TRT and AI

[Crom_is_good]

Hello again,
So I began my treatment of testosterone therapy on October 3rd. Currently taking 160 mg a week; planing on going to two injections a week. My estrogen levels were at 30 and I thought that was pretty good. However, my doctor has told me to take 1/2 mg Anastrozole after my Thursday injection and then the other half on Saturday.

My question is this. Is it really necessary to take Anastrozole on such a low dose of TRT? I've been doing some research and it seems that AI can be really, really bad for you. I've also heard that slightly elevated Estrogen while on Testosterone is good for your sex drive.

Some of you already know that as a young man I suffered a stroke due to Lyme decease. My sex drive has been very, very low for over 20 years because of it. Now at 43 y/o I'm really hoping to use TRT as a way to revive my sex drive and rebuild my body.
I want to keep my heart healthy as long as I can, and avoid any of the dangers that come along with small doses of Anastrozole. I'm considering just not taking the Anastrozole and not telling my doc. I don't want to violate his trust however.

There's a lot of talk about AI being really harmful. Do any of you think it's any reason for concern? I honestly just want to feel the effects my shots have on my system with no other interference.

Thanks in advance

 

[antelopers]

I would wait until you exhibit high E2 symptoms and do bloodwork before starting an AI. Crashing your estrogen is not fun, and it's unlikely that your estrogen is out of control so early.

 

[Vince]

Having testosterone levels of 230, I would consider estrogen levels of 30 very high. As you increase your testosterone you definitely will increase your estrogen. Even though that is true. If it was me, I would still like to wait until new labs are taken, before starting an AI.

 

[Systemlord]

If you want to keep testosterone higher in relation to estrogen, consider more frequent dosing, then if that fails to deliver results, considered a low dose AI, but .5 anastrozole may be too high a dose.

If an AI is needed, start out at .125 1x weekly for 10 days, then if symptoms persist, take it 2x weekly. I'm an AI over-responder, I once tried 1/8 of a 0.050 anastrozole and life became a living hell.

There are some who just can't touch AI's without severe consequences.

 

[Nelson Vergel]

I would avoid AIs. I bet your doctor also used the wrong estradiol test. Doctors that prescribe anastrozole at start of TRT do not know the latest estradiol data.

I can tell you are a new member. I suggest that you read this and stop the AI until your follow up tests are done.
Role of Estradiol in Men and Its Management

 

[MYTVC15]

Was that LCMS aka sensitive or ultrasensitive E2 depending on the lab or was it a straight up regular E2 test?

 

[antelopers]

I would avoid AIs. I bet your doctor also used the wrong estradiol test. Doctors that prescribe anastrozole at start of TRT do not know the latest estradiol data.

I can tell you are a new member. I suggest that you read this and stop the AI until your follow up tests are done.
Role of Estradiol in Men and Its Management

Estradiol is definitely important, but in your post did you believe AIs should be avoided completely, or used in minimal doses as to not crash estradiol levels?

 

[Vince Carter]

my doctor has told me to take 1/2 mg Anastrozole after my Thursday injection and then the other half on Saturday.

For one most every guy that's A LOT of Anastrozole even in the span of 7 days 1mg is a heavy dose.
Liek my other friends using the correct E2 testing and then comparing that to a symptoms should be the course of action.
An AI should never be a basic inclusion of TRT.
The dangerous part that you read about is exactly what you're Dr is prescribing.

 

[Crom_is_good]

For one most every guy that's A LOT of Anastrozole even in the span of 7 days 1mg is a heavy dose.
Liek my other friends using the correct E2 testing and then comparing that to a symptoms should be the course of action.
An AI should never be a basic inclusion of TRT.
The dangerous part that you read about is exactly what you're Dr is prescribing.

I would avoid AIs. I bet your doctor also used the wrong estradiol test. Doctors that prescribe anastrozole at start of TRT do not know the latest estradiol data.

I can tell you are a new member. I suggest that you read this and stop the AI until your follow up tests are done.
Role of Estradiol in Men and Its Management

Hi and thanks for the reply. I went in today for my shot of 160. I was able to make it out of the office without anyone bringing up the Anastrozole. However, as I was driving home and the nurse at the office called me. She told me to take my 0.5 as soon as I get home.
I told her I have the pills at home and will be sure to take it.

I decided not to take it however. I have full labs again on the 31st, and I know that if my estrogen spikes they'll know I haven't been taking the pills. 160 mg of cypionate seems low for that much Anastrozole. Two days after my Saturday dose I got a really bad headache and couldn't concentrate for nothing.

Thanks again in advance for the help. I'll be sure to read over the information in the link you provided.

Stay strong everyone

 

[Crom_is_good]

I would avoid AIs. I bet your doctor also used the wrong estradiol test. Doctors that prescribe anastrozole at start of TRT do not know the latest estradiol data.

I can tell you are a new member. I suggest that you read this and stop the AI until your follow up tests are done.
Role of Estradiol in Men and Its Management

Thanks again! This is a fascinating read. This forum has been pretty good to me. I'm learning a lot.

 

[Crom_is_good]

If you want to keep testosterone higher in relation to estrogen, consider more frequent dosing, then if that fails to deliver results, considered a low dose AI, but .5 anastrozole may be too high a dose.

If an AI is needed, start out at .125 1x weekly for 10 days, then if symptoms persist, take it 2x weekly. I'm an AI over-responder, I once tried 1/8 of a 0.050 anastrozole and life became a living hell.

There are some who just can't touch AI's without severe consequences.

Hi! Yea, two days after my Saturday dose I got a terrible headache and could not concentrate. I felt like crap. My doc already suggested moving to twice a week. After the 31st I start injecting myself and plan to do so. Thanks again.

 

[Crom_is_good]

Was that LCMS aka sensitive or ultrasensitive E2 depending on the lab or was it a straight up regular E2 test?

I'm pretty sure it was just the standard. I can call the office later today to confirm.

 

[Crom_is_good]

Estradiol is definitely important, but in your post did you believe AIs should be avoided completely, or used in minimal doses as to not crash estradiol levels?

If things got bad and I was having symptoms like nipple swelling or sensitivity I would consider it. I just really didn't see the point early on. It worries me though how adamant they are about me taking it. They only pulled my blood once. I would preffer to see how my body is responding to the testosterone before going down the AI path. Also, would you know if a supplement like DIM is a safer alternative?

 

[Vince Carter]

DIM is snake oil

 

[Nelson Vergel]

Estradiol is definitely important, but in your post did you believe AIs should be avoided completely, or used in minimal doses as to not crash estradiol levels?

Thanks for the great question.

My opinion is that:

1- AIs should not be prescribed at TRT start.

2- Sensitive estradiol should be measured after 6-8 weeks

3- A ratio of testosterone to estradiol of 14 and higher is not a cause of gynecomastia (divide ng/dL by pg/mL). All men on TRT have that kind of ratios.

4- Unless you have strong genetic predisposition to gynecomastia, AI's should not be used. If AIs are used, most men do not need doses over 0.25- 0.5 mg per week.

5- Water retention and sensitive nipples are usually NOT a symptom of high estradiol.

6- Using AIs have never been proven to decrease water retention. Water retention on TRT is caused by sodium retention.

7- It is not easy to recover from crashing your estradiol. Low estradiol can decrease sex drive and penis sensitivity, bone density and increase fat mass.

More here:

 

[antelopers]

Thanks for the great question.

My opinion is that:

1- AIs should not be prescribed at TRT start.

2- Sensitive estradiol should be measured after 6-8 weeks

3- A ratio of testosterone to estradiol of 14 and higher is not a cause of gynecomastia (divide ng/dL by pg/mL). All men on TRT have that kind of ratios.

4- Unless you have strong genetic predisposition to gynecomastia, AI's should not be used. If AIs are used, most men do not need doses over 0.25- 0.5 mg per week.

5- Water retention and sensitive nipples are usually NOT a symptom of high estradiol.

6- Using AIs have never been proven to decrease water retention. Water retention on TRT is caused by sodium retention.

7- It is not easy to recover from crashing your estradiol. Low estradiol can decrease sex drive and penis sensitivity, bone density and increase fat mass.

More here:

View attachment 8427

Great info, thanks.

I have always tried to stay under the 30 or 35 maximum with no AI, which leaves my total T no higher than 800 or so at an shbg of 35. I had gynecomastia before trt from puberty and had it removed. If it's safe I suppose I could experiment with pushing it even higher, because I still feel like trt is a little lackluster for me.

I'm guessing extreme circumstances would still warrant an AI, any reason to prescribe one besides a very poor t to e2 ratio?

 

[Crom_is_good]

DIM is snake oil

Thanks! Why I asked.

 

[Crom_is_good]

Thanks for the great question.

My opinion is that:

1- AIs should not be prescribed at TRT start.

2- Sensitive estradiol should be measured after 6-8 weeks

3- A ratio of testosterone to estradiol of 14 and higher is not a cause of gynecomastia (divide ng/dL by pg/mL). All men on TRT have that kind of ratios.

4- Unless you have strong genetic predisposition to gynecomastia, AI's should not be used. If AIs are used, most men do not need doses over 0.25- 0.5 mg per week.

5- Water retention and sensitive nipples are usually NOT a symptom of high estradiol.

6- Using AIs have never been proven to decrease water retention. Water retention on TRT is caused by sodium retention.

7- It is not easy to recover from crashing your estradiol. Low estradiol can decrease sex drive and penis sensitivity, bone density and increase fat mass.

More here:

View attachment 8427

This is all great information. After getting my Lyme under control I've been on this quest to become stronger. The one thing that has been a huge struggle for me has been sex drive and morning erections. No matter how many pull ups, tire tosses, sprints, squats or other I do the drive and morning erections just don't come as much as I would like.

Is it your opinion that as testosterone and estrogen rise together that sex drive and erection quality could improve? Currently my heart checks out and my cholesterol is looking good. I've introduced good salts and healthy fats into my diet some months back. Would love to not take the Viagra anymore if I don't have to.

I'm a total noob.

Really hoping to see improvements soon.

 

[MYTVC15]

From what I've gathered, if you're using T-cypionate and have high estrogen, it's the cypionate (the esters?) causing the water retention. Since my 6 week labs showed an E2 of 60 up from 16 prior to TRT (regular immunoassay) it prompted the clinician to blame water retention I have on the high E2 and put me on Arimidex.

Can anyone confirm if going to T-propionate will alleviate water retention and lower E2?

 

[antelopers]

From what I've gathered, if you're using T-cypionate and have high estrogen, it's the cypionate (the esters?) causing the water retention. Since my 6 week labs showed an E2 of 60 up from 16 prior to TRT (regular immunoassay) it prompted the clinician to blame water retention I have on the high E2 and put me on Arimidex.

Can anyone confirm if going to T-propionate will alleviate water retention and lower E2?

Elevated testosterone will eventually convert to e2, regardless of the ester. Anecdotally a lot of guys report feeling better on prop but I haven't seen these guys posting lower e2 ranges on an equivalent dose. In fact sometimes it's a little higher from the few sets of bloods I've seen..BUT their test is also higher and they have a more favorable ratio. Also remember that the reason steroid users love things like high test and especially dbol is because the quick boost of hormone feels good because it also boosts estradiol along with it and that gives a euphoric feeling. As Nelson mentioned, the water retention is more likely sodium or in my opinion also carbohydrate consumption than e2.

I'm switching to prop for a while to see how I do, I will let you know.