Need help on protocol

This is my first post. I feel like I’ve been riding a roller coaster since starting testosterone replacement Nearly one year ago. I originally suspected my testosterone perhaps may be a bit low since turning 40. I was noticing a general sense of fatigue, low motivation, anxiety, and just overall not feeling well. Libido was good. Therefore the primary care doctor I was seeing said it was.” Damn, near impossible to be low testosterone” . I decided to get it, checked on my own, regardless of his advice.

Total testosterone was 198
Free testosterone 8
E2 16

I returned back to my doctor with the lab results, and he suggested I get on testosterone cream, and that injections were only for bodybuilders. As you can imagine, doing some of my own research, I decided not to go back to that doctor ever again. I made my first big mistake and went to a wellness clinic. I was placed on 200 mg once weekly with 1 mg anastozole the day after injection.
For 2 weeks I felt invincible . Then came the fall. I was all over the place with mood, water, retention, aching joints and restlessness. After 6 months of trial and error I decided to take this more serious and go see a new doctor at the university I work at.

I was put on my current protocol of 100mg once a week and no AI.

Labs 6 weeks out from there :

Total test : 577
Free Test: 158
E2 : 32
SHBG : not tested but assuming low .

To be honest, I still don’t feel great. I have many days of restlessness, fatigue, lost many gains in the gym, and any motivation to work out. Also experiencing weird but mild anxiety daily it feels like. I really don’t want to get off of Trt as I know so many people who are doing well on it. I’ve asked all of them what their protocols are, and they all vary quite significantly.

Any suggestions ? I’m at my wits end and ready to give up and accept a subpar life as this is becoming quite stressful. I asked advice on Reddit and omg the bro science was next level with suggestions to double my dose , take deca, it’s all in my head , etc.

My current thinking is to drop to either 40mg twice a week or do daily injections at a small dose. Please help! Thank you all so much in advance for your time.

What’s the range in that free Test lab?

I know it said I was just above the range . I’m sorry I don’t know the range they used off top of head . Was p/ml I believe

Ok so if your FT was slightly above range, you should be ok. Yes your SHBG is likely low since your TT is mid range with above avg FT. I wouldn’t expect feeling bad on your labs as they looks decent. Did the pull a full CBC/CMP or any thyroid labs? You could play with injection frequencies. When did you draw labs in relation to your pin? Was it just before your next injection?

They did a full cbc and cmp with thyroid panel . All was good . Surprising to me !

It was taken maybe 2 days before next injection . I will say , my e2 prior to this lab work was 1. Yes , 1 from the AI and I felt like death hence new doctor . So it may just have been on the upswing and now it’s possibly high . Just a theory maybe .

I’ve considered doing daily shots to lower free test a little as maybe it’s making me restless ?? So hard to know any of this and I work in internal medicine !! How crazy

I would say give it a try with the more frequent injections. Your dose appears correct if not slightly high. You could try 10mg a day and you would have less E2 and FT. For some guys less is better.

Yeah maybe your right . So you think 10mg daily would be a good place to start ? I don’t need to feel like Superman just maybe like a normal healthy guy.

Appreciate the good advice!

Going from 200 to 100 per week is a big drop.

I wonder what it’d be like if you did 75mg twice a week for a total of 150mg. No AI.

What is your bodyfat%? I’ve found the higher my bodyfat, the more I aromatize. I wonder if that’s at play here as well.

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High bf . Tried 180, 160, 140 … most of them except really low like 50-70mg week

You’re probably going to have to inject more frequent than twice a weekly, as it seems you’re very sensitive to androgens.

You’ll need most likely daily or every other day injections, because the smaller doses tend to decrease side effects.

If you can get on Kyzatrex, an new oral testosterone undecanoate, do it.

The low SHBG needs investigating, like low thyroid function or type 2 diabetes?

The larger the dosage of testosterone, the greater impact it will have pushing the SHBG downward. TRT decreases SHBG in almost everyone.

Type 2 diabetics usually see an increase in SHBG.

Yeah I think daily injections may be the way to go , at least for a bit and see how I do. No hypothyroidism or Type 2. Just a low SHBG dude , perhaps some insulin resistance but nothing showing up in lab work. Once i get my protocol dialed in somewhat and feel like a normal human being I would love to start exercising daily again.

Did your thyroid check include t4 and t3 - not just tsh. I had low shgb and same symptoms - thought my thyroid was fine for a long time as tsh was normal. T4 and T3 were low though and thyroid medication has made a massive difference.