T Nation

TRT is Not Working Out, Should I Go Natural?

Should I give up on trt and try to return back to my natural levels? If so, is there a best way to go about doing this?

Just a bit of background - I have lost 40 lbs of weight since the end of 2017 in hopes of boosting my erections and sex drive. I lost the weight entirely through intermittent fasting (no food each day until after 6 pm). The fasting made me too weak for exercise, so I lost a bit of muscle too. I drink about 1 or 2 beers each week. I smoke medically prescribed marijuana for anxiety in moderation (about 1 gram a week or less).

I started trt a couple months ago in hopes of improving my energy and sex drive. Before starting, my wife and I usually had sex twice a day on average or 10 to 20 times each week. Before trt, I could maintain an erection for 45 minutes or so before it would soften or I would have to orgasm. After a couple months of trt and hcg, I can only have sex a couple times a week if I take 100 mg of sildenafil. My erections have gotten softer and softer and I am finishing quicker and quicker with each week that passes. I used to masturbate and look at porn a bit, but I haven’t done that at all in months. My wife is mad at me for getting into trt to begin with, and we’re both worried that going natural might not be an option anymore.

I go to a men’s health clinic for weekly injections of 200 mg of testosterone cypionate, and I use .50 ml of hcg twice a week at home. My first dose of hcg started on 12/17/19. I took the hcg to begin with in hopes it would increase my sex drive since the trt was killing it. I started taking 1 mg of Anastazole after my e2 came back a little high.

I took 1 mg Anastazole on 1/13/20, 1/16/20, 1/21/20, and 1/23/20. Since taking those, my sex drive has come to a screaming halt. My penis feels smaller and numb. From 2014 to the beginning of 2020, I cried exactly one time (while looking at my grandmother in her casket). In the last week, I’ve cried 5 times while feeling sorry for myself (not like me at all).

I have 3 sets of labs, and got blood drawn today for another one -


Initial labs

Age: 32

Height: 6’2

Weight: 170 lbs

Symptoms: Tired, no gains from exercise, grumpy, less interest in sex than before, occasional problems with obtaining and sustaining erections, occasional use of viagra since 2015.

Total Testosterone: 455

Calculated Free T: 6.46 ng/dL

Estradiol: 13.3 pg/mL

Weekly treatment of 200 mg of testosterone cypionate began on 11/12/19.


Weight: 176 lbs

Symptoms: Very low sex drive and more trouble obtaining and sustaining erections, but good overall energy and mood.

Total Testosterone: 471

Free Testosterone: 8.89

Estradiol: 14.5

Biweekly treatment of .50 ml of hcg began on 12/17/19.


Weight: 182 lbs

Symptoms: Even lower sex drive, even softer erections, but amazing energy and focus. Very little need for sleep at night (average of 4 hours or less). No fatigue at all.

Total Testosterone: 1063

Free Testosterone: 25

Estradiol: 51.6

First 1 mg tablet of Anastazole taken on 1/13/20.

You need to run from this place like your life depended on it… Literally.

1mg a week of Arimidex is insane. This will slowly kill you. Estrogen is directly responsible for libido and erections. This is why you now have zero libido.

Any clinic that forces you to go there for weekly injections is in it for the money and not the patient…

Where are you located?

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I cannot believe I agree completely with Danny again, but I do. Seriously.
That E2 od 13.1 is too low, it’s unhealthy. 51 was fine. You should drop the AI, you should drop the HCG, at least for now. And being neurotic isn’t a good enough reason to smoke weed. That doesn’t do you any favours after a while, some members here have talked about how it affected them. Try JUST test for a while.



Umm… I couldn’t get past this part. Nothing of value in my response, but damn man… You wanted to improve your sex drive??? Improve upon 10-20 times a week!!!

Good for you man. I did it 12 times in 10 days and was shooting cobb webs towards the end.

Listen to Danny, his advice will help.

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Cobwebs?!! Ha! Never heard that one before lol

I always knew that me and @hardartery and @bcostigan41 would become besties one day… I just knew it :wink:

I was thinking what @bcostigan41 brought up but didn’t mention it. Sex twice a day and you felt that your hormones were off? Most men would kill to have sex once a day, let alone twice. Was your wife wondering why you couldn’t go three or four rounds for some reason?

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I made it to here and just stopped. Your issue is obvious. Find a new provider or at the very least refuse to take anymore AI from them.

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Thanks for the response… I’m in Georgia, but basically Chattanooga, TN.

I do very well at work, so money is not an issue. I just want to feel better. Would a tele-clinic be better for me if I continue with therapy?

The provider said to take 2 mg Arimidex each week. When I talked with them on Tuesday, and I told him how I was feeling bad, he told me to take one Tuesday, Thursday, and if I still felt bad, then one on Saturday too. I believe that would actually be 3 mg in one week.

Do you think my baseline numbers were bad enough to need testosterone replacement to begin with? I just don’t feel like the energetic horny guy I used to be. Could the marijuana have anything to do with the low baseline levels?

She would like 7 to 10 times each day. She’s 5 months pregnant.

Thanks for the advice! Giving up weed wouldn’t be hard. Haven’t had any in weeks anyways.

Should I just stop everything?

Don’t give up on TRT because you are being terribly mismanaged. HCG can increase estrogen then needing an AI and now estrogen is crushed and is mostly a never ending battle for control.

There was this guy on 1mg anastrozole 3x weekly, he fell and broke his hips now held together with three bolts, he is 45 and has osteoporosis, not 85, but 45 years old and the suppression of estrogen is the cause.

TRT should begin in isolation, adjust your dosage up or down, if sides are experienced, inject smaller doses. It’s a good bet once you are optimize on TRT you won’t even need weed for anxiety.

I noticed TSH is at 4.18 (!) and is approaching hypothyroid territory, a high A/G ratio is linked to low thyroid hormones, TRT cannot work with low thyroid hormones. Your doctor should dig deeper and find out why TSH is elevated.

If supplementing iodine, this would be a cause for high TSH and would make sense because I would expect to see high triglycerides and high liver enzymes with hypothyroidism.


Weed has been known to lower T in some guys… No way to say if it was the case for you but it is possible.

I know a good doc in Orange Park, Florida who does telemedicine.

Unless something has changed Dr Keith Nichols is in Chattanooga, TN. Probably one of the best at this. Might be a bit more pricey but you get what you pay for. Probably be worth a call to them anyways.

I completely realize that he’s in Chattanooga. I’ve been pointing people elsewhere for a multitude of reasons.

Yes, give up everything and fix your eating. You’ll be fine in no time. You’ll need to wait out your restart, so probably 5 weeks or so, but really just eating again and some decent exercise is all you need. No need to mess with hormones if you don’t medically need it.

I was wondering about that, I haven’t seen his name much lately. I was thinking there was a bit of a falling out there, but I don’t pay real close attention to that stuff usually.

There was a bit of a tirade on this site a month or two ago from him that made me wonder about him. And it wasn’t with Danny, haha.

I still suspect he’s better than most, though perhaps not “the” best

Pardon me booooyyyy, is that the Chattanooga Choo Choo

Track twenty niiiinnneee

Just a quick update - My bloodwork from January 23 showed that I had 5.3 estradiol. I have not taken any more Anastrozole or hCG or testosterone injections since then. I feel pretty horrible, but at least I’m sleeping better now.

My sex drive is slightly better, and I have had a few morning erections in the last week. I am still not able to maintain an erection long enough for satisfying sex with my wife. Yesterday, I couldn’t even masturbate to orgasm. I just couldn’t finish.

I’m going to see Dr. Keith Nichols tomorrow for an initial consultation. Hopefully he will get me back in shape. I saw on his website that he does sonic wave therapy for erectile dysfunction, that looks promising.

With my estradiol so low, I wonder if I should take more hCG? I will probably wait to hear what the doctor has to say tomorrow.

Don’t take anything until you see him. He’ll get you fixed. I believe in him.