Total T & Free High on TRT, Not Feeling Increased Libido?

Been on TRT,HCG and Anastrozole for a few months. I hit a sweet spot a few times during this time when my libido was great but can’t seem to get it back. Currently taking 60mg test cyp twice per week, 500iu of HCG twice per week and .25 Anastrozole once per week. Most recent blood work on 04/10/15 has Total T-1641, Free T-244.5 & Estradiol-30 but my Dr only did those tests this time because I had more extensive work done in Feb.(see below).

At the time of the Feb test I was using the same protocol but taking Anastrozole .25 twice per week. Either way my Libido is still almost as bad as before I started TRT. I did not fast for either of these tests. Also I should mention that I’m diabetic and taking Insulin as well.

Blood Work:02/18/15

Medication Instructions Dosage Frequency Start Date End Date Duration Status
Cod Liver Oil Orally once per day 1 tabl Active
Armour Thyroid 15 MG Orally Once a day 1 tablet on an empty stomach 24h 30 day(s) Active
Anastrozole 0.25 Orally twice per wk 1 tablet 30 day(s) Active
Vitamin B Complex-C Orally once a day 1 capsule 24h Active
One Touch Test glucose test strips In Vitro x6/day 1 strip 90 days Active
Flaxseed Oil 1 tbl 24h Active
Zinc 100 MG Orally Once a day 1 tablet with a meal 24h 30 day(s) Active
human chorionic gonadotropin 500 iu sub cutaneous or im biw 500 iu 30 days Active
Vitamin D Orally once a day 1 tablet 24h Active
NovoLog Flexpen 100 UNIT/ML Subcutaneous tid 2-4 units 8h 30 days Active
Testosterone Cypionate 200 MG/ML Intramuscular once per wk 140 mg Active
Levitra 20MG Orally prn 1 tablet 30 days Active
Lantus SoloStar 100 UNIT/ML Subcutaneous hs 20 units 30 days A

ITAMIN D, 25-HYDROX, SERUM 2015-02-18
----25OH, VITAMIN D(32.0-100.0) 73.2
*Fingerstick Glucose 82947 2015-02-18
----Value(60 - 99 mg/dL) 134
TESTOSTERONE, SERUM 2015-02-18
----TESTOSTERONE, TOT.,S.(249.0-836.0) 1019.0
CBC w/DIFF, PLATELET CT. 2015-02-18
----POLYS(36.0-78.0) 55.7
----MCHC(29.0-35.0) 34.9
----RDW(10.9-16.9) 13.6
----BASOS(0.0-2.0) 1.9
----MCV(80.0-100.0) 92.0
----MCH(25.0-34.1) 32.2
----EOS(0.0-8.0) 5.0
----PLATELET COUNT(144-400) 135
----HGB(12.3-17.0) 14.5
----IMMATURE GRANULOCYTES(0.0-1.6) 0.0
----HCT(39.3-52.5) 41.5
----WBC(3.40-11.80) 3.59
----MPV(8.2-11.9) 10.6
----RBC(4.20-5.90) 4.51
----LYMPHS(12.0-48.0) 29.0
----MONOS(0.0-13.0) 8.4
TESTOSTERONE, FREE, SERUM 129.88
*Hemoglobin A1C 2015-02-18
----Value(4.0 - 5.6 %) 5.3% lower
SEX HORMONE BINDING GLOB. 2015-02-18
----SEX HORM.BIND.GLOB.(10-57) 79
CHEM PROFILE 29 2015-02-18
----GGTP(10-71) 15
----ALT(<41) 21
----Phosphorus(2.7-4.5) 2.8
----AST(<40) 30
----HDL as % of Cholesterol(>14) 29
----HDL CHOL., DIRECT(>40) 64
----Triglycerides(<150) 152
----Cholesterol(<200) 219
----Alk Phos(40-156) 65
----Bilirubin, Total(<1.2) 0.6
----LD(135-225) 152
----BUN/Creat Ratio(10.0-28.0) 12.4
----Calcium(8.6-10.4) 9.3
----Uric Acid(3.4-8.5) 5.8
----Iron(45-160) 104
----Creatinine(0.90-1.30) 0.97
----LDL Cholesterol(<100) 125
----e-GFR(>60) 83
----e-GFR, African American(>60) 100
----Total Protein(5.9-8.4) 6.3
----Chol/HDL Ratio(<7.4) 3.4
----Potassium(3.3-5.3) 3.6
----LDL/HDL Ratio(<3.56) 1.95
----Chloride(96-108) 96
----CO2(22-29) 25
----BUN(6-20) 12
----Albumin(3.5-5.2) 4.5
----Globulin(1.7-3.7) 1.8
----Glucose(70-99) 104
----Sodium(133-145) 136
ESTRADIOL, SERUM 2015-02-18
----ESTRADIOL(7.63-42.60) 12.24
*Urinalysis, Routine 2015-02-18
----UROBILINOGEN,SEMI-QN (mg/dL)(negative - ) negative
----URINALYSIS GROSS EXA()
----BILIRUBIN(negative - ) negative
----MICROSCOPIC EXAMINAT()
----SPECIFIC GRAVITY(1.003 - 1.030 ) 1.030
----NITRITE, URINE(negative - ) negative
----PH(5 - 8 ) 6.0
----OCCULT BLOOD(negative - ) negative
----GLUCOSE (mg/dL)(negative - ) negative
----KETONES(negative - ) negative
----URINE-COLOR(clear - yellow ) yellow
----APPEARANCE(clear - ) clear
----WBC ESTERASE(negative - ) negative
----PROTEIN(negative - ) negative
ALBUMIN 2015-02-18
----Albumin(3.5-5.2) 4.5
PROLACTIN, SERUM 2015-02-18
----PROLACTIN, SERUM(4.0-15.2) 8.3
LH (LEUTINIZING HORMONE) 2015-02-18
----LH(1.7-8.6) <0.1
MICROALBUMIN, URINE RANDOM/CREAT RATIO 2015-02-18
----CREAT.URN.TIMED/RAND(Not Estab.) 81.3
----MICROALBUMIN,RANDOM(Not Estab.) <1.2
----MICROALB/CREAT RATIO(<30.0) Can’t Calc
FSH (FOLLICLE STIM.HORMONE) SERUM 2015-02-18
----FSH(1.5-12.4) 0.2
GROWTH HORMONE 2015-02-18
----GROWTH HORMONE(<3.0) 0.3

Do not test GH, test IGF-1

You were injecting once a week and taking anastrozole twice a week. Anastrozole needs to match serum T levels and your levels were peaking and falling. So E2 control is a crap shoot. Do labs 1/2 between dosing and do not change that. Test E2 in three weeks then adjust. If was E2=30 increase dose by 30/22 factor to get near 22pg/ml

Suggest that you inject twice a week and take anastrozole at time of injection and hCG at same time. You need anastrozole in liquid form to manage the small doses. Some dissolve 1.0mg tablets in vodka and then dispense to water and drink.

Please read these stickies:

  • advice for new guys
  • thyroid basics
    – if body temps are low, thyroid dose is low, see if you can correct temperatures with thyroid dose changes.
    – even on thyroid meds, don’t ignore iodine

Do not test LH/FSH while on TRT, waste of time and $$$

We do not know if E2 control is cause of low libido and/or you still have thyroid hypo symptoms.