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No Sex Drive, Weak Erections, Bloodwork Done - Looking for Advice

Hey, I’m 50 and on TRT for about a year now. The reason I started TRT was because I was very depressed. It stopped when I started TRT and since then I’ve been mentally very well. The other reason was due to ED. That hasn’t really gotten better, rather worse. My erection isn’t really hard and my libido just disappeared. I just got my blood values and hope you can give me some advice on what I can do better. I think some values are pretty bad. Thank you in advance.

Protocol:
100mg Test Cypionate e3d
Anastrozole 0.5mg the morning after T
250UI HCG e0d
2000UI VitD daily

Bloodwork:
SHBG (21.6-113.1) 55.3 nmol/l
Total Testosterone (86.5-788) 1700 ng/dl
Free Testosterone (4.7-13.6) 33.7 ng/dl (calculated) = 1.99%
FSH (1.6-11.0) 0.50 mIU/ml
LH (0.8-6.1) <0.10 mlU/ml
Estradiol E2 29 pg/ml
DHEA-S (44.3-331.0) 72.9 myg/dl
TSH (0.3-3.5) 1.49 mlU/l
free T4 (11.8-24.6) 14.6 pmol/l
free T3 (3.0-7.8) 5.1 pmol/l
VitD (30-100) 94.4 ng/ml

Your E2 is out of line with your T levels. You’d probably feel better on a lower dose and less AI.

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Relative to your injection, when was this blood pulled?
Height and weight? BP? Other medications?
Why hCG?

On the surface, I’d cut test to 75mg per injection, cut anastrozole, cut hCG, add DHEA.

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why add DHEA?

Because his level is not optimal, his age, and it helps low T symptoms.

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What dhea dose do you normally see folks take?

50mg per day.

Oh lord I’m at 25 and side effect galore. Dropped it and they went away. 2nd try at dhea to. Is this pharmacy grade?

I feel it was like an estrogen being high. My face was bloated. Weird red rashes on top of cheek bones. Angry frustrated alll day. Sleepy midday like I’m zapped of energy and back to low t days.

I was going to ask for 5mg but will wait a while to try again.

TRT did not fix my ED and I have been on for almost 5 years now. I have done a lot of experimenting with different T and E2 levels.
TRT did fix my depression brain fog and memory issues. It also brought my libido back as long as my E2 does not get too high. I also blast twice a year with ~400mg/wk for 12 weeks and because I let my E2 run high to protect my joints I lose my libido and even cialas and livitra won’t keep my dick hard because I am never horny even during sex The blasting is only for the gym. Oh I’m 15 years older than you wrmuc.

On your blood they look pretty good. Your shgb sucks so you will have to run a high TT to get a good free T but like suggested yours is a bit too high. A bit too high is not good it just gives you sides. Get your FreeT to the top of the range without going over and give that 6 months. It takes us old guy a long time to start healing once we get dialed in.

Something that might help you get your SHGB down is switch to one injection every week. Big slugs of T usually drop ones shgb.
Good luck.

Blood was pulled in the morning before the next T injection.

Height: 5’9’’
Weight: 195

DHEA is added to my T - I didn’t ask why. But it looks like DHEA is in range.

Why should I cut HCG? After everything I read in the forum, it seems to me that this is the right strategy to go for.

Why are you taking it?

My Doc told me that. After I was asking the same question like you he said that it will help me feeling better and avoid that my testicles will shrink.

Please don’t misunderstand me when I question the answers. I just want to understand it better before I change anything. Since I am not satisfied with the current situation, I would like to change something. Is it really advisable to overturn the whole plan at once?

I want to try the following: no AI and HCG, switching T from e3d to e4d.
After 6 weeks I will have my blood tested again and hopefully I feel better until then.

Sounds interesting. I guess I have to find my comfort zone first.

If you have your TRT dial in for brain fog and depression I would ask the doc for low dose cialas(2.5-5mg) to take daily sex or not and livitra(20mg) for fun nights with the wife. Give the meds at least an hour to work. In 5 years I have not been able to fix my ED with TRT.
HTH
If US prices give you sticker shock look to India for the same drugs at 1/10th the cost and no script required.

@hrdlvn

My ed is like this: upon sexual activity, I feel the Initial beginnings of blood flow to penis. But it’s only slight. Not enough to give full erection. And the blood leaves fast.

Pde5s help a bit for keeping the erection and blood flow.

No problem. Unless you are currently attempting to conceive, or concerned with testicular atrophy, hCG is an unnecessary expense.

You’re not overturning the entire plan, modifying it by discontinuing hCG and anastrozole. After a year with less than ideal results, it is reasonable.

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any idea what the root cause of the ED is?

have any supplemenst helped?

where is your E sweet spot btw?

I’m guessing its because I am 65 years old and everything down there as somewhat quit working. But honestly I have no clue.

NO stack has really helped me it also contains two scripts one being low dose cialas the other a low dose blood pressure pill an a few amino acids.
My E2 sweet spot is 24-27 when my TT is around 750 FT 24

I read a study that loss of libido is only contributed to testosterone when TT is below 150 nmol/dl. According to the same study ED issues are only contributed to levels below 80 nmol/dl (!). Testosterone may not be the answer for all symptoms commonly associated with low levels.

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I agree with mindphaser.

I can get my TRT so where I feel great mentally, and where I feel sharp and just good. But libido and wood still aren’t seen.

I think libido and wood are something else completely. Neurotransmittal in nature. Gotta be.