Starting over with my journey on Testosterone- First Labs back

[EnlightenedViking]

Hi Guys,

I'm 5 years in on TRT after going through my late 20's with mild depression, low libido etc. Sure enough had Total T around 250-300.

Got on Test Cypionate injections for the past 4 years and while it helped for the first 2 years with energy, confidence, and sex drive. I feel like I have plateaued in a big way. I have less energy, sex drive is very up and down, and I still have to deal with ED from time to time.

I want to start from scratch and could use your help

Here are my latest lab results after injecting 200mg a week. I split the dose 1/2mL twice a week. This bloodwork would technically be my trough levels. Inject on Sunday am, bloodwork done on Wednesday morning.

Testosterone, Free & Total — 682 Total - 18 Free
Estradiol, Sensitive — 21.6
Growth Hormone (GH) — .1 (yes 0.1 is it normal to have no growth hormone while on TRT?)
Estrogen, Total — 97 - Seems high?
Dehydroepiandrosterone (DHEA) Sulfate — 277
Insulin-like Growth Factor-1 (IGF-1) —191
Sex Hormone-binding Globulin (SHBG) —  32.3
Parathyroid (PTH), Intact — 33
Pregnenolone — 29
Progesterone — 0.1
Hematocrit - 52.9 - High

Although I've recently moved to another state, I am ready to get another round done in case I am missing some key tests. As you all know it is almost impossible to find someone who can interpret these results in person.

Options I have considered to go get back to the drawing board:

- Going off TRT for 3-6 months(reset)
- looking into hCG to kickstart FSH and LH and get my balls working again, follow up with semen analysis.
- Continue on this path and make minor variations to the my current protocol.

[Cataceous]

Unfortunately your situation is not so unusual, at least judging by reports in the forums. TRT can seem to be working well for a good length of time, but then problems return. You may find some benefits in hCG use; it's worth trying. It improved TRT for me, but in the end it wasn't enough. I eventually got out of the rut, but it requires a pretty drastic protocol. I hypothesize that the suppressed upstream hormones are contributing to our problems. These include kisspeptin, GnRH, LH and FSH. Normalizing these levels makes things a lot better for me.

Regarding growth hormone, my understanding is that it varies a lot, so an individual measurement isn't so useful. Instead, IGF-1 represents more of an average measurement of GH, and is what we should go by.

What's the reference range for total estrogen? I doubt it's anything to worry about. Estriol and estrone are much less potent than estradiol, so probably nothing to be worried about with estradiol on the lowish side relative to testosterone.

Is your progesterone measurement on the 0.0-0.5 ng/mL reference range? I think as part of normalizing all hormones it's worthwhile pushing this up to mid-range.

[cujet]

It's not an easy journey. I'm an older guy, but I've been near zero T since age 33 due to illness. My journey took me to compounded creme, not because it's the best, or that it gives the best results, but because it's what I can deal with.

After all this time on T replacement, the method seems not to matter all that much, and More is certainly not better. I find that I must be below 800 and above 450.