Trying to avoid AI

[mooseman109]

My old handle was buggies100,been here awhile and somehow all that changed as we switched over. So about 6 years on Testosterone
Switched to defy last December after struggling with high HCT issues. They have restructured my protocol to 3 injections of cyp /week and 350 hcg at same time. Doseage started at 20 mg/dose, i kk ow it is low, but i respond to it and it keeps hct in line. We upped doseage to 25 mg 2 months ago in attempt to raise my free T
Below are most recent labs

Testosterone, Serum 793 -(264-916)

Free Testosterone(Direct) 18.0. (7.2-24.0)

Estradiol, Sensitive 31.6. (8.0-35.0)

Free T came up from 16 but E2 came up from 27.

Sex is good with 5mg cialis. May struggle to finish mid week in evening. Other than that I have no symptoms of high E2.

I have defy consult coming up in 10 days. I know she is going to push for an AI. Seems protocols can get more difficult to tune it once AI is added, from what I read here.
I also take 25 mg dhea every night. Have been on that before all protocol changes.

Any suggestions?

 

[MarkM]

What about trying to stop taking the DHEA? It seems in men, DHEA mostly converts to estradiol downstream. 31.6 for Estradiol Sensitive is not high unless you are feeling symptoms. Mine runs about 35.3 on the same range and I don't take an AI. I would strongly suggest taking no AI, regardless of what the Estradiol Sensitive is unless you have serious symptoms.

 

[Systemlord]

When my estrogen is high for me I'm fatigued, it causes me to be tired midday. I had a Defy consult 2 weeks ago I added an AI and it's been a godsend for me, it was the final piece of the puzzle.

 

[Vince Carter]

Wheres your SHBG through all this?

 

[mooseman109]

Wheres your SHBG through all this?

Mid 40’s on shbg

 

[MarkM]

Mid 40's SHBG with a dose of 25 mg three times a week sounds low. It would seem every 3.5 days would work better for you but we are all different and if 25 mg on three injections a week is what makes you feel good then that is what works for you.

 

[mooseman109]

Do you guys think i should up doseage to try to raise freeT? I do get drained mid day most days. I also get up at 4:15and workout and then work from 7am to 6pm five days weekly. I have run thyroid panels and all is in range.

 

[Systemlord]

I have run thyroid panels and all is in range.

You've been a member here long enough to know that isn't good enough, we are told by our doctors that we are normal and don't feel anywhere near normal.

 

[Vince Carter]

Do you guys think i should up doseage to try to raise freeT? I do get drained mid day most days. I also get up at 4:15and workout and then work from 7am to 6pm five days weekly. I have run thyroid panels and all is in range.

T, or Thyroid, isn't at all responsible for you trying to push 15 hour days.

 

[Vince Carter]

You've been a member here long enough to know that isn't good enough, we are told by our doctors that we are normal and don't feel anywhere near normal.

Good call, Sir.

 

[mooseman109]

Systemlord, you are correct in we are our own best source regarding how we feel. I have always believed lab numbers are just that, an indicator, a unit of measurement, not an end all to be all. I do not believe I have any thyroid issues.
MarkM, i could drop the dhea, it may be responsible for e2 climbing, it is the newest addition to protocol, about 6 months with it now. It has allowed me to lean out a bit. Has not really improved sleep as i was told it would. Also told it wuold help me not to fixate on things that piss me off. That also has not been a result
Vince Carter, you may be right. At 55 maybe I just can not push thru like I used to. I do notice a bit less of agressive drive in business and a little bit of my give a damn os broken. It could be time to dial back business

All the above aside, what are your thoughts on increasing dosage of T cypionate? I am always a bit hesitant and go slow due to a serious scare with hct I had 18months ago when it got up to 62!
Slow is definetly better than stroke!

 

[MarkM]

You have room for your free to to move upward and getting it to the high normal part of the range might help you feel better. So increasing the dose could help you there. It would also increase your E2 but you have room there too and evnif you get up around or over 35, which is the upper limit of the range, that is only a number, and if you feel good with a little higher E2 then no worries.

I've been a hard charger my entire life. Way more than most and way more than needed. My success in business came from out working everyone else and not because I was necessarily smarter than everyone else. So, while it had it positive effects, it also had it's draw backs in life. It's about finding balance and that is different for everyone. I finally found mine but wish I had found it earlier. I found that that balance helped me "give a damn" even more than before and the little things that pissed me off began to disappear. Maybe I was just becoming happier with myself and removing frustrations.

You might still want to look into your thyroid of post up your results that the doctor told you were "normal". The thyroid panel can have normal ranges and still not be performing at optimal levels. Your T numbers are not terrible and maybe if you are having low T symptoms it could be the thyroid since the symptoms can be very similar. If your thyroid is not performing properly it can hamper your TRT. The thyroid test that should have been run are: TSH, Free T3, Free T4, Reverse T3, and the two thyroid antibodies. If your doctor only ran TSH and T4/Free T4 then enough tests weren't run. You should really explore this more.

 

[mooseman109]

Thnaks guys, I a, pretty good overall, just trying to dial in. I occasionaly can loose erection prior to finishing. Even with daily 5mg cialis. It seems to happen more when i have had a long day or we are under time comstraints. Rarely happens on nice relaxed Saturday or Sunday mornings. I have chalked this up to just being tired. Could this be a sympton of E2 being too high? Orgasms have lost some what of an edge at times as well. And even though on 350 mg hcg 3 times a week, my testicles are not as big as they once were

 

[MarkM]

Some have had better success on testicular atrophy going with 500 iu twice a week verse the lesser 350 iu three times a week.

 

[Kirk001]

I would just tell your provider that based on the information you've seen you don't think an E2 of 32 is problematic with no estrogenic symptoms. If you want to make her happy you could get some to take as-needed, and then not take it unless you got symptoms.

 

[Gman86]

Do you know your DHEA-S level currently? If it’s on the high end, or over, then what you can do is lower your dose, which will lower E2, which will then give your room to up your testosterone dose and get your free T up a bit.

With a SHBG of 40, I highly doubt your E2 of 31 is the cause of your symptoms. If anything, 31 would usually be right in the E2 sweetspot for men with your SHBG. So it’s definitrly something other than E2. Possibly your thyroid like others have stated. Also make sure you take plenty of Magnesium. I already knew TRT drains magnesium, but I keep hearing it reiterated by top docs in the TRT community. So get on that as well if you’re not already taking some. Super important

 

[mooseman109]

Gman86, My Dhea runs 140-200. I do shbg twice a year, last 2 were 43 and 54. Prior to starting with Defy in dec, I was test only guy for 5 years. They added hcg and dhea. I only added hcg first for first 3 months and then added the dhea after that. That way when something goes wrong I know it is only one thing not which thing!!! My E2 was always around 14-18. Total T was always 500-600 and free T was 14-17. after 3 months of hcg added and splitting my Test cyp dose to 3 days weekly from once weekly, my E2 went to 24 and then I added dhea and 3 months later it is 31. I am not overly concerned about the number. Just know Christie at defy os gong to push for AI.
I googled high E2 symptoms. I have noticed that my nipples are now erect way more than before. Yes there are some erection issues, delayed orgasm, maybe loosing erection part way through, but libido is strong and morning wood is strong as well as up on command. So I do attribute erection issues more to being tired. What I have noticed is tightness in chest and shortness of breath, to the point I have a stress echo scheuled for this Wednesday. But after reading E2 can cause anxiety, it reminded me of when I first started TRT, it was due to anxiety and the chest pains I am feeling are exactly what I get back then. Also I asked my wife and security if I have been emotional over the last couple of months, both answered with a resounding YES!! So maybe this is a E2 issue.
I am going to drop the DHEA and see where this goes. The stress test is good anyway as I am 55 and my dad had first heart attack at 58.

 

[mooseman109]

Also I have been taking 200 mg of mag citrate in am and in pm as part of daily stack.

 

[Gman86]

What is the DHEA range on your labs? Just curious where 140-200 would put you in the range. Not sure if 140-200 is high or low, or in-between. Also whats the range for your SHGB labs? The numbers mean very little without the ranges.

How did you feel those 3 months on HCG before you added the DHEA?

And 200mg twice a day is an ok dose. I would personally at least double that though, and switch to Magnesium Glycinate or a liquid picometer-ionic form like Remag. It's basically just a liquid form that gets into the cells better.

 

[mooseman109]

Gman86,
Thanks for info on magnesium, I will look into the liquid.
SHBG range is 19-76, so last 2 average out at 48.5, basically I am right dead in the middle. DHEA range is 71-375. I was 103 before starting and now 133 after 4 months. So I am in the bottom 20%. The only positive I can notice since starting DHEA is that I seemed to have slightly leaned out without dieting. I was told I would sleep better and not get so focused on irritants. None of that has happened. Most of the symptoms I mentioned have started in the past 8 weeks, which would be about 8 weeks into the DHEA addition. So to answer your question, I felt better on HCG without dhea. No anxiety at all. It ids not bad anxiety now, mentally I am fine, but I feel it in chest and breathing patterns, which is typical for me. Just have not felt it in almost 6 years since starting TRT.