Need help with potential causes of ED (labs included)

[Nixter]

Would love some help trying to sort out potential causes for my ED on TRT now that I actually have old and new labs to post.

I should note that the most recent labs in Jan were while I was on AI. I have been on 100mg/wk, no AI previously, as well as 150mg/no AI, and I'm currently 4 weeks into 120mg/no AI. ED has been present throughout all various protocols, AI or not. I've also tried varying HCG protocols.

My level of ED is such that I can get it up but not for very long and the quality of the erection is often poor. I also require way more stimulation as I believe sensitivity is down as well. When I was natural, I had no problems in any of these departments. Cialis and Viagra both work for me but i'd love to not have to rely on them. Libido is fine btw.

I'm thinking that if after 6 weeks at 120/mg, that I dont see any difference, I think I will try going to 175 or 200mg/no AI, as 150mg is the highest I've been previously without an AI.

44yrs old, 14ish% BF, Train heavy 3X/wk, Solid diet.

All input welcome! Thanks.

2016 Natural

Ferritin -------------------71 24-444 ug/L
T4 Free --------------------14.7 10.6-19.7 pmol/L
T3 Free --------------------4.45 3.00-5.90 pmol/L
Prolactin ------------------15.6 3.8-20.6 ug/L
Estradiol ------------------95 <157 pmol/L
DHEA -----------------------7.6 <15.0 umol/L
Testosterone ---------------12.4 8.4-28.8 nmol/L
T Free Calculated ----------263 115-577 pmol/L
T Bioavailable Calc --------6.2 2.7-13.5 nmol/L
SHBG -----------------------30.0 10.0-70.0 nmol/L
25-Hydroxyvitamin D --------66 75-150 nmol/L


Jan 2020 200mg/wk 1mg Adex

Ferritin -------------------48 24-444 ug/L
T4 Free --------------------12.1 10.6-19.7 pmol/L
T3 Free --------------------4.76 2.60-5.80 pmol/L
Prolactin ------------------7.5 3.8-20.6 ug/L
Estradiol ------------------80 <157 pmol/L
Progesterone ---------------0.5 0.4-1.8 nmol/L
DHEA Sulphate --------------7.5 <15.0 umol/L
Testosterone ---------------41.3 8.4-28.8 nmol/L
T Free Calculated ----------1316 115-577 pmol/L
T Bioavailable Calc --------30.8 2.7-13.5 nmol/L
SHBG -----------------------18.4 10.0-70.0 nmol/L
25-Hydroxyvitamin D --------92 75-150 nmol/L

 

[Golfboy307]

Your total and Free T seem to be quite high if I am reading the ranges correctly. Some guys (including me) don't do well at those levels, including ED. Try to change your dosing so you are in the upper middle of those ranges and see how you do.

 

[Nixter]

Your total and Free T seem to be quite high if I am reading the ranges correctly. Some guys (including me) don't do well at those levels, including ED. Try to change your dosing so you are in the upper middle of those ranges and see how you do.

Just to clarify, The 2nd panel protocol is not what I'm currently on. That was 200mg/wk and 1mg Adex. After that I went down to 150mg, no AI. ED did not improve there but I should have given it longer. I think I only gave that protocol 4 weeks before dropping to my current protocol of 120mg and no AI. I've been at this dose for 4 weeks, no improvement in ED. I'll give it 2 more weeks and then try 175mg no AI.

 

[Golfboy307]

Ah gotcha. I will let some of the more experienced folks answer then. I didn't see anything that obvious. Are you able to obtain a sensitive Estradiol test where you live?

 

[Nixter]

Ah gotcha. I will let some of the more experienced folks answer then. I didn't see anything that obvious. Are you able to obtain a sensitive Estradiol test where you live?

No but I live close to the border and have got sensitive estradiol tests in the US before. I've always been in range.

I've mostly used HCG sporadically as a kicker when the boys get too small. After some reading this morning I think I might try 500IU 3x/wk to see if that does anything.

 

[Vince]

No but I live close to the border and have got sensitive estradiol tests in the US before. I've always been in range.

I've mostly used HCG sporadically as a kicker when the boys get too small. After some reading this morning I think I might try 500IU 3x/wk to see if that does anything.

What was the main reason or reasons, that made you decide to start trt?

 

[Nixter]

What was the main reason or reasons, that made you decide to start trt?

Good question Vince, as coming off will be a consideration if I can't get this sorted out. Two main reasons. First was a decline in recovery/muscle mass. I enjoy training a lot and it was depressing seeing a slow but steady decline in progress. Second reason was that I have spinal stenosis which limits inervation to my anterior deltoid and bicep in my right side. I was wondering if TRT could slow, stop, or reverse the atrophy. I'm happy to say that TRT stopped it and with very slow progress I've even been able to recover a bit of muscle and strength in that area.

I don't mind spending more time trying to find the correct TRT protocol but I will need to find a reliable and affordable source of Viagra/Cialis in the mean time

 

[Vince]

Good question Vince, as coming off will be a consideration if I can't get this sorted out. Two main reasons. First was a decline in recovery/muscle mass. I enjoy training a lot and it was depressing seeing a slow but steady decline in progress. Second reason was that I have spinal stenosis which limits inervation to my anterior deltoid and bicep in my right side. I was wondering if TRT could slow, stop, or reverse the atrophy. I'm happy to say that TRT stopped it and with very slow progress I've even been able to recover a bit of muscle and strength in that area.

I don't mind spending more time trying to find the correct TRT protocol but I will need to find a reliable and affordable source of Viagra/Cialis in the mean time

When covid-19 first started, I kept ordering from reliable RX. I kept well-stocked. So I really don't need any ED meds. I did put an order in to them last weekend, just to see how long it will take. Friends have been asking me about ordering from India again. So I thought I'd give it a try, and see how long it takes.

 

[Vince]

Good question Vince, as coming off will be a consideration if I can't get this sorted out. Two main reasons. First was a decline in recovery/muscle mass. I enjoy training a lot and it was depressing seeing a slow but steady decline in progress. Second reason was that I have spinal stenosis which limits inervation to my anterior deltoid and bicep in my right side. I was wondering if TRT could slow, stop, or reverse the atrophy. I'm happy to say that TRT stopped it and with very slow progress I've even been able to recover a bit of muscle and strength in that area.

I don't mind spending more time trying to find the correct TRT protocol but I will need to find a reliable and affordable source of Viagra/Cialis in the mean time

I really think when doing trt, it's better to start too low. And gradually increase your dose, it's too easy to overshoot the mark. That goes for testosterone and HCG.

 

[barry1]

I'd probably stick with generic viagra, cheap with goodrx coupon and add L arginine.

 

[Nixter]

I'd probably stick with generic viagra, cheap with goodrx coupon and add L arginine.

No Rx coupons in Canada sadly. However, once the border opens I found out that a British Columbia Rx can be filled in Washington and is allowed to be brought back over the border!

 

[Nixter]

When covid-19 first started, I kept ordering from reliable RX. I kept well-stocked. So I really don't need any ED meds. I did put an order in to them last weekend, just to see how long it will take. Friends have been asking me about ordering from India again. So I thought I'd give it a try, and see how long it takes.

Looks like Reliable does not ship to Canada

 

[Nixter]

Ok here's my latest labs @ 7 weeks of 120mg/wk split m/w/f, no ai. blood taken at trough. E2 is non sensitive but still, wow! It would seem that I can still lower my dose considerably. I'm thinking 90mg/wk. The E2 probably explains the crazy bacne I've been having

Test Total --------------------------28.2 8.4-28.8nmol/L
Test Free Calculated -----------755 115-577pmol/L
Test Bioavailable Calculated 17.7 2.7-13.5nmol/L
Estradiol ---------------------190 <157pmol/L
SHBG --------------------------------24.4 10.0-70.0nmol/L

 

[madman]

Who would put you on such a horrible protocol?

Your ferritin is too low and if these labs were done at trough than you were hitting way too high TT/FT levels 7 days post-injection and your peak TT/FT would be insanely high.

You drove down a perfectly normal SHBG 30nmol/L pre-trt to 18.4 nmol/L from using such a high dose of T injected once weekly.

You stated I'm thinking that if after 6 weeks at 120/mg, that I dont see any difference, I think I will try going to 175 or 200mg/no AI, as 150mg is the highest I've been previously without an AI.

This would be a bad move as 175-200mg/week would surely be too high let alone have your e2 through the roof without the addition of an aromatase inhibitor.





Jan 2020 200mg/wk 1mg Adex

Ferritin -------------------48 24-444 ug/L
T4 Free --------------------12.1 10.6-19.7 pmol/L
T3 Free --------------------4.76 2.60-5.80 pmol/L
Prolactin ------------------7.5 3.8-20.6 ug/L
Estradiol ------------------80 <157 pmol/L
Progesterone ---------------0.5 0.4-1.8 nmol/L
DHEA Sulphate --------------7.5 <15.0 umol/L
Testosterone ---------------41.3 8.4-28.8 nmol/L
T Free Calculated ----------1316 115-577 pmol/L
T Bioavailable Calc --------30.8 2.7-13.5 nmol/L
SHBG -----------------------18.4 10.0-70.0 nmol/L
25-Hydroxyvitamin D --------92 75-150 nmol/L

 

[Nixter]

Who would put you on such a horrible protocol?

Your ferritin is too low and if these labs were done at trough than you were hitting way too high TT/FT levels 7 days post-injection and your peak TT/FT would be insanely high.

You drove down a perfectly normal SHBG 30nmol/L pre-trt to 18.4 nmol/L from using such a high dose of T injected once weekly.

You stated I'm thinking that if after 6 weeks at 120/mg, that I dont see any difference, I think I will try going to 175 or 200mg/no AI, as 150mg is the highest I've been previously without an AI.

This would be a bad move as 175-200mg/week would surely be too high let alone have your e2 through the roof without the addition of an aromatase inhibitor.





Jan 2020 200mg/wk 1mg Adex

Ferritin -------------------48 24-444 ug/L
T4 Free --------------------12.1 10.6-19.7 pmol/L
T3 Free --------------------4.76 2.60-5.80 pmol/L
Prolactin ------------------7.5 3.8-20.6 ug/L
Estradiol ------------------80 <157 pmol/L
Progesterone ---------------0.5 0.4-1.8 nmol/L
DHEA Sulphate --------------7.5 <15.0 umol/L
Testosterone ---------------41.3 8.4-28.8 nmol/L
T Free Calculated ----------1316 115-577 pmol/L
T Bioavailable Calc --------30.8 2.7-13.5 nmol/L
SHBG -----------------------18.4 10.0-70.0 nmol/L
25-Hydroxyvitamin D --------92 75-150 nmol/L

Original post is old, see my last comment and labs

 

[Tman]

Just to clarify, The 2nd panel protocol is not what I'm currently on. That was 200mg/wk and 1mg Adex. After that I went down to 150mg, no AI. ED did not improve there but I should have given it longer. I think I only gave that protocol 4 weeks before dropping to my current protocol of 120mg and no AI. I've been at this dose for 4 weeks, no improvement in ED. I'll give it 2 more weeks and then try 175mg no AI.

Try skipping two doses and see if your symptoms improve. If so, your dosing is too high.

 

[Nixter]

Try skipping two doses and see if your symptoms improve. If so, your dosing is too high.

I pin 3x week. Do you mean skip 2 pins or skip 2 weeks?

 

[madman]

Ok here's my latest labs @ 7 weeks of 120mg/wk split m/w/f, no ai. blood taken at trough. E@ is non sensitive but still, wow! It would seem that I can still lower my dose considerably. I'm thinking 90mg/wk. The E2 probably explains the crazy bacne I've been having

Test Total --------------------------28.2 8.4-28.8nmol/L
Test Free Calculated -----------755 115-577pmol/L
Test Bioavailable Calculated 17.7 2.7-13.5nmol/L
Estradiol ---------------------190 <157pmol/L
SHBG --------------------------------24.4 10.0-70.0nmol/L

Seeing as you are on the 3 times weekly protocol (M/W/F) if you tested at true trough than you had blood work done Monday morning before your injection.

Keep in mind that on such injection protocol that your trough TT/FT/E2 levels will be even higher throughout the week as you are injecting M--48hrs-->W--48hrs-->F--72hrs-->M (true trough).

So your TT/FT/E2 levels would be higher on the Wednesday morning trough and Friday morning trough seeing as it is only 48hrs between your injections.

Whereas when you test true trough on Monday morning it is 72hrs since your F (last injection).

Those are decent TT/FT levels mind you I would not trust your FT as it was calculated using the Vermeulen method which is used at Labs across Canada.

You stated:

I should note that the most recent labs in Jan were while I was on AI. I have been on 100mg/wk, no AI previously, as well as 150mg/no AI, and I'm currently 4 weeks into 120mg/no AI. ED has been present throughout all various protocols, AI or not. I've also tried varying HCG protocols.

My level of ED is such that I can get it up but not for very long and the quality of the erection is often poor. I also require way more stimulation as I believe sensitivity is down as well. When I was natural, I had no problems in any of these departments. Cialis and Viagra both work for me but i'd love to not have to rely on them. Libido is fine btw

I would definitely look into trying out a pde-5 inhibitor as was already suggested.

 

[madman]

Original post is old, see my last comment and labs

I understand and was just responding to each post.

 

[madman]

Just to clarify, The 2nd panel protocol is not what I'm currently on. That was 200mg/wk and 1mg Adex. After that I went down to 150mg, no AI. ED did not improve there but I should have given it longer. I think I only gave that protocol 4 weeks before dropping to my current protocol of 120mg and no AI. I've been at this dose for 4 weeks, no improvement in ED. I'll give it 2 more weeks and then try 175mg no AI.

Here is the big problem with stating you have tried various protocols (changing doses/ use of AI no AI/ changing injection frequency).

You are changing things too early without giving your body a chance to adapt.

As you know whenever a change is made to one's protocol (increase/decrease dose) blood levels will be in FLUX leading up until levels stabilize 4-6 weeks and even then once levels have stabilized it can take 2-3 months for the body to adapt to those new levels and during this time is when you should truly gauge how you feel overall regarding relief/improvement of low-t symptoms (mood/energy/libido/erectile function/body composition/recovery).

You are doing this all wrong and as you can clearly see have been stuck chasing your tail.