Low libido with high testosterone
Current TRT Protocol: Testosterone Cypionate 100 mg once a week.
Have not changed my protocol in over a year but only in recent weeks have not had morning erections or libido in general. Lab results below. Any help appreciated!
Symptoms / Clinical Notes
Reduced libido
Reduced spontaneous/morning erections in recent weeks
Still capable of erections, including occasional nocturnal erections
No AI use
No finasteride/dutasteride or other medications
Sleep reportedly good; no snoring
supplements: vitamin D3/K2, magnesium glycinate, zinc
Testosterone Panel
Total Testosterone: 1239 ng/dL (High; ref 249–836)
Free Testosterone (Calculated): 31.10 ng/dL (High; ref 4.60–22.40)
Bioavailable Testosterone: 793.7 ng/dL (High; ref 110–575)
SHBG: 30.2 nmol/L (Normal; ref 16.5–55.9)
Albumin: 4.7 g/dL
% Free Testosterone: 2.51%
% Bioavailable Testosterone: 64.06%
Estrogen / Pituitary
Estradiol (E2): 33.2 pg/mL (Normal; ref 11.3–43.2)
Prolactin: 11.5 ng/mL (Normal; ref 4.0–15.2)
LH: <0.300 mIU/mL (Suppressed on TRT; ref 1.70–8.60)
FSH: <0.300 mIU/mL (Suppressed on TRT; ref 1.5–12.4)
Thyroid
TSH: 2.340
Free T4: 1.39 ng/dL
T3 Uptake: 39.08% (borderline high)
Prostate
PSA Total: 1.05 ng/mL
Free PSA: 0.355 ng/mL
% Free PSA: 33.81%
Vitamin D
Vitamin D: 34.8 ng/mL