TRT, feeling drained, high estrogen and sensitivity to anastrozole?

Hi guys,

I've been on TRT for 10 weeks with the following protocol starting from week 5:

Monday: 500 I.U HCG
Tuesday: 0.25mg Anastrozole
Thursday: 500 I.U HCG
Friday: 150mg Testosterone Cypionite
Saturday: 0.25mg Anastrozole

Prior to week 5 I did not inject any forms of HCG, it was just plain testosterone cypionite. I also stopped anastrozole because it makes me feel cold, tired and moody.

The first 4 weeks was awesome, I have completely cleared away my brain fog and my mind became very sharp, my energy level has improved, and for the first time in 5 years I felt very alpha. But for the past 2 weeks I've been feeling extremely drained and tired. My brain fog came back and it was a lot worst than before I started TRT. Also, I felt like a wimp and I became sensitive and emotional. I wanted to cry watching 50 shades of grey, and my sex drive slightly decreased.




My last lab work came back with the following results: (The lab was done 5 weeks ago when I switched to a new doctor):

Testosterone, Serum 424 ng/dL Range 348 - 1197
Estradiol, Sensitive 121pg/ml High Range 3 - 70
Free testosterone(Direct) 8.4pg/ml Low Range 9.3 - 26.5





Could it be the high estrogen? What should I do now guys? Should I hop back on the anastrozole even though it is making me feel weird?


Thanks!

taylorogy, I know you will get better answers from others, but the first thing I would do is split my dose of testosterone to twice weekly.

Easy, your estrogen levels are through the roof and why you have the symptoms that you present with.

You need to get back on your AI as soon as possible.

For a dose of 150 mg a week to have serum levels of 424 is very low. When did you get your blood work done relative to your last injection.

Need to see all your hormonal labs beyond just these as well.

Taylorogy

Are you sleeping well? Going to bed later than usual? How is your caffeine intake? Working out late? Stress? etc (I can list 100 things that could be causing your fatigue).

Yes, your estradiol (sensitive) is high. I wonder what the ultrasensitive value would be.

Most people on this site know I am not a friend of anastrozole, so I am not going to start my soap box again.

How is your thyroid, by the way? Adrenal fatigue can also be a strong factor in fatigue that does not respond to TRT.

Nelson Vergel said:

Taylorogy

Are you sleeping well? Going to bed later than usual? How is your caffeine intake? Working out late? Stress? etc (I can list 100 things that could be causing your fatigue).

Yes, your estradiol (sensitive) is high. I wonder what the ultrasensitive value would be.

Most people on this site know I am not a friend of anastrozole, so I am not going to start my soap box again.

How is your thyroid, by the way? Adrenal fatigue can also be a strong factor in fatigue that does not respond to TRT.

Click to expand...

Nelson, it is a Sensitive assay. He's very high and it's not healthy as you know. He needs to get back on his AI and have his body adjust to its use. He can't live at this level for long.

He can try, but I bet money it won't make a difference in his fatigue. Only one way to find out.

If he is sleeping well and still having fatigue, I would test TSH, free T3, free T4. Depending on that, I would go ahead and test cortisol/DHEA (4 saliva samples in one day).

I wish people used these questions so that we can stop guessing so much:

https://www.excelmale.com/forum/sho...-After-Initiation-of-Testosterone-Replacement

His symptoms are far more than just fatigue:

"But for the past 2 weeks I've been feeling extremely drained and tired. My brain fog came back and it was a lot worst than before I started TRT. Also, I felt like a wimp and I became sensitive and emotional. I wanted to cry watching 50 shades of grey, and my sex drive slightly decreased".

All of these indicators combined with the timing of when it happened and his discontinued use of an AI and the correct lab reflecting elevated E2 all points to the high serum level as the main culprit.

If he only had fatigue sans these other facts I would agree with you...but if it walks like a duck LOL

Vince said:

taylorogy, I know you will get better answers from others, but the first thing I would do is split my dose of testosterone to twice weekly.

Click to expand...

Hi Vince, Thanks for the suggestion. But wouldn't that be too much? I'm doing self intramuscular injection in the glute would that scar my muscle very bad?

Gene Devine said:

Easy, your estrogen levels are through the roof and why you have the symptoms that you present with.


You need to get back on your AI as soon as possible.


For a dose of 150 mg a week to have serum levels of 424 is very low. When did you get your blood work done relative to your last injection.


Need to see all your hormonal labs beyond just these as well.

Click to expand...

Nelson Vergel said:

Taylorogy


Are you sleeping well? Going to bed later than usual? How is your caffeine intake? Working out late? Stress? etc (I can list 100 things that could be causing your fatigue).


Yes, your estradiol (sensitive) is high. I wonder what the ultrasensitive value would be.


Most people on this site know I am not a friend of anastrozole, so I am not going to start my soap box again.


How is your thyroid, by the way? Adrenal fatigue can also be a strong factor in fatigue that does not respond to TRT.

Click to expand...

Hi guys, thanks for taking the time out to help me out. I had my blood work done 4 weeks after my injection from my first doctor, I guess that is why it is low. My first doctor prescribed me one injection every 2 weeks with no HCG or anastrozole. Even though I felt great and all but I started feeling pain in my testicles. And I was very afraid of losing my fertility because I am only 22. So I switched to another doctor. That's when I had my new bloodwork.


My sleep is okay, though I do have trouble falling asleep so I sleep pretty late. Somewhere around 12am-2am. Once I fall asleep I usually stay asleep and rarely wakes up. The first 4 weeks on testosterone I felt superb, and every night I slept like a baby and woke up by myself feeling fresh and well rested. But for the past 2 weeks I've been getting several sleep paralysis where I'm half awake, feeling suffocated and gasping for air, woke up and can't fall back asleep. Otherwise I sleep quite well. But even though I sleep for more than 10 hours a night I still woke up feeling exhausted, brain fog and mentally fatigue.


I cut out all caffeine beside 1 cup of natural green tea in the afternoon. I stop working out late at night and currently trying to switch to working out in the morning. My stress level is quite high due to work. I run a startup web technology firm and for the past 7 weeks its been quite stressful. But when I was on test for the first 4 weeks it really did helped boost my tolerance in coping with stress. Lately I am just feeling out of it and drained.


I guess my high estro is due to my previous doctor not prescribing me A.I. So my current doctor prescribed me 0.25mg anastrozole twice a week. When I first took the 0.25mg anastrozole I just felt terrible. I felt tired, and very cold for some reason so I cut it out cold turkey. Since then I started experiencing all of these symptoms. Sometimes I would just feel extremely emotional and I have no idea why. So today I started to take anastrozole again. The med was specifically compounded by this pharmacy. I decided to take half the dose (around 0.12mg) by crack opening the capsule and dumped out half of the powder. My symptoms was greatly improved and I felt great. My brain fog nearly went away and I feel positive instead of feeling emotional and wimpy. I've got so much done today and I felt very productive. Could this just be a placebo effect or it is really because of my estrogen? How should I go about dosing anastrozole now? I also heard that it is not good for your lipid or something like that?


I have no idea about my thyroid. I am willing to go get checked and post results. I also don't know if I have adrenal fatigue. But where do I go about to have those test done? Should I go to my doctor or just get a private lab test online?


Thanks again guys, I really appreciated your help!

taylorogy,injecting twice weekly won't scar your muscle and it does seem the best way to keep your testosterone level ( no spikes )

Actually, I think Gene and Nelson are both hitting some key points, it's just a matter of piecing them together IMO. Like Gene, I go by the E2 sensitive assay, and if you're getting a 121pg reading, it's definitely over the top.

Nelson is correct just the same, as the fatigue is an after fact of earlier events ... Estrogen is needed in the right amounts for men, that we know. Like any other hormone, if you get it out of balance then every action will cause a reaction. With excessive estrogen serum levels, this could be contributing to other factors that are adding stress to the body. Again, any of these hormones in excess or that are even deficient can trigger certain reactions from the body, which is always aiming to regain homeostasis.

So, my speculation is that the high E2 is prompting the adrenals to pull more pregnenolone to produce higher levels of Cortisol. This is also fairly common with women having estrogen dominance issues during the peri and post menopausal phases, where progesterone is absent to keep the estrogen in check. This ultimately plays havoc on the adrenals, and they thyroid is also part of the casualty, as it needs cortisol to be produced in a semi-normal circadian pattern.

So it's IMO probably all the above. You have excessive high E2. The body is reacting with elevated cortisol, and depending where DHEA-S is at in relation to the circadian profile, you might be experiencing a Stage 2 Adrenal Fatigue (adapted divergence), or maybe Stage 3 at the Maladaptation Phase 1. Again, it's all speculation just based on what you described. You would have to run a complete Cortisol Saliva 4x kit w/DHEA-S saliva, plus a complete thyroid panel. Reverse T3 could also be triggered in an event like this, which would curb ATP.

On a good note, I suspect you will see much of this get corrected when you get your E2 reduced and sustained to a suitable level. However, without correction, the other issues can get worse, and then you have a whole new set of problems to manage.

And yeah, as noted above, get those spikes under control pronto!

Would caffeine cause fatigue?

Vettester Chris said:

Actually, I think Gene and Nelson are both hitting some key points, it's just a matter of piecing them together IMO. Like Gene, I go by the E2 sensitive assay, and if you're getting a 121pg reading, it's definitely over the top.

Nelson is correct just the same, as the fatigue is an after fact of earlier events ... Estrogen is needed in the right amounts for men, that we know. Like any other hormone, if you get it out of balance then every action will cause a reaction. With excessive estrogen serum levels, this could be contributing to other factors that are adding stress to the body. Again, any of these hormones in excess or that are even deficient can trigger certain reactions from the body, which is always aiming to regain homeostasis.

So, my speculation is that the high E2 is prompting the adrenals to pull more pregnenolone to produce higher levels of Cortisol. This is also fairly common with women having estrogen dominance issues during the peri and post menopausal phases, where progesterone is absent to keep the estrogen in check. This ultimately plays havoc on the adrenals, and they thyroid is also part of the casualty, as it needs cortisol to be produced in a semi-normal circadian pattern.

So it's IMO probably all the above. You have excessive high E2. The body is reacting with elevated cortisol, and depending where DHEA-S is at in relation to the circadian profile, you might be experiencing a Stage 2 Adrenal Fatigue (adapted divergence), or maybe Stage 3 at the Maladaptation Phase 1. Again, it's all speculation just based on what you described. You would have to run a complete Cortisol Saliva 4x kit w/DHEA-S saliva, plus a complete thyroid panel. Reverse T3 could also be triggered in an event like this, which would curb ATP.

On a good note, I suspect you will see much of this get corrected when you get your E2 reduced and sustained to a suitable level. However, without correction, the other issues can get worse, and then you have a whole new set of problems to manage.

Click to expand...

Hi Vettester Chris,

Thank you so much, this is very informative! Do I get the cortisol test from my doctor? Can you give me some advice on how I should dose my anastrozole? I took around 0.12mg on Tuesday and I felt great, I had a raging night and morning wood the following day. (It was compounded to 0.25mg, I opened the capsule and dumped half of it out) Today is Friday and I slowly feeling drained again. Originally my doctor prescribed me 0.25mg twice a week, but whenever I took 0.25mg dose I feel cold, is like my body temperature changed. I also feel weak and a bit nauseated. Should I just start taking half the capsule twice a week then?

Thanks again for all your help!

dallas101346 said:

Would caffeine cause fatigue?

Click to expand...

Oh yes it does, therefore I cut it out completely. And the crash is just bad.

Taylor, I doubt your doctor will be getting you the correct cortisol tests. The 4x Saliva Diurnal kit w/ DHEA-S saliva for the DHEA/Cortisol correlation analysis is what you need. ZRT or Canary Club is the place to go for this. They will mail it to you, fill the tubes, send it back and that's that.

Regarding body temps ... Have you taken yours anytime recently? Again, the suspicion is not only adrenals, but also thyroid. Everything could be triggering more than desired conversion of Reverse T3, which is just one method on how the body can "curb" activity & energy, while the body is under stress, illness, imbalances, etc. If thyroid labs get requested, you NEED Free T4, Free T3, Reverse T3, TSH, & TPO & TgAb antibodies. Many doctors will write off some of these listed labs .. Don't let that happen!

In the meantime, if you're inclined, maybe we could get a 5 day body temp average from you? This would include taking your temp upon rising, then again 3 hours later, then 3 to 4 hours thereafter (3x day) .. Do this for 5 days in a row. I'm looking at the daily average, and then looking at the daily variance & variance of the daily average throughout the week. This would be a decent start with knowing if your adrenals & thyroid are under distress ...

It would be good to not only get the noted specific labs, but to see the general CBC's, Metabolic, Lipids, etc. I don't know exactly "why" the Adex at that dose is causing that (??) .. Obviously, it prompts me to want to see what's been mentioned, but also labs like ALT & AST, and your lipids, so in essence labs will do the talking and leave the speculation out.

Taylor, if you do the 5 day Temp Test, feel free to post it up or you can PM it if you're not sure, I'll provide some comments on it. There's some good information out there on this and much more with the likes of Dr. Bruce Rind and Dr. James Wilson (FYI).

You felt great for four weeks, that was how long it took your body to shut down production. Now that you're only source is the injections. I agree, 150 once a week is far too much at one time, I'd go 75 twice a week, and consider .25 Anastrozole EOD.

how does caffeine cause fatigue

Dallas101346

Caffeine can make you crash and exhaust your adrenals if used heavily.

Thanks. What is the best way to test the status of the adrenals?