T Nation

No Libido on TRT, Help Me Find the Missing Puzzle

Hi, newbie poster here. I’m a 29yr old male and I’ve been on TRT for 4 months. 200mg cyp once every two weeks. My morning test before starting TRT was in the low to mid 200’s. I have not noticed ZERO changes in libido (main concern.)

My first blood test since starting TRT taken on the day of injection (b4 injecting)
I have hypothyroidism and take Synthroid 75mcg everyday to keep it in check.

Estradiol- 19.1 pg/mL (Range 7.6 - 42.6 pg/mL)

SHBG- 10.7 nmol/L ( Range 14.5 - 48.4 nmol/L)

TESTOSTERONE (ESOTERIX)- 390 ng/dL (Range 348 - 1197)

FREE TEST (ESOTERIX)- 140 pg/mL (Range 52 - 280)

% FREE TESTO- 3.6 % (Range 1.5 - 3.2)

PROLACTIN- 16.27 ng/mL (Range 4.0 - 15.2 ng/mL)

TSH- 1.540 uIU/mL (Range 0.450 - 4.500 uIU/mL)

THYROXINE,FREE 1.60 ng/dL (Range 0.82 - 1.77 ng/dL)

My big concern is that I have low SHBG, and I have read that those with low SHBG don’t really respond well to TRT. Are there any red flag lab values that may be causing me to not respond to TRT? any help or suggestion would help. Thanks!

Several issues. First, your protocol is awful! Injecting once every two weeks is terrible. You will experience significant ups and downs in your hormone levels. Testing the day of the next injection doesn’t give an accurate picture. Can’t even guess what your levels are on day 2, 5, 7?? Folks who inject once per week have issues. You will not get good answers here or good results on this protocol. Sorry.

Where to start … READING!

Please see these 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
  • thyroid basics
  • finding a TRT doc

Your protocol is horrible. So things can get better.

You need to self inject T twice a week.
E2 needs to be managed near E2=22pg/ml

TSH should be nearer to 1.0 and often needs to be lower.
Check oral body temperatures as per the thyroid basics sticky.
Body temps can be a dosing guide.
TSH alone is inadequate for thyroid management.

LH/FSH should be before TRT, too late now
fT4 - please not T3, T4

TRT may improve SHBG in some cases.

If thyroid is under medicated, that can hit libido.

Were you not using iodized salt long term before thyroid problems?
Post oral body temperatures.

Your biggest challenges are your knowledge, which we address here and the problem that your doctor is an idiot and that makes your doctor normal.