Question on TRT adjustment

[strong2744]

I've been on TRT for years but struggle to find that "sweet spot". I was prescribed 80mg every 5 days but my libido was very inconsistent and my labs would show my peak to be above normal range just to see it dive to high 300's/low 400's by the time of the trough. My estradiol was would always come back in mid to high 20's so I don't think it was that. Then I switched to the 3.5 day protocol to keep my trough from falling too much. After several weeks I felt good but my Tesosterone level was too high at 1200 being by trough and my estradiol shot up to 68 so the dr reduced it to 60mg of Cyp every 3.5 days. This has been my new dose for three weeks now and my libido sucks again. I have to go back for blood work in another 3 weeks but my questions are. Isn't the 3.5 day protocol supposed to keep estrogen in check? And if so, does it usually spike with the testosterone level after an adjustment? Prolactin, SBGH, and free test are also within desirable ranges. I'm hypothyroid and take medicine for that also. And unfortunately my low T was initially steroid induced. Thanks for any suggestions.

 

[kenpoengineer]

10 months on TRT myself. No, the E3.5 days does not necessarily help control E2. The protocol helps smooth out the peaks and valleys of TT. Your body has a unique aromatization of testosterone into estrogen. Libido is more a result of estrogen level. Hang in there, it takes years to get TRT ironed out.

Your 68 E2 may be the reason libido tanked. My E2 sweet spot seems to be 32.

 

[LMuscle]

Some people never get it quite right, such as myself. I've been on trt for four years and still have a terribly inconsistent libido. Just keep an eye on labs, and make small adjustments. My labs are perfect, but my libido is 10% of what it used to be. Gotta be something other than hormones

 

[The Matrix]

Here is what my observation about estradiol and chasing it all over the place.

Chasing estrodial has started to become no different then a psychiatrist prescribing a SSRI. Where the doctor give a drug its corrects the symptoms, but rarely addresses the underlying cause. Since working with integrative psychiatrists they are finally starting to see the whole picture. In stead of treating based upon a "disease management" approach they are going to a more "disease preventative" approach .

By using an AI you can control estrodial, but as many are finding out its not working. It is only masking deeper issues needing to being evaluated So instead of chasing the rabbit and its turds down the hole it might be good idea to look at your health through macro-managing it rather then micro-manage lens. By doing so I think you will see a lot of things have been over looked helping one to make a huge impact on your health

I rarely see any people going back to the basics building blocks or pillars of their health. Rather we have been accustomed to addressing down stream effects instead of going upstream. Do I agree people need an AI? yes. Providers should not just stop there, but rather further evaluate for possible explanation of why. Since being involved with cases with medical doctors, their view and practicing of medicine is slowly starting change.

Hippocrates once said "Food is thy medicine medicine is thy food". This was original foundation of medicine. Where did we go wrong?

 

[disgraziato]

I agree. Also there is no standard protocol amongst the physicians that treat hypogonadism. I've found some just start you on the patch or cream or underarm deodorant type, pellets, shots etc etc and leave it at that. Not many are knowledgeable enough to realize estrogen needs to be monitored and controlled, and not many at all recommend concurrent HCG usage to maintain HPTA, which I think is of paramount importance. Basically guys, shop around for a doctor you find competent and caring and not some moron that just puts you on T and forgets you.