Disappointed with subq bw & Anastrozole question

canatct · Apr 28, 2015

BW after a few months of Pfizer Test Cypionate 50mg E4D IM;

Total T 726 (348-1197 ng/dL)
Free T *30.3 (7.2-24 pg/mL)
Estradiol Ultra Sensitive 33 (8-35 pg/mL)

BW after 4 weeks subq 25mg EOD;

Total T 707 (348-1197 ng/dL)
Free T 18.6 (7.2-24 pg/mL)
Estradiol Ultra Sensitive *54 (8.0-35 pg/mL)

Both labs were performed at Labcorp morning of injection but before injecting.

I'm 6' and around 265 lbs and 50 yrs old. Naturally very muscular but about 40 lbs overweight. And being honest I don't exercise or eat like I know I should.
As you can see my free T dropped with subq and E2 shot up. I did feel better the first 3 weeks with subq (no facial bloating or libido problems like with IM), but the last week I have started experiencing anxiety, mood swings, lack of libido and frequent urination.
My Dr. is a GP and was very hesitant about prescribing Anastrozole, but after some internet searching he did, and said I would be his "guinea pig". He told me to take .25mg and play it by ear.

My question(s) are;
1-how long does it take for the Anastrozole to begin working?

2-If I switch back to IM should I take it the day of injection or after?

3-Should I have another Ultra E2 test 24 hrs after taking the Anastrozole to see what my number is, or just go by how I feel?

FWIW I don't have low SHBG, and I had the Sensitive Estradiol (not ultra) in Sept/2014 prior to starting TRT and results were 16 (3-70 pg/mL).

Gene Devine · Apr 28, 2015

Hi Canatct - I am amazed at the variance in your labs due to the SC injection.

To me, it makes no sense at all why it would have such an impact. If anything, your numbers should have even gotten a little better.

What is your SC injection protocol same as IM?

There is always variability in labs so that's a given, but what a change.

I am wondering if your first labs were just after you started for a "few months" and your levels really haven't settled in yet where your second set of labs is more consistent to where you really live...just guess here.

Answers:

My question(s) are;
1-how long does it take for the Anastrozole to begin working?
A: Almost immediately. It peaks in serum at about 50 hours after taking it with a 100 hour half life. Take no more than .5 mg per week or .25 twice weekly. Very powerful antagonist in men and can tank E2 very quickly...and you don't want that trust me.

2-If I switch back to IM should I take it the day of injection or after?
A: If you switch back, and I personally think you should, take the .25 mg of the AI 24 hours after the injection.

3-Should I have another Ultra E2 test 24 hrs after taking the Anastrozole to see what my number is, or just go by how I feel?
A: Wait 6 weeks and get E2 tested again.

canatct · Apr 28, 2015

Thanks Gene.

I injected IM for over 3 months before the first labwork. I immediately switched to subq EOD and had the bw 4 weeks to the day after switching. The bw with IM injections was 4 days after inj with blood drawn the morning of but before injecting (the trough). Do you think my E2 could have been high 24 hrs post and then settled down to 33 in the trough? Maybe I needed and AI all along?
I really hate to go back to IM but I guess I'll have to in order to get my free T back up.

Gene Devine · Apr 28, 2015

canatct said:
Thanks Gene.

I injected IM for over 3 months before the first labwork. I immediately switched to subq EOD and had the bw 4 weeks to the day after switching. The bw with IM injections was 4 days after inj with blood drawn the morning of but before injecting (the trough). Do you think my E2 could have been high 24 hrs post and then settled down to 33 in the trough? Maybe I needed and AI all along?
I really hate to go back to IM but I guess I'll have to in order to get my free T back up.

One of the biggest benefits for smaller dose SC injections is that it lowers aromatase synthesis!

It makes no sense other then sticking with SC for another few weeks and get confirming labs.

Really weird to be honest.

canatct · Apr 29, 2015

Another question. Will lowering E2 with the AI result in higher free T/ total T?

Gene Devine · Apr 29, 2015

canatct said:
Another question. Will lowering E2 with the AI result in higher free T/ total T?

Yes, it will increase both and you are retarding conversion to E2 thereby increasing Testosterone serum levels.

Nelson Vergel · Apr 29, 2015

Canact
Go back your original protocol (IM, 50 mg every 4 days) and don't take anastrozole. You may want to bring in HCG at 250-500 IU twice per week.

canatct · Apr 29, 2015

Thanks for the input Gene. I really appreciate it.

Nelson, I asked my Dr yesterday for a prescription of Novarel and he said no way. I really didn't think he was going to prescribe the AI. If I dropped the AI and added HCG wouldn't that increase my E2 even more?
I really appreciate your reply to my thread. I love this website.

canatct · May 8, 2015

Well it's only been 10 days since I started the Anastrozole. So far I'm still doing 25mg subq EOD and have taken .25mg E4D of the AI (3 total) and for the past few days my mood has been bad! I feel PO'd at the world. My poor wife. Is it too early for more blood work or do I need to wait it out a little more? I'm anxious to see if the AI is even working or maybe T has jumped.

Gene Devine · May 8, 2015

canatct said:
Well it's only been 10 days since I started the Anastrozole. So far I'm still doing 25mg subq EOD and have taken .25mg E4D of the AI (3 total) and for the past few days my mood has been bad! I feel PO'd at the world. My poor wife. Is it too early for more blood work or do I need to wait it out a little more? I'm anxious to see if the AI is even working or maybe T has jumped.

Way to much of the AI.

You last BW had you only at 54 pg/ml.

.25 mg once a week would have been more than enough to bring your E2 levels into normalized levels.

Without BW it's speculation but the change in your mood could be caused by suppressed E2 levels.

It's not to early to test again.

Do you have any other symptoms of suppressed E2 like no/low libido, ED, cold easy, no energy, focus...things like that?

I would have done what Nelson suggested above and just go back to your original protocol where you didn't even need an AI.

Get BW done...

canatct · May 8, 2015

Gene Devine said:
Way to much of the AI.

You last BW had you only at 54 pg/ml.

.25 mg once a week would have been more than enough to bring your E2 levels into normalized levels.

Without BW it's speculation but the change in your mood could be caused by suppressed E2 levels.

It's not to early to test again.

Do you have any other symptoms of suppressed E2 like no/low libido, ED, cold easy, no energy, focus...things like that?

I would have done what Nelson suggested above and just go back to your original protocol where you didn't even need an AI.

Get BW done...

Gene, my libido is down quite a bit but that's the only other symptom other than the crappy mood. I don't have a lot of energy but didn't before, and feel hot most all the time.
I was so hoping subq would benefit me as I use 31g 5/16 and injecting is a breeze.
I'll have T, free T and ultra sensitive estradiol done Monday morning.
Thanks for the input.

Gene Devine · May 8, 2015

canatct said:
Gene, my libido is down quite a bit but that's the only other symptom other than the crappy mood. I don't have a lot of energy but didn't before, and feel hot most all the time.
I was so hoping subq would benefit me as I use 31g 5/16 and injecting is a breeze.
I'll have T, free T and ultra sensitive estradiol done Monday morning.
Thanks for the input.

And Prolactin as well.

canatct · May 8, 2015

Gene Devine said:
And Prolactin as well.

Why prolactin?

CoastWatcher · May 8, 2015

A high blood prolactin concentration interferes with the function of the testicles/the production of testosterone. So...decreased energy, supressed libido, erectile issues. Not a pretty picture.

Gene Devine · May 9, 2015

canatct said:
Why prolactin?

Because even mid to elevated Prolactin can kill libido...you need to rule it out.

It's not that uncommon for higher levels of Prolactin to decrease libido.

A very small dose of Cabergoline can enhance libido even in guys with mid level range.

It took my libido from normal to that of a 18 year old overnight...kid you not!

canatct · May 9, 2015

Gene Devine said:
Because even mid to elevated Prolactin can kill libido...you need to rule it out.

It's not that uncommon for higher levels of Prolactin to decrease libido.

A very small dose of Cabergoline can enhance libido even in guys with mid level range.

It took my libido from normal to that of a 18 year old overnight...kid you not!

Thats a good reason! I'll include Prolactin and post results when I get them. Thanks much!

canatct · May 18, 2015

canatct said:
BW after a few months of Pfizer Test Cypionate 50mg E4D IM;

Total T 726 (348-1197 ng/dL)
Free T *30.3 (7.2-24 pg/mL)
Estradiol Ultra Sensitive 33 (8-35 pg/mL)

BW after 4 weeks subq 25mg EOD;

Total T 707 (348-1197 ng/dL)
Free T 18.6 (7.2-24 pg/mL)
Estradiol Ultra Sensitive *54 (8.0-35 pg/mL)

Both labs were performed at Labcorp morning of injection but before injecting.

I'm 6' and around 265 lbs and 50 yrs old. Naturally very muscular but about 40 lbs overweight. And being honest I don't exercise or eat like I know I should.
As you can see my free T dropped with subq and E2 shot up. I did feel better the first 3 weeks with subq (no facial bloating or libido problems like with IM), but the last week I have started experiencing anxiety, mood swings, lack of libido and frequent urination.
My Dr. is a GP and was very hesitant about prescribing Anastrozole, but after some internet searching he did, and said I would be his "guinea pig". He told me to take .25mg and play it by ear.

My question(s) are;
1-how long does it take for the Anastrozole to begin working?

2-If I switch back to IM should I take it the day of injection or after?

3-Should I have another Ultra E2 test 24 hrs after taking the Anastrozole to see what my number is, or just go by how I feel?

FWIW I don't have low SHBG, and I had the Sensitive Estradiol (not ultra) in Sept/2014 prior to starting TRT and results were 16 (3-70 pg/mL).

Update;
I took .25mg of the Anastrozole on 4/28, 5/02, and 5/06. No more. Had labs on 5/13 (7days after last AI dose) and below are my results.

Testosterone 688 (348-1197)
Free Test 13.6 (7.2-24)
Estradiol, Sensitive 13.7 (8.0-35)

As you can see, everything dropped. I'm still doing 25mg test cypionate subq EOD, and must admit I feel pretty good except my libido is down.
My hair fell out an an alarming rate for a couple weeks after starting the Anastrozole. Don't know if that was the cause or DHT, as I've never had DHT checked. I don't like taking Anastrozole and hope I can continue without it.

I am in the process of scheduling an appt with Defy Medical, so I can add in HCG, and hopefully get some answers from a Dr in the know.

a_crossfitter · May 18, 2015

Perhaps you should loeer your AI dosage per week too. Try splitting the AI pill into smaller chunks and take .125mg at a time.

Split your 1/4 pill into half and take 1/8 of a pill twice a week.

The other thing you might want to try is to split your weekly dose into three and no AI. That did the trick for me

dallas101346 · May 19, 2015

Gene Devine said:
Because even mid to elevated Prolactin can kill libido...you need to rule it out.

It's not that uncommon for higher levels of Prolactin to decrease libido.

A very small dose of Cabergoline can enhance libido even in guys with mid level range.

It took my libido from normal to that of a 18 year old overnight...kid you not!

Not to hijack, but gene, how much and where did you get caber?

Also, I too have seen the difference in E2 going IM to subQ. When I am on IM, I have nearly no issues with E2... subQ and i get lower T levels with higher E2. My issue is that I don't think I handle the swings in estrogen that well.

SubQ does keep things more stable.

Cooper · May 19, 2015

Gene Devine said:
Because even mid to elevated Prolactin can kill libido...you need to rule it out.

It's not that uncommon for higher levels of Prolactin to decrease libido.

A very small dose of Cabergoline can enhance libido even in guys with mid level range.

It took my libido from normal to that of a 18 year old overnight...kid you not!

So if Prolactin is elevated how should it be treated to lower it?

Disappointed with subq bw & Anastrozole question

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