't do for your sex drive.
www.yahoo.com
As an expert on andrology and sexual dysfunctions, urologist Andrew Y. Sun, M.D., sees plenty of patients who’re struggling with low libido. And most are pretty sure they already know why: They must have low testosterone levels. Even if it turns out they don’t, “most of them still strongly believe that increasing their testosterone levels will improve their libido,” says Sun, who practices at Urology Partners of North Texas.
Sun’s...
