T Nation

50mg E3.5D IM. First 6 Weeks Great, Then Back to Old Symptoms

I’ve spent many months researching and becoming comfortable with the idea of TRT before deciding to take the plunge. I tried once before, with a terrible protocol for my needs (200mg/wk) and my dick broke, anxiety went through the roof, and I ran away scared, but determined to become more knowledgeable and prepared.

Having said that, I’ve been on TRT now for 11 weeks @ 50mg E3.5D. The first 4-5 weeks, everything “clicked”. Sex drive through the roof, anxiety completely resolved, confident, motivation to go to the gym was incredible… I felt like a completely new man. At 6 weeks, I had bloods taken. The doctor was pleased with the results, and because I felt great, we kept as is. Immediately after, I started regressing… Frequently tired, morning erections more intermittent, sex drive dropped, anxiety started rising again. I’ve stuck with my protocol and intend on going for more blood work soon - However I’m curious if there’s anything in my current bloods that might help indicate why I’m struggling.

Background:
35 years old
Overweight - 6’/275lb - Thick build. I powerlift, wide shouldered. I’m thin at 225lb/happy at 240-250. I lost roughly 100lbs (peaked 375lb) over the past 4 years to try and handle this situation naturally, but my test levels were actually even worse down 100lb. So here’s a breakdown of my results thus far:

Pre-TRT Bloods (run at my Dr’s office - I believe Quest Labs**):
Serum Testosterone 338 ng/dL (348-1197 range)
Free Testosterone 6.51 ng/dL (4.7-24.4 range)
Estradiol 21.1 pg/mL (25.8-60.7 range)
SHBG

6-Week Test Results @ trough (3.5 days after last shot, right before I pinned)
Tested by LabCorp***
Serum Testosterone 811 ng/dL (264-916 range)
Free Testosterone 18.7 pg/mL (8.7-25.1 range)
Estradiol 26.5 pg/mL (7.6-42.6 range)
SHBG 28.8 nmol/L (16.5-55.9 range)

Sooo…. Estogen spikes (tough to know without testing peak right?)? Not enough free T? Any thoughts or suggestions? I’ve considered daily SubQ pinning, but my work schedule involves a lot of travel, and I’d like to stick with this current E3.5D protocol if at all possible… But if everyone agrees that this could be estrogen spike-related, I can be openminded if absolutely necessary… Sorry for the lengthy post and thanks in advance.

You’re going to save yourself a lot of suffering if you listen to my advice. Your problem has nothing to do with current Testosterone level or Estradiol level with your TRT protocol. There is no spike in Estradiol while dosing 100mg per week in two divided doses as you have been doing.

Test your Thyroid and Cortisol.
-Free T3
-Free T4
-24 Hour Saliva Cortisol

Do you take iodine and selenium supplements?

Do you also know who will compete in the NBA finals 2020?

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I will have to respectfully disagree with @TRT_Phoenix

Your issues most likely stem from insufficient testosterone levels. You felt great for the first few weeks. This was because you were adding exogenous testosterone to your natural production. Now that your natural production has been supressed, your levels have dropped and you don’t feel as good anymore.

You need to bump up your dose. Your ideal dose will be somewhere between 150-200mg a week.

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All your levels are higher in the beginning of the week, you said you felt good at 4-5 weeks and later started feeling bad again, your levels were lower at 4-5 weeks and you were doing well. If your levels are substantially higher in the beginning of the week, maybe your body doesn’t like levels this high.

I found out I feel best with FT at around 15 pg/mL (6.8-21.5) and feel worse with it at the top of the ranges. Another thing, 8 weeks is when you will know if the protocol is a success or not, your levels might be stable at 6 weeks, but you body is still adapting at this time.

All of this could be thyroid related. These labs show where you were, not where you are now. I have seen on occasion members hormone levels continue increase beyond 6 weeks.

Are you on an AI?

I will have to respectfully disagree with @systemlord on this one in regards to your levels being “too high”. This is something I see a lot off and is pretty clear, cut and dry in my book.

You’re still seeing things one way, you are always recommending men shoot for VERY HIGH levels.

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I realize that you feel better with lower levels. However, I can attest with enormous mountains of evidence that you are an exception to the rule. I’m basing my argument on the vast majority. If I had to bet money on it, that’s how I’d bet. Just think of it: he felt great at first. Why is that? Natural levels plus exogenous levels. That wouldn’t be a matter of opinion. It’s kinda the way it works. If you only saw how many emails I get from guys who feel great and first and then don’t after 4-6 weeks, this is why. The increase the dose to compensate and poof! Issues are resolved.

I’m not saying this is absolutely what is going on with this person. But I’d say I have a 49/50 chance of getting this one right based on everything I’d seen to date. He is obviously free to do as he wishes.

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Thanks for the replies everyone. I’ve been lurking and reading up on threads on this forum for quite some time, so I’m aware that there seems to be some disparities on how several of you commenting would handle this situation (dbossa/systemlord).

To be frank with you, after going back through some of my messages to try and recall when I started noticing that the benefits were decreasing, I actually started feeling worse even before this bloodwork was taken… And frankly had expected my estradiol levels to be higher than they were due to my higher body fat.

I am NOT taking an AI.

For what it’s worth, probably should also mention that my TRT clinic prescribed a “tri-test” blend, which is 100mg Test C, 75mg Test E, and 25mg Test P /ML - I’m up for my refill, and they are willing to do straight Test C if you all believe that might be better… They touted the various esthers as “delivering more evenly” when I was given the option.

Your estradiol levels are not a concern. Believe me. TRT isn’t going to make you worse due to higher levels of bodyfat. This is another myth. If you are deficient and have all the symptoms of low testosterone, replenishing those levels to an optimal level will make you feel better. You will then have the energy and will to be more active which will help with the fat loss. I would absolutely use either straight Cypionate or Enanthate. This way if you have an intolerance to one oil you’ll know right away and switch to a different one. KISS (Keep it Simple Stupid)

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I can certainly request that both of those be tested on my next bloodwork - FWIW, my original bloods (pre-TRT) did include Free T3, which was 3.7 pg/mL (2.0-4.4) and TSH which was 2.66 IU/mL - But I’d imagine not having the “after” result probably renders those numbers useless lol.

I do NOT take iodine or selenium at this time, but am open to doing so if suggested or needed.

Take my advice here: Do ONE THING AT A TIME

I cannot stress this enough.

Get T levels optimized. Assess after 6-8 weeks. Once you’re feeling better you can try adding something else if need be. Don’t throw in too many variables as you won’t know what is doing what. I wasted 3 years doing that. Don’t do it.

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For all we know his levels kept rising after 6 weeks, seen it before.

Well, I’m not saying you’re wrong, because at the end of the day who the hell knows… BUT… I know where I’d put my money and I wouldn’t lose any sleep on that bet :wink:

I’m wondering if your FT and E2 levels are actually too low.

At 120mg (34mg EOD) my TT was 600ish and E2 was 25. I was having similar problems with ED that lead me to the urologist to begin with. I’ve upped my dose on my own and at 42mg EOD my TT is 1312, FT is 249 (24.9) and E2 is 49.

I’m feeling much better here. Wonder if you’d feel the same with a higher dose. Following along to see how things shake out. Good luck

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How can you say this when you see his labs? LOL TT and Free T look great… instead of jumping to a dosage increase he should rule out other possible causes for his symptoms. It Could most certainly be that his Thyroid is now not able to compensate for the return of normal sex hormone levels… Hypothyroidsim and/or adrenal fatigue could both be causing the crash on TRT. Only one way to find out is to test as mentioned above.

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I don’t think either one of you guys are wrong per say.

His TSH is 2.66, thats a little ways away from the optimal number of a TSH of 1.

However just because one person has “great” numbers, doesn’t mean its great for them.

Let’s get another full thyroid hormone panel along with more detailed bloodwork like pregnenolone, DHEA-S, Iron labs, nutritional values ( Vit D, C, Selenium, etc) amongst others.

I wouldnt be surprised in the end if he needed to bump that 100mg to 120mg in the end.

Nevertheless, TSH is the one that jumps out as the most obvious need of addressing.

i think @brickhoss1 should address that and possible underlying causes in relation to that first.

Dude, his levels havent reached even NEAR peak levels the first weeks. IE his testosterone levels was LOWER when he FELT BETTER. Now, after 6 weeks, his testosterone is PEAKING yet he feel worse.

You arent very smart are you?

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I think stayb the course.

Def do more labs next time

Thyroid
Cortisol
Prolactin
Ferritin
Metabolic panel
CBC

I’m just helping roughly 30 people a day and getting a 95% success rate. What do I know. Do it your way. Doesn’t change my life. Once you’ve exhausted every other possibility you’re free to try out my advice if you wish in a few year’s time. Been there, done that.

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