T Nation

New Poster - TRT and Erection Issues


#1

I've been on the trt journey for quite a few years and always have windows of success but often have many more periods of low libido/ed/pe issues. I've been on shots, hcg, t-gel and have so many questions.

Here were labs from a few years ago
50mg td preg
100mg oral DHea
50mcg Synthroid
5mcg t3
25mg HC (10, 5, 5, 5)
100mg Test Cyp/ week
330iu HCG m, W, F

Here are my labs:

Testosterone Total 1231 (348-1197)

Free T 44.8 (8.7-25.1)

E2 (sensitive labcorp) 22

Preg 40

Prog 2.3 High (0.2-1.4)

Dhea-S 800 (160-449)

TSH 0.613 (0.450-4.5)

T4 6.5 (4.5-12.0)

T3 113 (71-180)

FT3 3.4 (2.0-4.4)

RT3 24.8 (13.5-34.2)

AT ANOTHER POINT THIS WAS MY PROTOCOL

t4 250mcg
no t3
no preg/prog (due to it lowering libido big time)
no dhea
Test Cyp IM 20mg tues/ 20mg fri
added back hcg 250iu 3x/week
no AI

Issues:
libido/erections were spotty, added hcg back and they were amazing with daily cialis, then they tanked again, thinking high e2
preg/prog makes me feel great mentally and energy wise, but kills libido...dht low is theory
feeling less energetic lately....high rt3 is theory

labs:

t4 9.8 (4.5-12.0 ug/DL)

Total t3 0.9 (0.6-1.6 NG/ML)

rt3 36 HIGH (9-25 ng/dl)

Progerstone <0.5 (<1.4 NG/ML)

DHEA-S 237 (167-592 ug/dl)

Total Test 1100 (250-1100)
Test Free 218 HIGH (35-155)

Estradiol 31 (<29 pg/ml)

Estradiol Free 0.73 HIGH (<0.45 PG/ML)

Estrone 54 (<68 pg/ml)

DHT 49 (16-79 NG/DL)

Usually when I do shots, my energy is up, but on injection day, I lose all function of my penis and not till about six days after shots do I start getting erections again, (with or without cialis). I was a very low e2 guy before trt so AI's tend to scare me.

At one point last summer I was on Fortesta, 5 pumps, t3, and zoloft. This was three months of great erections, drive, and stamina in bed. That all fell off after a while.

I have also had this on shots and hcg, but again, after some weeks, everything goes to shit.

My guess is that the gels worked great last summer because I was coming off shots and my TT and e2 hit some kind of perfect window along with the zoloft keeping my pe in check and anxiety low. I'm guessing the effects wore off bc eventually the gel was not doing it's job. TT tested at 450 at the end of that experiment.

I'd like to get on a consistent protocol and have the confidence to work with an AI. Even with the 50mg Test Cyp 2x a week, I get the dead penis effect on injection day and after. Is this E2?


#2

[quote]osiris13 wrote:
I’ve been on the trt journey for quite a few years and always have windows of success but often have many more periods of low libido/ed/pe issues. I’ve been on shots, hcg, t-gel and have so many questions.

Here were labs from a few years ago
50mg td preg
100mg oral DHea
50mcg Synthroid
5mcg t3
25mg HC (10, 5, 5, 5)
100mg Test Cyp/ week
330iu HCG m, W, F

Here are my labs:

Testosterone Total 1231 (348-1197)

Free T 44.8 (8.7-25.1)

E2 (sensitive labcorp) 22

Preg 40

Prog 2.3 High (0.2-1.4)

Dhea-S 800 (160-449)

TSH 0.613 (0.450-4.5)

T4 6.5 (4.5-12.0)

T3 113 (71-180)

FT3 3.4 (2.0-4.4)

RT3 24.8 (13.5-34.2)

AT ANOTHER POINT THIS WAS MY PROTOCOL

t4 250mcg
no t3
no preg/prog (due to it lowering libido big time)
no dhea
Test Cyp IM 20mg tues/ 20mg fri
added back hcg 250iu 3x/week
no AI

Issues:
libido/erections were spotty, added hcg back and they were amazing with daily cialis, then they tanked again, thinking high e2
preg/prog makes me feel great mentally and energy wise, but kills libido…dht low is theory
feeling less energetic lately…high rt3 is theory

labs:

t4 9.8 (4.5-12.0 ug/DL)

Total t3 0.9 (0.6-1.6 NG/ML)

rt3 36 HIGH (9-25 ng/dl)

Progerstone <0.5 (<1.4 NG/ML)

DHEA-S 237 (167-592 ug/dl)

Total Test 1100 (250-1100)
Test Free 218 HIGH (35-155)

Estradiol 31 (<29 pg/ml)

Estradiol Free 0.73 HIGH (<0.45 PG/ML)

Estrone 54 (<68 pg/ml)

DHT 49 (16-79 NG/DL)

Usually when I do shots, my energy is up, but on injection day, I lose all function of my penis and not till about six days after shots do I start getting erections again, (with or without cialis). I was a very low e2 guy before trt so AI’s tend to scare me.

At one point last summer I was on Fortesta, 5 pumps, t3, and zoloft. This was three months of great erections, drive, and stamina in bed. That all fell off after a while.

I have also had this on shots and hcg, but again, after some weeks, everything goes to shit.

My guess is that the gels worked great last summer because I was coming off shots and my TT and e2 hit some kind of perfect window along with the zoloft keeping my pe in check and anxiety low. I’m guessing the effects wore off bc eventually the gel was not doing it’s job. TT tested at 450 at the end of that experiment.

I’d like to get on a consistent protocol and have the confidence to work with an AI. Even with the 50mg Test Cyp 2x a week, I get the dead penis effect on injection day and after. Is this E2?[/quote]

It definitely could be your E2. It also affects your testosterone levels if it’s too high. Also shbg plays big part for you. You’ve had really high testosterone levels, alot of aromataze has been going on for sure.

I don’t have any experience or knowledge about depression/panic disorder medication ( zoloft etc ).

It might be just me but it’s bit hard to follow what stats are new.
You really need to take new tests the past ones doesn’t reflect todays reality.
You need to experiment with an AI, the days you had naturally low E2 are long gone.


#3

[quote]Divyx wrote:
It might be just me but it’s bit hard to follow what stats are new.
You really need to take new tests the past ones doesn’t reflect todays reality.
You need to experiment with an AI, the days you had naturally low E2 are long gone.
[/quote]

I agree with no longer having low e2. I’m currently on gels b/c I thought they were the reason why my EQ and drive came back so strong. What I think really happened was that once off the shots and on gels, my e2 fell through a sweet spot and thats when I felt great.

Should I go with the suggested shots protocol and take my AI on the day of the shot?


#4

[quote]osiris13 wrote:

[quote]Divyx wrote:
It might be just me but it’s bit hard to follow what stats are new.
You really need to take new tests the past ones doesn’t reflect todays reality.
You need to experiment with an AI, the days you had naturally low E2 are long gone.
[/quote]

I agree with no longer having low e2. I’m currently on gels b/c I thought they were the reason why my EQ and drive came back so strong. What I think really happened was that once off the shots and on gels, my e2 fell through a sweet spot and thats when I felt great.

Should I go with the suggested shots protocol and take my AI on the day of the shot?[/quote]

I’m not a doctor but that’s when you will “peak” the most so yes on the day of the shot. You just have to experiment with it, there’s not telling what works and sometimes it takes time but can be well worth it in the end.


#5

Your testosterone levels are higher than they probably need to be. Combined with the fact that you erections go away for days after injections and then come back eventually as the drug gets eliminated, this suggests that you may get better results from a lower dose.


#6

Dhea-S 800 (160-449) - too much DHEA

Please try injecting 50mg T twice a week or EOD. With weekly, levels are all over the place and lab results are more a function of lab timing than anything else. T and E2 levels are changing a lot. With frequent injections your labs actually reflect what your protocol is doing.

This may be your problem: https://en.wikipedia.org/wiki/Sertraline#Sexual_side_effects

It is not pleasant tapering off of any SSRI. You cab try Wellbutrin which does not have sexual side effects.


#7

I’m am now doing the 50mg Test Cyp M and Thurs. Are you saying leave out the hcg and ai for now to get a basis to run labs off of?


#8

When injecting T twice a week, take anastrozole at time of injection. The levels will change but T & anastrozole will roughly stay in balance.

You need less DHEA!!!

You did not describe what AI or dose.


#9

I have been off the DHEA for a while, so it should be down.

As far as AI’s, I have better luck with Aromasin, Adex, at even a .25mg dose makes me feel odd.

I was thinking 6.25 Aromasin on the day of injection, or doing that much EOD.


#10

So I have been on 50mg Test Cyp 2x a week (Sun and Th). No HCG, no AI. Here are my labs taken right before my next injection.

TT 878 (250 - 1100)
Free T 165.9 (35-155)
DHT 25 (16-79)
E2 Sensitive 21

As usual, libido and erections are very poor right after injection and don’t improve until a few days after. Sometimes even waiting an extra day to take my next shot gives improved libido and erections. DHT is low and gel’s always brought it up high (which often improved sex function, but never rasied TT or e2 to a good level). Should I consider adding the AI in now with my shot?


#11

Your E2 looks ideal.
It would be interesting to see if labs done when your libido is low indicated anything.

Reviewing your old labs I see some thyroid issues.

The stickies are not links in the 2nd post of 1st forum topic.
Please read ‘thyroid basics explained’.

Post oral body temps as suggested.
Body temps can indicate if thyroid meds are adequate.
rT3 can block fT3
T3 med, solo, can stop T4–>T3

Perhaps the T peaks are making metabolic demands that out-pace your thyroid function.
Similar if adrenals are weak, do “AM cortisol”


#12

Thanks for the fast reply. I’ve been on the adrenal/thyroid rollercoaster for years now. Originally my am cortisol was low, around 11 and I had been on HC for many years. t4/t3 combos always made me feel worse. T4 has mixed results. T3 does a good job of boosting serotonin and sexual response.

It is very interesting on the thyroid basics that t4 effects tyrosine, I can attest to this. T3 improves premature ejac and anxiety where t4 gives more motivation but increased anger and premature ejac, all signs of eleveated NE.

Iodine supplimenting with lugols or iodoral always gave me issues. Even with selenium and salt loading.

Have been doing t3 only here and there as it feels best.

I’m at an impasse on dropping t3 and trying IR again, or just sticking with t3 and adding HC again. I do agree with you that the tshot is causing a metabolic overload because shot days give me freezing cold hands and feet and a shriveled penis.


#13

This really rings the rT3 bell for me.

My temperatures had dropped. Iodine did not help this time. Took Nature Thyroid T3+T4 and that did not work. Took T3 and temps improved with that. Concluded that rT3 was the problem.

Do you use body temperatures as a thyroid dosing guide?
If your T3 time/sustained release?
Have you noted how you feel VS body temperatures?
With TRT shots, thyroid levels may be inadequate.


#14

It has been a while but here is my protocol and labs:

Test Cyp 50mg Tues and Sat
HCG 250iu Tues and Sat
No AI
No thyroid

Labs taken on shot day, before my shot:
Total Test 807 (250-1100)

E2 Ultrasensitive 21 (<29)

TSH 2.03 (.35-4.94)

TT3 0.8 (0.6-1.6)

FT4 1.0 (0.7-1.5)

RT3 25 (8-25)

Issues:
Minor erection issues here and there
Big issue with motivation and drive (unless I take 10mg Ritalin)
Feel more sexual and less blah on shot day, before I take the shot


#15

TT could be higher.
FT not tested. So only have half of the picture,
E2 is great!

TSH is way to high, should be closer to 1.0
T3=.8 is way below mid-range
fT4=1.0 is below mid-range
rT3 is definitely elevated.
fT3 is the active hormone, not tested, expected low

Please note major change in rT3 range. Did you type that correctly? Different company?

No thyroid meds. - why?
What has been your source of iodine?
Feeling cold easily?
Outer eyebrows sparse?

Looks like adrenal fatigue to some extent.

Please report oral body temperatures as per last paragraph.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.


#16

The rt3 range must have changed due to a different lab. My Dr writes the script and our local hospital has to send out the rt3 and does the rest in their lab. I’m guessing they switched the outsource lab.

I went off thyroid for 6 weeks to get a baseline reading. Also I only feel fleeting improvements on thyroid supplementation, it works great then everything goes to shite. T4 only will give a boost in energy and motivation for a while, then wear off, t4 hurts erections too. T3 only (5mcg 2x or 10mcg 2x) gives great erection and sex response for a while.

Lugols has always made things worse, sore throat from it for as long as I take it, even with selenium.

Will take temps for three days morning and afternoon and report that back.

Had been on HC and also medrol for a few years, also had transient effects. Preg always boosted blood cortisol labs and has a good mood/energy effect, but converts to lots of prog and kills sex drive/erections the most.

I had taken propecia for 6 months when I was 20.

I have everything here, synthroid, cytomel, naturethroid, hc, lugols…just always stuck chasing a dosage that gives actual consistent improvement.


#17

More T4 creates more T4–>rT3?

"Lugols has always made things worse, sore throat from it for as long as I take it, even with selenium"
This is an interesting data point. Throat does not like iodine or thyroid gets sore. Iodine in pills would differentiate. Do you chase iodine down with water so throat has fleeting exposure Thread is getting hard to review - have you been tested for thyroid auto-immune, Hashimoto’s?


#18

Did you by chance get things figured out? I have the exact same symptoms as you! I completely lose sexual function for 3-4 days after my injection even with cialis/viagra.