Been on TRT for a few months. Been reading this site and others and I am still learning. Started at 200mg for about a month. Broken up 2x a week. And my estrogen kicked in. After that hot flashes and the great sides that come with it. Reduced libido and soft erections. On Armidex .5mg x2 a week. Decided to but it back 120mg a week. Upped the Armidex 1mg x2 a week. After first labs I was at 1499 test and 35 estrodial At 200mg. Pregnenlone was 21. Any help is always appreciated. Still looking for my missing sex drive.
Need to post labs with reference ranges.
You left out important blood markers such as FT, SHBG, DHT, prolactin let alone RBCs/hemoglobin/hematocrit.
Started at 200mg for about a month. Broken up 2x a week. And my estrogen kicked in. After that hot flashes and the great sides that come with it. Reduced libido and soft erections. On Armidex .5mg x2 a week.
Should have looked into things deeper before hopping on that cookie-cutter protocol..... 200 mg T/week with an AI thrown in to boot!
200mg T/week is a whopping dose to start on let alone split into 100 mg T every 3.5 days which would easily have you trough TT and more importantly FT through the roof let alone estradiol will skyrocket.
Unfortunately most end up using an AI and in some cases a whopping dose to manage the elevated e2 which can cause numerous issues due to driving down estradiol too low.
Much more sensible to start low and slow on a T-only protocol without the use of an AI as we want to see how our body reacts to testosterone.
Many would prefer to avoid the use of an AI if possible as having healthy estradiol levels are critical to your overall health due to its beneficial effects on (cardiovascular health, brain health, libido, erectile function, bone health, tendon health, immune system, body composition).
A good starting dose is 100-120 mg T/week split (50-60 mg every 3.5 days).
Most men on trt are injecting 100-200 mg T/week and even then many would never need what would be considered the high-end dose (200 mg T/week) to achieve a healthy let alone very high trough FT.
Many can easily achieve a healthy let alone high or in many cases absurdly high trough FT on 100-150mg T/week whether split twice weekly (every 3.5 days), M/W/F, EOD let alone daily.
After first labs I was at 1499 test and 35 estrodial At 200mg.
You left out one of the most important blood markers.....free testosterone let alone SHBG.
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.
The only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).
SHBG is critical to know as it will not only have a significant impact on TT/FT but can dictate what injection frequency may suit you best.
As you can clearly see on the 200 mg T/week (100 mg every 3.5 days) protocol your trough TT 1499ng/dL is very high and although we have no idea where your SHBG sits you can rest assured that it will be absurdly high even if you have high/highish SHBG.
With a trough TT 1499 ng/dL your trough FT could be around 50 ng/dL and that is with high SHBG!
FT 5-10 ng/dL would be considered low.
FT 16-31 ng (high-end) is healthy.
Most men will do well with FT 20-30 ng/dL and many tend to fair better with levels on the higher end.
Some may choose to run absurdly high levels 50-80 ng/dL.
Not everyone will do well when running too high an FT level.
Your trough FT was most likely through the roof.
Many can end up struggling with sides when running too high a trough FT.
Comes down to the individual.
Decided to but it back 120mg a week. Upped the Armidex 1mg x2 a week.
Smart move lowering your dose but you made a drastic cut in your dose so expect a bumpy ride during the next 4-6 weeks as blood levels need to stabilize and it is common to experience ups/downs during the transition as the body is trying to adjust.
Even then once blood levels have stabilized it will take time for the body to adapt to the new set-point and this is the critical time period when one should gauge how they truly feel overall regarding relief/improvement of low-t symptoms.
When starting trt let alone tweaking dose (increasing/decreasing) every protocol needs to be given 12 weeks in order to claim whether it was a success or failure.
Patience is key and this is where many fail!
Coming down will always be harder than going up and in your case you made a drastic dose reduction going from a whopping 200 mg T/week split (100 mg every 3.5 days)--->120mg split (60 mg every 3.5 days).
Top it off that you made the grave mistake of not dropping the AI and why you upped the dose to a whopping 1 mg 2X/week while lowering your dose of T from 200--->120 mg/week is beyond me as you will just end up crashing your estradiol which can cause numerous issues!
If anything seeing as you already lowered your T dose then drop the AI and give it 4-6 weeks until blood levels stabilize then get blood work done to see where your TT, FT, estradiol, and SHBG sit.
You can also test DHT and prolactin.