T Nation

On TRT 2 Months, Should I Increase My Dose?

I’m 20 years old, been on trt for two months. My protocol is 20mg of Test undecanoate (Nebido) daily 140mg/week. So far I have been feeling much better, my erections are back in full strenght, getting morning wood most days of the week, my mood and energy have also improved greatly.
My libido has not improved a lot though.

This is my pre trt lab work

TT: 341 ng/dL (118 - 948)
FT: 8 pg/mL (4 - 30)
LH: 4.58 mUI/mL (1 - 7.1)
FSH: 2.46 mUI/mL (0.480 - 4.170)
E2 (non sensitive): 32.40 pg/mL (11.8 - 36.6)
Prolactin: 6.65 ng/mL (2.1 - 17.7)
SHBG: 17.4 nmol/L (10 - 57)
TSH: 1.247 uU/mL (0.480 - 4.170)
fT4: 1.40 ng/dL (0.83 - 1.4

Two months on trt
TT: 682 ng/dL
E2 (non sensitive): 32.9 pg/mL
SHBG: 17.7 nmol/L

My question is should I up my dosage to say 175mg a week or should I wait more time for levels to reach a stable level?

Im doing good but I feel there is more potential if my test is higher.

I believe your problem is estrogen is too high for you to do having lower SHBG which means the majority of your hormones are free, high Free T and high Free E2 hidden under that normal looking estrogen number.

Libido is tied to estrogen and not just testosterone, high or low estrogen will hamper libido, simply lower your dosage.

What do you think about keeping my dosage and start using an AI?

I think you are asking for trouble and suffering, you act like there’s no consequence to being of drugs. They are chemicals not natural to the body, we are bombard by chemicals all day long and is why we are facing disease throughout the population.

I bet if you get estrogen closer to 25, your libido will be higher, we are talking about a small dosage decrease. Blocking a hormone that’s responsible for putting minerals into bone is not recommended.

Do you want your bone density to be compromised?

But my E2 was already at 32 prior to starting trt, how would lowering my dosage bring it closer to 25?

You’ve only been on TRT for 2 months, it takes longer to realize maximum benefits. Testosterone is a hormone, it’s not fast acting like a drug. I would give it more time.

Onset of effects of testosterone treatment and time span until maximum effects are achieved

Effects on sexual interest appear after 3 weeks plateauing at 6 weeks, with no further increments expected beyond. Changes in erections/ejaculations may require up to 6 months. Effects on quality of life manifest within 3–4 weeks, but maximum benefits take longer. Effects on depressive mood become detectable after 3–6 weeks with a maximum after 18–30 weeks. Effects on erythropoiesis are evident at 3 months, peaking at 9–12 months.

Prostate-specific antigen and volume rise, marginally, plateauing at 12 months; further increase should be related to aging rather than therapy. Effects on lipids appear after 4 weeks, maximal after 6–12 months. Insulin sensitivity may improve within few days, but effects on glycemic control become evident only after 3–12 months. Changes in fat mass, lean body mass, and muscle strength occur within 12–16 weeks, stabilize at 6–12 months, but can marginally continue over years. Effects on inflammation occur within 3–12 weeks. Effects on bone are detectable already after 6 months while continuing at least for 3 years.

The time-course of the spectrum of effects of testosterone shows considerable variation, probably related to pharmacodynamics of the testosterone preparation. Genomic and non-genomic effects, androgen receptor polymorphism and intracellular steroid metabolism further contribute to such diversity.

Alright Systemlord, thank you for your advice, one last question.

Do you think my SHBG will decrease over time or will it stay that way?

Out of curiosity, was your TRT approved by insurance or are you going the private route? You pre -TRT TT and FT numbers are very similar to mine.

I did see an endo with my insurance who said I could benefit from trt and suggested doing Nebido (which is the only ester available in my country right now) but he wanted me to take one shot every 12 weeks. Luckily I can get everything over the counter, so I’m self treating.

1 Like

SHBG will find a new range on TRT, however it won’t be static and will fluctuate. SHBG increases after a workout, if anything SHBG increases with age.