Low libido and weak erections - protocol change?

[get1200]

Hi all, I've been on trt for about 4 years, currently under Dr Saya's care. My libido recently went down dramatically and my erections, which have not been consistently great in years, have gotten much worse recently. They start OK, but 2 minutes later starts getting softer and softer. I'm 34 years old, in great shape, and I generally feel good on the current protocol, albeit with some intermittent anxiety.

Current protocol works out to be about 145mg/week of test, with injections happening every 4 days. Adex .1mg on the day after injection. About 4 months ago, I went from every day injections, to the current every 4 days protocol. The libido problem started about a month ago, so I'm not sure it's related to changing injection frequency. One thing to note is my TSH was around 1.3 for the last few years, and now is much lower.

I have an appointment with Dr Saya in a month, but I would appreciate any feedback on potential root cause and solutions from fellow forum members! Please let me know if there's anything else concerning in the labs as well.

Labs are attached, and were taken on day 4 right before injection...

 

[Systemlord]

The libido problem started about a month ago, so I'm not sure it's related to changing injection frequency.

My advice, go back to what worked before. Hormones are a fickle thing, getting the peaks and valleys swinging just right is what’s needed.

Another thing it could be is long term AI usage can lead to suppressed E2 down the road.

One thing to note is my TSH was around 1.3 for the last few years, and now is much lower.

Mine too. I started TRT with a TSH at .89 and is now .45. TRT steps on the metabolic gas pedal more, demands more from everything else, including the thyroid. The lower TSH is an indication the pituitary is slamming on the brakes to keep thyroid hormones from getting out of control.

My fT3 and Total T3 is higher on TRT than previously.