T Nation

Ask Physiolojik Thread


Hey man. It’s super individual and requires a lot of communication back and forth to get to the actual breakdowns of what I’d use per patient. It’s why emailing is much easier.


@unreal24278 I just had a conversation with Eric Serrano about this yesterday haha. If anyone on here knows him he can get pretty fiesty - we said that shbg dosage shit is the single biggest bs move in hormone replacement right now. Guys don’t seem to understand how quickly shbg changes and it truly has nothing to do with how your body aromas and eliminates testosterone - that’s hepatic and genetic.

@unreal24278 their argument is lower dosages give them lower rates of aroma so they think it’s helpful to them. At the end of the day if someone wants to stick themselves Ed (I’ve done it with prop) that’s their business. But telling people it’s required with shbg being low is blatant horseshit

Libido is a function of serotonin and dopamine among other factors - estrogen is required for serotonin and nitric oxide production etc. libido is dramatically more complicated than e2 numbers and shbg. If it were that easy why are guys in my practice having e2 over 100 with raging libido and then guys with e2 in the 30s feeling like trash? People don’t bother to ask themselves about life stress, sleep, diet, toxins, drugs, etc. these are basic things

The majority of the issues with libido are mental and neurological based.


@physioLojik would estrogen being required for serotonin mean that higher levels (of E2) be beneficial for depression?

On that line, I saw a study the other day that 500 mg per week of testosterone is very effective for treating depression. Unfortunately I don’t think that my doctor would go with that one!



@Graemsay 100%.


I did IR for 3 weeks 1 month the labs. is this not enough cushion time?

what dosage do you recommend T4 and T3, I rather go for the synthetic one. its better and more reliable AFAIK…



This I can not comment on.

1 month I think your thyroid should stabilize


how soon after I get through with post cycle can I have blood work done to see how well I recovered ? last pin will be april 21st gonna start post cycle protocol nolvadex 40/40/20/20 starting may 6th ending june 2nd.


Ye but with longer estered test, the hormonal fluctuation between e3.5d, EOD or ED shots is minimal. The issues these individuals are experiencing are 99% of the time not E2 related at all anyway, thus it’s just irritating to see the ED protocol for TEST CYP being parroted for everyone with a small issue to try… What’s next? Testosterone undecanoate twice per day (injectable), but not once per day, as the 10ng/dl fluctuation in total testosterone levels might be too much for us to handle!

I’ve done it with TNE and PROP. before, however we are talking about limited periods of time though, purely for experimentation (and at TRT doses). I wouldn’t want to stick myself with test prop/TNE for the rest of my life, it’s a pain and unnecessary.

I thought DHT also (along with oestrogen) played a large role in NO production? Low libido from hypogonadism isn’t just caused from a deficiency in oestrogen, thus deficiency in serotonin and NO (at least that’s what I think). Testosterone and Dihydrotestosterone themselves have profound neurologic impacts, and are thus also going to be somewhat responsible for neurotransmitter balance. (am I wrong)

Hey, are you telling me my daily dose of methamphetamine (four days on, three days off) could be causing me to feel shitty? Was almost sure it was estrogen. You see I take my meth for four days, then feel terrible for the next three days. However if I take some exemestane on the fifth and sixth day I feel fine… BUT, I mixed up the bottles for desoxyn and exemestane.

The above paragraph is a joke… obviously… The meth is actually diacetylmorphine… pffft wouldn’t mess around with any of the hard stuff

(edit, just making sure everyone knows I am kidding around)


Thanks @physioLojik - I’ll get back to you after my consult with Defy because that consult is already paid for.

Based on lab work above, you clearly don’t think my E2, Prolactin or Testosterone are something to worry about. It’s more of a neurotransmitter issue . Correct? E2 = 66 is obviously much higher than oft-mentioned e2=22pg/ml goal but in your messages you’ve talked about your patients with over 100 E2 and no ED problems. So, I don’t need to worry about adjustment to TRT protocol.

I should add - if this is indeed a neurotransmitter problem, why did it just happen in the last 2 months or so? I mean, I have had ED for past 2 years or so but it is inconsistent and always fixed with a 5mg Cialis. But now days even Cialis 25mg (5 times my normal dosage) doesn’t work. So, if it was a neurotransmitter issue, wouldn’t I have this problem for past 2 years, not just last 2 months since I’ve been on a consistent TRT protocol?

This is why I keep suspecting that this might be a cardiovascular problem - maybe my arteries were a little clogged with cholesterol 2 years ago and gradually they have become so much more clogged that even 25mg Cialis is not enough to relax them to allow for blood flow.

I’m really worried it might be close to arteriosclerosis and that scares me because there is no effective way to reverse that condition. I read a lot of studies and it looks like 2+ years of high dose statin can reverse it but only 100th of a mm, not by much. So, if my arteries that carry blood to penis are blocked, no amount of dopamine, nitric oxide, seretonin is going to fix it and no amount of statin drug is going to reverse it. That is what worries and scares me!

I want to add:

  • I’m not fat or overweight. 5’10, 155lbs, never been over 162 lbs.
  • Reasonably clean diet for past 6 months
  • Workout 2 to 3x a week
  • 8 months ago diagnosed with hypothyroidism (hairloss, insomnia and brain fog were my symptoms) and thats when I first started seeing endocrinologist and was subsequently diagnosed with low T and was put on TRT, prediabetic and was put on low-dose Metformin as a precuation to prevent diabetes and high cholestrol and was put on Crestor for it.

I was admittedly on a poor junk food diet for about 2 years but I ate only one or 2 meals a day so I never got fat, never consumed calorie surplus, I guess. But since 8 months ago I was diagonsed with so much shit, I made lifestyle changes and been living a reasonably healthy lifestyle. Can be improved further but it is several times better lifestyle than before.


I don’t think 2 years of bad cholesterol will give you plaque.
Wife recently had a ct cardic angiogram. You can get this test if insurance covers it. It checks for plaque build up and gives a calcium score .
Dr chaNged her from zocor to crestor because she had 25% plaque in a artery. I read also that lipitor and crestor are only 2 statins that can reverse plaque. Key I read was ldl being below 70.

For when I had low e2 nothing could get my dick up. No medication. Many times I thought I had high e2 and it was low.

You can also get a contrast abdominal ct that will check for arteialsclorosis south of your heart.


Thanks @charlie12 - I’ll privately pay for it and get it done. At the moment, no insurance.


For the abdomen and pelvis CT I drank a contrast AND they also did IV. They saw every organ and blood vessels. Even prostate. Colon. All intestines.


You’re super overthinking this.


UPDATE - just had my consult with Defy Medical. Here are the adjustments:

They switched me to cream and we’d have a follow-up in 4 weeks:

  1. Testosterone 20% cream. 2 clicks to start with. Upto 3 clicks. Didn’t say need to apply on scrotum but if I wanted to, they said, half of one click would be sufficient for scrotum and the remaining to be applied over body - shoulder, chest, waist whatever.
    (they said, my DHT is in lower half and cream should help increase it - that should help with libido; and they said that because I am naturally low SHBG, daily application of cream is preferable to twice a week shots)

  2. Upped my HCG to 500 IU twice a week (instead of 250 IU twice a week)

  3. AI Anastrazole .125mg only if needed

So, I’ll be on this protocol for 4 weeks and see how it goes if libido and erections come back.


If your DHT is low, you should consider Masteron.


What do you think about this dht level? Would masteron cause benefit at these levels? @studhammer


Hey brother,

I don’t know. It seems on the low end of the range. I know you saw my post about the fast effects I’m already seeing on Mast. I didnt get blood work like I should have but I feel like the NPP impacted my DHT and its functions related to erections and libido.


I’m really happy that masteron is helping you; npp messed up your serotonin and dopamine. Masteron has very strong affect on dopamine. Just be careful because your body will start to realize an overload and downregulate those receptors.


What would a good long term dose be? Or is there such a thing? @physioLojik


I always thought that once you have saturated a given receptor that it automatically Upregulates those receptors. Why are serotonin and dopamine receptor different?