HCG out of stock and Dr without experience on Arimidex

[Lowtuk]

Hi All,

Hope everyone is well.

I have been on trt for 9 months now and had to change from nebido to sust 250 earlier in the year due to no benefits from the Nebido.

I went through a few months of feeling better on the must 250 but my libido has been very low for the whole treatment.

I started to feel tired, anxious, increased stomach fat around 6 weeks ago and my estradiol was at 50 so dr prescribed clomid and after 3 weeks my estradiol was in the 60's so he prescribed Nolvadex and I started to feel better but the estradiol test last week showed 99 so I'm not sure what to do. I am hopefully having the E2 sensitive test done tomorrow.

My total test is coming in the high 700's 1 week after injection when tested and my injections are every 7 days.

I have asked my dr if I can take arimidex and he said he has no experience with it and so to carry on with nolvadex, should I carry on with nova even though my oestrogen is rising?

Should I self medicate with Arimidex and if so how?

Should I split my suit injections or space them to 10/12 days?

Thanks for your help

 

[Systemlord]

Quite a few red flags, if you doctor has no experience with Arimidex than it's safe to assume he doesn't normally do this very often. SHBG will dictate dosing and injection frequency. If you're low SHBG, then a 700 trough is a problem.

Estrogen is likely high at peak, frequent injections provide smooth stable levels with less
fluctuations.

Typically to get the full picture we need Free T3, Free T4, Reverse T3 and antibodies.

 

[Nelson Vergel]

Anastrozole NEVER increases libido or erection quality. Never, so don't fall for it.
Nolvadex shuts down your IGF-1 and muscle gains. It also has no effect on quality of life.

 

[Lowtuk]

Hi Systemlord,

My Free T4 is 12.82 pmol/L I will have to order the other tests.

Hi Nelson,

What would you suggest for my current situation to lower E2 and reduce my high oestrogen symptoms ?

 

[Systemlord]

Hi Systemlord,

My Free T4 is 12.82 pmol/L I will have to order the other tests.

Hi Nelson,

What would you suggest for my current situation to lower E2 and reduce my high oestrogen symptoms ?

You're throwing out numbers without including the ranges, I have no idea if Free T4 is midrange or if it is low. If that's 99 pmol/L then E2 is perfect, 99 pmol/L would be 26.96 pg/mL and would be midrange on US measurements.

 

[Lowtuk]

Sorry systemlord, I'm not used to how to post the numbers etc... still learning.

E2 99 pg/ml range 15.0-31.5
Test 7.21ng/ml range 1.75-8.16
Free T4 12.82 pmol/L range 7.86 - 14.41

I have the below tests due on the 27th of August which will be 10 days after my last suit 250 injection.

Glucose (random)
Bilirubin (total)
SGOT
SGPT
FSH
LH
Prolactin
Estradiol
Testosterone
Beta HCG
Complete Blood Count
Free Test

Should I ask for anything else?

I have nolva and arimidex on hand. Should I do anything with these in the next 13 days to help with my symptoms?

Many thanks and apologies for the incorrect posting.

 

[Nelson Vergel]

Hi Systemlord,

My Free T4 is 12.82 pmol/L I will have to order the other tests.

Hi Nelson,

What would you suggest for my current situation to lower E2 and reduce my high oestrogen symptoms ?

Provide units and ranges on your estradiol.

You are assuming those are "high estradiol" symptoms. They could be also symptoms of poor sleep, high cortisol, etc

 

[Lowtuk]

Hi Nelson,

I have edited the post above to show levels and tests I will be having, should I add anything to the tests?

 

[Nelson Vergel]

When will you get your sensitive estradiol test?

 

[Lowtuk]

tomorrow I am hoping

the sensitive test is being done at a different hospital

 

[Lowtuk]

Hi All,

So had my doctors appointment today and he has said the sensitive E2 test is not available here.

However I had my blood tests taken yesterday and the results were.

test 6.29ng/ml range 1.75-8.16
estradiol 22pg/ml range 15.0-31.5

I took 1mg of Arimidex on Friday so would this have dropped my Estradiol, if so how do I continue dosing it as don't want to crash.

The dr has said that with my test levels and estradiol I should feel on top of the world but I don't. His recommendation is to cease the sustanon as he feels I don't get the benefit from it and to move to 75mg of testosterone gel daily and dhea as well.

Has anyone tried this, are there any recommendations?

 

[Blackhawk]

Dosing arimidex is very tricky and very individual. Some guys respond to very small doses like .0625mg 2x/week, common dosing is 0.125-0,25mg 2x/week and some (rarely) need as much as 2mg/week. Doses are typically divided into at least 2/week.

You are playing with fire taking 1mg doses. You could easily crash your E2, which is both uncomfortable and dangerous. You risk bone loss, cardiovascular problems etc if estradiol is too low. One of Nelson's articles recommends levels no lower than 20. to keep out of trouble.

Research risks of low estradiol.

https://www.excelmale.com/forum/threads/estradiol-in-men-myths-and-facts-by-nelson-vergel.13500/

 

[Lowtuk]

Hi Blackhawk,

I took 1mg at the start as read a protocol stating that but after more research I found out it was a lot, it's dropped my estradiol from 99 to 22 in 4 days so obviously powerful, I'm not sure what to do now with the dosing? should I leave it for a few weeks or take .25mg with my next injection which will be my last as I'm moving to the compounded gel at the end of the month

 

[Blackhawk]

Search and you find many references to low estradiol problems. Here's one result from https://www.excelmale.com/forum/threads/role-of-estradiol-in-men-and-its-management.2309/

STUDY LOOKING AT EFFECT OF ESTRADIOL ON MORTALITY IN MEN:

This study found that estradiol levels of < 21.80 pg/ml and > 30.11 pg/ml resulted in greater mortality in men.


Abstract

CONTEXT:

Androgen deficiency is common in men with chronic heart failure (HF) and is associated with increased morbidity and mortality. Estrogens are formed by the aromatization of androgens; therefore, abnormal estrogen metabolism would be anticipated in HF.


OBJECTIVE:

To examine the relationship between serum concentration of estradiol and mortality in men with chronic HF and reduced left ventricular ejection fraction (LVEF).


DESIGN, SETTING, AND PARTICIPANTS:

A prospective observational study at 2 tertiary cardiology centers (Wroclaw and Zabrze, Poland) of 501 men (mean [SD] age, 58 [12] years) with chronic HF, LVEF of 28% (SD, 8%), and New York Heart Association [NYHA] classes 1, 2, 3, and 4 of 52, 231, 181, and 37, respectively, who were recruited between January 1, 2002, and May 31, 2006. Cohort was divided into quintiles of serum estradiol

quintile 1, < 12.90 pg/mL;
quintile 2, 12.90-21.79 pg/mL;
quintile 3, 21.80-30.11 pg/mL;
quintile 4, 30.12-37.39 pg/mL;
and quintile 5, > or = 37.40 pg/mL.

Quintile 3 was considered prospectively as the reference group.


MAIN OUTCOME MEASURES:

Serum concentrations of estradiol and androgens (total testosterone and dehydroepiandrosterone sulfate [DHEA-S]) were measured using immunoassays.


RESULTS:

Among 501 men with chronic HF, 171 deaths (34%) occurred during the 3-year follow-up. Compared with quintile 3, men in the lowest and highest estradiol quintiles had increased mortality (adjusted hazard ratio

---

, 4.17; 95% confidence interval [CI], 2.33-7.45 and HR, 2.33; 95% CI, 1.30-4.18; respectively; P < .001). These 2 quintiles had different clinical characteristics (quintile 1: increased serum total testosterone, decreased serum DHEA-S, advanced NYHA class, impaired renal function, and decreased total fat tissue mass; and quintile 5: increased serum bilirubin and liver enzymes, and decreased serum sodium; all P < .05 vs quintile 3). For increasing estradiol quintiles, 3-year survival rates adjusted for clinical variables and androgens were 44.6% (95% CI, 24.4%-63.0%), 65.8% (95% CI, 47.3%-79.2%), 82.4% (95% CI, 69.4%-90.2%), 79.0% (95% CI, 65.5%-87.6%), and 63.6% (95% CI, 46.6%-76.5%); respectively (P < .001).

Reference:

Circulating estradiol and mortality in men with systolic chronic heart failure.
JAMA 2009 May 13;301(18):1892-901.


STUDY LOOKING AT THE EFFECT OF ESTRADIOL ON BONE DENSITY IN MEN:

This study followed young and older men's testosterone and estradiol to see their impact on bone density. Estradiol below 11 pg/ml was associated with increased bone loss.

Abstract

Estrogen appears to play an important role in determining bone mineral density in men, but it remains unclear whether estrogen primarily determines peak bone mass or also affects bone loss in elderly men. Thus, we assessed longitudinal rates of change in bone mineral density in young (22&#8211;39 yr; n = 88) vs. elderly (60&#8211;90 yr; n = 130) men and related these to circulating total and bioavailable estrogen and testosterone levels. In young men bone mineral density increased significantly over 4 yr at the mid-radius and ulna and at the total hip (by 0.32&#8211;0.43%/yr), whereas it decreased in the elderly men at the forearm sites (by 0.49&#8211;0.66%/yr), but did not change at the total hip. The rate of increase in bone mineral density at the forearm sites in the young men was significantly correlated to serum total and bioavailable estradiol and estrone levels (r = 0.22&#8211;0.35), but not with total or bioavailable testosterone levels. In the elderly men the rates of bone loss at the forearm sites were most closely associated with serum bioavailable estradiol levels (r = 0.29&#8211;0.33) rather than bioavailable testosterone levels. Moreover, elderly men with bioavailable estradiol levels below the median [40 pmol/liter (11 pg/ml)] had significantly higher rates of bone loss and levels of bone resorption markers than men with bioavailable estradiol levels above 40 pmol/liter. These data thus indicate that estrogen plays a key role both in the acquisition of peak bone mass in young men and in bone loss in elderly men. Moreover, our findings suggest that age-related decreases in bioavailable estradiol levels to below 40 pmol/liter may well be the major cause of bone loss in elderly men. This subset of men is perhaps most likely to benefit from preventive therapy.

Reference:

Relationship of Serum Sex Steroid Levels to Longitudinal Changes in Bone Density in Young Versus Elderly Men.
The Journal of Clinical Endocrinology & Metabolism August 1, 2001 vol. 86 no. 83555-3561

 

[Lowtuk]

Thank you for that Blackhawk

 

[Blackhawk]

Hi Blackhawk,

I took 1mg at the start as read a protocol stating that but after more research I found out it was a lot, it's dropped my estradiol from 99 to 22 in 4 days so obviously powerful, I'm not sure what to do now with the dosing? should I leave it for a few weeks or take .25mg with my next injection which will be my last as I'm moving to the compounded gel at the end of the month

I sure can't tell you. First as you stated, you are looking at non sensitive testing which typically reads much higher than sensitive test results. This implies you have already potentially crashed your E2. Second, all I have to go on is the common wisdom on the topic which is that everyone responds in their own way to anastrozole.

Personally, i was put on 0.125mg 2x/week, that's total of .25 a week. I modified this to 0.0625 EOD which is so much easier for me since I am on T and HCG EOD as well, so take it all the same time. This dosage is about 10-12% less than the prescribed dose. I am waiting for sensitive E2 test to come back to find out where my E2 is now.

However, I am a different person than you, with different hormone metabolism on a different protocol. There is no way to say whether a protocol like mine would work for you.

 

[Lowtuk]

Thanks Blackhawk,

Appreciate all of the feedback, going to try different doctors to get the sensitive E2 test to check my actual levels.

 

[Systemlord]

If thyroid function is low then you would not expect to see good results on TRT, don't accept your doctor telling you your normal.

 

[Jon H]

Anastrozole NEVER increases libido or erection quality. Never, so don't fall for it.
Nolvadex shuts down your IGF-1 and muscle gains. It also has no effect on quality of life.

I in no way want to derail this thread. However, I need to state that I am very sensitive to E2 levels (both high and low). If my E2 gets too high, which for me is anything over 35, my erections and libido both go in the crapper. Anastrozole will bring my E2 into a good range, which for me is a very narrow window of 20-30, and in doing so will definitely help my libido and erection quality.