Labs results

[Mike1970]

Hey Guys,

On Nebido 1000mg 4ml every 8 weeks
Normally week 2 to 6 feel great, nocturnal erections and erections at will.
I'm now at nearly week 4, no erections at all, loss libido, so I got bloods done

Testosterone = 25.7 nmol/L
SHBG = 27 nmol/L
Calculated free T ≈ 650 pmol/L
Oestradiol = 205 pmol/L
Lab male E2 range = 41–159 pmol/L

Any advice
Thanks
Mike

 

[Mike1970]

Hey Guys,

On Nebido 1000mg 4ml every 8 weeks
Normally week 2 to 6 feel great, nocturnal erections and erections at will.
I'm now at nearly week 4, no erections at all, loss libido, so I got bloods done

Testosterone = 25.7 nmol/L
SHBG = 27 nmol/L
Calculated free T ≈ 650 pmol/L
Oestradiol = 205 pmol/L
Lab male E2 range = 41–159 pmol/L

Any advice
Thanks
Mike

Anyone?

 

[Cataceous]

The default with this limited information is to blame the high estradiol, but it's rarely going to be that simple, and the symptoms in your case do not necessarily match. Testosterone is robust, so insufficiency is not the problem. Do you know the methodology of the estradiol test? If it's an immunoassay-based test then there's a chance the result is exaggerated due to cross reactivity with things like C-reactive protein. Are there any clear-cut signs of high estradiol levels, such as heightened emotional responsiveness?

How long have you been on TRT? Over time some men seem to develop problems associated with HPTA shutdown, with many of the symptoms you mention. In such cases guys may waste years tweaking the TRT dose, experimenting with aromatase inhibitors, etc., all to no avail.

Do you have other treatment options besides Nebido? Shorter esters are more suited for experimenting. If you have access to testosterone nasal gel, e.g. Natesto, then it's something to fall back on if all else fails. Short-acting testosterone like this is less disruptive of other hormones and may resolve related issues.

 

[FunkOdyssey]

Anyone?

I would pause on blaming an unchanged TRT protocol that was previously working fine, or your relatively unremarkable labs besides slightly high e2. For all we know, your e2 was at the same level in the past when you were doing well.

Cast a wider net first, and look for things that have actually changed. What else is happening in your life? Think about sleep, stress, diet, supplements, medications, allergies, work, and relationships to start. Any other symptoms that have changed or developed besides the poor libido and erections may be important too.