T Nation

Help w/ Protocol Based on Blood Tests

Hello all. Maybe some of you more experienced can help. Im 3 years in and having issues getting dialed in. I’m fairly close but I still struggle with estrogen issues every few months (both low and high.) I’m 45, good shape. Run 6x a week and a BMI of maybe 22. some days I feel great and others my energy is oddly crap

When I first began trt, both my estrogen u/s (13) and my T (305) values were too low

Ive experimented with Raising and lowering my T and waiting 4 or 5 weeks but found that if I don’t take enough testosterone my estrogen drops too low and I have bad symptoms and obviously if I inject too much my E rises out of control. What has my doctor confused is I over respond to Anast and have dropped my E to 0 3x in 3 years.

I now inject EOD subcutaneous To try to not use an AI and My dosage now is 110mg a week split into 4. I take 25 units of HCG EOD in the alternate days. On this protocol my estrogen slowly creeps up so that after 2-3 months I’m way too high. If I take a small dosage of an AI like anast, it drops me rapidly so I’m a little bit of an over responder and have to be careful with dosage. Every 2- 3 months I’m stuck in this limbo where I don’t know if my E is high or low and I’m stuck waiting a week or 2 until I can figure out what’s up. When I take an AI I can drop too low so it’s like a month without sex while I test getting this right. I don’t mind the tests but it effects my life sometimes as I have Erectile dysfunction for a few weeks or I feel odd sexually. I take DIM daily and I’ve dabbled in Proviron but I can’t decide if it really helps my estrogen issue.

Do you guys think it’s worth switching to T to an every day schedule? I’m wondering based on my T levels if I maybe should even increase a little.

Here are my most recent tests (I just cut and paste the things I thought were important) I think my estrogen is slightly borderline high (2 weeks ago I was experiencing E issues and took a tiny dose of an AI) and I took a micro dose After seeing this value to knock it down a tiny bit. I have more tests if needed.

Any advice would be greatly appreciated. I’ve had a few doctors and none are really knowledgeable

ESTRADIOL, ULTRASEN,LC/MS 29

GGT 18

LD 162

TSH 0.84

T4,FREE 1.3

T4 (THYROXINE), TOTAL 6.9

T3,TOTAL 133

T3,FREE 3.4

AST 36

ALT 40

FERRITIN 77

PROLACTIN 11.1

ESTRADIOL 33

TESTOSTERONE, FREE 87.4

SEX HORMONE BINDING GLOB 32

PROGESTERONE <0.5

TESTOSTERONE,TOTAL, MS 584

DHEA SULFATE 126

FSH <0.7 L

LH <0.2 L

Estradiol of 33 is way too high? Are you experiencing any sides? 33 is not that high. Most people on this board are much higher. On my last labs I was 36

Mostly my libido is not what it is normally. My libido is usually much higher. I’d normally say it’s just random but my libido has been off for over a month. Im a little hotter than normal but not anything crazy. I am running my AC at 68 and sweaty at night

If you started having estrogen sides after introducing HCG, lower the dosage.

I’m not obsessed with the number. If I feel ok with my E at 40 I’d be happy. I had to take an AI to get to 33 and I feel better than I did 3 weeks ago. I’m trying to get to a point where I don’t need an AI. I’ve tried lowering my T dosage to 100 and 90mg a week but I was miserable and had a weird sense of fear which I discovered was because my T dropped to under 400. I feel better at something like 120mg a week but I eventually have estrogen issues and I spend a month or longer trying to fix it with blood tests and AI’s. I think I’m going to stay at 110mg and inject daily and try this for 6 weeks and then retest.

I may try lowering the hcg … that’s a good idea

Why are you running the HCG?
“I’m a little less horny” is a temporary problem that would go away if you left it alone for a month or two, probably. Nothing is absolute, so no one can say absolutely.
It is a bgood idea to dial in one thing at a time. That would mean JUST testosterone for a while until you get your spot, then consider experimenting with thinga like HCG and Proviron.

Im running HCG for multiple reasons, mainly because I may still want kids later and I don’t want something atrophying on my body. There also may be a reason I need to stop trt one day and I want the ability to recover my normal functioning. I’m orgasms feel weirdly uncomfortable when I’m not on hcg where my semen has an different consistency (for obvious reasons) That might go away. As for libido, yes it’s very subjective but it’s unusual for me to go this long without a desire for sex. I will admit it could be other factors such as the stress from the world right now but my estrogen was high before the latest reading.

I will try removing the HCG for 2 months and see if my estrogen still slowly spikes

Saw this video made by some of the forum experts and DRs about ignoring estrogen, and just going with the basics. I’m sold.

Im going to stop using HCG and not using an AI if my estrogen goes up