Hi, I have a few questions, but med protocol and lab numbers first. Have been on HRT since September 2013. I will be looking for advice/answers regarding other labs to run that might shed further light on what is needed to feel and perform my best.
My med protocol:
60 mg testosterone cypionate, subcutaneous E3D
0.125 mg anastrozole/DIM E3D, same day as testosterone
500 IU HCG E3D, day after testosterone/anastrozole/DIM
Tadalafil: 5 mg maintenance dose daily before bedtime
My latest numbers: December 2014, Labcorp
Total T: 1013 (348-1197)
Free T: 23.1 (6.8-21.5)
PSA: 1.9 (0-4)
TSH: 1.42 (0.450-4.500)
DHEA-S: 302 (71.6-375.4) but Labcorp did serum instead of sulfate. 6-month prior was 333.6 with TT of 915 and FT of 22.1.
Estradiol: 23 (7.6-42.6)
Total Cholesterol: 181 (100-199)
Triglycerides: 55 (0-149)
HDL: 69 (>39)
LDL: 101 (0-99)
Baseline lab numbers prior to HRT: August 2013, Labcorp
Total T: 380 (348-1197)
Free T: 8.9 (6.8-21.5)
PSA: 1.2 (0-4)
TSH: 1.89 (0.450-4.500)
DHEA-S: 256 (71.6-375.4)
Estradiol: 5.9 (7.6-42.6)
LH: 5.9 (1.7-8.6)
Total Cholesterol: 226 (100-199)
Triglycerides: 70 (0-149)
HDL: 68 (>39)
LDL: 144 (0-99)
First, couple of questions/explanations/issues. I feel pretty good since starting HRT, but not great. I do exercise hard 4-5 times a week. Eat pretty healthy. Age: 48. Height: 5'11". Weight: 190 lbs. Sleep is always less than is needed. I tend to wake up early (5ish) and go to bed on average around 11. Pretty tired most of the time so may not be getting quality sleep. Seem to wake up tired.
I had previously been doing 250 IU HCG EOD but upped to 500 E3D. Testicular size seems smallish at either dosing schedule. Seems to be fluctuation in size throughout the week. Is that normal? Would a temporarily higher dose, maybe 1000, help increase testicular size by jump starting Leydig cells. If so, what would be a safe protocol?
Used to never have nighttime erections. Better since starting HRT, but I also do the 5 mg Tadalafil daily/nightly to help with this. Erection always stronger in the mornings upon waking. Erection strength and/or ability to achieve/keep one later in the day may be an issue sometimes.
Have always been on the nervous/anxious end of things. Performance anxiety has been an issue in the past. Social anxiety can be a problem too. Generally, just don't feel well enough to engage. Single for years and years. Confidence is an issue. Have done my share of SSRI's in the past with improvement in sociability. Stopped because they tend to cause/contribute to ED problems. In combination with Wellbutrin, they are not as bad. Currently, take Wellbutrin (150 mg) only in the morning. Not sure if it addresses anxiety much, but at least it is one less known to cause ED issues.
Seem to have always had memory problems. May be getting worse, but I don't know. Perhaps the anxiety contributes to this.
I am looking to optimize how I feel, how I perform, etc. No doubt I'm on the right track with HRT and my numbers look pretty good I think. Looking to run some additional labs that might shed more light on the anxiety, sometimes less strong erections, etc. I have 6-month labs coming up in June and would like to do some fine-tuning. I know there are more things that could be checked.
Back in December 2013 I had a few additional things checked.
Vitamin D, 25-Hydroxy (30-100) which came in at 46.2.
Thyroid Peroxidase (TPO) Ab (0-34) which was 12.
Triiodothyronine, Free, Serum (2-4.4) which was 3.6.
Does anyone know some additional things to check (beyond the basics) that might address anxiety and strength of erections? HRT is expensive so I'm looking to optimize.
If there is already a post that would be beneficial for me to read, please let me know.