Hey everyone, first time posting. I'm 43, 5'8", 175lbs. Body fat around 12%. Total T was at 338, Free T was really low end of normal (don't have labs in front of me), Estrone was high (Estradiol was around 18, I think), SHBG was low end of normal as was LH, Cortisol was upper normal. Prolactin was middle of normal. Everything else (TSH, T3/4) was right in the middle of "normal", and my doctor seemed okay with the readings.
I started TRT (with a HRT specialist) 4 weeks ago using pellets. I have not had my 6 week follow-up bloodwork yet. I was given 12 pellets and prescribed .5mg of AI weekly, which I split and take on Mondays and Thursdays. I have to do pellets as my job has me traveling away from home, (with no access to refrigeration) so there's no way I could keep up with an injection regimen, nor getting frequent refills.
The reason I started on TRT was due to numerous symptoms; loss of libido, lousy erections, ZERO spontaneous erections or morning wood, loss of muscle, night sweats, etc., for about the last year. The loss of libido and lousy EQ was the worst part.
So, at the 1 month point, the only improvement I've seen is the return of morning wood and a little more energy. EQ hasn't changed much, but I know that can take up to a year to improve. I have also changed my diet after reading this website, to lower saturated fats & maximize NO2 production, got back in the gym, and started running again.
My concern is that I haven't really felt ANY increase in libido, which was one of the most disconcerting symptoms I had. All the studies I've read say that libido generally starts improving around 3 weeks and peaks at about 6 weeks. At 4 weeks now, is it likely that I just am not going to see any change? Is this normal not to feel a huge improvement? Maybe I was expecting too much? Or is it just way too early to panic (so to speak)? Could it be that even with 12 pellets, my levels are still not high enough to make a difference yet? All the studies relating to improvement @ 3 weeks are using injectable T, not pellets. My doc did say the pellets peak at 6 weeks, so maybe with pellets its just a bit delayed? Should I suggest skipping a dose of AI to see if I feel better with a little higher Estradiol level? I think 18pg/ml is kinda low, isn't it?
I was taking the .5mg of AI every Monday morning, but I read that if Estradiol levels get too low, that can cause issues as well. I did not feel any different on Sunday night than I did on Wednesdays when the AI is at its peak. But just to be safe, I split the dose, figuring it couldn't hurt to have a steadier flow.
I know there is a lot of knowledge here. I like and trust my doctor, but as we all know they are very busy. If there are any suggestions I could take to her, that would make my time with her more productive. Appreciate any input.