T Nation

On TRT, Impotent 85% of the Time

Here are my numbers, i am already on daily small injections of cypionate, I experience wild fluctuations in sex drive and erections to at times being great for a couple weeks to total impotence for weeks on end without changing anything in my regimen, i have tried AI and HCG, nothing seems to make any difference, if anything makes things worse… at times i go from good sex drive and erection quality to terrible seemingly literally overnight… is there anything else i should potentially test? Thanks

Total Testosterone - 687
Free Testosterone - 19.1
SHBG - 23
Estradiol Sensitive - 37
DHEA S - 254.1 (range 138-475)
Progesterone - 0.4 (range 0.0-0.5)
Prolactin - 8.1 (range 4-15.2)
DHT - 50 (range 30-85)

Other tests like Thyroid TSH, Free T3 normal, no diabetes

How often do you take an ai? If you are taking it intermittently when you feel something you will have difficulty in your body stabilizing

What is your protocol? Meds? HCG?

If you haven’t been on this daily protocol for at least 6 weeks, I would expect all your levels to be fluctuating wildly.

Your estrogen may be a little high for you, elevated estrogen can negatively affect erection quality and lower libido.

You concerned yourself with the bound hormone Total T and free hormone Free T, but when it came to estrogen testing, you disregarded free estrogen and I would expect it to be on the higher end since SHBG is on the lower end.

Decreasing your body fat percentage will go a long way towards lowering estrogen.

Normal isn’t useful in a world where it is known the reference ranges aren’t normal and no two doctors can agree on normal.

The evidence for a narrower thyrotropin reference range

It has become clear that previously accepted reference ranges are no longer valid as a result of both the development of more highly sensitive TSH assays and the appreciation that reference populations previously considered normal were contaminated with individuals with various degrees of thyroid dysfunction that served to increase mean TSH levels for the group. Recent laboratory guidelines from the National Academy of Clinical Biochemistry indicate that more than 95% of normal individuals have TSH levels below 2.5 mU/liter.

Reference ranges for TSH and thyroid hormones

Though TSH remains the most commonly used endocrine test in clinical practice, the issue of an appropriate TSH, and to a lesser extent, free T4 and free T3 reference ranges is still under debate. First of all the distribution of TSH reference range is not normal, with median values (also depending on population iodine intake) usually between 1-1.5 mU/L. On the other hand, upper TSH reference limit is (assay-dependent) usually around 4.2-4.5 mU/L. There is also an argument that significant number of patients (up to 30%) with TSH above 3.0 mU/L have an occult autoimmune thyroid disease.

Thank you, yes i suspect i feel like “Free estrogen” is high, but is there any damn way to lower free estrogen? my body fat is about 21% or so… im not sure how much i can realistically bring it down, its been hard for me to really bring it down much, its slightly above average but nothing terrible…

i feel like something estrogen related is going on but AI doesnt seem to help becuase i feel it doesnt lower “free estrogen”, i have tried supplements, everything…

often times my dick feels really numb like its injected with novocaine or something… i get no morning wood 99% of the time… basically feels a lot like high estrogen but AI doesnt help…

i can crash my estrogen to the point where my joints are clicking and it still doenst make me feel any better, nor getting it to “ideal” levels , AI has just never done anything positive for me frankly

Crashed estrogen can feel like high also. Honestly when my E2 was crashed is when my dick felt numb. I only saw one lab in your thread and you have been taking an AI so unless I have missed something you may actually be fighting crashed estrogen not high.

What do you mean by “Free estrogen”? That’s not a thing that I’m aware of. E2, or estradiol is the level to be aware of, and if it’s crashed it’s worse thn if it’s high. High BF doesn’t necessarily have anything to do with your E2, it just CAN affect it.

It turns out my lack of erections in my case was do to edema that wasn’t detected until the later critical stages, been on a diuretic for 3 days and erections are non-stop. I haven’t inject T for 3 weeks! The 20+ long cough is gone as well, there was fluid in the lungs and that means edema was an issues long before TRT.

Bingo. Fix this first, then worry about your protocol.

Start with your diet, and introduce regular exercise. You will feel like a new person at even 18%. You will be a new person at 15%. Anything below 15% will just add to the benefits.