Critique my TRT. Acne Problems

I’m 35, 200lbs, 6’, 19% bf. Currently running 180mg test a week split into two even injections for 10 months now. Take 1mg anastrozol every other week and dim daily 1mg daily finesteride for dht block
Total t is 846
Free t is 256
And my estradiol is a 47
I feel great but my problem is I’m getting cystic acne on back and shoulders. I have tried doxy, all body washes. And nothing seems to be working been dealing with this for 6 months and can’t get control of it. I don’t think my numbers are that extreme or far out of wack. Curious if you all think that maybe it’s and estrogen issue or if I should dial back to 160mg test for a while and see how that goes. Looking for some advice thanks.

Not every man needs high normal T, some do just fine midrange or slightly higher. As far as the cystic acne, this may mean you’re over responding to Test, possibly due to short gene CAG repeats or sensitive androgen receptors.

I can’t think of a worse TRT protocol, blocking estrogen, and DHT, two hormones converted from testosterone, benefits of TRT and you’re blocking them!

AI’s haves a very short half-life, so infrequent dosing may be problematic.

Blocking estrogen, even with healthy levels, may have downstream effects. Same with blocking DHT. Some can get away with doing this, some can’t.

Some men can take years to develop Post Finasteride Syndrome, which is not reversible.

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So what you’re saying is I should get off the finesteride anastrozol and dim and see what happens. That actually I might need higher estrogen levels and that might help?

I’m going to drop the test dose down to 160 as well and see how I handle that

I would totally trade acne for feeling great lol

Systemlord is of course the expert, but just thinking, have you considered your diet? Your BF is a little high, so if you are eating badly, that could be exacerbating the issue.

Yea I’m bulking right now I was shocked how high it was honestly. but yes I stay away from all dairy lactose intolerant anyway. no sugary drinks only water and occasionally beers with the boys but once a month at best. But what I’m gathering is that it might be best to lower dose quit all estrogen blockers and dht blockers and get labs done again in six weeks and see how things go over the next 6 weeks as well?

The best, what you think are the healthiest diets can cause rosacea, acne, bloating and GI issues. To find out, give a carnivore diet a go. I’m losing a pound of fat every couple of days on the carnivore diet. I was at a plateau for so long, now I losing weight.

The idea behind the carnivore diet is to restrict carbs and force your body to use fat for energy.

You took the hardest route, using these two drugs instead of just lowering your dosage and over complicating things. Whoever is in charge of your prescriptions, TRT, fire them!

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I’m getting off all that right now do you think a drop to 160 is good and then get labs in 6 weeks and if I still have all these issues drop another 20 until I find a happy place? I don’t want to drop to much to quickly obviously I just don’t know how much is to much. Should I just go to 140 right away and possibly work my way back up Orr…

I’m on no diet lol but I do eat clean m-f 8oz cooked ground beef or ground turkey twice daily along with a carb source either steamed vegetables or fruit Satyrdays and sundays are a free for all but no excess carbs like pizza or pasta as I don’t like red sauces but I get what your saying. And I appreciate all the comments and suggestions. I’m just really trying to get this dialed in the best as I can so next summer I don’t look like a connect the dot game on my back lol

Oh dang, didn’t know that, sorry OP :joy: guess I need to keep learning

Some people just can’t digest vegetables very well, and only when they are eliminated does progress begin… A women who lives in Alaska hunts wild game, stores the meat, true grass fed, no HMO, cut out vegetables and lost over 100 pounds with no exercise, just diet alone.

Grass fed meat in the health food stores, pesticides were sprayed on that grass that the cows ate!

More frequent lower quantity injections can help keep estrogen down

Two things: 1. One of the more prominent side effects of taking exogenous testosterone and elevating your T levels is that this hormone can stimulate your subaceous glands in the skin to produce more oil/sebum. This I’ve found is pretty highly genetic or individualistic. I’ve had fellow BB’ers develop some gnarly acne on test and others never suffer from it. Me, I luckily took accutane when younger for acne and once you’ve taken that drug (which is now not even sold/prescribed anymore I’m told), a lucky benefit is you NEVER get acne again! I think you can still possibly find this stuff online and if you look for it and find it, ORDER IT! Shit is a miracle for acne…but do pay attention to all the potential side effects! There are several possible ones…the main one that bothered me was the severely dry, cracked lips. I had to grease my lips up practically with axle grease! But I learned better to look ridiculous than bear the pain of splitting lips.

  1. Be sure you are washing with an abrasive loofah, and for your back, get that loofah on a stick so you can REALLY get in there and scrub it. BUT, make sure you are also using a bodywash that has a very abrasive exfoliant in it. I use the Dove for men, it’s got a red label on it, and it’s really good. But just find any bodywash that claims it is exfoliating as it will have all those tiny little bits of grit that will really break down that outer layer of skin and remove the built up sebum.

I agree with you and some of the others also on the lowering the dosage, that might also help as well. Sometimes when you are taking more than the true “replacement” dose your body needs, acne and other higher-test sides will present. Also, you gotta figure out a more consistent dosing with your arimidex…taking it like you are is DEFINITELY yo-yo’ing your hormone levels week after week, also another probable contributor.

Good luck!


Say what? I’m not doubting your claim, I’m just curious what you’re specifically doing to achieve this and what your diet looked like prior to starting carnivore. How are you measuring body fat loss?

The only difference is zero sugar and carbs. I even went through carb withdrawal and had intense cravings. I’m measuring on a scale.

I also lift weights 7 days a week for at lease an hour, hour and a half.

First, this is not TRT. I don’t the purpose of it :
1/ Slightly supraphysiological BT for you (as you usually do not suffer from acnea while on endogenous T)
2/ True chemical castration for E2 and DHT : what was the original goal of combating the two metabolites of T which represent a potent effect?

What is your goal? (besides “comfort”)

Allow me to digress :
1/ Accutane is still available as a generic (isotretinoine)
2/ You may or may not cure the acnea after an accutane course : I had more than 8 (yes eight) courses of up to 100mg/d in my life (and still counting). I will never recommend it to anyone. Especially someone who wants to develop his body. It is basically a chemotherapy and really counterproductive for gaining muscle. One of the mecanisms by which it exerts effect on sebaceous glands is by reducing serum IGF-1 levels…
Scientists are still debating if Test/DHT is more potent at inducing acnea or whether it is E2. (The same goes for BPH by the way).

Well, I cannot speak to your #2 as I took Accutane, as stated above, when I was around the age of 14-15, so I wasn’t even lifting weights yet and nor did I know/care about IGF-1. If it indeed does affect that, it might be worth looking into and seeing if this potential side effect is just temporary while taking Accutane or if it persists.

Perhaps you @miosie are an outlier to the effectiveness of Accutane as both my siblings also took it as did several of my friends at the time, and ALL of us got rid of our acne and NEVER had acne again (BAD acne…I may get a zit or whitehead randomly now but the awful cystic, painful, gross acne is GONE). I’m sorry your results were not the same.

I do think one of the reasons accutane stopped being widely prescribed was the prevalance of various unpleasant side effects, but again, not all individuals experience them. As I stated above, the main one the really bothered me and my siblings and friends was the extremely dry/cracked lips. But that is easily remedied with some strong lip balm.
Bottom line: If you are in fact suffering from really severe acne, I would highly recommend looking into taking a course of accutane. The shit works!

And hey, since you are not a female, you don’t have to worry about the worst potential side effect: it can make your unborn baby severely deformed, looking like a sea monkey or quasimodo. Seriously, I do remember the packaging to my prescription had these terrifying illustrations of what the medicine can do to unborn children! Ha, wild. But with the exception of @miosie , it works amazingly well.


I agree with you @meastlake1 : Accutane works, at least better than all other options. But looking at the Reward/Risk ratio, I’d say : better tune the “TRT” or stop it all together, rather than adding another harsh molecule into the mix…
I would recommend Accutane for a teenager for all the benefits, but not for someone having acne for comfort…