T Nation

Very Worried About My T Therapy

Hi,been on Trt now for about 4 years, I’m 42 and diagnosed with hypogonadism, everything worked great up until a year ago, now the once every 12 week injection (nebido) seems to be killing my libido and erections, things improve prior to my injection and then straight after the injection it’s gone again, I’m worried about telling my endo in case he takes me off treatment as its done so much more for me than just sexually, any one gone thru similar or any advice would be great, thanks in advance

It’s probably a hormone that has fallen out of range, labs is the only way to confirm? You might also want to check your thyroid numbers. Just tell your doctor how much TRT has helped you and he/she will search for the answers. It’s likely you hitting your sweet spot somewhere in the middle of your injection, I hate Nebido because it can be difficult to get dialed in properly. Nebido is garbage for most.

You need blood work. Stop guessing. You need to know Test, free test, estradiol, etc. check out KSMans stickies for a complete list. If your doc won’t do it, get it done yourself at Private MD

Nebido is a long acting ester. What ML of what MG are you taking? I see typical concentrations are 4ML of 1000MG. Due to the long acting nature of the ester through its release is much slower than say CYP or E. The answer to why you feel poorly lies with the injection protocol and its effects on SHBG and or E conversion. Why I state this is even 1ml of 1000mg weekly (which is 250mg) on a ester witha half life of between 33 and 39 days (± 3.5 days) would cause of a build up far in excess of the recommendations of 100mg per week of a 7 day ester.

Yes, 4ml of 1000MG , saw my endo today, and had my injection yesterday, 17 weeks after my last,should be 12 weeks…he took my bloods and when I told him its working in reverse, as in libido and erections go after the injection and he was very surprised, and asks if I ever took anabolics! I havent!!
He’s arranged for me to miss my next needle and he’ll take bloods again at 16 weeks… another 4 months for me to wait, wondering… I asked about clomid and hcg and he said they’re not licensed for use by men here (Ireland)
I don’t know what to do, but I need to do something other than sit and wait… any advice on my next step

Will do, thanks very much

Are you able to self-inject T wherever you are?

Your current method is not working.

You are making E2 from FT–>E2 and as T levels drop into the cesspool of E2, you are estrogen dominate. Are your nipples getting affected. Are you getting mood problems such as intolerance or bitchiness?

Thyroid can be an issue, see “body temperatures” below.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

I suggested I was estrogen dominant and he,my endo laughed, said I couldn’t be as I’m so lean, about 10% bodyfat
I wouldn’t know where to get T from as nebido is provided by the state, so I don’t pay for it at the moment… yes I’m moody, intolerant and bitchy… hadn’t noticed anything about my nipples, one is tender and excretes some fluid if squeezed, very little tho

Your current doctor is unable to help you, he is unskilled in male hormones and laughs in your face when you ask him a valid question. He’s the ignorant one and unwilling to learn, these type of doctors are the worst kind!

I’ll ask for a copy of my labs in a few days and post up when I get them and we can take it from there

I have a feeling that the lab results won’t cover very much, is there a full list anywhere of every blood test needed?

Ask to take nebido home to self-inject once a week. You can use #29 1/2" 0.5ml insulin syringes and inject subq. Suggest 125-150mg.

Most state run healthcare systems are a TRT trainwreck.

No need, I have 3 vials in my locker :stuck_out_tongue_winking_eye:
I order the prescription from my doctor and make an appointment with the nurse,so I collect the T from the pharmacy and bring it in… thanks for your advice

I’m estrogen dominant and have never been able to get rid of the fat in my lower abdomen and back no matter how hard I try (and thankfully have noticed it decreasing since starting an AI). However, since looking into my issues, I’ve come to the conclusion that the effect of estrogen levels in men isn’t that well-known or researched. I’ve read many, many times of men being discouraged from getting estradiol levels tested because estrogen is irrelevant to men (obviously not the case).

When I wanted to ask my doctor about it, I had a difficult time even finding a list of symptoms and, even then, thought I had low levels due to having more symptoms in common. I read, for instance, that high estrogen in men results in water retention and less frequent urination, but I’m the exact opposite: I pee 15-20 times a day. In other words, I’m doubting it impacts every man exactly the same way and everyone gets every symptom. But, the only way to be sure is getting it tested.

This sticky of KSMan’s has a list of what bloodwork you should get.