Prescribe high arimidex dose...help!

Thread starter #1
So I started trt about 5 months ago. 1 weekly injection 200 mg test cyp. I really didn't notice any significant changes. Went back for blood work and found that my test was in the 900s but my e2 was 75. He prescribed 1mg arimidex eod. About two days after taking first dose my sex drive went through the roof but after doing some research it seems that is a very high dose to take. It has only been a week of taking it. Should I reduce the dose? 75 is high e2 but I don't want to reduce it to nothing....any advice would be helpful. Thanks
 
#2
The reason you feel no better is do to the level of care you are receiving, your doctor doesn't really know how the TRT game is played and it shows. The AI dosage is enough that in time it will cause osteoporosis, why start out on such a high test dosage to where you have to throw absurd amounts of arimidex at it? SHBG is a marker doctors used to determine dosing and injection frequency, so where does your SHBG sit at?

It's common to see doctors using the standard E2 labs which overstate a mans E2 levels, then the doctor prescribes a huge dosage AI. A recipe for disaster.

Was the E2 labs LC/MS/MS method?
 
Thread starter #3
I was never made aware of SHBG. This doctor was my fertility specialist but he also specializes in "men's health." After finding out having a baby would not happen I asked about treating my low testosterone. First test showed 286 about 3 years ago. Subsequent tests showed testosterone at 224 and 186. Looking at the printout of the test results it shows they tested hematocrit(42.8%),e2(75.62 pg/ml, range 6.70-38.70), fti%(144, range 34-106), and test(9.45 ng/ml range 2.49-8.36). All it says about testing methods was that it was done in house.
 
#4
I was never made aware of SHBG. This doctor was my fertility specialist but he also specializes in "men's health." ..............QUOTE]


Looks like your doctor established a low standard for "specializing in men's health" I'll bet the wrong estradiol test was used. He probably used the test for women which is the Roche ECLIA test. The one you need is the Estradiol Sensitive test which is the LC/MS/MS assay that Systemlord already mentioned. I sure wouldn't want him treating me or any one in my family.
 
#5
Run SENSITIVE E2 and see where you are at.
Discountedlabs.com has it for a very reasonable cost.
Standard E2 can show HIGH, when you are within range with the CORRECT test... The SENSITIVE E2 TEST.
If you are treated for HIGH E2 based on the STANDARD test, that is incorrect for men, when you are NOT high you will crash your E2 and then you will be up a creek.
 
Thread starter #6
Run SENSITIVE E2 and see where you are at.
Discountedlabs.com has it for a very reasonable cost.
Standard E2 can show HIGH, when you are within range with the CORRECT test... The SENSITIVE E2 TEST.
If you are treated for HIGH E2 based on the STANDARD test, that is incorrect for men, when you are NOT high you will crash your E2 and then you will be up a creek.
Thanks for the help. Just ordered the test. Will post the results when I get them. Also plan on stopping arimidex until I get the results.
 
Thread starter #7
One more thing. Allot of what I'm reading seems to say that splitting the testosterone dose into two shots a week is a better approach than one injection a week. Would it be a good idea to start doing that without consulting my doctor first? Or should I wait and see what he says?
 
#8
One more thing. Allot of what I'm reading seems to say that splitting the testosterone dose into two shots a week is a better approach than one injection a week. Would it be a good idea to start doing that without consulting my doctor first? Or should I wait and see what he says?
There are a number of red flags flying in regard to your protocol, as has been pointed out. One, large (very large) single dose of testosterone every week, a whopping dose of anastrozole...all of which suggests, no, more than suggests, it indicates that your doctor is out of his league when it comes to managing a patient on TRT. I'm not at all sure that you can expect constructive input when you raise such questions with him. All that said, splitting your dose is a very good idea. You should see a reduction in peaks/valleys, and that should lead to a better subjective response on your part. Where does your SHBG sit?
 
#9
Most people don't do very well on one large weekly injection and find that splitting the dose into two equal injections per week woks much better for them. I would go ahead and make that change and I think you idea of stopping the arimidex until you get the results on the Estradiol Sensitive test is a good idea. There is a good chance you will not need it.

Once you find out what your SHBG is then you many need to adjust your injection frequency again. Your SHBG will determine what injection frequency you should be on. Very low SHBG individuals need every day or every other day (EOD) injections of small amounts of T to be successful on TRT while high SHBG people normally need one large injection a week. Most of us fall somewhere in the middle but it is important to find out what your SHBG is. Again, it will determne the proper injection protocol you should be on.
 
Thread starter #10
So I got my e2 sensitive test results back today and it was 11.2. Thank god I decided to look into this. I just assumed my doctor new what he was doing. I don't doubt my e2 was high, but the 4 mg of arimidex I took in one week per my doctor's instructions must have knocked it down to 11.2. Is that possible? Could 4 mg in a week decrease it that much? I literally knew nothing about the importance of checking e2 til this week. My plan now is to split my injections into two a week instead of one, then retest in a month.
 
#11
Yes, 4 mg of arimidex in one week is more than enough to crash someone's estradiol. I'd advise you to completely stop taking the arimidex until you have symptoms of high E2, which may be never. Even if you must end up taking some, it could be as little as 1/8th to 1/4th of a pill. 4 mg a week is what they might give a woman with breast cancer.
 
Thread starter #13
It says the range is 8.0-35.0, and no I had a rough month financially so I didn't get my shbg tested also, just my e2. I plan on getting it done when I go back next month.
 
#15
that's insane. 1mg of arimidex every other day would crash my e2 on 1000mg testosterone a week.. thats how potent that dose is.. 0.25mg twice weekly first week and then once weekly until next set of labs would work just as good and much safer with smaller risk of crashing e2 (which is pure hell and seems like forever to get over it)
 
Thread starter #16
Yeah it seems my doctor is pretty incompetent, it's crazy he even performed a surgery on me last year. I just thought he knew what he was doing so I never questioned his protocol but I'm just glad I caught this before it was too late. But I've really been educating myself this last week or so.
 
#17
Yeah it seems my doctor is pretty incompetent, it's crazy he even performed a surgery on me last year. I just thought he knew what he was doing so I never questioned his protocol but I'm just glad I caught this before it was too late. But I've really been educating myself this last week or so.
We all have to be our own advocate. The vast majority of men who start TRT give it up, walk away within the first year. The reason? An incompetent doctor prescribed an insane protocol and the patient felt worse after a few months of treatment than he did prior to therapy.
 
#18
Been on self administered TRT for a year now and the learning process has been very interesting and frustrating at the same time! Did bloods after first 3 months and E2 was 67, bought some Arimidex and thought 0.25mg twice a week would be a good start. 2 months later got very painful joints (shoulders and knuckles) did bloods & was in single figures 8.7 - OUCH crashed E2!! Took 2 months of taking no Arimidex to get back to normal & and start being pain-free. I now take 0.25mg once a week and skip taking Arimidex every 4th week, this keeps me at 28-35 which feels good to me. Some people are very sensitive to Arimidex and i'm one of those people. There is no excuse for a Doctor to get these basics wrong.
hct hematocrit was my next big challenge!
 
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