T Nation

High T Levels But TRT Doesn't Feel as Effective as It Used To. Labs Included

I’m 48, 180lbs, low body fat, work out 4 to 5 days per week. I’ve been on TRT for 4 years. When I first started, I went to a men’s health clinic and they tested me, My Test levels were in the low 200’s and they put me on 100ml once per week. I felt great…mood, energy, libido all through the roof. That lasted about a year and I had a regular visit with my doc and I explained that what was going on and she told me she is a hormone specialist and she could give me a much better level of care than the men’s clinic. I went along with it and she actually did. She recommended that I also use HCG and Anastrozole. This was about the time I found this forum as well. Since her protocol matched up with what is suggested here, I felt like I was in good hands.
We experimented with dosages of the HCG and the Testosterone eventually modifying my TRT to go with the standard protocol that is recommended here. I do 25ml of Test every Monday and Friday (equals 50ml or 100mg per week) and 1/10 ml (6 drops) of Anastrozole at time of T injection (I believe I’m an over responder). I also do 25ml of Hcg EOD. I think my most recent labs (taken on a Wednesday (close to ½ way between my T doses) look good although a tad bit high on the T. Problem is, I no longer wake up with morning wood and don’t have the same libido I use to have. No problems at all with ED, I just liked having a high libido. I also don’t feel quite as good as I did when I first started. So, I guess my question is after being on TRT for a while, dose the feeling of high energy, great mood and high libido sort of calm down or should I be considering a change in my doses or what? Obviously, my T levels are on the high side so I can’t believe it’s that?

Here are my labs:

The last one on a page by itself was:
SHBG 34.4 nmol/l 16.5 – 55.9

Sometime less is more, too much of anything is bad for you. Not everyone on earth is going to feel their best with high free hormones over the range. HCG might be the cause of lowered libido, some men feel great on it for awhile, then the benefits fade.

I’ve heard countless stories of men who at first feel amazing on HCG, then it starts making them feel worse. If you were a low SHBG guy I would tell you when FT is high, free E2 must also be high. Regular E2 sensitive can be misleading in regards to free E2 levels.

So would you suggest cutting back on HCG or to try cutting it out all together?

You need to lower test dosage anyway because your HCT is high, this already suggests you’re on too much test. Cut back test and keep the HCG for now, wait and see. You don’t want to go changing more than one thing at a time otherwise you won’t know what worked and what didn’t.

Small changes one thing at a time, labs every 6 weeks and note how you feel. Suggest 40mg twice weekly (80mg weekly).

My Hemoglobin and Hematocrit are both slightly elevated but I’m just about due to give blood so I’m guessing giving blood will correct that. Also my Cholesterol is high but I didn’t fast before the test (didn’t know they were testing cholesterol). Other than that, how do these labs look? Is my T actually too high or is that on the high end of where it should be? It looks to me like my Estradiol is about right and my Calcium Serum (?) seems high, which seems crazy because I don’t drink milk or take supplements other than multivitamin. My SHBG seems right in the middle of the range.

Humans aren’t numbers. Your labs look acceptable, but you gotta go by what you feel.

So I went on a 10 day trip and couldn’t take the HCG while out of town because there was no way to refrigerate it. I did continue with the T twice per week while traveling. It’s a short time, but my libido does feel like it has increased slightly without the HCG. Do you still think I should reduce my dose of T vs. reducing my dose of HCG?

I’ll add my thoughts. I feel terrible when taking hcg and also I’ve learned anastrazole/arimidex. I haven’t tried aromasin as of yet.

Your T levels are too high. Your other natural systems are now going to be overtaxed because they’re now your limiting factor.

I’ve been through the same situation you’re in over the course of a few years and through experimentation. I’ve injected 50 mg’s EOD, 25 EOD, 100 twice per week, 50 mg twice per week with variations of an AI, HCG and nolvadex.

Your HCT levels are a concern. When HCT becomes high, our blood becomes thick and viscous and can lead to all sorts of issues including blood flow issues, increased strain on your hearts stroke volume, increased risk of stroke, blood clots etc.

I’ve been surprised that I feel better sexually, physically, mentally and emotionally with a lower T level.

I’d suggest you stop taking everything, even your T for a week. I’d then suggest starting your T again at a reduced dose, possibly 30-40 mg, twice per week with no hcg or ai. With a reduced T, you may not need an AI.

Are you sure you need an AI? Are you planning on having more kids regarding needing hcg? I feel better taking 20 mg of nolvadex per day than I did taking hcg. Taking nolvadex instead of hcg also helps keep your hpta loop in tact via stimulating our pituitary gland to secrete LH/FSH whereas hcg does not.

Your cholesterol is also a concern and suggest systemic inflammation. How is your diet and stress?

Note if you feel better after donating blood.

Avoid iron fortified:

  • flour
  • bread
  • mixes
  • pasta
  • rice
  • cereals

Have we covered iodine and thyroid in one of your many other threads?

Calcium: https://www.mayoclinic.org/diseases-conditions/hypercalcemia/symptoms-causes/syc-20355523
Are you using calcium based heart burn remedies?
Taking calcium supplements?

TRT eliminates typical bone loss processes in men caused by low T or low estrogens.

Cholesterol: HDL is very strong and cardio vascular protective.
Was lab work fasting? With your exercise LDL should be lower. Cholesterol is mostly created in the liver and dietary intake minor.

In previous lab work (a year or so ago) with my doc, my E levels were high which is when she put me on Anastrozole. My next labs, my E was VERY low which so she suggested I take a reduced dose (she suggested half)…that is when I read up here on this board about being an over responder. So, I figured out how to take a pill and dilute it with vodka and I’ve been taking 1/10 of a dose with every T shot (twice per week). I’ve had a vasectomy so no plans to have more kids. I’m assuming nolvadex is prescription only so I’d need to suggest to my doc we make that change. I was taking the HCG mainly because it seems like the suggested protocol. Also, I do get a little teste shrinkage and slight aching when I was on just T (when I first started TRT 4 years ago). I didn’t fast before my blood work (had a big breakfast) as I didn’t realize they were testing for Cholesterol but in past bloodwork my cholesterol has been high. I eat pretty healthy, low-ish carbs, very low sugar, a lot of protein, drink a lot of tea and water, usually have a few alcoholic beverages in the evenings, but no smoking or other drugs.

Also, no calcium heart burn remedies (don’t get heart burn) and not taking any calcium supplements. Only thing I take is a multi-vitamin (Centrum which does have 210mg (21% DV) of calcium and a 50mg Zinc.

I did not fast before labs

iodine—Buying a thermometer today to start testing my body temps

Your T levels are also quite high. Your estrogen may be fine with your T levels more in the 700-800 range. Nolvadex/Tamoxifen is typically prescription, but can also be found on research chemical websites.

I’m a cautious person and am often concerned with worst case scenarios; in this case it would be for some extreme reason of no longer being able to get TRT. In that event, I would want to at least give my hpta axis & testes a chance to produce T on their own. This is only possible if the loop between our pituitary and our testes isn’t shut down. HCG doesn’t prevent that shutdown as it only simulates LH.

Cholesterol won’t be related to a fasted state or not, blood glucose levels would however. Cholesterol also isn’t related to dietary fats. It is however, directly related to systemic inflammation, typically dietary (a lot of processed carbs or food allergies/sensitivities) and environmental stressors.

I think you’d feel a lot better if you could get your HCT and Cholesterol in optimal ranges. HCT will reduce naturally with lower T levels. Do you really want to donate red blood cells for the foreseeable future? I know very little about causes regarding your calcium levels which is why I haven’t touched on it. A quick google search came up with this though: http://www.parathyroid.com/high-calcium.htm

Did your Dr talk about it at all with you?

Ok, body temps don’t seem too low,

Waking temps last few days:


I do use iodized salt and always have…

And Hostile, I haven’t spoken to my doc. She only does labs 2 times per year and I did this one on my own. My next scheduled visit with her is May.

Based on those temps your thyroid is likely fine right now with the potential exception of the high calcium blood serum levels. I think you should investigate the details in that link I shared above.