T Nation

Acne /Libido and Effects of High Testosterone Levels

I have been on TRT since 2018. Initially I was on the gel and got severe acne. I switched to the injections and the acne continued but not as severely

Under both the gel and the injections, my total testosterone levels average around 1,100 for every test.

My current dosage of 0 .5 ml of 200 mg of Testosterone Cypionate(twice a week)

Do you guys on TRT all have acne issues? If not, what are you T-levels ?What I have read here is my “high” T levels could be a contributing factor to my acne issues. I once "tried to reduce my T-levels(after consultiing with my TRT doctor) from 0.5ml to 0.4ml twice week and I felt awful for a long time, I went back up to 0.5ml and get back to some sense of normalcy.

I do have libido/erection issues and I read that could also be a symthom of high T-levels(Low T as well). Not sure how true is this

Is there a recommended Total T level that we should all be aiming at or is everyone different and as long as lab results are okay, the T-level can vary.

In terms of how I feel. I feel great and at 51 I am in the best shape of my life in the gym so that’s definitely a result of my high test levels.

So my real question is. Is my high T-level contribution to my acne, low libido and problems maininting an erection? Other than those sympthoms, I feel perfectly fine and I am in the best shape of my life at the gym.

Without other lab results it’s impossible to answer your question. What’s your e2, FT, SHBG, etc? I’ve had TT numbers >3,000 and had zero acne. It’s not one number that determines things, it’s the whole picture.

This I’d look at e2 and prolactin. Isn’t acne partly a hygiene thing too?

The acne is from fluctuations/hormonal changes. I get some breakouts if I make changes to my protocol. Do you take any ED meds at age 51?

Thanks for the initial results guys. I just checked my lap results .I got a missed call from my TRT doctor today(first time ever). I guess he maybe was concerned about the results. I am waiting for him to call me back.

Free Testosterone 29.1 high
Total Testosterone 1,008 high
Hematocrit 54.5 high
Estradiol - Sensitive 38.8 High
Sex Horm Binding Glob(Serum) 22.6 normal
Hemoglobin 17.5 normal
PSA 2.4 normal

Regarding the results, my last two Estrodiol lab results were within the “normal range” and thus, I am surprised it much higher now. Last July it was 26 and the time before then was 19. I have been using 1/2 tablet per week of Arimedex for the past 2 years. He will probably suggest I move up to 1 tablet per move to help better control my Estrodiol.

Even with the high testosterone levels, I do still have libido/erection/ED issues and I do take 20mg Cialis as needed.It doesn’t help alot though. I have never had my prolatiin levels checked so I will suggest to him if this is something he thinks we need to do labs for.

Other than acne, low libido/erection/ED, I feel fine physically. At 51, I am in the best shape of my life and I normally do 2 hour workouts at the gym 3 days a week. My hope with “medicine adjustment/new medications”, I can solve the acne, low libido, erection, ED issues.

I did go to the Dermotologist some time ago and she prescribed Doxycycline(pills) which basically stopped any new acne. Unfortunately, unlike TRT injection, they are not meant to be taken forever and as soon as my 3 months prescription ended, the acne came back. Not as bad a before though so I will be looking at another solution to hopefully stop the acne.

BTW, additionally, when I went to get my physical done recently, the results showed that my creatinine and protein levels were on the high side. I can attribute this to the creatine powder I use in my prework drink and the high protein level attributable to my post workout high protein shake. As you know, protein is good for muscle building and recovery. I will be initially cutting down on my creatine powder intake in half for now.

Any other labs that my TRT doctor should consider me taking over that checking my prolactin levels?

Those labs look perfectly normal. I would be hesitant to increase AI with those labs.


Your body may be telling you something here. Too much t?

Drink water before you test, HCT of 54 should come down if you hydrate. Controlling your estrogen is what is contributing to your problems, but oh well, most folks dont want to listen to that part. Estrogen of 38 is not a big deal. It can be in the 60s and its fine if you have high Test. Careful with the the AI. Take 5mg of Cialis as a pre workout instead.

I have been on TRT around a year, I didn’t have acne until my last blast. I thought it would come down when I went back to TRT levels but not quite yet. It’s all on my back, just annoying bumps more than anything, but it is new. In regards to HCT, whether it is temporary or not giving blood works, and you can do it every 60 days. I got my HCT below 47 last test.