It's not too surprising. Just changing the injection frequency from weekly to twice weekly can knock down peak serum testosterone by up to 20% or so. When your body is used to higher levels it takes time to adapt to the reduction. It's not fun, but it's worthwhile in the long run. Same with dose reductions, but you can spread those out over a longer period to minimize the discomfort.
Help with urinary issues while on TRT - BPH or 'overactive pelvic floor muscle'
- Thread starter TonyG
- Start date
E2 result just came in. It's low, please let me know what you recommend in terms of the AI dose
madman
Super Moderator
You still have not tested your SHBG which is critical as you need to know where it sits.
Not only will it have a significant impact on TT/FT achieved but will also play a role in what injection frequency may suit you best.
Your e2 is way too low and basically on the verge of crashing!
As I stated earlier you just recently switched your protocol 2 weeks ago 160 mg/week --->80 mg every 3.5 days so your overall weekly T dose is still the same and top it off that you are also injecting hCG 500 IU 3 X week and unfortunately still taking the AI (although lower dose than the previous protocol) and as you can clearly see on the lab work results you just posted that your estradiol is horribly low.
Good chances are you would feel like s**t let alone you are only 2 weeks in since switching up your protocol.
Again we have no idea where your TT/FT level will sit on your current protocol as you are 2 weeks in and hormones are in flux and you will need to wait until blood levels stabilize (4-6 weeks) than have blood work done.
I would drop the AI and although your TT/FT levels may very well still be too high in 4 weeks when you have blood work done because your weekly T dose of 160 mg (80 mg every 3.5 days) is still a fairly high dose let alone you are also injecting hCG 500 IU 3 X week we want to see where your e2 sits on such protocol (dose T/injection frequency) without the use of an AI.
Dropping the AI will let your e2 come back up and as I stated above chances are your TT/FT levels may still be too high (current protocol) and come 4 weeks when you have labs done your e2 may very well come back high!
Once labs are done if your TT/FT levels are still too high and depending on where e2 sits you may very well have room to lower your T dose further and avoid hopping back on the AI.
You can also lower your T dose slightly now if you feel it is truly needed but keep in mind that you would need to start over and wait for blood levels to stabilize (4-6 weeks).
madman
Super Moderator
Look where your e2 sits as of now!
Let alone you are only 2 weeks in on the new protocol (starting your 3rd week) as of today.
Per our discussion the last AI I took was on 1/11/21. (dropped it like we talked about)
I felt great from 1/11-1/19.
On 1/20 my mood tanked again with anxiety, depressed, feeling crazy emotional.
1/21 slowly feeling better
1/22 felt great again
1/23 evening had anxiety / panic attack
1/24 morning felt great, tanked in the evening, anxiety.....
Tomorrow will be the start of the third week with no AI, and start of the fifth week with the split Testosterone dose.
My question is, is this roller coaster in mood normal because I came off the AI?
Changing/removing the AI dose reflects similar on the body like changing the Test dose?
Just when I begin to feel better, i get hit by a bus......lol.......it makes you wonder "should I get back on the AI?" or "what am I doing wrong"
madman
Super Moderator
Just tough it out as you are 5 weeks in and will have blood work done soon.
I know it is easier said than done but you will be running around in circles if you start changing things up too soon.
Depending on where your TT/FT/e2 levels sit if things look good then you will need to give it a few months to gauge how you truly feel.
Worst case scenario would be if your TT/FT levels are still too high then you may need to tweak your protocol (dose T/injection frequency) but unfortunately would then need to wait another 6 weeks for blood levels to stabilize.
I scheduled my appointment for the blood work. It will be at the start of the 7th week before my injection.
Is the panel below the one to get?
Panel: CBC, CMP, TT, FT, Lipids, Prolactin, Ultra Sensitive Estradiol, and SHBG
Last edited:
madman
Super Moderator
This is thorough and includes the most accurate assays for TT/e2 (LC/MS-MS) and FT (Equilibrium Ultrafiltration).
Quick update - over the last few days I definitely feel swelling in my lower extremities - legs, knees, feet, ankle. Feels like i'm carrying a tank around, lol
From the research I have done on this forum this seems to be a side effect of E2 going up - nothing to be alarmed about?
Lab results are above
This was take at the start of my 7th week at TROUGH @ 0.4ml twice a week, no AI, HCG 500IU 3x a week
No improvement in the BPH symptoms so far.
Let me know what you think, and thank you =)
madman
Super Moderator
As you can clearly see your trough TT 906 ng/dL is still on the high end (mind you not absurdly high) and more importantly, your FT is still very high due to your lowish SHBG 19 nmol/L.
Keep in mind that these are trough levels and the peak will be higher!
What really stands out is your absurdly high e2 90 pg/mL (LC/MS-MS)!
You are hitting these trough levels on 160 mg T/week split twice weekly (80 mg every 3.5 days) + hCG 500IU 3 x/week.
You definitely have room to lower your dose slightly but I would try dropping the hCG first and then retest e2 as it may very well be contributing to the absurd e2!
Once you know where your e2 sits without the use of hCG you can decide on your next move.
I use HCG strictly to prevent atrophy. I don’t want atrophy - should i drop the HCG to 250IU?
madman
Super Moderator
I understand but just drop it temporarily so you can see where your e2 sits.
Would rather see where your TT/FT/e2 truly sits without the addition of hCG.
If you do not want to spend the $$$ then just get labs done for e2 (LC-MS/MS).
How long do I stay off the HCG for it to reflect on the labs?
In other words, starting tomorrow if I stop taking it, when should I get the bloodwork?
New E2 result is above. This was taken at trough on the start of my 10th week on the new dose (March 1, 2021). No HCG, No AI.
The last hCG dose I took before getting the lab done was on Thursday 2/18/21.
madman
Super Moderator
Tough as it may have been over these past weeks at least you can now see where your e2 sits on a T-only protocol.
Now you can clearly see that your estradiol is absurdly high due to your high FT (post # 30).
You easily have room to lower your T dose.
Post #30
My reply post #31:
madman
Super Moderator
This is where e2 sits on your current protocol 160 mg T/week split twice weekly (every 3.5 days).
Again although your trough TT 906 ng/dL is not absurdly high your FT is high due to your lowish SHBG 19 nmol/L.
These are trough levels and peak levels will be even higher!
You easily have room to lower your T dose.
I would look into 120 mg T/week split twice weekly (60 mg every 3.5 days).
Decide what you feel is best for you.
Dropping your overall weekly dose and increasing injection frequency is another option but I would prefer to change one thing at a time.
Where do your body fat levels sit?
Thank you for replying.
I have no idea regarding my body fat levels. How do you check that and why is it relevant?
Tony shoot me a pm as I sufferd from all the same symptoms your having now when I was on trt.. maybe we can figure this out. I stopped trt 2 or so yrs ago due to the same issues yiur having. I want to get back on it so I'm back here on the forums to try to learn a bit more before I proceed..
Nelson Vergel
Founder, ExcelMale.com
Risk Factors Affecting Decreased Libido Among Middle-Aged to Elderly Men; Nocturnal Voiding is an Independent Risk Factor of Decreased Libido - PubMed
Current cigarette smoking, frequent nocturnal voiding, and a low SHIM score were the independent risk factors for a severely low libido. K Shigehara, Y Kato, M Iijima, et al. Risk Factors Affecting Decreased Libido Among Middle-Aged to Elderly Men; Nocturnal Voiding is an Independent Risk Factor...
pubmed.ncbi.nlm.nih.gov
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