Anastrozole needed with Tamoxifen HPTA Restart?

Thread starter #1
Hi Guys,

I'm getting off TRT to possibly get my wife pregnant. I also have struggled with anxiety a lot while on trt.
My question is do I need an AI during my 4-6 weeks of tamoxifen? I am very sensitive to E2. While working with defy we figured out that I cannot be over 15 pg/ml (sensitive test) with my E2 or anxiety will be high.

What's confusing is that the PA from defy (very nice guy) says that the e2 gets bound up with Tamoxifen so I wont need an AI. And even if the test shows elevated you will not have symptoms. But then I'm reading from other sources (Ksman user from another forum) and other info that men would need and AI to keep e2 in range during treatment and also take it an additional 3 weeks after tamoxifen is stopped to prevent e2 rebound. Then Taper off AI.

Defy picked Tamoxifen (and I agree) because of my anxiety and previous bad side effects with clomid before trt.

What do you guys think?
 
#3
Probably doesn't answer your question, but why would you need to get off TRT to get your wife pregnant? I had no issues getting mine pregnant, and I didn't have to change a single thing in my TRT protocol.

I had my sperm tested at a lab and it was very healthy. Isn't that one of the reasons we are on HCG, so that we can remain fertile?
 

bkb33

Active Member
#4
Probably doesn't answer your question, but why would you need to get off TRT to get your wife pregnant? I had no issues getting mine pregnant, and I didn't have to change a single thing in my TRT protocol.

I had my sperm tested at a lab and it was very healthy. Isn't that one of the reasons we are on HCG, so that we can remain fertile?
I'm wondering about this as well. I am beginning TRT soon, and fertility is a big priority. Based on everything I've read, I don't think you'd need to get off of it as long as you use HCG properly...that is, unless you really want to get off of it because of the anxiety, which is a different issue.
 
#5
Hey buddy, I feel your pain 100% and I’ve been right where you are. I’m blessed to say that my wife and I are expecting our baby girl any day now!!! Prior to my wife getting pregnant my sperm count was at zero due to TRT with T Enanthate. I stopped T entirely and switched to HCG monotherapy with extremely heavy levels, like 2-3,000 Iu’s every other day or at least M/W/F. If you’re currently sterile, adding HCG to your TRT will most likely not be the jumpstart you need.

Tamoxifen and the AI are serious serious drugs and they’re probably contributing to your anxitety more than anything. This is where therapy is more of an art than science. Do not just listen to your doctor when he says take this or that. Listen to your body and start small. My doc initially had me on Tamlxfin and AI and it completely crashed my E. Talk about a hell ride! Start with very low amounts of the AI and only as needed. Frequently self examine your breasts and only use Tamoxifen if you start to notice a change.

Once you get your fertility back, get your wife pregnant and then you can start TRT with HCG to maintain fertility. Don’t stop until the baby is born and you’ve decided you don’t want anymore kids. HCG will not elevate your T levels to that of TRT, but it will keep you somewhat sane while you regain fertility. On HCG only I thankfully regained my fertility, but keep in mind it takes at least 4 months for new sleep to cycle through, so your somewhere on a 6 month timeframe till getting pregnant.

Make sure you and your wife understand what you’re about to go through and that she’s there to support you through the highs and lows and hormonal changes that will inevitably come with trying to do this. It’s not easy or fun, but it can be done!

Let me know if you have any questions. I’ve learned a lot through my own personal experience. I understand everyone is not the same, which is why this is an art and science. Problems occur when docs prescribe dosages as if we’re all the same.

Make sense?
 
#6
Seriously research the Tamoxifen. If I were you I would stop that stuff right away, unless you’re growing breasts or have breast cancer. I felt like a woman on Tamoxifen, I bet that’s where your anxiety is coming from.
 

Nelson Vergel

Founder, ExcelMale.com
#7
I think that an HCG phase (500-1000 every other day) followed by clomiphene (12.5-25 mg)phase is good enough. Tamoxifen decreases IGF1 and deflates your gains at the gym. Anastrozole has no place in PCT since, without TRT, it can be counterproductive for libido and erectile function.
 
#8
One thing Tomoxifan definitely does for me is Lower cholesterol. I needed life insurance and i took 10 mgs of tomoxifan for 3 weeks and it lowered my cholesterol significantly. If it didnt raise my shgc and lower igf-1, i would use it much more often. Tomoxifan also Does NOT raise T levels nearly as good as clomid for me. Clomid, especially the name brand works much better.
 
#9
Clomid worked for me for fertility for my first child. However, when it came time for my second I told my wife there’s no way I’m going back on Clomid. The side effects were way too much to handle again. Plus there’s not many long term studies, so I was nervous about what other damage it was doing.
 
#10
Reading so many different protocols for coming off. Do you have to have hcg? Saw where some people said clomid only, some nolvadex only, some both...I know like all medicine its an individual issue, but knowing where to start would help. Heard clomid causes just as bad of anxiety as you get when you're on trt. So many different variations to account for. Lots to learn, thanks in advance for everyones time.
 
#12
Clomid worked for me for fertility for my first child. However, when it came time for my second I told my wife there’s no way I’m going back on Clomid. The side effects were way too much to handle again. Plus there’s not many long term studies, so I was nervous about what other damage it was doing.
what are the side effects you had while on Clomid?
 
#13
@Ronnny my side effects were a head in the clouds feeling, anxiety, and minor affect on vision. This sounds weird, but the worst side effect was an incredibly difficult ability to get something out of your head. For example, if I heard a catchy song, it would be nearly impossible to get it out of my head. I mean almost to the point of making you go crazy. I’d be at work or try to sleep or whatever, I would just keep replaying the song in my head. It was so bad, I actually stopped listening to music and tried to avoid it. I would walk into the grocery store and I’d hear a song in the background on their radio and it would get stuck in my head. Drove me crazy!! Once I stopped Clomid it slowly dissipated and now it doesn’t happen at all, at least nothing abnormal. I’m 100% confident it was a direct effect of the Clomid. I know my body well and I try to always be aware of how I’m feeling. Clomid made me feel “off”, just not normal. It was only for the purposes of fertility, so once my wife reached 2nd trimester I stopped. For our second child I learned of HCG and that worked much much better.
 
Thread starter #14
@OsiRuss25 are you planning on coming off TRT for the purposes of fertility? @Jiu Jitsu Dude any update on how things worked out for you?
Update for all: I finished my 30 days of tamoxifen then I ran bloods immediately and My LH was 14.4 (Wow). FSH was 11.7. Testosterone was 559ng, Free was 53.5 pg/ml (range 46-224), E2 sens was 20pg/ml (more on that below) Been off tamoxifen for 2 weeks now. Been off Trt for 51 days now.

Major continual anxiety came 3 days before getting off Tamoxifen and has continued. Bad Shortness of breath frequently. So bad I can't work well. For reference: when 3 weeks off trt I tested Total T at 162ng and E2 at 4.4 pg/ml sensitive test. And I felt decent for the next 3 weeks also until my E2 hit 20pg during my tamoxifen stint with no AI.

Apparently if no AI was used during PCT for someone like me the estrogen can climb by getting stimulated from the LH to the leydig cells in the testicles and can be hard for the AI to eliminate/reduce it from the testes.

After tamoxifen cycle I ran 3/16mg anastrozole divided doses over a week span and it only dropped 2 points to 18pg/ml (on sens test). We figured out at Defy that I am "Hyper Adaptive Sensitive." That's when your body has always had a really low E2 and has adapted to it over many years. Then E2 goes double or triple with trt injections and I go nuts lol. Most people don't have this issue. It's rare. So I must be in the low range like 5-10ish. 20 or 30 kills me with anxiety.

Any Idea of how long the E2 takes to run less in the testicles? Or how to get my E2 lower but not to quick as to crash it. I've taken another 3/16mg AI over last week again and will test e2 tomorrow again. I'll let you guys know the score.

In a couple more weeks hopefully my body will naturally keep it lowish without last minute rebound intervention I'm doing. Sorry about the novel but I'm not doing so well yet. I'll call defy tomorrow for another consult. Hopefully this will all be over in a couple weeks. At least I know what I felt like before trt.
 
#15
@Ronnny Clomid made me feel “off”, just not normal. It was only for the purposes of fertility, so once my wife reached 2nd trimester I stopped. For our second child I learned of HCG and that worked much much better.
That was strange side effects that you had. I took only 25/12.5 mg /day and did not get any side effects.I did not get any positive effects from Clomid other than raised testosterone level. I am now on Cypionate.
 
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