My TRT Odyssey: Lab Results and More

[Frizzle]

Thank

Not having any major problems with acne. I think high E2 contributes to oily skin and acne as well. Seems to be improved with AI.

It’s great that you share your experiences in such detail. Especially for post Accutane guys like myself as our bodies seem to work differently. Thank you!

How would you rate your libido and mental health at the moment and what dose is most effective for you? For me higher doses of test (near 200mg/week) seem to boost libido but erections aren’t great, less good than before TRT. Maybe I’ll try the 20% cream.

 

[FunkOdyssey]

Thank

It’s great that you share your experiences in such detail. Especially for post Accutane guys like myself as our bodies seem to work differently. Thank you!

How would you rate your libido and mental health at the moment and what dose is most effective for you? For me higher doses of test (near 200mg/week) seem to boost libido but erections aren’t great, less good than before TRT. Maybe I’ll try the 20% cream.

I don't really want to evaluate anything at the moment because I just changed things drastically. Since discovering the AI is the world's most effective BP and sleeping medication, I bumped my dose back to the 50 mg EOD and am going to see what happens with that.

My mental health in terms of mood has been good (better than baseline) on basically every protocol I've tried.

I haven't found any protocol with injections that has a consistent positive effect on libido. Only cream did that for me so far. However, I have plenty of things remaining to try with injections. I'll be looking at how different T/E2 ratios and absolute E2 levels affect libido. If I don't have any luck modifying those, the next thing will be less frequent injections, which I think will now be well tolerated using AI assistance.

In terms of what you've observed, most likely the higher doses that improve your libido are sending your E2 too high for good erectile function. There are many studies supporting the idea that excessive E2 is bad for erections. It literally drains the blood out of the penis by causing venous leakage. Hopefully, that high E2 is not also responsible for the higher libido (it sometimes is).

I think the only surefire method to distinguish which hormones are responsible for certain effects is to experiment with some AI. It's really a great troubleshooting tool even if you don't continue using it long term.

 

[tropicaldaze1950]

Thank

It’s great that you share your experiences in such detail. Especially for post Accutane guys like myself as our bodies seem to work differently. Thank you!

How would you rate your libido and mental health at the moment and what dose is most effective for you? For me higher doses of test (near 200mg/week) seem to boost libido but erections aren’t great, less good than before TRT. Maybe I’ll try the 20% cream.

My questions, too, and agree with @Frizzle; you're experimenting the right way; posting labs and what you're experiencing.

 

[RotnGun]

I don't really want to evaluate anything at the moment because I just changed things drastically. Since discovering the AI is the world's most effective BP and sleeping medication, I bumped my dose back to the 50 mg EOD and am going to see what happens with that.

My mental health in terms of mood has been good (better than baseline) on basically every protocol I've tried.

I haven't found any protocol with injections that has a consistent positive effect on libido. Only cream did that for me so far. However, I have plenty of things remaining to try with injections. I'll be looking at how different T/E2 ratios and absolute E2 levels affect libido. If I don't have any luck modifying those, the next thing will be less frequent injections, which I think will now be well tolerated using AI assistance.

In terms of what you've observed, most likely the higher doses that improve your libido are sending your E2 too high for good erectile function. There are many studies supporting the idea that excessive E2 is bad for erections. It literally drains the blood out of the penis by causing venous leakage. Hopefully, that high E2 is not also responsible for the higher libido (it sometimes is).

I think the only surefire method to distinguish which hormones are responsible for certain effects is to experiment with some AI. It's really a great troubleshooting tool even if you don't continue using it long term.

Do you have any ideal at what estrogen level that will cause erections to somewhat go downhill? Any chance you can list some of these studies?

 

[tropicaldaze1950]

I don't really want to evaluate anything at the moment because I just changed things drastically. Since discovering the AI is the world's most effective BP and sleeping medication, I bumped my dose back to the 50 mg EOD and am going to see what happens with that.

My mental health in terms of mood has been good (better than baseline) on basically every protocol I've tried.

I haven't found any protocol with injections that has a consistent positive effect on libido. Only cream did that for me so far. However, I have plenty of things remaining to try with injections. I'll be looking at how different T/E2 ratios and absolute E2 levels affect libido. If I don't have any luck modifying those, the next thing will be less frequent injections, which I think will now be well tolerated using AI assistance.

In terms of what you've observed, most likely the higher doses that improve your libido are sending your E2 too high for good erectile function. There are many studies supporting the idea that excessive E2 is bad for erections. It literally drains the blood out of the penis by causing venous leakage. Hopefully, that high E2 is not also responsible for the higher libido (it sometimes is).

I think the only surefire method to distinguish which hormones are responsible for certain effects is to experiment with some AI. It's really a great troubleshooting tool even if you don't continue using it long term.

Dr. Rand McClain starts all patients, if I'm correct, on a weekly injection of 200 mg and 1 mg of anastrozole. From a clinical perspective, easier to manage patients on the same protocol, then adjust as needed, though 1 mg of anastrozole gives people pause in the 'no ai, ever' realm. Then you have Dr. Rouzier and topical cream applied to the scrotum, 200 mg daily, I believe, who says never manage E2. For those of us for whom the 'right' balance is elusive, it drives you crazy.

I've stated many times that I'm under the care of a highly experienced urologist and I'm his problem patient. Your experiments with anastrozole demonstrate that it's not poison and it has a place in TRT. My doctor's mentor, Dr. Shippen, said, in effect, many years ago, that eventually, all men on TRT would be using an ai because of endocrine disrupting chemicals. Though I'm frustrated with not being able to find a dose and protocol that resuscitates my erectile function and lose weight instead of gaining(E2?), I believe being on TRT has been and is, beneficial. At 73(74in May) I not only want to preserve my health, such as it is, but improve it, to whatever extent is possible.

 

[FunkOdyssey]

Do you have any ideal at what estrogen level that will cause erections to somewhat go downhill? Any chance you can list some of these studies?

I think more important than naming a specific number is just understanding that such a number exists. In other words, for most guys, there is some threshold E2 level beyond which your erections will suffer. Once you have that idea in mind, you can work on figuring out what your personal threshold is.

If you find that answer unsatisfying, and you want a specific and probably inaccurate number, Cortex Labs has some great videos on the negative effects of E2 on erections. He believes anything above 35 pg/mL starts weakening erections. You'll see his reasoning and evidence for that statement in the videos.

 

[FunkOdyssey]

Dr. Rand McClain starts all patients, if I'm correct, on a weekly injection of 200 mg and 1 mg of anastrozole. From a clinical perspective, easier to manage patients on the same protocol, then adjust as needed, though 1 mg of anastrozole gives people pause in the 'no ai, ever' realm. Then you have Dr. Rouzier and topical cream applied to the scrotum, 200 mg daily, I believe, who says never manage E2. For those of us for whom the 'right' balance is elusive, it drives you crazy.

I think you are more likely to get away without E2 management on scrotal cream than other forms of TRT. The astronomical DHT levels may inhibit aromatase and/or antagonize estrogen effects in tissues.

 

[Cataceous]

...
If you find that answer unsatisfying, and you want a specific and probably inaccurate number, Cortex Labs has some great videos on the negative effects of E2 on erections. He believes anything above 35 pg/mL starts weakening erections. You'll see his reasoning and evidence for that statement in the videos.
...

An issue with the cited paper is the use of an immunoassay to measure estradiol. No details are given about the assay, so there is some concern that measured estradiol could be artificially inflated in those men with elevated C-reactive protein. It seems likely that systemic inflammation alone would correlate with ED.

 

[FunkOdyssey]

Another anecdote of higher T and less aromatization after switching from SC to IM: https://www.reddit.com/r/trt/s/En5dBX6JBu

 

[wushback]

Is there any reason why specifically the Hikma TestE preserved your cognitive function as opposed to the TestC or TestP? I've been on TestC and have experienced severe cognitive decline over the past 5 years, was only able to recover by dropping the test and using hCG and enclomiphene instead.

 

[FunkOdyssey]

Is there any reason why specifically the Hikma TestE preserved your cognitive function as opposed to the TestC or TestP? I've been on TestC and have experienced severe cognitive decline over the past 5 years, was only able to recover by dropping the test and using hCG and enclomiphene instead.

I wish I had a good explanation but I don't understand the mechanism. I suspect it relates to the benzyl excipients, but how and why, I don't know.

 

[Mastodont]

Is there any reason why specifically the Hikma TestE preserved your cognitive function as opposed to the TestC or TestP? I've been on TestC and have experienced severe cognitive decline over the past 5 years, was only able to recover by dropping the test and using hCG and enclomiphene instead.

Did you drop the test completely? By any chance did you have pregnenolone or dhea, progesterone checked at any point? Could be BB is doing something in the long run or then its just the upstream hormone shutdown from trt that gradually causes cognitive decline.
Edit: forgot to ask, how about libido, did it decline as well?

 

[Cataceous]

... its just the upstream hormone shutdown from trt that gradually causes cognitive decline.

Given that GnRH has a role in neurogenesis, I favor this explanation. I had cognitive gains when I started supplementing with it.

 

[Mastodont]

Given that GnRH has a role in neurogenesis, I favor this explanation. I had cognitive gains when I started supplementing with it.

Did you ever experience anything similar from anything else, i wonder if its from GnRH directly or say pregnenolone or dhea?

 

[Cataceous]

Did you ever experience anything similar from anything else, i wonder if its from GnRH directly or say pregnenolone or dhea?

I believe it's GnRH directly. I cited some research in this thread. In mouse models:

A striking observation was that GnRH promoted adult neurogenesis despite aging.​

 

[MTNMan6000]

I believe it's GnRH directly. I cited some research in this thread. In mouse models:

A striking observation was that GnRH promoted adult neurogenesis despite aging.​

I fully agree with @Cataceous. I was on Testosterone for 24 years and came off for this reason. The data on aging, the hypothalamus and GNRH cognition is really interesting - my cognition and well being improved.

 

[Mastodont]

I fully agree with @Cataceous. I was on Testosterone for 24 years and came off for this reason. The data on aging, the hypothalamus and GNRH cognition is really interesting - my cognition and well being improved.

Interesting, and congratulations on the recovery, may i ask if you were on test only or did you use hcg, and did it make any difference if so?

 

[wushback]

Did you drop the test completely? By any chance did you have pregnenolone or dhea, progesterone checked at any point? Could be BB is doing something in the long run or then its just the upstream hormone shutdown from trt that gradually causes cognitive decline.
Edit: forgot to ask, how about libido, did it decline as well?

Dropped test completely when I started on the hCG and enclomiphene 2-3 months ago.

Had DHEA and pregnenolone tested multiple times over the years and both were in normal ranges, no improvements with supplementation.

Libido dropped to 0 over the 5 years I was on TRT, still very low but improving on the hCG and enclomiphene. Looking to restart the TRT with hCG + enclo if I can get it to work without impacting my cognition.

I suspect the BB does something immediate, since I enter a dissociative fugue like state for 1-2 days after each shot of TestC. I also think that HPTA shutdown, specifically LH down regulation, is responsible for the more persisting cognitive decline since that seems to be addressed by the hCG which is an LH analog and it is known that there are many LH receptors in the brain.

 

[wushback]

I believe it's GnRH directly. I cited some research in this thread. In mouse models:

A striking observation was that GnRH promoted adult neurogenesis despite aging.​

Interesting. I've recieved separate cognitive benefits from hCG and enclomiphene since stopping TRT. Perhaps the LH analog action of hCG and the GnRH releasing action of the enclomiphene play separate roles in preserving cognitive function in the setting of (or recovery from) TRT.

 

[Cataceous]

...
Libido dropped to 0 over the 5 years I was on TRT, still very low but improving on the hCG and enclomiphene. Looking to restart the TRT with hCG + enclo if I can get it to work without impacting my cognition.
...

If you're looking to preserve GnRH signaling in the presence of exogenous testosterone then you're pretty much limited to testosterone nasal gel, e.g. Natesto, or the combination of oral testosterone and enclomiphene. Alternatives are either less practical — e.g. injecting exogenous GnRH (gonadorelin) several times daily — or speculative — e.g. adding cistanche extract and enclomiphene to a conventional TRT protocol.

... Perhaps the LH analog action of hCG and the GnRH releasing action of the enclomiphene play separate roles in preserving cognitive function in the setting of (or recovery from) TRT.

Plausible, though for me adding GnRH to TRT led to a much greater improvement than when adding hCG. LH is a pulsatile hormone, so I feel that SC/IM hCG is an imperfect replacement.