Erection Issues/Help

[Milkman13]

Hello all. I am to the forum and would appreciate any advise. Am a 36 year old male who years ago did steroids off and on and then developed erection issues. So I decided to go to a clinic and get on trt about 3 months ago. I did have a spinal fusion at the beginning of this year but had these issues prior to that. So I’m able to get semi hard but not fully or able to sustain it. Could someone please give me insight. My next follow up appointment is in a couple weeks.

My current protocol is as follows:
200mg of test Cyp split into 2 injections
100mcg of Gonadorelin 2 times a week
.5mg of Armidex on day of injections

bloods are attached.

 

[MarcoFL]

Cut your dose in half! take it from someone older and.... I would do that and stop the AI and retest in two months. I bet you will feel better!! I would add full thyroid panel and fasting insulin. Your fasting glucose is higher than I would want! how is your diet?

 

[Vince]

No testosterone panel?

 

[Milkman13]

Cut your dose in half! take it from someone older and.... I would do that and stop the AI and retest in two months. I bet you will feel better!! I would add full thyroid panel and fasting insulin. Your fasting glucose is higher than I would want! how is your diet?

I’m very anal about my diet. I eat clean and track everything.

 

[Milkman13]

No testosterone panel?

This is the panel they sent me for.

 

[MarcoFL]

No testosterone panel?

his total T was 1460 and taking 200mg per week I am guessing his FT is high also.

 

[Systemlord]

I'm curious as to why you were placed on an AI and question whether you needed it at all. It's usually best to start TRT in isolation and attempt to dial in rather than start out on an AI when it might not even be necessary.

 

[Milkman13]

I was sweating a lot and advised them I was still having ED issues and that’s what they added in.

 

[Systemlord]

I was sweating a lot and advised them I was still having ED issues and that’s what they added in.

I'm afraid your labs leave more questions on the table, like Free T and SHBG levels. If you're SHBG was really low or mid range pre-treatment, your Free T levels would mostly likely be astronomically high and a dosage reduction may be all that was needed and instead you were given an AI.

A lot of these TRT clinics really don't have a clue how to manage men on TRT. If I were you I would cut my dosage to about 120mg weekly and stop the AI.

 

[Milkman13]

Hopefully on my follow up they can give me some answers.

 

[madman]

Hello all. I am to the forum and would appreciate any advise. Am a 36 year old male who years ago did steroids off and on and then developed erection issues. So I decided to go to a clinic and get on trt about 3 months ago. I did have a spinal fusion at the beginning of this year but had these issues prior to that. So I’m able to get semi hard but not fully or able to sustain it. Could someone please give me insight. My next follow up appointment is in a couple weeks.

My current protocol is as follows:
200mg of test Cyp split into 2 injections
100mcg of Gonadorelin 2 times a week
.5mg of Armidex on day of injections

bloods are attached.

You are missing two of the most important tests on your lab work.

FT and SHBG.

Have no idea where your SHBG sits but with a very high TT 1500ng/dL you can rest assured that your FT level is high and even then if these labs are true trough then your peak TT/FT/e2 levels will be much higher.

You are being over-medicated as 200 mg/week (100 mg every 3.5 days) is a whopping dose and many would never need such a dose to achieve a healthy FT level.

Top it off that you are taking an AI to control your elevated e2 which is a result of your very high TT level which would have your FT very high and again if these are trough levels then a TT 1500 is way too high (twice weekly injections).

Even then I would be more concerned with where your FT level sits as although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the beneficial effects.

You need to have your FT tested let alone SHBG.

Regarding FT you need to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration if you want to know where it truly sits on such protocol (dose T/injection frequency).

Use Nelsons discountedlabs.

Either assay will suffice!

1 Testosterone, Total and Free (NO Upper Limit) plus Hematocrit

2 Testosterone, Total, LC/MS and Free (Equilibrium Ultrafiltration)


Bet your FT will be very high even if your SHBG is on the higher end.

You would most likely fair much better lowering your dose as you may very well be able to drop the AI let alone feel much better.

The horrible protocol you have been put on.....high dosed T, aromatase inhibitor and top it off that your doctor has no f**king idea what he is doing prescribing you gonadorelin which will not replace hCG and injecting such a dose 2 times weekly is pointless!

My current protocol is as follows:
200mg of test Cyp split into 2 injections
100mcg of Gonadorelin 2 times a week
.5mg of Armidex on day of injections

 

[MarcoFL]

I was sweating a lot and advised them I was still having ED issues and that’s what they added in.

I had been on 150mg split 3X per week at TT of 1300-1400 and was sweating every night also taking an AI. I am now on 12mg everyday with TT 800 and zero sweats at night. I kept reading all the guys here saying LESS is BETTER and finally followed their advice. All I can say is I am way more relaxed at the lower dose. My SHBG seems to have gone down on lower daily doses which is not the norm. Everything is just more in sync now

 

[Milkman13]

You are missing two of the most important tests on your lab work.

FT and SHBG.

Have no idea where your SHBG sits but with a very high TT 1500ng/dL you can rest assured that your FT level is high and even then if these labs are true trough then your peak TT/FT/e2 levels will be much higher.

You are being over-medicated as 200 mg/week (100 mg every 3.5 days) is a whopping dose and many would never need such a dose to achieve a healthy FT level.

Top it off that you are taking an AI to control your elevated e2 which is a result of your very high TT level which would have your FT very high and again if these are trough levels then a TT 1500 is way too high (twice weekly injections).

Even then I would be more concerned with where your FT level sits as although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the beneficial effects.

You need to have your FT tested let alone SHBG.

Regarding FT you need to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration if you want to know where it truly sits on such protocol (dose T/injection frequency).

Use Nelsons discountedlabs.

Either assay will suffice!

1 Testosterone, Total and Free (NO Upper Limit) plus Hematocrit

2 Testosterone, Total, LC/MS and Free (Equilibrium Ultrafiltration)


Bet your FT will be very high even if your SHBG is on the higher end.

You would most likely fair much better lowering your dose as you may very well be able to drop the AI let alone feel much better.

The horrible protocol you have been put on.....high dosed T, aromatase inhibitor and top it off that your doctor has no f**king idea what he is doing prescribing you gonadorelin which will not replace hCG and injecting such a dose 2 times weekly is pointless!

My current protocol is as follows:
200mg of test Cyp split into 2 injections
100mcg of Gonadorelin 2 times a week
.5mg of Armidex on day of injections

Thank you for the in-depth reply. So either one of those panels would work?

 

[Milkman13]

I had been on 150mg split 3X per week at TT of 1300-1400 and was sweating every night also taking an AI. I am now on 12mg everyday with TT 800 and zero sweats at night. I kept reading all the guys here saying LESS is BETTER and finally followed their advice. All I can say is I am way more relaxed at the lower dose. My SHBG seems to have gone down on lower daily doses which is not the norm. Everything is just more in sync now

Did you experience any erection issues?

 

[madman]

I was sweating a lot and advised them I was still having ED issues and that’s what they added in.

Typical trt mill prescribing high dosed T protocol off the hop which would have ones FT let alone estradiol levels too high only to be remedied by an AI which in many cases may cause more issues.

They are basing your labs off of TT without even checking your FT which is critical and lowering your trt dose would bring down your FT which would lower your e2 and negate the need to use an AI.

Even then as I stated earlier with a TT in the 1500s your FT is going to be high even if you have higher SHBG and if these are true trough levels then your peak levels will be much higher.....go figure!

You need to retest your FT.

Thank you for the in-depth reply. So either one of those panels would work?

Yes.

 

[Milkman13]

Typical trt mill prescribing high dosed T protocol off the hop which would have ones FT let alone estradiol levels too high only to be remedied by an AI which in many cases may cause more issues.

They are basing your labs off of TT without even checking your FT which is critical and lowering your trt dose would bring down your FT which would lower your e2 and negate the need to use an AI.

Even then as I stated earlier with a TT in the 1500s your FT is going to be high even if you have higher SHBG and if these are true trough levels then your peak levels will be much higher.....go figure!

You need to retest your FT.


Yes.

Gotcha. Thank you so much.

 

[MarcoFL]

Did you experience any erection issues?

very high T impacts everything. You want to try and have all systems working together.

 

[Milkman13]

So I held off on getting blood work and had my appointment with my doctor. He said he believes my prolactin levels are high and wanted to test them. So I had them tested and they are normal but it came back with low SHGB. How do I correct that?

 

[Cataceous]

Testosterone suppresses SHBG, estradiol enhances it. Cut your TRT dose drastically and dump the AI, as has been recommended. Although your prolactin is in range, some guys can have trouble at this level, particularly if they started from a lower level and it crept up. This was my experience.

 

[Milkman13]

Thank you for your response. How much would I even cut my dose?