AI monotherapy

[Bill0716]

Has anyone tried, or can advise on AI monotherapy. My test levels are good but my free test is low, SHBG and est are high (bloods below).

I was prescribed 125mg enanthate weekly and HCG 500iu 3 times a week yesterday, however I am extremely concerned about fertility and have decided to think about the whole trt thing for a few weeks before jumping on, and I’m doing my best to educate myself more before doing so (thanks to those in this forum). I am healthy, fit (12-15% body fat) with good amount of muscle for a natural, most of my sides are mental (depression/ tiredness/ major irritability etc), although I do suffer with Mail pattern baldness and very slight puffy nipples (not gyno).

Do those of you in the know believe that I coukd benefit from AI monotherapy, instead of TRT, as I understand that this could lower my estrogen, and in turn increase my free testosterone, whilst also having no negative affect on my fertility? Appreciate any response. Cheers

Test Results - no TrT or AAS

Online blood test (June’19) - FSH 2.1 IU/L (range 1.5 - 12.4)
LH 5.8 IU/L (range 1.7 - 8.6)
Oestradiol 185 pmol/L (range 41 - 159) HIGH!!!
Total testosterone 26 nmol/L (range 8.64 - 29)
Free test (calculated) 0.36 nmol/L (range 0.2 - 0.62)
SHBG 65 nmol/L (range 18.3 - 54.1)

NHS blood test (July’19) - Total T: 20.6 nmol/l (6.0 - 27.0) (lower than before)
17 B Oestradiol 141 pmol/l (55.1-115.6)
SHBG 56 nmol/L (13-71)

 

[M.J]

I guess with your high normal level of T, there is not harm trying out AI.

I started using AI with my protocol as soon as I saw E increasing, gave me anxiety, felt very tired and effected my sexual performance.
After adding AI I feel much better libido increased but I am taking very very low dosage. Like 0.025mg after mixing it with vodka.I tried 0.25 a quarter of one pill and it was very strong. Too low not good and too high also not good.

 

[Bill0716]

I guess with your high normal level of T, there is not harm trying out AI.

I started using AI with my protocol as soon as I saw E increasing, gave me anxiety, felt very tired and effected my sexual performance.
After adding AI I feel much better libido increased but I am taking very very low dosage. Like 0.025mg after mixing it with vodka.I tried 0.25 a quarter of one pill and it was very strong. Too low not good and too high also not good.

Thanks mate. The doctor is reluctant to prescribe me an AI, so thinking of going it alone, so 0.025mg a week is what you’re taking? And why mix with vodka? Any dangers of trying an AI at a small dose and then coming off, as far as you’re aware? Cheers

 

[M.J]

Thanks mate. The doctor is reluctant to prescribe me an AI, so thinking of going it alone, so 0.025mg a week is what you’re taking? And why mix with vodka? Any dangers of trying an AI at a small dose and then coming off, as far as you’re aware? Cheers

Check out my posts search sustanon+hcg and arimidix I learned from other guys in this forum.
You can’t go too low and also too high is not good, I take it EOD to stay near 20pg. My testosterone injection cuz high estrogen so I manage that by taking this dose, if I increase it I will crash my E i guess anything below 15pg is also not good some say below 20. So this dosage manage my injection. And keep me within this sweet zone. Some people say after time u don’t need to take AI as your body get adjusted ( no idea if true or not )
For you u need to know what is causing high E maybe you only need to take AI for sometime. Not permanent, maybe you can start low .25 a pill or even .125 if you can cut that pill.
I noticed my libido increase when I reach that level near 20pg fee much better everything is good.

 

[Vince Carter]

The general consensus on this forum is that it's not used because it doesn't work, though it entirely makes sense we've not seen success with AI mono, for whatever reason(s)

 

[Bill0716]

The general consensus on this forum is that it's not used because it doesn't work, though it entirely makes sense we've not seen success with AI mono, for whatever reason(s)

Interesting, is there any theory behind why it wouldn’t work without TRT? I did have a look on reddit as well, which is the usual forum I use, and there was nothing on there either so perhaps it’s just not a viable option for a natural. I did find a couple of studies supporting its use though, such as the one below:
https://www.ncbi.nlm.nih.gov/m/pubmed/15001605/

 

[Bill0716]

Check out my posts search sustanon+hcg and arimidix I learned from other guys in this forum.
You can’t go too low and also too high is not good, I take it EOD to stay near 20pg. My testosterone injection cuz high estrogen so I manage that by taking this dose, if I increase it I will crash my E i guess anything below 15pg is also not good some say below 20. So this dosage manage my injection. And keep me within this sweet zone. Some people say after time u don’t need to take AI as your body get adjusted ( no idea if true or not )
For you u need to know what is causing high E maybe you only need to take AI for sometime. Not permanent, maybe you can start low .25 a pill or even .125 if you can cut that pill.
I noticed my libido increase when I reach that level near 20pg fee much better everything is good.

Will do. I’d love to know why. Doctor didn’t seem concerned and the only reason he suggested was because my SHBG is high and that’s forcing more test production and subsequent aromatisation. I’m going to try boron in the short term as well as reducing my fats down within macros to see if that helps. Most known reason I’ve come across is if you’re overweight, but as I said in the post I am in good shape so really confusing.

 

[M.J]

Will do. I’d love to know why. Doctor didn’t seem concerned and the only reason he suggested was because my SHBG is high and that’s forcing more test production and subsequent aromatisation. I’m going to try boron in the short term as well as reducing my fats down within macros to see if that helps. Most known reason I’ve come across is if you’re overweight, but as I said in the post I am in good shape so really confusing.

I think Vince thought u want to use it alone to increase T.
I assume you want to mange you E, if you have a constant reason generating E like my self (injections) u need to tune your dose not to go very low. Please also read the post about arimidix half life, they say u need to take it at least twice per week, after 10 days you reach stable state. So you can tell if your dose is good after 10 days. I think u need to go low and go up slowly everybody have a different reaction but this stuff is very dam strong I had around 50pg maybe took .25 next day I had high anxiety pretty much I crashed my E I guess didn’t take anything for a week then lowered it to 0.025 now I think I am doing good based on my last test double checking tomorrow.

 

[DragonBits]

Thanks mate. The doctor is reluctant to prescribe me an AI, so thinking of going it alone, so 0.025mg a week is what you’re taking? And why mix with vodka? Any dangers of trying an AI at a small dose and then coming off, as far as you’re aware? Cheers

I am surprised the doctor prescribed enanthate with your high total t levels.

You could try hcg mono, it will boost your total t even more and not hurt your fertility.

This might be enough on it's own.

But it might boost your E2 even higher, then you can ask your doctor for an AI to fight the high E2. You can then either take AI mono or AI + HCG.

They mix with vodka to be able to more exactly be able to get a small dose. You can then use an eye dropper for a dose.

I often use an AI for a couple of weeks after in injection of Nebido. So I would always be starting and stopping an AI.

I only use 0.125 a week which I spit roughly in half. Probably more like 2/3 1/3, I don't try and be scientific about it.

 

[Bill0716]

I am surprised the doctor prescribed enanthate with your high total t levels.

You could try hcg mono, it will boost your total t even more and not hurt your fertility.

This might be enough on it's own.

But it might boost your E2 even higher, then you can ask your doctor for an AI to fight the high E2. You can then either take AI mono or AI + HCG.

They mix with vodka to be able to more exactly be able to get a small dose. You can then use an eye dropper for a dose.

I often use an AI for a couple of weeks after in injection of Nebido. So I would always be starting and stopping an AI.

I only use 0.125 a week which I spit roughly in half. Probably more like 2/3 1/3, I don't try and be scientific about it.

Thanks, that sounds like a solid option. One thing I have read however is that hcg causes more e2 to be produced in the testicles, which an AI would be useless at combating. I suppose at the very least it would stop atomatasiation which would result in a lesser increase, at least.

I was as suprised as you are that he prescribed testosterone with my numbers, hence my scepticism to go on such a protocol and shut down my natural production. Would hcg and ai, as you suggest have any negative affects on natural production/ fertility (my main concern) I’d say it didn’t work, and I decided to quit cold turkey?

Thanks again for the response, really appreciate it.

 

[DragonBits]

Thanks, that sounds like a solid option. One thing I have read however is that hcg causes more e2 to be produced in the testicles, which an AI would be useless at combating. I suppose at the very least it would stop atomatasiation which would result in a lesser increase, at least.

I was as suprised as you are that he prescribed testosterone with my numbers, hence my scepticism to go on such a protocol and shut down my natural production. Would hcg and ai, as you suggest have any negative affects on natural production/ fertility (my main concern) I’d say it didn’t work, and I decided to quit cold turkey?

Thanks again for the response, really appreciate it.

If E2 did increase on your next blood test, that would likely justify the doctor prescribing an AI.

You could then take the AI without the HCG, assuming the HCG by itself didn't work as well as you hoped. What you tell the doctor is up to you.

Not sure how hard it is to get an AI without a prescription in ?London? since you said NHS. If it is easy to buy, you could try it on your own.

You should check thyroid hormones since your overall T is pretty good.

HCG is used to increase fertility, so I can't see that it would hurt fertility.

You could also look into other reasons for your higher SHBG, here is a chart on suggestions to lower SHBG.

Maybe you restrict carbs too much? Vit D levels?

SHBG – A Modulator to be Modulated | ZRT Laboratory

 

[Bill0716]

If E2 did increase on your next blood test, that would likely justify the doctor prescribing an AI.

You could then take the AI without the HCG, assuming the HCG by itself didn't work as well as you hoped. What you tell the doctor is up to you.

Not sure how hard it is to get an AI without a prescription in ?London? since you said NHS. If it is easy to buy, you could try it on your own.

You should check thyroid hormones since your overall T is pretty good.

HCG is used to increase fertility, so I can't see that it would hurt fertility.

You could also look into other reasons for your higher SHBG, here is a chart on suggestions to lower SHBG.

Maybe you restrict carbs too much? Vit D levels?

SHBG – A Modulator to be Modulated | ZRT Laboratory
View attachment 8025

Great info - thanks.

Yes, I’m in London although had to go to the other side of the country for the doctor I saw as none round here other than Harley street who are notorious for ripping people off!

I have had thyroid hormones checked, as well as vitamin b, iron and cortisol (some others too) all fine. I haven’t had vitamin d checked but plan on doing this. I have started supplementing vitamin d (over the counter pills from health store) as well as zinc and boron. I am pale skinned and don’t get as much sunlight as i would hope. I have also started eating less fat and more carbs, although I was by no means on a keto diet, I did eat a lot of nuts/ avocados/ fatty fish etc. Which I have reduced now. I’m hoping a reduction in fats can also lower the estradiol.

I will see how these natural solutions pan out and also see what he thinks about hcg without the testosterone.

Many thanks again for your help!

 

[Cataceous]

There's the question of which estradiol test was used? If the standard immunoassay was used then there is some risk that the figure is wrongly inflated. Besides that, 50 pg/mL is not that high considering your SHBG. Free estradiol is calculated as about 0.96 pg/mL, which only a bit above the middle of the reference range of 0.2-1.5.

As Vince implies, AI monotherapy may improve numbers, but its lack of popularity suggests it causes more problems than it solves.

 

[DragonBits]

There's the question of which estradiol test was used? If the standard immunoassay was used then there is some risk that the figure is wrongly inflated. Besides that, 50 pg/mL is not that high considering your SHBG. Free estradiol is calculated as about 0.96 pg/mL, which only a bit above the middle of the reference range of 0.2-1.5.

As Vince implies, AI monotherapy may improve numbers, but its lack of popularity suggests it causes more problems than it solves.

The single biggest reason AI monotherapy isn't popular is that it requires a fairly high total T.

Nearly everyone on here comes here because of low T. His total T measured 593-749. I never saw anyone with a total T that high even go on TRT. An AI seems reasonable experiment.

what do you suggest in his situation?

 

[Gman86]

The single biggest reason AI monotherapy isn't popular is that it requires a fairly high total T.

Nearly everyone on here comes here because of low T. His total T measured 593-749. I never saw anyone with a total T that high even go on TRT. An AI seems reasonable experiment.

what do you suggest in his situation?

Before starting TRT I tested my total T twice. First time was around 700, and 2nd time was around 600. If I only had total T done, I would of thought I had pretty damn good T levels for a 27 year old, and my doctor would of thought the same thing. Luckily we tested free T both times. First test it was barely over the low end of the range, and 2nd test it was below the low end of the range, due to a high SHBG. Since free T is the only value that matters, I was lucky enough to get prescribed TRT. The OP has an even higher SHBG than me, by about 10 points. Going by his total T is pointless. All that matters is his free T, which imo could be causing low T symptoms.

 

[Bill0716]

Before starting TRT I tested my total T twice. First time was around 700, and 2nd time was around 600. If I only had total T done, I would of thought I had pretty damn good T levels for a 27 year old, and my doctor would of thought the same thing. Luckily we tested free T both times. First test it was barely over the low end of the range, and 2nd test it was below the low end of the range, due to a high SHBG. Since free T is the only value that matters, I was lucky enough to get prescribed TRT. The OP has an even higher SHBG than me, by about 10 points. Going by his total T is pointless. All that matters is his free T, which imo could be causing low T symptoms.

And how do you feel now? What was your protocol?

I’m not adverse to starting TRT, but only if it is necessary and I am able to preserve fertility. I’m 30 years old so similar age group and I’m getting a lot of mixed feedback about jumping on with my numbers at such a young age.

Did you try boron or anything to naturally lower SHBG before getting on TRT? And are you on HCG, any idea if you have managed to stay fertile?

Thanks for your help

 

[Bill0716]

There's the question of which estradiol test was used? If the standard immunoassay was used then there is some risk that the figure is wrongly inflated. Besides that, 50 pg/mL is not that high considering your SHBG. Free estradiol is calculated as about 0.96 pg/mL, which only a bit above the middle of the reference range of 0.2-1.5.

As Vince implies, AI monotherapy may improve numbers, but its lack of popularity suggests it causes more problems than it solves.

Thanks for the response mate.

They don’t offer the sensitive test in the uk, so this is the best I can get. What concerned me was that I’m c20% over the highest reference point, on both tests.

Have you got a conversion tool to get to the pg/ml values? I had a look online before but was unsure on the best one to use.

Could SHBG be causing this to be inflated? Or does it not work like that.

Thanks for your help

 

[Vince]

Has anyone tried, or can advise on AI monotherapy. My test levels are good but my free test is low, SHBG and est are high (bloods below).

I was prescribed 125mg enanthate weekly and HCG 500iu 3 times a week yesterday, however I am extremely concerned about fertility and have decided to think about the whole trt thing for a few weeks before jumping on, and I’m doing my best to educate myself more before doing so (thanks to those in this forum). I am healthy, fit (12-15% body fat) with good amount of muscle for a natural, most of my sides are mental (depression/ tiredness/ major irritability etc), although I do suffer with Mail pattern baldness and very slight puffy nipples (not gyno).

Do those of you in the know believe that I coukd benefit from AI monotherapy, instead of TRT, as I understand that this could lower my estrogen, and in turn increase my free testosterone, whilst also having no negative affect on my fertility? Appreciate any response. Cheers

Test Results - no TrT or AAS

Online blood test (June’19) - FSH 2.1 IU/L (range 1.5 - 12.4)
LH 5.8 IU/L (range 1.7 - 8.6)
Oestradiol 185 pmol/L (range 41 - 159) HIGH!!!
Total testosterone 26 nmol/L (range 8.64 - 29)
Free test (calculated) 0.36 nmol/L (range 0.2 - 0.62)
SHBG 65 nmol/L (range 18.3 - 54.1)

NHS blood test (July’19) - Total T: 20.6 nmol/l (6.0 - 27.0) (lower than before)
17 B Oestradiol 141 pmol/l (55.1-115.6)
SHBG 56 nmol/L (13-71)

I remember Dr. John Crisler saying that, he had one patient that was only an AI and no other therapy.

 

[Cataceous]

The single biggest reason AI monotherapy isn't popular is that it requires a fairly high total T.

Nearly everyone on here comes here because of low T. His total T measured 593-749. I never saw anyone with a total T that high even go on TRT. An AI seems reasonable experiment.

what do you suggest in his situation?

The studies on AI monotherapy don't imply that high starting T is needed; you can get get quite large boosts in total T.

I'm just advising caution due to his starting with normal free estradiol.

 

[Gman86]

And how do you feel now? What was your protocol?

I’m not adverse to starting TRT, but only if it is necessary and I am able to preserve fertility. I’m 30 years old so similar age group and I’m getting a lot of mixed feedback about jumping on with my numbers at such a young age.

Did you try boron or anything to naturally lower SHBG before getting on TRT? And are you on HCG, any idea if you have managed to stay fertile?

Thanks for your help

Oh I tried literally everything. When I first got my labs back I researched for weeks. And then spent like $200 on supplements. I tried literally everything! Every supplement that you can think of to lower SHBG I’ve tried, no joke. I can’t remember the whole list, as it was 5 years ago, but I know for sure I’ve tried boron. I even had one of my TRT doctors prescribe me Danazol for a bit. I forget why I stopped taking it. I must of either had side effects, or maybe it didn’t work, or maybe it worked, but not good enough to justify the price. I honestly forget, but I’m sure if it worked well I would of stayed on it. So it most likely didn’t work as well as I wanted it to.

So the first few years I was on HCG monotherapy. Had a lot of E2 and gyno issues. Tried Clomid. Felt the worst I’ve ever felt in my entire life. Very depressed, almost suicidal. Just felt absolutely horrible. Then started Testosterone with HCG after that, and was on that up until around the beginning of this year. Stopped using an ai and HCG at the beginning of the year, to see how I felt on just testosterone alone. I currently feel pretty good, just have a lot of brain fog. But I’ve had brain fog the whole time on HRT, and am pretty sure it’s due to the black mold in the house I’ve been at the last 5 years. Coincidentally when I was 27 and started having low T. I’ll be 33 next month. Other than the brain fog I’m doing well in all categories.

As far as fertility, imo you have nothing to worry about. There’s a lot of stories of guys getting women pregnant on testosterone alone. Then you add in HCG, and you have a pretty good chance of being fertile, if you weren’t on testosterone alone. Then if that doesn’t work, there’s always FSH that should help do the trick. And if for some reason that doesn’t work, HMG should do it. Then there’s obv Clomid, but I’m scared shitless of that stuff. Luckily, there’s a ton of options out there for us. If I were you, I wouldn’t worry at all. If you are worried, I would just freeze your sperm, and then start TRT. That way you literally have nothing to worry about.

But honestly HCG can usually do the trick. I was on 1000iu’s of Empower’s HCG for months and months, along with my testosterone injections. I stopped the HCG around January of this year, and just kept doing testosterone by itself. In March I ended up knocking up my ex girlfriend by accident. That was two months completely off HCG, and just on testosterone propionate by itself. I actually had an appt for the baby yesterday. Here’s a couple of the ultrasound pics. So hopefully my story puts you at ease a bit. Other than the brain fog, I feel much better than I did when I had very low free T. And I literally got my ex pregnant by accident, without even trying, while off of HCG for two months. So I personally wouldn’t let fertility concerns prevent you from feeling better. But again, if you’re still worried about it for some reason, just freeze your sperm and hop on HRT. Starting HRT was the best decision I’ve ever made. Don’t regret it one bit.