Long-time lurker, first-time poster.
I have read every sticky post and as many other relevant posts I can find here, and it is a great source of information. Because of the amount of experience and knowledge here, I am hoping that someone can confirm for me my planned treatment.
I am a 52 years old male that has been on TRT for 11 years. My T was at 102 11 years ago and I was diagnosed as secondary hypogonadism. Went through lots of tests then that I canÃ¢Â?Â?t recall now, and was satisfied with the diagnosis. I tried creams, Androgel and Striant (the buccal dissolving tablet) and none raised my T beyond 300. That is why I use IM. I stay in the 600-1000 range depending on when the draw is done and I get T checked twice a year.
My current regimen is 100mg T-Enanthate weekly by IM into the thigh muscle. I started using T-Enanthate about 6 months ago in place of T-Cyp as I discovered I am allergic to cottonseed oil. The T-Enanthate is suspended in sesame seed oil. Have a great PCP and do my injections at home.
I have had my SHBG tested dozens of times over the years, and it is never been higher than 7 pg/nl; and usually 5 pg/nl. With such low SHBG levels, much of what I inject quickly becomes free T.
My most-recent labs are a month old. Currently, my hematocrit has risen to 52, hemoglobin is 19.1 and my RBC is at 6.1. Two weeks ago, I started giving whole blood donations and will continue to do so every 8 weeks as allowed in order lower my hematocrit and RBC, so I think IÃ¢Â?Â?m taking the right path there.
Thyroid panels are always normal. PSA is around 2 and DREs show no enlargement of prostate.
My last T lab was 48 hours after an injection, so I was at supraphysiological levels. I have NEVER had numbers that high and even followed up with an endo that specializes in TRT. He told me not to worry as the labs are not that accurate and it would be high 48 hours after IM injection.
Keep in mind this was 48 hours after my usual 100mg IM:
T-Serum: 1176 ng/dl
Free-T Ã¢Â?Â? Direct: >50 (range was 7.2-24 pg/ml, so I was so far above range it just says>50)
T-% Free+weakly bound: 55.5%
T-Free+weakly bound: 652 (range was 40-250 ng/dl)
FSH and LH, near zero, as one would expect
Last week, I finally convinced my PCP to allow me to get the sensitive male assay test for E2. I received the results yesterday, and am at 42 pg/ml. I know from reading this forum, this is too high.
Why Am I Here?
For years, I felt pretty good with this regimen, but for the last year or so, I am just not feeling like I used to. I can't always focus my efforts in my works every day. Some days IÃ¢Â?Â?m in the game 100% and other days I feel like I have ADD. IÃ¢Â?Â?m gaining weight and losing muscle mass. I NEVER have a morning erection now and never have spontaneous ones either. I can get hard and have sex with my wife, but never hard like it should be and doesnÃ¢Â?Â?t last long. Occasionally, I have trouble cutting off my using stream. I also never get pimples now. IÃ¢Â?Â?m also having occasional bouts of PACs or premature atrial contractions, which respond well to Xanax and a beta blocker. Strangely, these typically occur 3 days after an injection, more or less.
Do I switch to EOD Sub-Q injections to lower the Ã¢Â?Â?punchÃ¢Â?Â? of the free T, or do I stay the course with 100mg weekly IM dosing and ask for an aromatase inhibitor? I see my PCP again for this issue on January 4th, so all input is welcome.