At wits end with ED problems

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Defy Medical TRT clinic doctor
My personal experience is when my Free T is too high, I get ED. I am low SHBG too. Your Free T is really high. Have you considered lowering your dose? Also, try losing the AI. AI plays havoc with my libido and erections.
You mean when u have high free T and u dont take AI, it will be converted into Estrogen and that causes ED not free T itself right?
 
So yesterday I took the .25 anastrozole being my e2 was so high at a minimum of 72 a week before on 7/10 and no AI since the last one on 7/9 where I took .05 anastrozole.. About 2 hours after I was having raging hard-ons during the day. By 10pm, they just weren't working again. This is what I run into.
 
So yesterday all day I could barely touch myself and I be hard as a rock. this was about an hour and a half after I took the anastrozole. Last night it wasn't working again and I went soft and that's after a Viagra. This morning... Wet noodle. So now I don't know if my e2 is too high or low or if this is the reason. There needs to be some correlation with the anastrozole because it was working all day for hours.
 
So yesterday all day I could barely touch myself and I be hard as a rock. this was about an hour and a half after I took the anastrozole. Last night it wasn't working again and I went soft and that's after a Viagra. This morning... Wet noodle. So now I don't know if my e2 is too high or low or if this is the reason. There needs to be some correlation with the anastrozole because it was working all day for hours.


Why are you still f**king with the AI?

You just recently lowered your T dose, drop the AI, and give it 4-6 weeks as your hormones are still in FLUX.

Tough it out as you will most likely experience ups/downs during the transition until blood levels stabilize.

Seems doubtful that you have had any consistency with the numerous protocols you have been on since 2017.

Looked over all your numerous threads on here.

You have low SHBG and from the get-go, you were running very high FT levels which had you playing the AI game trying to control your e2 let alone constantly donating blood to control your elevated RBCs/hemoglobin/hematocrit only to end up in the "oh no I crashed my ferritin" merry go round.

Even on the handful of protocols where you had your trough FT levels at the top end of the range, you were still f***ing with the AI taking it here and there only to be left wondering is my estradiol too high or crashed.

Then you would randomly get labs and go through the same routine again (AI/no AI, hCG/no hCG) while at the same time trying to understand why you are experiencing libido/ED issues.

If you think trt will have a man running around with raging hard-ons and a crazy sex drive 24/7 than you will be running around in circles for years to come.

As Nelson stated and I have mentioned in numerous threads over the years there is much more involved when it comes to libido/erectile function than simply having healthy TT/FT/e2/DHT levels.

Poor vascular health, lack of quality sleep, excess stress whether (physical/mental), thyroid/adrenal dysfunction, poor diet, and the lack of exercise effects on overall health.
 
Why are you still f**king with the AI?

You just recently lowered your T dose, drop the AI, and give it 4-6 weeks as your hormones are still in FLUX.

Tough it out as you will most likely experience ups/downs during the transition until blood levels stabilize.

Seems doubtful that you have had any consistency with the numerous protocols you have been on since 2017.

Looked over all your numerous threads on here.

You have low SHBG and from the get-go, you were running very high FT levels which had you playing the AI game trying to control your e2 let alone constantly donating blood to control your elevated RBCs/hemoglobin/hematocrit only to end up in the "oh no I crashed my ferritin" merry go round.

Even on the handful of protocols where you had your trough FT levels at the top end of the range, you were still f***ing with the AI taking it here and there only to be left wondering is my estradiol too high or crashed.

Then you would randomly get labs and go through the same routine again (AI/no AI, hCG/no hCG) while at the same time trying to understand why you are experiencing libido/ED issues.

If you think trt will have a man running around with raging hard-ons and a crazy sex drive 24/7 than you will be running around in circles for years to come.

As Nelson stated and I have mentioned in numerous threads over the years there is much more involved when it comes to libido/erectile function than simply having healthy TT/FT/e2/DHT levels.

Poor vascular health, lack of quality sleep, excess stress whether (physical/mental), thyroid/adrenal dysfunction, poor diet, and the lack of exercise effects on overall health.
I agree. I just did so bc my e2 was so high and I didn't feel good. I'm pretty good mentally and physically otherwise as far as I know. I posted the labs. Was looking for thoughts on them.
 
I agree. I just did so bc my e2 was so high and I didn't feel good. I'm pretty good mentally and physically otherwise as far as I know. I posted the labs. Was looking for thoughts on them.

You have been given ample advice to drop the AI and stay consistent with your protocol until you have blood work done at 6 weeks.

Make sure to get these tests through discountedlabs.

This is a very economical panel that includes: 1- Hematocrit: Portion of total blood volume made up of red blood cells. Testosterone replacement therapy can increase hematocrit. Hematocrit over 52 may increase blood thickness and cardiovascular risks. 2- Total (LC/MS- No upper Limit) and Free Testosterone by Equilibrium Analysis.







Or better yet seeing as your prolactin was low on previous blood work than this would be the more cost-effective seeing as it includes:
This discounted lab test panel for men includes total testosterone by liquid chromatography/mass spectrometry (the most accurate testosterone test), free testosterone (ultrafiltration), hematocrit, ultrasensitive estradiol, and prolactin hormone.
 
Last edited:
When it comes to testing free testosterone than you would be smart to invest in the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best) if you want to know where your FT level truly sits.

2- Total Testosterone (LC/MS- No Upper Limit) and Free Testosterone (Dialysis)





2- Total Testosterone (LC/MS- No Upper Limit) and Free Testosterone (Ultrafiltration)
 
When it comes to testing free testosterone than you would be smart to invest in the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best) if you want to know where your FT level truly sits.

2- Total Testosterone (LC/MS- No Upper Limit) and Free Testosterone (Dialysis)





2- Total Testosterone (LC/MS- No Upper Limit) and Free Testosterone (Ultrafiltration)
Why those tests instead of the ones I've been doing which seem to be what most are recommended to do?
 
Why those tests instead of the ones I've been doing which seem to be what most are recommended to do?

When it comes to FT than the most accurate testing methods are ED and UF.

Labcorp and Quest both offer them!

Ordering through discountedlabs would most likely be cheaper.

Some of your previous blood work was done through Quest using the FT Equilibrium Dialysis and some were done using the direct immunoassay.
 
When it comes to FT than the most accurate testing methods are ED and UF.

Labcorp and Quest both offer them!

Ordering through discountedlabs would most likely be cheaper.

Some of your previous blood work was done through Quest using the FT Equilibrium Dialysis and some were done using the direct immunoassay.
So are my results inaccurate to advise? My insurance has covered all testing so far.
 
So are my results inaccurate to advise? My insurance has covered all testing so far.

These labs results were done using the more accurate FT assay Equilibrium Dialysis
Screenshot (1647).png

Screenshot (1648).png

Screenshot (1650).png



These were done using the direct immunoassay
Screenshot (1649).png

Screenshot (1651).png



When you get labs done at 6 weeks on new protocol order the FT Equilibrium Dialysis.
 
madman would you say free T is whats most important when it comes to libido and erection strenght?

I think men with too low shbg get their free T thru the roof, sometimes even on moderate doses, which makes their free e2 go insane aswell fucking up the libido.

Thoughts?
 
madman would you say free T is whats most important when it comes to libido and erection strenght?

I think men with too low shbg get their free T thru the roof, sometimes even on moderate doses, which makes their free e2 go insane aswell fucking up the libido.

Thoughts?

No, as it is much more complex than simply having healthy T levels.


 
Beyond Testosterone Book by Nelson Vergel
It would be so cool for all of us if we could blame one number for our bad erections. Then we could change it and get hard again. This is a fantasy that takes a few weeks or months of trial and error to realize what old timers are trying to tell you. I have seen it several times every month for the past 10-15 years.

An erection is more complicated than an algebra equation. Post #58 from madman explains this well.
 
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