Perplexing result.. thoughts?

[R2D2]

Hi there,

I'd really appreciate any thoughts or guidance on protocol/results below. I am quite surprised by the prolactin result, and even the T and E result as I am on a low daily dose and this is before my next injection. Any thoughts would be very appreciated. Purpose is TRT and not sport.

Protocol
Frequency: Daily subq injections
Enanthate: 6.25mg
Propionate: 5mg
Total T in syringe: 11.25mg (translates to 8.65mg daily Testosterone when you remove weight of ester)
HCG: None
AI: None
Injection site: subq in midsection
Time: 9am every morning

Result - 08:30am ('before' daily injection)
Albumin 44 g/L (Range: 34 - 50)
SHBG 21 nmol/L (Range: 16 - 55)
FSH 0.3 IU/L (Range: 1.5 - 12.4)
LH 0.5 IU/L (Range: 1.7 - 8.6)
Oestradiol 148 pmol/L (Range: < 192)
Testosterone 24.0 nmol/L (Range: 7.6 - 31.4)
Free Testosterone - Calc. 0.658 nmol/L (Range: 0.2 - 0.62)
Free Androgen Index 114.3 (Range: 24 - 104)
Prolactin 441 mIU/L (Range: 86 - 324)
DHEA Sulphate 6.9 umol/L (Range: 0.44 - 13.4)

Questions
1. Is my prolactin extremely high? Should I be worried? What could the causes be?

2. Is this my theoretical trough value as test was taken before my next injection? I'm not sure if there are other systems in the body (e.g. during sleep) that may elevate the result taken at 0830. Is it likely I'd have a lower result in the earlier hours?

3. Assuming that this is my trough value, it is expected that I will hit my peak value after the daily injection. Given my protocol, when is the peak expected to occur? After 4-6 hours? I am expecting a much higher result. I have not yet taken this blood test reading as I want to fix the trough first.

4. My blood test last year where the protocol was more or less the same - no Enanthate, only Propionate at higher dose. I had higher T and E values but much lower Prolactin values. Can someone explain how this would make sense?

Thanks,
R2

 

[Cataceous]

1. In the units I'm used to your prolactin is 20 ng/mL. This is elevated, but not extreme. Are you experiencing any of the possible side effects, such as reduced libido, long refractory period, anorgasmia? Although a prolactinoma isn't impossible, my impression is that these usually result in much higher numbers. More likely your TRT dosing is a factor in pushing it up.

2-3. Yes, these are trough measurements. This means testosterone and estradiol are going to be higher at other times. In particular, if your absorption rate for propionate is similar to mine then your peak testosterone could be over 60% higher, putting it close to 40 nMol/L or >1,100 ng/dL. Given that your SHBG is a little below normal I'd rather see your current trough values at your peak. This would perhaps mean a 30-40% dose reduction. It would be good to try to measure peak values before making changes. There's some guesswork involved with the timing. Between two and four hours post-injection I get values that at least match predicted peaks. It's suggestive, but not definitive. You may know I'm a fan of this kind of propionate blend, so I will be interested in seeing whatever you report.

4. Having lower prolactin on propionate with similar dosing is not expected. However, I have had prolactin decide to go higher after a long period of stability. So it's not always going to be predictable. If you happen to visit an aggressive doctor then you may end up getting an MRI. But you could just see if changing the TRT dose has any effect. Also, I trust you were fasting for your test and had abstained from sexual activity in the day before? Otherwise prolactin may only have been temporarily higher.

 

[TorontoTRT]

There are no peaks and troughs with daily injections. The results look about right for the amount you’re injecting. 79 mg test a week is not that much.

 

[JA Battle]

There absolutely are daily peak and trough when using propionate ester. Which is why I’m assuming you are using this like cataceous and myself.

I also would inject intramuscularly with insulin pin.

Prolactin can be from progesterone deficiency.

 

[tropicaldaze1950]

Hypothyroid or subclinical hypothyroid.

 

[R2D2]

Thanks @Cataceous and apologies for the 'very' delayed response:

1. In the units I'm used to your prolactin is 20 ng/mL. This is elevated, but not extreme. Are you experiencing any of the possible side effects, such as reduced libido, long refractory period, anorgasmia? Although a prolactinoma isn't impossible, my impression is that these usually result in much higher numbers. More likely your TRT dosing is a factor in pushing it up.

4. Having lower prolactin on propionate with similar dosing is not expected. However, I have had prolactin decide to go higher after a long period of stability. So it's not always going to be predictable. If you happen to visit an aggressive doctor then you may end up getting an MRI. But you could just see if changing the TRT dose has any effect. Also, I trust you were fasting for your test and had abstained from sexual activity in the day before? Otherwise prolactin may only have been temporarily higher.

I am certainly experiencing more of these side effects since reducing my dosage further (see below); however, I can't confirm whether it is correlated with Prolactin as I didn't get it measured (which I will do in future and ensure that I fast and refrain from sexual activity to gain an accurate reading). I'm hoping previous results were an anomoly. That said, reduced libido has been a lasting issue.

2-3. Yes, these are trough measurements. This means testosterone and estradiol are going to be higher at other times. In particular, if your absorption rate for propionate is similar to mine then your peak testosterone could be over 60% higher, putting it close to 40 nMol/L or >1,100 ng/dL. Given that your SHBG is a little below normal I'd rather see your current trough values at your peak. This would perhaps mean a 30-40% dose reduction. It would be good to try to measure peak values before making changes. There's some guesswork involved with the timing. Between two and four hours post-injection I get values that at least match predicted peaks. It's suggestive, but not definitive. You may know I'm a fan of this kind of propionate blend, so I will be interested in seeing whatever you report.

On the same protocol, but testing at 1800 in September '21 (which is the suggestive peak reading):

Albumin 48 g/L (Range: 34 - 50)
SHBG 25 nmol/L (Range: 16 - 55)
Oestradiol 128 pmol/L (Range: < 192)
Testosterone 33.7 nmol/L (Range: 7.6 - 31.4)
Free Testosterone - Calc. 0.857 nmol/L (Range: 0.2 - 0.62)
Free Androgen Index 134.8 (Range: 24 - 104)
Prolactin 128 mIU/L (Range: 86 - 324)
DHEA Sulphate 8.7 umol/L (Range: 0.44 - 13.4)

- Compared to the 0830 result (in original post) and 1800 result here, T range = 33.7 - 24 = 9.7 nmol/L (29% variation). My aim is to target a 20-25% variation.
- The prolactin result is much better. Oestradiol is also lower but still too high and somewhat unexpected? If I'm understanding your post, we'd expect both T and E to be higher at 6pm? Is that correct?

Changes to protocol since then:
- Reduced Propionate by 20% (from 4.15mg after ester to 3.32mg)
- Total Dose: 3.32 Prop + 4.5mg Enan = 7.82mg after ester (vs. 8.65mg previously)

AM Result (Nov '21):
Oestradiol 201 pmol/L (Range: 41-159)
Testosterone 21.9 nmol/L (Range: 8.64 - 29)
Note: reference ranges have changed vs last tests having me wonder whether the lab performing the test has changed..

PM Result (Nov '21):
Oestradiol 173 pmol/L (Range: 41-159)
Testosterone 29.9 nmol/L (Range: 8.64 - 29)

Qualitative results: Less anxiety and acne but also much less energy. Morning wood awful. Observe E is again higher in am than it is in PM. Again too high.


Questions:

1. I have since changed the protocol, reducing the Propionate further (by 50% or 1.66mg after ester) but also increasing the Enanthate from 4.5mg to 7.2mg thus a total of 8.86mg after the ester is removed. It's been about 6 weeks and I haven't been well - fatigue, lethargy, essentially low T symptoms. I can't quite make sense of it. My circadian rythm is quite disrupted and libido is virtually non existent. Can you think of why I may be experiencing this phenomenon? Many folks are fine with Enanthate alone, so I don't quite know why I'm having issues

2. In the results above, particularly Nov '21, my Testosterone is in range, however E is very high. Given that my Testosterone isn't at a supraphysiological levels, why might my E be so high? Is this normal? Could the blend be contributing to this issue in some way?

3. Where do I go from here? I have been looking for a reliable clinic in the UK but not yet successful. Those I have found are somewhat generic, will insist that I drop the propionate entirely, and aren't going to suggest that I do anything starkly different to what I'm already doing independently. Not quite sure what to do.

Thanks again,
R2

 

[R2D2]

There are no peaks and troughs with daily injections. The results look about right for the amount you’re injecting. 79 mg test a week is not that much.

Thanks

 

[R2D2]

There absolutely are daily peak and trough when using propionate ester. Which is why I’m assuming you are using this like cataceous and myself.

I also would inject intramuscularly with insulin pin.

Prolactin can be from progesterone deficiency.

Thanks, I presume Progesterone can be checked and supplemented to balance things out?

 

[R2D2]

Hypothyroid or subclinical hypothyroid.

I'm hoping I'm not having to layer on something else to worry about.. but it's good to receive your steer on other avenues I could look into, thanks

 

[Cataceous]

- Compared to the 0830 result (in original post) and 1800 result here, T range = 33.7 - 24 = 9.7 nmol/L (29% variation). My aim is to target a 20-25% variation.

...

Reiterating: Although I'm not certain, I think there's a decent chance that peak serum testosterone with propionate occurs 2-6 hours post-injection. If this is the case then your peak could be higher than the 33.7 nMol/L figure. A drop of 20-25% off of peak is pretty conservative. Young men can naturally have a 40% drop from peak to trough, which may also be viewed as a +/-25% swing about the average level.

...
- The prolactin result is much better. Oestradiol is also lower but still too high and somewhat unexpected? If I'm understanding your post, we'd expect both T and E to be higher at 6pm? Is that correct?
...

At 0.38% of testosterone, estradiol is actually towards the lower end of the normal range of 0.3-0.6%. The way to bring it down is to reduce testosterone to more natural levels.

...
1. I have since changed the protocol, reducing the Propionate further (by 50% or 1.66mg after ester) but also increasing the Enanthate from 4.5mg to 7.2mg thus a total of 8.86mg after the ester is removed. It's been about 6 weeks and I haven't been well - fatigue, lethargy, essentially low T symptoms. I can't quite make sense of it. My circadian rythm is quite disrupted and libido is virtually non existent. Can you think of why I may be experiencing this phenomenon? Many folks are fine with Enanthate alone, so I don't quite know why I'm having issues
...

First, although testosterone and estradiol are important, they are clearly not the whole story. We touched on that in a previous thread, and I'll say more about that below. Second, you may not have tried levels that are normal and appropriate for your physiology. Your lowest peak testosterone seems to be at least 30 nMol/L. For healthy young guys the average peak level is more like 22.5 nMol/L. Unless you know what your levels were at your prime you have to assume a 50% chance that they were lower than 22.5 nMol, and a very high chance that they were under 30 nMol/L. Thus I think it's worthwhile to explore lower levels. This is what I've done over the years, taking from as much as 10 mg testosterone (without ester) daily to as little as 3.7 mg, and eventually deciding that 4.4 mg feels best, at least in conjunction with other elements of my protocol.

...
2. In the results above, particularly Nov '21, my Testosterone is in range, however E is very high. Given that my Testosterone isn't at a supraphysiological levels, why might my E be so high? Is this normal? Could the blend be contributing to this issue in some way?
...

One hypothesis is that estradiol can lag testosterone, and thus is reflecting testosterone that was supraphysiological earlier in the injection cycle. It's not the most satisfying of explanations, given that the variations in estradiol aren't always that consistent. So we have to assume there are other variables in play. I have found that using propionate, either alone or in a blend, contributes to apparent "noise" in measurements. The subdued variation seen with frequent injections of longer esters gave me more consistent and predictable results. Nonetheless, I think the variation in serum testosterone obtained with a blend gives subtly better subjective results and is more natural than steady levels.

... That said, reduced libido has been a lasting issue.
...
3. Where do I go from here? I have been looking for a reliable clinic in the UK but not yet successful. Those I have found are somewhat generic, will insist that I drop the propionate entirely, and aren't going to suggest that I do anything starkly different to what I'm already doing independently. Not quite sure what to do.

I don't think you've completely exhausted the options in conventional TRT. There's lower dosing to explore, and I don't recall if you've tried hCG. If you haven't used hCG before then it's something to consider. I found adding it to TRT to be a definite improvement. In addition, you should monitor progesterone and supplement if it's low. As suggested by @tropicaldaze1950 you should ensure proper thyroid function, because symptoms can overlap those of low testosterone. If you do all this and are still having problems then there are other things to try, but with less direct supporting evidence that they are effective. You can try raising dopamine and/or acetylcholine with drugs or supplements. Your latest prolactin measurement doesn't point to reduced dopaminergic activity, so you'd want to be careful with dosing. Finally, there's restoration of the hormones upstream of testosterone. However, you have to be pretty motivated to implement such a demanding protocol. It took all of the above things to get me to the point where I can say that in most areas I am nearly as good as I was before becoming hypogonadal, and in some ways better. Unfortunately, even the best clinics are not to the point of helping guys try all of these treatments. In the best case you may find one to partner with that will at least tolerate your experimentation.

 

[R2D2]

Thanks @Cataceous , very insightful as always. Apologies for the delay, I wanted to get new results before replying. Your assertion that Propionate peaks earlier and drops quickly, I think is correct from the attached results. Notice the 29th July 2019 result (I had initially thought that this was a mistake) - but given how high Prop peaks, I’m guessing it is not only accurate, but the drop off is aggressive and substantial. NB: the 2019 result is Prop only, 10.5mg daily.

I have used HCG before, but haven’t for over 3 years due to wanting to settle on a reasonable protocol (per results) before re-introducing / benefit from the subjective results associated with it. I’ve been caught up with work, so this has all taken much too long.

It’s quite surprising that the propionate would lift the result to 40+. Subjectively, I don’t feel great at the 20 mark (per AM result). In the evenings, I feel quite pessimistic. I reduced the propionate by 50% (so only 0.01ml or 1mg) for 5-7 days during the holiday - and I crashed. Slept a lot, depressed, low energy (could this be due to disproportional Estradiol in the system?). Resolved this issue soon after increasing it to 0.02ml / 2mg and introducing Vitamin D (not sure if this affected state of mind). Is this feasible? I’m struggling to understand how a small reduction in Propionate could have such a profound effect (assuming no effect from VitD). I was still within the first 3 weeks of increase the Enanthate from 6.25mg to 10mg (incl. Ester), so perhaps coincidentally, could it be a case that the Enanthate wasn’t quite stable when I reduced the Propionate, and it caught up when I increased the Prop to 0.02?

In conclusion then - I’m dosing too high. How would you suggest I reduce the blend/dosage? Is 3 weeks sufficient before attaining AM/PM results?

Thanks again

 

[R2D2]

I don't think you've completely exhausted the options in conventional TRT. There's lower dosing to explore, and I don't recall if you've tried hCG.

Just thinking more about this and acknowledging your point of Prop introducing noise in results, any thoughts on how I may be responding to Prop vs Enan from the above results?

I'm not sure whether it would be more sensible to reduce the Propionate by 50% to 1mg or reduce the Enanthate instead to maintain the 3:4 P:E ratio you previously opined as a target to try? For instance:

- Propionate: 3mg (so increase by 50%)
- Enanthate: 5mg (so decrease by 50%)
Total: 8mg / 6.09mg (excl. Ester) daily

(I'm currently on 8.86mg daily on current protocol - but a 40+ nmol/L result albeit short period, is quite worrying)

Alternatively, I could remove the Propionate entirely and dial-in Enanthate, as I'm not sure if the Propionate introduces 'too much variation' in my body. While it is difficult to tell because of the blend, my most recent results (14/01 - Trough AM result 20.1 vs 16/01 - Peak PM result 47.0) shows at least a 133% change between Peak and Trough. Surely this is not good, even if only for e.g. 3-5 hours?

While it is difficult to calculate a true average, my Nov '21 results on the same protocol as Jan '22, show that 4 hours after the peak Jan result, my peak reduces from 47 to 29.9 - so a substantial 85% drop, reducing the variation between Trough and somewhat tempered Peak to 36%, which you've mentioned is natural when consulting the research (and therefore acceptable). But that 133% range - ugh, can't be good.

Does this thinking pass your litmus test/analysis?

Opinion appreciated ahead of further experimentation!

Thanks
R2

 

[Cataceous]

Thanks @Cataceous , very insightful as always. Apologies for the delay, I wanted to get new results before replying. Your assertion that Propionate peaks earlier and drops quickly, I think is correct from the attached results. Notice the 29th July 2019 result (I had initially thought that this was a mistake) - but given how high Prop peaks, I’m guessing it is not only accurate, but the drop off is aggressive and substantial. NB: the 2019 result is Prop only, 10.5mg daily.

I have used HCG before, but haven’t for over 3 years due to wanting to settle on a reasonable protocol (per results) before re-introducing / benefit from the subjective results associated with it. I’ve been caught up with work, so this has all taken much too long.

It’s quite surprising that the propionate would lift the result to 40+. ...

Your recent results are puzzling. That's a lot of variation for having propionate supply less than 20% of the testosterone. My best guess is that the 16-Jan-22 results are incorrect. They seem inconsistent with the earlier measurements. In contrast, the 29-Jul-19 values make more sense as peaks on only propionate.

I'm doubtful that a reduction in your testosterone dose by less than ten percent is responsible for your apparent crash. But I won't say it's not possible. Arguably if the enanthate wasn't stabilized then the relative reduction in daily peak testosterone could be much more than 10%.

Regarding your extensive test results, do you happen to have more precise injection times? That is, how many hours post-injection are you measuring possible peaks?

I don't know if you want to mess with it, but given how little propionate you're on at the moment, I would take advantage of that to try only daily enanathate for long enough to stabilize and get some measurements. I'd measure testosterone and SHBG to get an estimate of free testosterone. The general expectation is for free testosterone to be proportional to dose, barring significant changes in underlying metabolism. If you determine your constant of proportionality then you can get a better sense of what was happening when you were taking only propionate or a blend. It would also be interesting to compare to your EOD enanthate results, which seem low for the dose—perhaps because you didn't hit the true peak. That is, you were averaging 10.8 mg of testosterone per day, yet were seeming to hit serum levels that the average guy would get with more like 7 mg.

Longer term I do favor a blend that gives a daily variation in serum levels of up to 25% about the mean. The idea is to have daily peak testosterone hit a modest normal level, while troughs can appear borderline hypogonadal—as seen in healthy young men.

 

[R2D2]

Your recent results are puzzling. That's a lot of variation for having propionate supply less than 20% of the testosterone. My best guess is that the 16-Jan-22 results are incorrect. They seem inconsistent with the earlier measurements. In contrast, the 29-Jul-19 values make more sense as peaks on only propionate.

Regarding your extensive test results, do you happen to have more precise injection times? That is, how many hours post-injection are you measuring possible peaks?

Agreed, although the Jul-19 results were taken 20.5 hours after injection (I was injecting the night before). I have re-attached the table with injection times, and hours after injection. What do you think?

Nonetheless, I think I should switch to another lab to retrieve results to check

I don't know if you want to mess with it, but given how little propionate you're on at the moment, I would take advantage of that to try only daily enanathate for long enough to stabilize and get some measurements. I'd measure testosterone and SHBG to get an estimate of free testosterone. The general expectation is for free testosterone to be proportional to dose, barring significant changes in underlying metabolism. If you determine your constant of proportionality then you can get a better sense of what was happening when you were taking only propionate or a blend. It would also be interesting to compare to your EOD enanthate results, which seem low for the dose—perhaps because you didn't hit the true peak. That is, you were averaging 10.8 mg of testosterone per day, yet were seeming to hit serum levels that the average guy would get with more like 7 mg.

Inclined to agree - however, one of the reasons that I was keen to move to Prop only (and now a blend) is because I was quite, how to put it, anxious when on Enan only. Is it possible that Enanthate only could cause significant anxiety? Could turning to Cypionate instead make a difference?

Longer term I do favor a blend that gives a daily variation in serum levels of up to 25% about the mean. The idea is to have daily peak testosterone hit a modest normal level, while troughs can appear borderline hypogonadal—as seen in healthy young men.

Theoretically I agree. Per above, my Enan-only experience wasn't great and I've been trying to mimic a 'gel only' experience but with better pharmacokinetics with injections. Not sure what is going on with my current results with the blend. Will re-measure, but I've dropped my Enanthate dose by 25% for the last few days. It will be quite puzzling if the results are similar as recent, in which case, I will remove Prop and re-baseline on Enan only and start again..

Thanks

 

[Cataceous]

For the fun of it I tried some data fitting on your numbers. I didn't get anywhere with the dual-ester numbers. But the propionate results at least weren't totally outlandish. The model I used assumes an exponential decay in serum levels beginning at some fixed time post-injection. The best number for the post-injection delay to exponential decay is about 8 hours. This wouldn't necessarily be the peak, but could represent a point not too long afterwards. The other interesting number is the half-life value of about 18 hours. That's actually pretty close to the nominal figure of 0.8 days. Given the assumptions made and the small data set one should take these results with a grain of salt.

I doubt you'd find cypionate to be much different from enanthate. The apparent half-lives are similar; it's this rate of absorption that differentiates the testosterone esters.

While the doses you've used are physiological, they are all above the average daily natural production of 6-7 mg testosterone. I can't say for sure that your metabolic clearance rate isn't above average, but your lab results at least hint that your average free testosterone is also above the average for healthy young men. This is a roundabout way of encouraging you to consider exploring lower doses. That's how I've ended up at 4.4 mg per day, having tried a variety of doses ranging from 3.7 mg to 10 mg.

 

[R2D2]

For the fun of it I tried some data fitting on your numbers. I didn't get anywhere with the dual-ester numbers. But the propionate results at least weren't totally outlandish. The model I used assumes an exponential decay in serum levels beginning at some fixed time post-injection. The best number for the post-injection delay to exponential decay is about 8 hours. This wouldn't necessarily be the peak, but could represent a point not too long afterwards. The other interesting number is the half-life value of about 18 hours. That's actually pretty close to the nominal figure of 0.8 days. Given the assumptions made and the small data set one should take these results with a grain of salt.
View attachment 19364

I wished that I could say that I understood this! I've read it a couple of times. If not too much trouble, could you breakdown the table column by column and any formulas used? Would be great to learn more about it.

I doubt you'd find cypionate to be much different from enanthate. The apparent half-lives are similar; it's this rate of absorption that differentiates the testosterone esters.

I'm more wondering whether I'm having some uncommon/adverse reaction to the ester itself. Is this a possibility? Not sure if I'm overthinking it..

While the doses you've used are physiological, they are all above the average daily natural production of 6-7 mg testosterone. I can't say for sure that your metabolic clearance rate isn't above average, but your lab results at least hint that your average free testosterone is also above the average for healthy young men. This is a roundabout way of encouraging you to consider exploring lower doses. That's how I've ended up at 4.4 mg per day, having tried a variety of doses ranging from 3.7 mg to 10 mg.

Due to some important meetings coming up, I've decided to not go for Enan only (yet), due to risk of too many changes but would collect clean data (which I'm keen on doing). Instead, I've reduced the propionate by 25% (1.453mg per day) and Enan by 12.5% (6.3mg), totalling 7.75mg actual T per day (from 8.86). It's only been a few days, but already noticed soft wood / no morning wood etc. But my mood is more optimistic.

Do you think I'd be better to reduce the Enan further (e.g. 25%), bringing total to 1.453+5.4 = 6.85mg?

I'm trying to reduce adverse effects on thinking performance/energy, yet want to get that peak lower.

Thanks

 

[Cataceous]

I've attached the spreadsheet so you can look at the equations. Ignore the "TE" fields, since this is only for propionate. The inputs are your measured testosterone "T", your dose, "TP d", and measurement time post-injection, "Hours". Testosterone dose from propionate, "TP", is calculated as the dose times 0.837, a slightly different conversion factor than what you used. "TP Hours" is the length of time of the assumed pure exponential decay. It's just "Hours" minus the "TP Peak" parameter. "TP Fraction" is the amount of decay expected during "TP Hours" according to the half-life parameter, "TP Half". "TP T" multiplies the testosterone dose by the decay fraction. Among the assumptions are that SHBG doesn't change much and testosterone remains proportional to free testosterone, so that testosterone is also proportional to dose. The constant of proportionality is the "T Scale" parameter. From the inputs and the parameters we create a predicted T field, "Prediction", which we then compare to the actual value "T", subtracting to get the "Error" field. The errors are squared and summed to get a measurement of total error, which is 170.14 in the example. Normally you'd use an optimization algorithm to minimize the error, but I just did some manual iterations to arrive at the post-peak time and half-life parameters. Aside from the many assumptions, another problem is that there's little variation in dose and post-injection time. The accuracy of the model beyond these narrow inputs is questionable and untested.

If there were going to be an unusual adverse reaction to a testosterone ester I'd think it would be along the lines of an allergic reaction, though I don't know if that's even plausible. Generally the testosterone esters are considered inert until they reach the bloodstream, where the esters are rapidly cleaved, freeing the testosterone. At that point the source of the testosterone becomes irrelevant; the molecules all act the same. It seems more likely that a symptom of anxiety is related to some hormonal and/or neurotransmitter imbalance. Unfortunately it's complex and highly individualized. Tying in to what @JA Battle said above, progesterone is calming and balances estrogen. DHEA and pregnenolone can possibly promote anxiety. Oddly, topical DHEA sends my anxiety skyrocketing, whereas oral DHEA is fine, perhaps because in the oral route it's mostly going to DHEA-S rather than DHEA.

The control of other parameters, such as morning wood and "thinking performance/energy" is also maddeningly complex. I had loss of morning wood when I was hypogonadal, but also at times on TRT when my total testosterone was ~800 ng/dL, well above average. We probably need to consider a bigger picture, one that includes testosterone, estradiol, progesterone, DHT and prolactin, along with kisspeptin/GnRH/LH/etc.

If you have important events coming up then I'd defer significant protocol tinkering until afterwards. After that I think it's worth spending significant time at somewhat lower doses to see how they compare. Adjusting this one variable is a limited action, but it can affect estradiol and DHT, and possibly prolactin as well.

 

[R2D2]

@Cataceous, insightful and thoughtful as always, thank you. Agree with your thoughts above. I’ll take a look at your spreadsheet and try to adopt in my results going forward. Much appreciated.

 

[Willyt]

@Cataceous, insightful and thoughtful as always, thank you. Agree with your thoughts above. I’ll take a look at your spreadsheet and try to adopt in my results going forward. Much appreciated.

@R2D2 - Any updates on your protocol and test results?

 

[R2D2]

Hi @Cataceous, @Willyt,

By way of an update, please see my results since February attached.

I think my Peak result in May is incorrect - I think I missed the Propionate peak, somewhat evident by the higher estradiol value in the Trough result.

In terms of my most recent July result, this is on the Enanthate only protocol of 12.5mg / 9mg (actual T) per day. I tested only the Trough/AM result on the basis that there is very little variation on such a protocol.

@Cataceous, would you suggest that I test a PM / theoretical peak result on the Enanthate only protocol anyway? Any thoughts on the result (T: 25.4 nmol/L, E:140 pmol/L)? I'm not sure where to go from here e.g. reduce the dose? Reduce and combine with Gel to increase variation? (I'm not keen on introducing the Propionate due to its disproportional effect and the potential uncontrolled/questionable source)

Subjective results on the Enan only protocol:
++
- More controllable acne (although still present)
- Less erratic mood (On the Prop/Enan blend, I became quite morbid/pessimistic each evening)

--
- Much reduced erectile quality; much softer and less lasting
- Increased anxiety in social situations when I am presenting to senior folks at work
- Less zest/interest for outdoor activities e.g. on the Prop/Enan blend, I was partaking in outdoor hobbies much more than now
- Sleep quality is worse

Thoughts appreciated on how I ought to amend my protocol to increase variation before I dive into new changes. Many thanks