TRT Protocol Sanity Check

TLDR:

• 80mg twice weekly (160mg weekly) -> heart palpitations
• reduced to 30mg EOD (105mg weekly) -> no palpitations, TT 751, E2 59
• provider suggested daily 15mg (105mg weekly) no AI -> good, bad, crazy?

Hi all, I've been on TRT for the last two months and feeling a hell of a lot better.

There has been one hiccup, about a month ago I had a few occurrences of heart palpitations. So I go see a cardiologist and they suggest that I stop TRT completely. I push back and suggested that we try a dosage reduction from 160 mg to 105 mg weekly. This includes going from twice a week to every other day as suggested by my TRT provider. That seems to have done it. I'm still feeling good, not as good as on 160, but still much better.

I just got labs back this week, after 4 weeks at 105, and my testosterone came back at 751 ng/dl which I'm more than happy with. Seems like I was definitely higher than needed when I was on 160. Most other points looked good including my cholesterol which was actually better. However, my E2 came back high at 59 pg/ml with a reference range of 7.6 to 42.6.

It seems to me that the high E2 was likely the cause of the heart palpitations. If it is high at 105 weekly I think it makes sense that it would be a bit higher at 160 weekly.

After relaying all of this to my provider, I asked about taking an AI. They have suggested that I not take an AI, but that I go from every other day to daily. I don't mind sticking daily, but dosing 7.5 units sucks, even in a 0.5ml insulin syringe. I asked about 100mg/ml but they don't offer anything except 200mg/ml. I'm just curious what you lot think. Dose this make sense?

I'm also thinking of switching to evening shots for convenience. Any issues with this?

I do generally feel much better. Energy is up, the ED is better, and my metabolism is starting to recover even though I've not been exercising due to the cardiologist telling me to stop while we wait for tests. (I'm starting back Monday as all the tests show I'm fine and the palpitations have stopped anyway) I turn 34 next week and actually feel like a man in his 30's.

Bonus question: DHEA-S came back low as well. Is this worth supplementing?