T Nation

Any Good Doctor in Europe?

Hello guys. I am on TRT for 6 month due to a problem in hypophysis. At first everything were ok. Taking Nebido every 1.5 months. Then my doctor insisted on taking the next shot after three months. My Testosterone fell to the bottom. I couldn’t get out of bed. I was desperate! So I looked for another doctor who suggested taking 250 enanthate per week. Things we’re good but after a month my E2 hit the sky. Low libido showed up again. I talked to him about high E2 and he said that it is not a problem…!!! Then I went to another doctor who suggested 250mg enanthate per two weeks. Thinks are still not good regarding sex drive… And then I searched for urologists instead of endo but they don’t know nothing about E2 and low libido. So I am looking for a good consultation anywhere in Europe… Prefer UK because of the language but any one who is good will do… Any suggestions please?

Doctor strange up north is pretty good, or Doctor Who in the West. Shit joke eh? Anyway

250 test per week is a bit much for TRT. Lots of guys do well on 100-125mg per week. You could ask that doctor to prescribe 125mg and try that dose.
Does your doctor let you self inject ?
Any HCG or AI with that protocol?

For what it’s worth I’m not long done a 500mg test run and dumped the HCG and AI and never had a problem.

Are you carrying much fat ?
Do you have a recent blood panel to post here ?
It’s hard to suggest anything from the limited info you have posted. As for knowing any doctors in UK with TRT expertise, that’s gonna be tough.

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I am 42y.o. 180 cm, 92kg. Not much fat. Weight lifting 3 times/week. Doctors say big NO to AI . They are for women with breast cancer they all said. Haven’t tried or asked for HCG (don’t they alter e2?)
250mg/15 days . It is not perfect but it’s ok. Self injections yes
Blood test are all good except of course LH, FSH, E2. I will post them afterwards

You could try splitting the dose into 3.5 day injections so twice per week, that will not cause as big a E2 spike. Reducing the dose from 250 to 125 will also help lower E2. Sometimes guys see that big E2 number and freak out, I’ve fell victim to that in the past. That alone can mess with your head and sex drive etc. I just leave mine alone now and get on with it. You can always use 5 mg daily cialis just for reassurance, I use it everyday in part of my supplement stack. Look into splitting dose or/and reducing dose.
What is your SHBG on labs ? LH and fsh usually tank on trt so don’t worry about them numbers

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Your experience with your doctors is pretty typical as state healthcare doctors are shackled and do not have medical freedom to do what’s necessary. There are men on low dose AI’s and are doing fine, of course those men are working with doctors operating private practices who specialize in TRT and have a greater degree of medical freedom to do what’s necessary .

The obvious simple solution to your problem is split the doses multiple times per week, this will decrease the likelihood of converting testosterone to estrogen.

My estrogen was sky high on weekly injections, I bloated up like a hippo and as I injected smaller doses more frequently, estrogen decreased significantly. I found that my estrogen was lowest on daily injections even when compared to an EOD protocol.

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Thank you all. I will try splitting the dose and monitor my E2. Here are my recent lab tests. Sorry it is all Greek to you! You will get it from the codes

Guys thank you for your replies. I forgot the most important analysis. It show lower SHBG (11.2 nmol/L) and also high PTH (102.3 of/ml ) but normal Calcium. Any comments on this would be great

In light of your labs and very low SHBG, daily injections is recommended and is your best chance at controlling estrogen. TRT will lower SHBG even more and smaller injections more frequently has been known to not suppress SHBG as much as larger injections.

High SHBG men need large injections in order to lower SHBG, you need the exact opposite.

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Thanks @systemlord. Do you think daily androgel would be as good as daily injections ?

No I don’t because as it is you are already struggling to control estrogen, tropicals make it more difficult to control testosterone and estrogen. In general androgel is so ineffective it’s almost a big pharma scam, the actual amount of testosterone percentage is very low.

Androgel is hundreds of dollars for a prescription per month, you can get a 3 month supply of testosterone cypionate for under $50 dollars and the latter in the most effective way to raise testosterone to the high normal ranges.

There is a reason why doctors are offering tropicals , (1) they are inept in their abilities to design a modern TRT protocol or (2) are in it for the money.

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So what would the daily dosage of injections be?

I recently was on 7mg daily and after only 3 weeks scored 417 which isn’t half bad when you consider was right in the middle of a protocol which had 3 more weeks to go to see levels increase. You should not be going after high normal total testosterone or estrogen will always be a problem, higher Free T, higher Free E2.

You need to aim lower towards just below midrange, 450-500. I am and feel great on 18mg EOD (72mg weekly), SHBG is 22.

I would do 7-9mg daily using 29 gauge insulin syringes in the shoulders and outer quads, I can tell you right now your doctor will likely pushed back on this idea, but it’s your only chance. You may need more or less, but it’s a good starting point.

This is close what a true hormone expert would recommend, it was recommended by an expert and it worked. I never had lower estrogen on any protocol before the daily protocol.

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Thanks . I will do my best with the doctor. Otherwise I might split it in 2 injections weekly and see how it goes. Thank you all. I already love this forum!