callin marianco and swale please!!

[ironaddict69]

hello to both of you, and thanks again for helping with this site. your greatly appreciated!

i have a few questions
im on TRT and my doc recently lowered me to 100 mg a week, he felt 200 was too high and it had me around 1500 on the test chart, free was over the range too
1. can anti aromatase drugs like aromasin decrease sex drive? i can get erections if i really want them, its just my sex drive is BAD. however im on day 3 of thyroid armour and feeling a little better, and starting isocort soon due to low cortisol.

2.can low cortisol lower it too? i know being hypothyroid it will be lowerr but i wasnt sure about cortisol.

3. how can you lower progesterone? mine was slightly over the top range, even with estradiol being normal.

[ironaddict69]

oh and whats with people on here saying pellet therapy is better than injections?
i inject twice a week so my blood levels are real stable. i heeard of a guy having low sex drive on the injections, then switched to pellets and it was much better...any ideas? some of the guys on here are SOLD on pellet therapy over injections.

[JanSz]

Originally Posted by ironaddict69

hello to both of you, and thanks again for helping with this site. your greatly appreciated!

i have a few questions
im on TRT and my doc recently lowered me to 100 mg a week, he felt 200 was too high and it had me around 1500 on the test chart, free was over the range too
1. can anti aromatase drugs like aromasin decrease sex drive? i can get erections if i really want them, its just my sex drive is BAD. however im on day 3 of thyroid armour and feeling a little better, and starting isocort soon due to low cortisol.

2.can low cortisol lower it too? i know being hypothyroid it will be lowerr but i wasnt sure about cortisol.

3. how can you lower progesterone? mine was slightly over the top range, even with estradiol being normal.

I have a note to my self (got it either from LEF or book LifeExtension Revolution) Usually pogesterone correct itself when other hormones are corrected.

[ironaddict69]

ahh. ok. thanx man. i heard its actually good for you, but it lowers sex drive?

[HeadDoc]

Progesterone does oppose DHT. However, it does not lower sex drive in all. Sex drive has multiple causes.

[marianco]

Originally Posted by ironaddict69

hello to both of you, and thanks again for helping with this site. your greatly appreciated!

i have a few questions
im on TRT and my doc recently lowered me to 100 mg a week, he felt 200 was too high and it had me around 1500 on the test chart, free was over the range too
1. can anti aromatase drugs like aromasin decrease sex drive? i can get erections if i really want them, its just my sex drive is BAD. however im on day 3 of thyroid armour and feeling a little better, and starting isocort soon due to low cortisol.

2.can low cortisol lower it too? i know being hypothyroid it will be lowerr but i wasnt sure about cortisol.

3. how can you lower progesterone? mine was slightly over the top range, even with estradiol being normal.

1. TRT ideally should have a target of getting total testosterone to at least 650 ng/dl, while trying to keep the testosterone mostly within the physiologic range, i.e. max 1000 ng/dl. This can be difficult with some forms of TRT. For example, an oil-based testosterone cream can have peaks of testosterone up to 4000 ng/dl, with a half-life of about 12 hours. But the peak is very short-lived in this case and can be acceptable if not a good treatment for many men.

2. If problems such as decreased sex drive persist when total testosterone is over 650 ng/dl, then testosterone itself is not the problem. There are other neurotransmitter/hormone/immune system cytokine problems occurring - which need to be evaluated and treated.

3. Having an appropriate amount of estrogens, particularly estradiol (the most potent one), is important for sex drive. Estrogens provide sexual aggression - which means it contributes to the desire to have sex. An estradiol level gives a good indication of the total estrogen activity since all the estrogens actually determine estradiol level (when not done as a fractionated estrogens test).

4. An aromatase inhibitor can drive estradiol too low, causing a loss of sex drive. When estradiol is too low, testosterone many even increase blood pressure rather than reduce blood pressure.

5. Thyroid hormone deficiency can reduce sex drive, as well as energy.

6. Cortisol deficiency - e.g. from adrenal fatigue - can reduce sex drive. Cortisol deficiency impairs the mind's ability to reduce norepinephrine levels. This is necessary to relax a person. Sex is a resting function as opposed to a fight-or-fllight function.

7. High progesterone levels can excessively sensitize a person to estrogens, which can lead to reduced sex drive. Progesterone can also reduce DHT production by blocking alpha-reductase enzyme. This may lead to a reduction in sex drive, particularly if total testosterone is low and DHT's influence is necessary to promote sex drive.

8. Progesterone is primarily produced in the adrenal glands, along with the rest of the adrenal cortex hormones in response to ACTH, which is released in response to stress or reduced energy levels (such as from hypothyroidism) with higher need for cortisol production. Progesterone production is largely independent of estradiol production.

9. To reduce progesterone, one has to reduce external stress levels as well as address hypothyroidism and cortisol deficiency/adrenal fatigue.

10. Adequate progesterone is needed to have sex drive.

11. Testosterone pellets can work well with many men. It keeps total testosterone at nearly absolutely even levels. There is no roller coaster effect. By gradually releasing testosterone, one nearly completely avoid problems with estradiol and DHT. Testosterone pellets however ties the person to their physician, making the person dependent on their physician. One can't travel for extensive periods of time, for example, since one has to have the pellets inserted surgically about once every 3 months. The person has less independence from their physician. There are few physicians that do the pellets because it is a more invasive procedure and many disagree with that philosophy, calling it a primitive form of medicine. However, for the person that can live with the physician dependency, travel limitations and the idea of having an invasive procedure regularly done, testosterone pellets actually can be the best form of TRT since it greatly simplifies treatment and can be very effective.

12. If one can correct thyroid and adrenal problems first - completely optimizing thyroid hormone and adrenal gland function - which unfortunately is not often done - then one can have good sex drive with lower levels of testosterone and with lower levels of testosterone replacement. This is one reason the Endocrine Society's guidelines for TRT indicate that one must not just treat low testosterone levels when there is not symptom of a deficiency. Treat the person not the labs - as one of the important lessons in physician training states.

[HeadDoc]

and last but not least, let's not forget that primal ingrediant: romance.

[marianco]

Originally Posted by HeadDoc

and last but not least, let's not forget that primal ingrediant: romance.

Yes!

And to have romance, we have to be able to produce adequate amounts of the hormone, Oxytocin.

Unfortunately, if a person grew up neglected, such a person may not be able to produce enough oxytocin. Sometimes optimizing the hormones may restore this.
It took Harry Harlow's monkeys five generations to compensate for the early neglect. I wonder if this may be offset by providing consistent, secure attachment. My wife and I have varying degrees of success with the feral kittens we raise. They have taught me quite bit about adrenal functioning.

[ironaddict69]

how to you optimize that hormone?
marianco what dose do you put your patients on with trt? my dr just lowered me to 100 mg this week and i took a dive. i felt much better on 200 mg. he freaked out because my test was 2200, but it was because i spiked my dose to 800 mg a week for a while. it was stupid, lets not evne go there, but i feel like i need more than what he lowered me to. being as its only 64 actual miligrams of test due to the ester weight

[marianco]

Originally Posted by ironaddict69

how to you optimize that hormone?
marianco what dose do you put your patients on with trt? my dr just lowered me to 100 mg this week and i took a dive. i felt much better on 200 mg. he freaked out because my test was 2200, but it was because i spiked my dose to 800 mg a week for a while. it was stupid, lets not evne go there, but i feel like i need more than what he lowered me to. being as its only 64 actual miligrams of test due to the ester weight

The starting dose for testosterone cypionate or testosterone enanthate injections is 100 mg/week.

Depending on the half-life of testosterone, the dose is adjusted up or down.

The target is a total testosterone of about 650 ng/dl, while attempting to keep the peak under 1000 ng/dl

One way to estimate the half-life of testosterone is to inject 200 mg of ester then measure the total testosterone about 4 days later. The total testosterone should be 1000 ng/dl - for T. enanthate. If it is about 600 ng/dl, then the half-life is about 3.5 days. The weekly dose would then be about 200 mg/week.

If the person has hypothyroidism, and thyroid hormone treatment is started, this will raise SHBG levels. This will then lengthen the half-life of testosterone and increase total testosterone level. A lower dose of Testoserone cypionate or enanthate is then needed to keep a person within the reference range.

A physician would freak out with a total testosterone of 2200 ng/dl. This takes the patient to unknown territory. The risks include hypertension, hyperlipidemia, diabetes, etc., etc.