I hope everyone is doing good. Haven't posted in months because I've been in a long depression, then my wife was sick, then our oldest cat became ill and she was euthanized last week. The best thing was that we've been in Florida but this has been a tough year, so far.
My protocol for the past 3 months has been 15 mg Test E, sub q, daily. Self ordered all labs through Discounted Labs. In December my TT was 390 & FT was 6.0(6.6 - 18.3). April labs:
TT - 777 ng/dL 348-1197
FT - 16.2 pg/mL 6.6 - 18.3
E2 - 29.7 pg/mL 8.0 - 35.0
Pros: Libido is up, mood is better, getting nocturnal erections 2-3 nights per week, sometimes multiple times during the night.
Cons: No morning wood nor daytime erections, 10 lb. weight gain/waist size increase, prostate feels irritated, though last DRE in May was normal(small & smooth). PSA was 2.6, normal for me since I started TRT, though there might be inflammation issues.
I'm considering doing the same protocol as IM and retest when I see my doctor back in Maryland.
As I've mentioned many times, I have untreatable bipolar illness and the meds I take are just for sleep(low dose Doxepin & low dose Klonopin), but my sleep isn't all that good. I eat mostly salads similar to antipasto, with organic sandwich meats, cheese and hard boiled eggs, kalamata olives, olive oil & vinegar, fruit, corn tortillas(organic), OJ, water.
I didn't do a full panel because of money and have been lazy about finding a doctor in Florida, since I have insurance and could have many more labs ordered. I know my DHT has always been between 29 and 32, which might account for erectile & prostate issues. Thanks for reading and all thoughts/observations are welcomed.
Sorry to hear you've had such a tough time.
It'd be a little hard untangling any physiological stress from psychological given you're going through a lot. It's definitely possible to have erection issues, for example, just from chronic stress.
Lack of morning wood might mean your stress hormones are kicking in more strongly in the morning, meaning higher norepinephrine among other things, leading to erection problems. The increase in girth is likely water weight and/or stomach distension, both of which *could* be from your slightly high sensitive E2 level (it might be as high as low-40s for non-sensitive, which is what pretty much all the studies use for measuring E2 and determining good or bad levels). Estradiol and not so much DHT can cause prostate issues. But obviously you can't inject more frequently.
How's your zinc doing? If you're deficient or on the lower or even middle range, you might consider supplementing; 50 mg (with 2 mg of copper) might give you a few point drop in E2, but Peak has done his homework on his concerns about zinc. Dr Mark Gorden uses zinc in high doses (like 160-180 mg a day) as an aromatase inhibitor because of concerns about anastrozole. You also might look into trying calcium d glucarate to lower your E2 a few points. You could alternatively -- or additionally -- try a supplement to change estrogen metabolism, meaning the E2 number might not drop noticeably but metabolites like the good 2 hydroxyestrone would increase and bad ones like 16a- hydroxyestrone would decrease if you were to take DIM, I3C, or a few milligrams of iodine (look into the latter first before plunging in); DIM increases 2 and decreases 16a hydroxyestrones, and possibly (conflicting data) decreases 4 hydroxyestrone, and people who have high activity for this pathway are at higher risk for prostate cancer -- which tells you how estrogen is more a danger than DHT for prostate issues.
If you're having bipolar issues, I strongly recommend you get lithium tested through walkinlabs.com (for like less than $30) and try lithium orotate (here's a great article
on its many benefits, including bipolar and mood; it also increases GABA sensitivity, which means more of a brake on norepinephrine/anxiety, which could resolve many of your remaining issues, like erections and sleep), which you can get online from iHerb or amazon.com (just read the reviews -- it really helps a lot of people). Basically lithium is an essential nutrient, meaning we need to get it from diet, and most people don't; lithium orotate differs from lithium carbonate, previously prescribed for bipolar before mood stabilizers like lamictal came along which posed fewer problems (thyroid slowdown issues, toxic levels, etc.) than carbonate, in that carbonate is prescribed in high doses as a crude way to force it into cells, whereas orotate can be taken at much lower levels (5-10 mg) with much better absorption and fewer if any side effects.
As for klonopin, the nasty secret here is benzos disrupt sleep architecture (N1, N2, N3 [slow-wave sleep -- the restful type], and REM [emotional organization]), causing some people to get less of a sleep benefit from it. I'm at the point of being unintentionally "hooked" on it because I played around with xanax too much with my doctor's blessing and went to K because it had a much longer halflife, and I take it 4-6 hours once daily before going to bed so it doesn't affect my sleep as much, but obviously you can't do that. As said above, lithium sensitizes GABA receptors, and that could mean you'll have an easy time coming off K (many people do already, but the horror stories float to the top). Otherwise, the same stress chemicals that are likely influencing your erection quality in the morning and during the day might be making your sleep less restful. You might look into progressive muscle relaxation, deep breathing, mindfulness meditation, and/or Yoga before bed to help you get more relaxed.
Consistently practiced mindfulness meditation (like 20 minutes per day for at least two months, then you can do less) can do very good things for psychological stress, especially if you worry or ruminate about things. If you're into this stuff, I'd recommend the book The Mindful Way Through Anxiety, which has a program and cd with it for practice. Great stuff.
I'd recommend getting your thyroid checked, as this is a big player in increasing norepinephrine: TSH, free T3, and free T4 at least, and reverse T3 and antibodies if you can get them. Life Extension has a good thyroid hormone panel you can order and take the lab order to your nearest Labcorp.