T Nation

My 3 Year TRT Journey from Hell. Advice Needed

Hi folks

I would be extremely grateful for those who take the time to read this and offer advice if possible. I am a former anabolic steroid user and now suffering from low testosterone. Before starting TRT my bloods were:

LH 5.0iu/L REF: 1.0-10.0
FSH 9.0iu/L REF: 1.0-12.0
OESTRADIOL <18 pmol/L REF:95-223
PROLACTIN 264mU/L REF: 86-324
TESTOSTERONE 12.0 nmol/L REF: 9.0-29.0

I started TRT under the care of a TRT doctor in the UK and was prescribed the following starting protocol: 62.5mg Test E twice per week + 500iu HCG twice per week. Despite my blood work looking very good on this protocol, much to my disappointment it did absolutely nothing for libido. We made some tweaks to my protocol by adjusting the frequency of the HCG administration but still felt no different. My E2 was recording around 160 pmol which was right at the top of the range for this particular lab. We experimented with a lower test dosage 100mg per week split *2 but again made no difference. We put testosterone back to 125mg per week and introduced Examastane @6.25mg twice per week and got blood work for E2 done at week 2, 4 and 6. My doctor then increased dosage to 6.25mg EOD. I got blood work done which saw my E2 around 90pmol but I should mention this was on the standard assay. We then tried me on Test E shots EOD and then daily but much to my disappointment I was still suffering from very low Libido. I had forgot to mention that with a little persuasion from me, I was also prescribed Levothyroxin 100mcg per day as blood work showed a slightly sluggish Thyroid but unfortunately this also did nothing for me. My latest blood work for Thyroid shows:

TSH 2.37mIU/L (0.27 - 4.2)
FREE T3 5.2pmol/L (3.1 - 6.8)
FREE T4 21.4pmol/L (12 – 22)

I also got Dihydrotestosterone tested which came back at 3.25nmol/L (0.33 - 3.01)

I also got DHEA Sulphate tested: 5.54umol/L (2.41 - 11.6)

Now for something interesting that I’m hoping someone can give some feedback… About 18 months ago approximately 18 months into my TRT journey, feeling sorry for myself and pissed off, I was two weeks away from a beach holiday and thought F**k it, I’m going to take some test prop to try and trim up for the beach holiday… Now as expected, this did nothing for libido… However, three days after discontinuing the test prop when presumably the test prop would have cleared, when going to bed that night, and just for that night only I had good libido, pretty much to a level where it should be (normal)… And again around 7 months ago, I had a holiday booked and again feeling pissed off I took for just 10 ten days some dbol tabs and whilst as expected this did nothing for libido, however, three days after when presumably the dbol would have cleared I had the exact same experience as previous. Can anyone shed some light on this?

So where am I today… Just last month and still feeling no better, I decided to see a different TRT doctor in the UK for a second opinion. Whilst he agreed with all the treatment plans my original doctor had provided, he believed I may have damaged my testosterone receptors from my years of steroid use. He suggested to try and overcome this, he prescribe me a higher test dosage sustanon 250mg once per week whilst continuing the Examastane and HCG. On the night before my third shot I did feel an improvement in libido but only about half way where it needs to be. Unfortunately this was for one night only and after getting bloods done my new doctor decided to increase test dosage to every five days. This has now left me feeling worse than ever.

As you can probably imagine, I am finding this all very depressing and unfortunately I am now at a stage where I do not believe that this issue can be resolved. I would really appreciate any advice from members here inparticular why I felt good the three days after droping the dbol/test prop…

Many Thanks for reading…

Is it about Libido or ED?

Its a Libido issue… No probem with errections.

Have you had recent blood tests and what was the E2? Why are you taking HCG, fertility or just Docs advice?

Just curious - You seemed to have tried a lot of different protocols. How long would you say you’ve been on a single protocol doing everything consistently every single time?

I know for me, 8 weeks is the minimum and sometimes longer, to feel/see differences. It been take many months for libido to come back… But you have to stay consistent with your protocol for that to happen.

I would say minimum six weeks before making changes and they were generally very small changes ie. switching HCG fom 500iu twice per week to 200iu EOD to 100iu daily. I was on the twice per week test dosages for several months before switching to daily injections.

There is some evidence that the balance between dopamine and acetylcholine governs sexual arousal. This is substantiated by the usage of eg Vitex in former times in monks to temper libido ( therefore Vitex is also called monks pepper). A potential mechanism of action of Vitex could be its dopaminergic potency.
Ie you could try to increase acetylcholine levels by substituting with eg alpha GPC.

However there is no scientific/medical evidence for this, it’s rather based on anecdotal evidence.

But maybe worth a try in your case.

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Im not interested in fertility… But was docs advice to run HCG… From from what Ive read HCG provides other benifits on trt.

Assuming you’re talking about maintaining HTPA function? I’ve read that as well and it makes sense to me, my problem is I just don’t tolerate HCG well at all and I’ve tried a few times.

Honestly I would suggest just taking test to try dial in. You were on 125Mg/week I think? So run from 150-180mg/week split into 2 shots for at least 8 weeks. Do bloods again and evaluate how you feel. Then go up or down in dose, change the injection protocol and do the same again. Once you’ve stabilized and found a good T dose, look at other products if you feel the need.

I can’t comment on the thyroid or how you felt when taking other compounds but off the top of my head it may be for that short period you had higher levels of test. On that point, it’s not worth taking something off the cuff for a few days. You’re just complicating your life. Get dialed then blast a properly planned course if that’s your intention.

I may be one of the few people that completely understand what you are going through. I also was a steroid user, currently 28 years old (not sure how old you are) and have had the same phantom symptoms. Most notably the whole (insert literally any protocol of any substance) feel worse, cease use, then days or weeks after all of the sudden I will actually have results. There is probably something very similar with our brains/ metabolic function that is causing this and yes it is extremely frustrating because even the best doctors don’t comprehend these scenarios. My libido experience is very odd. For example this past summer I took a few anadrol, felt like garbage for a week then after stopping I was on a date and did about 90mph home to slam this girl just because the urge was that high. Keeping in mind that the previous year off all supps that was never the case. I am in the same boat though and happy to discuss this headache. I understand the depression too, you are not alone at all. Oh and side note I believe this is tied in to either A the reward center or B the opiate based receptors. Any time I took a prescribed narcotic my sex drive was much higher.

Thank you for your reply… I may discuss with my doctor about dropping the HCG… I’m also thinking of trialing test prop for daily injections. It just really baffles me that after dropping the dbol which I used for just ten days that I can a return to good libido for just a few hours only… I did think about repeating this but getting bloods done on the same day of feeling good. The whole thing really frustrtes me…

Exemestane is a likely source of your problem. Where is your E2 at?

Thank you for reply m8… Your support is much appreciated… Are you still sticking with your same protocol or have you given up on making amendments? Can I ask what is your protocol? P.S I am 41 years old.

For over a year I was not taking any hormones due to extreme frustration and I actually felt half way decent (not great) but not terrible either. Once I was about a year down the line of just my daily supplements and prescription medication I’ve been dealing with a lot of negative symptoms, leading me to believe my system had some level of functioning and then crashed and was not functioning anymore. I recently started an EOD testosterone enanthate protocol with 25mg every other day to see what type of response I have with it. So far nothing to write home about though.

E2 was at around 90 pmol on the Enanthate protocol… This was standard assay… I am going to discontinue the sustanon, drop the examastane and go back to daily jabs of test e and HCG… Looking back, I wish I had tried this before starting the AI… Quick question… How long will it my body to produce the e2 again after dropping the Examastane? Am I looking at weeks, months?

You can also try test cream. Lots of guys report libido increases from cream. Also, i can attest to prop daily. Daily shots can be annoying, but if you are going to daily, prop is best. Given your case, id probably drop the HCG. Start by adding in some dhea and pregnenolone. Then bring in some HCG down the road if necessary.

Thank you for your reply… Do you you find the test prop jabs painful? Are you in the UK? What dosage are you taking? My doc told me to avoid DHEAS supplement he said the other one you mentioned was OK… I took it but felt nothing.

24 hr half life, so you’ll come up after a couple of days.

I’m right there with you bud. I’m in the same boat.

I also feel the hope waning but the alternative is to accept a life of mediocrity or just end it but i don’t have that in me.

I’ve also had the libido in the middle of the night. It’s weird and i feel like it’s a placebo to an extent. Whenever i introduced something new that i have hope would work, i would have that raging nightly libido. It happened for a night when i went to the anabolic doc and he suggested my first protocol. Also happened when i quit weed and it was for 3 nights straight. However its more annoying but it happening at the most useless time.

Have you had any periods of success? @george1978

This is most likely an adrenal insufficiency problem. Do a 24 Hour Saliva Cortisol test. The fact that you noticed the improvement when you stopped the Test. Prop., is evidence that your adrenal function began to rebound from the HPTA/Adrenal glands suppression.
This is all too common. TRT and thyroid cannot work without cortisol. Cortisol is the most important, and must be addressed.