TRT with no results

[RoneTone]

I think I edited the post after you replied, but basically fatty liver (non-alcoholic that is) is caused by insulin resistance. High blood sugar and insulin resistance damage your endothelial walls (and kill your erections). I invite you to research this topic heavily. Evaluation of endothelial dysfunction in patients with nonalcoholic fatty liver disease: Association of selenoprotein P with carotid intima-media t... - PubMed - NCBI

Also: "Classically, insulin metabolic signaling results in vasodilation via increased nitric oxide (NO) production and increases in bioavailable NO. However, in conditions of insulin resistance, it promotes vasoconstriction and vascular proliferation. Insulin effects on endothelial cells." New insights into insulin action and resistance in the vasculature

So you have any sort of blood sugar issues or insulin resistance or are pre-diabetic you will be more often in a vasoconstricting state. This is why you can get an erection but it fades quickly.

You can also look thin and still be insulin resistant.

As I said in the first post - you might also have too much norepinephrine (stuck in 'flight mode') and this causes vasoconstriction (get a boner but it fades quick). But again, this is highly correlated to insulin resistance and fatty liver. To test this you could try some norepinephrine blocking compounds and see if your erections improve.

 

[MRHansen]

Yeah, a FBG is better than nothing, but not ideal to see where you fall on the metabolic scale. Get a A1C, do a OGTT or better yet do an insulin survey with your OGTT. That's good on the trigs. Also test your liver with AST, ALT, and GGT.

Still, I think if you have onset fatty liver and are overweight those are the two biggest areas I would focus on to get better erections (and better libido). Your hormone levels look pretty damn good and don't see any glaring issues (except low normal SHBG and personally I would take less T and not use an AI but that's just me). I also agree with another poster that recommend you inject more frequently. I inject EOD and have lowish SHBG like you. I got much better results this way.

So dividing the shots into two a week would be better? if i split them up into two 100 mg shots it would be same dose but would the bodys reaction be different? So different so you could skip the AI ? Im thinking it has to do with peak levels then ?
Or maybe take two 80 mg twice a week and try without the AI ?

If i change i can only change one thing at a time, or else i have no chance of knowing what is causing the difference.
Thank you

 

[dnfuss]

Yeah, a FBG is better than nothing, but not ideal to see where you fall on the metabolic scale. Get a A1C, do a OGTT or better yet do an insulin survey with your OGTT. That's good on the trigs. Also test your liver with AST, ALT, and GGT.

Still, I think if you have onset fatty liver and are overweight those are the two biggest areas I would focus on to get better erections (and better libido). Your hormone levels look pretty damn good and don't see any glaring issues (except low normal SHBG and personally I would take less T and not use an AI but that's just me). I also agree with another poster that recommend you inject more frequently. I inject EOD and have lowish SHBG like you. I got much better results this way.

Not sure why so many posters simply assume the OP has NAFLD. Other than a lower-range SHBG, which is modestly correlative but by no means dispositive, I see no basis for such a diagnosis. And in fact his very low triglycerides are usually inversely correlated with NAFLD. A proper diagnosis would require much more extensive bloodwork and radiology at least.

 

[MRHansen]

Hair loss is thyroid related, we need to see a full set of labs for your thyroid. You would then need to retest Free T3 since you can't test Reverse T3 without also testing Free T3. Free T3 increases metabolism and testosterone is metabolized in the liver, TRT cannot work if there are thyroid problems.

TSH
Free T3
Free T4
Reverse T3
Antibodies

Hello again, im back with new blood work results from Thyroid tests, they show;

Free t3 3.20 pg/ml (1.88-3.83)
Free t4 0.90 ng/dl (0.70-1.48)
THS 1.148uIU/ml (0.350-4.940)
Thyroglobulin Antibody 1.13IU/ml (0.00-4.11)
Microsomal Antibody 1.27 IU/ml (0.00-5.61)
TSH Receptor Antibody 0.50IU/L (0.00-1.75)

Reverse T3 was not available unfortunately but i hope these numbers can tell if it looks acceptable or if any could cause symptoms. As i read them they look within range.

Thank you.

 

[Systemlord]

So dividing the shots into two a week would be better?

This^^^, weekly dosing isn't always optimal no matter the SHBG, some men just don't respond well to TRT when levels are declining too much between injections and I'm one of those men. The longer I did weekly injections regardless of the level, I just felt like I was in withdraw all the time.

It took a long time to figure out libido and erections were best when injecting 10mg daily, this protocol gave me the best results in every department without the need for an AI. My SHBG is about the same as yours.

Will twice weekly provide you optimal results, maybe and many not. If you don't feel anything on weekly, then your next move needs to be dramatic for the results to be dramatic.

 

[MRHansen]

This^^^, weekly dosing isn't always optimal no matter the SHBG, some men just don't respond well to TRT when levels are declining too much between injections and I'm one of those men. The longer I did weekly injections regardless of the level, I just felt like I was in withdraw all the time.

It took a long time to figure out libido and erections were best when injecting 10mg daily, this protocol gave me the best results in every department without the need for an AI. My SHBG is about the same as yours.

Will twice weekly provide you optimal results, maybe and many not. If you don't feel anything on weekly, then your next move needs to be dramatic for the results to be dramatic.

Ok, thanks for your input. Have any regarding my Thyroid tests and levels ?