question from a user
I started TRT early January because of low libido, weight gains, low energy. The clinic I worked with started me at 200 mg per week of test cyp, daily injections. They also prescribe NP Thyroid. I gained about 15 lbs within the first three weeks, and gained some good energy and libido for about one or two weeks. But while the water weight stayed, the libido and energy went away. At our first two months checkup, since there was no improvement in the original symptoms anymore, the dosage was increased to 250 mg. They didn’t think a blood test was necessary but gave me one anyway since I asked for it. TT @ 970, E2 @ 72, T3 @ 5.6. On the following checkup, two months later libido is nowhere, energy is low, hematocrit his @ 54, blood pressure was getting higher. But since the symptoms were not improving, the clinic increased the dose to 300 mg. When I asked for a blood test, they said they do not chase numbers, they want to improve the symptoms. I tested on my own and the TT was > 1500 , E2 @ 103. I do not feel good increasing the dose and instead lowered it on my own to 150 mg and reached out to a new clinic, they order blood test before meeting with a doc. What would you do ? What else should I do ?
AlphaMD's Answer
You do not need to go to 300mg a week. They're not addressing your Estrogen in this scenario at all despite it likely being related to your water retention & the libido disappearing. For reference, anytime some gets near 50 we will start to look for reported symptoms & address it accordingly. It's very likely that the benefits you would normally feel from those other levels are being impacted by that staggering 103 E. We would drop your dose like you suggest if you were our patient, or we would keep you at the 200mg if you liked it otherwise & want you to take an AI or take other significant measures to reduce your Estrogen. I would absolutely look for a second opinion.
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