Things went sideways after lowering dose/adding AI

[Ericd306]

So, after 8 weeks in, I was feeling great with maybe a little bit of water retention. Here are those labs.



After reviewing with defy, we agreed to lower me from 160mg/week (two 80 week) to 140mg (two 70mg) and add 0.1mg adex per week. No HCG or anything else either course. Fast forward 3 weeks and I feel like shit. ED that I’ve never had, apathetic, lost muscle size, just not the same. Pulled quick labs and unfortunately they ran the wrong E2 test but here goes:



Any thoughts before i get on the phone with defy?

 

[fifty]

Makes no sense. What changed? Time of labs?

 

[Ericd306]

Nothing outside of lowering from 160mg to 140mg and adding super small doses of Anastrozole. I’m a known over responder as 0.1mg weekly put me down around an e2 of 17 and lower on Clomid monotherapy

 

[Ericd306]

Also, this was the day before my true trough day so TT will even be lower when compared to where I was on 160mg (1300+ on trough/injection day)

 

[Vince]

I would stop the AI, continue injecting the same amount of testosterone. Hopefully you'll feel better.

 

[S1W]

My first thought is that you’re only 3 weeks into the change and how you feel now/lab values at present may not be indicative of how you’ll feel longer term on this protocol.

Lots of guys complain about ED, feeling like they’re not even on TRT, etc when making protocol changes. In my experience weeks 2-4 into a change are always the worst of it.

That said I’m generally not a fan of AIs but there are guys who do well on them.

 

[Tman]

I would stop the AI, continue injecting the same amount of testosterone. Hopefully you'll feel better.

Nothing outside of lowering from 160mg to 140mg and adding super small doses of Anastrozole. I’m a known over responder as 0.1mg weekly put me down around an e2 of 17 and lower on Clomid monotherapy

Stop taking the AI and let things stabilize. You should always only change one thing at a time otherwise you're not sure what's causing what and then you start chasing your tail. Robin UT a little bit is it going to cause everything to go sideways other than your body readjusting to a smaller dose, so most likely its effects from the AI. I'm an AI over responder as well I took .125 twice in the same week and put me in the hospital thinking I had a heart attack turned out it was a panic attack. I lowered my dose and dropped the AI and so far, knock on wood I've been feeling pretty good, better than I have in a long time. Just praying it continues because I was at a point where I didn't know what each day would bring. For the longest time I was trying to get my e2 around my shbg numbers as it slow for me oh, and my testosterone higher. My focus on lowering e2 really came from this site and I regret ever going down that road.

 

[Gman86]

If you were feeling great before, just got back to old protocol. 160mg/ week split into 2 injections. Drop the ai. Problem solved.

Defy will understand when you tell them that you just want to go back to your old protocol. They’re extremely understanding, and receptive to your wishes, in my experience.

Why didn’t you test free T the second time around?

 

[Vince Carter]

My own take on it was 20mg change was too much, plus the AI, should have target a reduction of about 10mg and that alone and then work down. too much change at one time could be the sole reason you feel bad at 3 weeks.

 

[Ericd306]

My own take on it was 20mg change was too much, plus the AI, should have target a reduction of about 10mg and that alone and then work down. too much change at one time could be the sole reason you feel bad at 3 weeks.

Update: it’s been a week since I quit my .05mg Anastrozole. Already starting to feel a bit better in the past day or two. Hoping to speak to defy this week and see if I can go to 150mg and no AI. I felt better at 160mg and I clearly feel better without the AI even if my labs say my E2 is high. Concerned as the nurse who called me the other day acted as if it’s irresponsible to let me E2 be “that high” and we just do something about it. Will definitely speak to someone else this week as that was the first time I’ve experienced that behavior with them. She was only looking at the numbers, not listening to how I feel and just telling me that it’s the high E2 that’s the problem. Even when I explained it was only after adding AI and lowering my dose that the problem started. I also reminded her that I’ve driven my E2 below 17 on just 0.1mg/week when I was on higher dose Clomid monotherapy.

 

[Gman86]

Update: it’s been a week since I quit my .05mg Anastrozole. Already starting to feel a bit better in the past day or two. Hoping to speak to defy this week and see if I can go to 150mg and no AI. I felt better at 160mg and I clearly feel better without the AI even if my labs say my E2 is high. Concerned as the nurse who called me the other day acted as if it’s irresponsible to let me E2 be “that high” and we just do something about it. Will definitely speak to someone else this week as that was the first time I’ve experienced that behavior with them. She was only looking at the numbers, not listening to how I feel and just telling me that it’s the high E2 that’s the problem. Even when I explained it was only after adding AI and lowering my dose that the problem started. I also reminded her that I’ve driven my E2 below 17 on just 0.1mg/week when I was on higher dose Clomid monotherapy.

Wow I’m surprised by their views on this. I guess not every doctor/ nurse thinks the same way at Defy. I’ve had a very different experience with Dr. Saya my first consultation, and Nurse Jill every other consultation. They were both very open to accepting my opinions on how to direct my treatment, and worked with me on how to do so, instead of just dictating their opinions without taking my thoughts into consideration.

 

[Ericd306]

Totally agree and that’s always been the case for me. Mike, Jill, Dr. Calkins, all great!

 

[Gman86]

Totally agree and that’s always been the case for me. Mike, Jill, Dr. Calkins, all great!

Ya defy has been a god send. Literally everything a guy could want in a clinic. If you have someone that doesn’t take your feelings and opinions into consideration, and decided to mess with your protocol even though you felt great on it, I would just switch to someone else at defy. No offense to whatever doctor/ nurse you’re currently seeing. That’s just what I would personally do.

 

[madman]

So, after 8 weeks in, I was feeling great with maybe a little bit of water retention. Here are those labs.



After reviewing with defy, we agreed to lower me from 160mg/week (two 80 week) to 140mg (two 70mg) and add 0.1mg adex per week. No HCG or anything else either course. Fast forward 3 weeks and I feel like shit. ED that I’ve never had, apathetic, lost muscle size, just not the same. Pulled quick labs and unfortunately they ran the wrong E2 test but here goes:



Any thoughts before i get on the phone with defy?

You stated "So, after 8 weeks in, I was feeling great with maybe a little bit of water retention."


First off you tested your FT with the wrong assay!

Unfortunately regarding testing ones FT (free testosterone) most are using the direct analog-based free testosterone immunoassays which are inaccurate.

If anything you should be getting the equilibrium dialysis or better yet save yourself the money and use the Calculate free testosterone with TruT by FPT - Try the public free testosterone calculator at tru-t.org

Do you truly know your FT levels?

What were you expecting.....reason your e2 is so high is simply because your FT levels are too high for you on such protocol 160 mg/week (80 mg every 3.5 days).

Your TT is 1350 ng/dL (trough) and having SHBG at 37.1 nmol/L would have your FT levels at 48.80 ng/dL (range 16-31 ng/dL)

You than state....."After reviewing with defy, we agreed to lower me from 160mg/week (two 80 week) to 140mg (two 70mg) and add 0.1mg adex per week. No HCG or anything else either course. Fast forward 3 weeks and I feel like shit. ED that I’ve never had, apathetic, lost muscle size, just not the same. Pulled quick labs and unfortunately they ran the wrong E2 test but here goes"


If anything lowering dose slightly without adding an a.i. would have been the more sensible approach as you easily had room to lower your TT/FT levels which would result
in lower e2.

Now on the new protocol 140 mg/week (70 mg every 3.5 days) your TT is 883 ng/dL and your SHBG is 26.8 nmol/L which has your FT level at 31.90 ng/dL (just slightly above top end reference range 16-31 ng/dL)

Your FT levels are still very good.

I would say the main reasons you feel like shit are because of the addition of the a.i. which resulted in hammering your e2 too low although we have no idea where it truly sat as the wrong testing method was used.

Top it all off 2 changes were made at once.....lowering your dose by 20 mg/week and adding an aromatase inhibitor.

Also anytime one tweaks a protocol whether increasing/decreasing T dose hormones will be in flux during the following weeks until levels stabilize (6 weeks) so it is common for one to experience ups/downs regarding mood/energy/libido/erections so to judge how you feel during this transition when hormones are in flux is pointless and even than once T levels have stabilized I would give it 2-3 months at new said dose/protocol to truly gauge whether it is beneficial or not.

* Highly doubtful you lost muscle size!

 

[madman]

Curious about labs

 

[Ericd306]

* Highly doubtful you lost muscle size!

Whether actual muscle mass was lost or not, I don’t know, but look/feel very flat. Lost a lot of fullness.

 

[Ericd306]

So my e2 sensitive labs came in at 59. This was 5 days since my last .05mg Adex dose and I haven’t taken any more since. And I feel great again. So f’n weird. I’m sweating a bit at night but otherwise, high libido, morning wood, no bloat. I don’t get it. Speaking to defy today.

 

[Tman]

So my e2 sensitive labs came in at 59. This was 5 days since my last .05mg Adex dose and I haven’t taken any more since. And I feel great again. So f’n weird. I’m sweating a bit at night but otherwise, high libido, morning wood, no bloat. I don’t get it. Speaking to defy today.

I actually felt better with my e around 50 than I did around 30 no idea why and not sure if it was healthy or not but based on feelings alone that was the case.

 

[Ericd306]

Just got off the phone with Defy. They’re keeping me at 150mg (140 dropped my TT a good amount) but 3 times a week to help e2 slightly. No more AI. They’re the best