T Nation

How to Proceed: TRT Not Working


I am currently on:
-Testosterone Cypionate 60mg twice per week
-HCG 250IU twice per week (day before each T-Cyp injection)
-Armour Thyroid 1gr twice daily
-Ferrex Forte 2 capsules daily

Current Bloodwork 8:30AM 07/16/2013:

           Result            Range

Cortisol AM: 13.9 6.2-19.4
Cortisol PM 4.4 2.3-11.9

Ferritin 34 30-400
(Was at 30, dropped to 23, so began Ferrex Forte 2 capsules daily) Goal is 70+, will take forever at this rate...

Free T3 2.7 2.0-4.4
Free T4 1.20 0.82-1.77
Estradiol 36.2 7.6-42.6
Testosterone, Serum 1178 348-1197

Free Testosterone and Reverse T3 were ordered. May take longer to receive those results.

Should my morning cortisol be higher? I was thinking of doing anastrozole at only 1/4 tablet once per week. Twice per week seems to be too much. Any thoughts/advice? I currently am not seeing any body composition improvements, libido still low maybe 4/10 at best. Erections seem weak in morning and sometimes I do not have a morning erection. No strength, actually weaker than before TRT.

Would DHEA/Pregnenolone cream fix the cortisol issue?


I'm in the same boat Phoenix. With my regimen I was at the top end of the scale in total and free testosterone and estradiol was in check with anastrazole but I felt no different as well in terms of energy, mood or libido. After months on this regimen I decided to check out DHT and found that despite the other optimal levels, I was below the reference range in DHT. Have you ever checked out your DHT levels?

Good Luck


Yes. My DHT was flagged low before TRT, but is now in the normal range. I think it has to be my thyroid. I can say more once I get my reverse T3 result. My theory is it may be going up again, as it has been flagged high before even using thyroid meds. It could be my ferritin being a rate limiting factor preventing my metabolism from increasing and thus my body composition will refuse to improve.

This is beyond frustrating. Are all your levels optimal now? What about thyroid? Thank you for replying. It means alot that you are in the same boat as me. My doc couldn't believe me when I said I was getting no effect from having my testosterone high....


I stopped my TRT protocol because I wasn't feeling any better so my levels aren't optimal now but were on TRT - with the exception of DHT. I didn't dive too far into other issues like thryoid/adrenal/etc. because I wanted to keep it simple. My approach was to "correct" one thing at a time instead of tackling on everything all at once. Having said that, my basic thyroid values (TSH, T3, T4) looked to be normal, around 2.0 (TSH).

What were your pre-T values and what are your values on TRT? How long have you been on TRT and do you have E2 numbers to report?


I have a feeling rt3 will be in top of range..

How is your digestion? Any stomach issues?

I'm I'm the same boat.. TRT did jack sht for me but give me pimples


Make room for me in that boat. How are you guys injecting? I'm guessing SQ. I'm on the same protocol 60mg. 2X weekly and hCG 250ius. M-W-F and my T is at 452. I'd love to be in the ranges that KSman writes about in his TRT Protocol sticky. My Dr thinks that SQ might not be for me.


Where is ur thread clarkster? Bump it I'm curious now :slightly_smiling:


Here is the link to my first thread about my Pre-TRT values. I restarted TRT in April of this year 2013 because my previous doctor referred me to her. She has proven the most helpful. I see her this Tuesday 07/30 and I hope she will increase my Westhroid-P dose.


How do I determine if I have digestion issues?


I just received my Reverse T3 and Free Testosterone results.

                        Result          Range

Free Testosterone (Direct) 20.8 9.3-26.5
Reverse T3 17.1 9.2-24.1

Being that my Free T3 is only 2.7, I need a dose increase.
My Reverse T3/Free T3 ratio is not optimal yet. The ratio I calculated is 15.8 and should be 20 or higher.

Free Testosterone dropped a bit. It was 24.5 before. This is probably because my estradiol came up too high. I am going to try an eighth of anastrozole twice weekly to hopefully hit my goal of
22 Estradiol.


What are you going to increase your dose to?


Your SUB-Q injections....is that for Test, or HCG?


I'm on 1gr Westhroid P in the morning and 1gr at noon daily. I will see if she will increase me to 1 & 1/4gr twice daily. And retest in 4 weeks. I see her this Tuesday.