T Nation

Lab Results and a Crappy Endo

Hey, been here before, after giving up hope before ive decided to fight back, I’m 43 or trt(nebido) for 5years and after great results for about 3 years it all decided to go to pot, poor erections and loss of libido,now i am relying on viagra and cialis for a sex life…im getting nowhere with my endo and have had one appointment with a uroligist, which was really only a chat and quick exam, right now im 2 weeks before my next injection and i had my bloods done for the endo who i saw on the 4th jan, hes happy with the t levels despite being low as im due a jab soon, but thats it, he doesnt want to talk about anything else bar T levels, and to be honest im not sure what to ask or suggest anymore, hcg and clomid seem to be off the table so im just left feeling frustrated that im not getting the medical care i need especially when i know other guys are availing of these as well as or in replacement of trt
Id appreciate soon help in what to do or say next,
Thanks in Advance

Try yet another doc or go private.

Also, you should consider being a platelet donor at that level. You’d be giving double donations at each sitting and doing a lot of good.

Your testosterone levels are pathetic on Nebido, I feel like crap if I’m below 500 ng/dL or 17.35. If you hadn’t mention being on Nebido, I wouldn’t think you were even on TRT. Men seek out TRT for levels this low.

You need to locate someone who specializes in TRT, not some garden variety endo or urologist. State healthcare doctors don’t have time to sit down and figure out your case, you need someone who won’t rush you through the process.

You need to go private and you may be able to get enanthate, Nebido is garbage and you won’t find anyone here on it.

Your estradiol is very low. That should have triggered your endo, as low levels are actually dangerous for your long term health. You need to ditch him and do something else.

That would explain why he needs viagra and cialis, low estrogen will kill erections.

Thanks systemlord, ive been looking into alternatives but nebido seems to be the only trt available in ireland so im stuck with it for now, feeling very frustrated at this stage, which only makes this worse, i expected my T to be low as its 12 weeks since the last injection, we’ve been adjusting the frequency to see what optimal and as it stands now its every 14weeks… i have a years supply, would you suggest a jab asap??

I was hoping youd all notice the low estrogen, how can i improve that??

To dial-in my protocol, I use Total T, Free T, SHBG and estrogen. If you have low estrogen, than more testosterone is needed since we convert testosterone into estrogen. The minimum for estrogen should be above 80 pmol/L - 128 pmol/L. SHBG will be a big factor in how much of it is free and bioavailable.

Your doctor doesn’t even know the basics for how to manage a TRT protocol, I can assure you by now you know more than your doctor

So it seems, i will look for another endo as i can continue like this
A t injection will raise my T and estrogen simultaneously?? How do i combat aromatisation,as ive suspected that is also what happening and killing my libido etc… is the only option an Ai like clomid??

Your E2 is already low. You dont need an AI.

I will look more into all of what you all have said, next jab is due soon and will get a full bloods done a few weeks after and upload for you , thanks very much for the advice

Sorry, trying to get my head around it all

Aromatase enzymes live in fat tissue, more fat tissue, the more aromatase enzymes. If you were on enanthate, you could inject T twice weekly or EOD to minimize how much each injection aromatizes therefore lowering estrogen.

I inject 21mg EOD to minimize aromatisation, twice weekly injections, estrogen is sky high.

You probably won’t have these problems looking at your labs.

Yeah no problem. Aromatase lives in fat among other places and converts T to E2. When your E2 is high that means you are converting more into E2 in other words a lot of aromatase.

As far as i can see this is all i get here in Ireland through the proper means… not a great selection really

Especially consider gels are poorly absorbed and lots of men don’t respond well to long esters and that fact it difficult to keep level in the therapeutic ranges between injections. Everyone metabolizes testosterone at a different rate, so long esters are only good for a select few.