1. #1

    Complete Hormone & Wellness Panel - E2 slightly elevated

    31 years old. 1.5 years into TRT for secondary hypogonadism. 150mg per week prescribed by my endo. Doctor is a really nice guy but also very well known and very busy. A lot of time I take it upon myself to educate myself rather than asking questions. After year and a half I decided to add 100iu of Corion HCG every day subQ. I also take 25mg of DHEA along with DIM every night before bed. I've had great luck with a single injection and managing E2 without an AI but something that I have noticed is every 3-4 weeks I start to get irritable and emotional. After 3 different sensitive E2 tests, I found that around the time I start getting irritable my E2 peaks between 35-38 out of a 8-35 scale. At this point it starts messing with my daily life as I start slacking and losing interest on important jobs and projects. I cant help but have a negative mindset.



    At this point I believe I am in need of an AI. These labs are taken on my peak 48 hours after injection. The glucose marked as high was due to something I drank earlier in the morning prior to the test.

    I have some Arimidex on the way and I am a bit confused on a starting dose. With my E2 not elevating as high and most people I have seen on here with E2 issues, what would be appropriate dose to bring a 35 down to 22 and what would be the frequency for the symptom timeline.

    Any help is appreciated.
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  3. #2
    Moderator Vince's Avatar
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    Excellent panel, good job. If I were you, I wouldn't even think of lowering that nice 35.4 estradiol level.

    Role of Estradiol in Men and Its Management

    https://www.excelmale.com/showthread...Its-Management
    I am not a medical practitioner. Any suggestions I provide are not medical recommendations and are just my opinions. Please consult with your physician on any matters concerning your health.

  4. #3
    Not many of us are going to say that 35 is a treatable E2 level. What I would do instead of AI, add Calcium D Glucarate @ 500mg twice per day and cut the DHEA in half. DHEA is a notorious for aromatase especially if taken in the wrong form.

  5. #4
    Thanks for the replies. I've had my E2 as low as 22.5 and as high as 38. I definitely am effected by irritability when it drifts into the higher 30s. As I mentioned, it seems to build up every 2-3 weeks then goes back to normal after a week or so.

    Vince, I have been considering stopping the DHEA all together but I may just split it it 12.5mg per day. I started with 25mg morning and 25mg at night and it cause a lot of anxiety! I ordered some Calcium D Glucarate.

    I agree that an AI seems excessive and I have been avoiding it but I am looking for a way to level everything out only when needed. It effects my relationships and work. This has been a loooooooooooong process and journey but I am inching closer and closer to what works for my body.

    I'm open to any other suggestions. Thanks again.
    Last edited by 1911; 02-14-2018 at 09:49 PM.

  6. #5
    You are injecting your testosterone, 150mg, once weekly? Have you considered more frequent smaller doses to see if that manages peaks a bit better? Where does your SHBG sit?
    I am not a physician. Comments offered here are for discussion purposes only. Please consult your doctor before initiating, changing, or stopping any therapy.

  7. #6
    Quote Originally Posted by CoastWatcher View Post
    You are injecting your testosterone, 150mg, once weekly? Have you considered more frequent smaller doses to see if that manages peaks a bit better? Where does your SHBG sit?
    When I first got put on TRT I took the forums advice and split the injections to every 3.5 days. I did that for 8 months and the whole time I was holding 35lbs of water. Extremely bloated and wasn't feeling good. After I switched to 1 injection all the water dropped and everything cleared up. What I got out of it was my e2 stayed steady high on the split while with 1 injection I have time for it to level naturally until my next injection. I am thinking that it does not completely drop down to where it started and over a 3-4 week span it builds to the higher end where it effects me.

    SHBG was only tested pre-TRT and 1 year in. Pre was 24.5 and 1 year on TRT was 34.5 on this scale: 20 - 49y: 16.5 - 55.9
    Last edited by 1911; 02-15-2018 at 12:55 AM.

  8. #7
    From the manufacturer website: "The recommended daily dose, ARIMIDEX 1 mg, reduced estradiol by approximately 70% within 24 hours and by approximately 80% after 14 days of daily dosing. Suppression of serum estradiol was maintained for up to 6 days after cessation of daily dosing with ARIMIDEX 1 mg."

    If my E2 is peaking at 38 and I take .25mg of Arimidex the day after my weekly injection...Based on the manufacturers calculations, would this mean that .25mg would reduce E2 levels by 17.5% within 24 hours bringing it down to 31.35 on a single dose? If that is the case, I am basically looking to take the .25mg 24 hours post injection, get E2 tested, see where I am at. Do not take it again for 2 weeks and then get my E2 retested and see where I am sitting. Based on that range I should get enough information to get an idea of dosage and timing. Am I thinking in the right direction or am I missing something here?

  9. #8
    Quote Originally Posted by 1911 View Post
    From the manufacturer website: "The recommended daily dose, ARIMIDEX 1 mg, reduced estradiol by approximately 70% within 24 hours and by approximately 80% after 14 days of daily dosing. Suppression of serum estradiol was maintained for up to 6 days after cessation of daily dosing with ARIMIDEX 1 mg."

    If my E2 is peaking at 38 and I take .25mg of Arimidex the day after my weekly injection...Based on the manufacturers calculations, would this mean that .25mg would reduce E2 levels by 17.5% within 24 hours bringing it down to 31.35 on a single dose? If that is the case, I am basically looking to take the .25mg 24 hours post injection, get E2 tested, see where I am at. Do not take it again for 2 weeks and then get my E2 retested and see where I am sitting. Based on that range I should get enough information to get an idea of dosage and timing. Am I thinking in the right direction or am I missing something here?
    Yep you're all wrong and in the wrong direction but whatever other forum you're cut and pasting from might be more conducive to AI use with your numbers but almost as a rule no one on EM is going to endorse what you're doing.

  10. #9
    Quote Originally Posted by Vince Carter View Post
    Yep you're all wrong and in the wrong direction but whatever other forum you're cut and pasting from might be more conducive to AI use with your numbers but almost as a rule no one on EM is going to endorse what you're doing.
    I am not cutting and pasting from any forum. I cut and pasted from the fda.gov accessdata information listed on Arimidex found here: https://www.accessdata.fda.gov/drugs...020541s015.pdf

    Something I learned over the last 1.5 years is that everyones chemistry is so different that one person may be living in hell with their E2 in high 30s while someone who has their E2 in the 50s all year round without any issues. I am in tune with body enough to know when things are wrong. I know when I am having high E2 side effects based on irritability, acne, ED, and not being able to focus on work. This is a complete opposite of how I function on a daily basis when everything is in tune. Your opinion that "non one on EM is going to endorse what youre doing" may be a little far fetched. There are many doctors like Dr Rand McClain for example, who say they would never allow a patient to be at the high end of the estradiol test. They aim for the 20-22 mark like many others.

    Yes, I agree that an AI is extreme. As I mentioned, I have tried everything suggested over the year+ to get things in check. Vitamin D, Iron + Zinc, DIM, Calcium D-Glucarate, eating clean, exercising, NEVER drinking alcohol, sleeping minimum 7 hours a night. I am lean at around 12% bf. I really am not sure what my choices are other than a low dose of Arimidex when needed.

    Not sure why you are being negative here when I am just looking to get some help like everyone else. Instead of saying no you are wrong...why not point me in the right direction? I come on here looking for suggestions and advice. The forum and your methods are not always 100% correct. If you read a few posts up, everyone here promotes splitting the injection into 2 parts when all that did for me was made me 35lbs heavier, EXTREMELY BLOATED, and feeling terrible.

    At this point are you suggestions I suck it up, ignore how I feel because the "number" isn't high enough to be considered treatable? That just doesn't make sense.

  11. #10
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    Quote Originally Posted by 1911 View Post
    Thanks for the replies. I've had my E2 as low as 22.5 and as high as 38. I definitely am effected by irritability when it drifts into the higher 30s. As I mentioned, it seems to build up every 2-3 weeks then goes back to normal after a week or so.

    Vince, I have been considering stopping the DHEA all together but I may just split it it 12.5mg per day. I started with 25mg morning and 25mg at night and it cause a lot of anxiety! I ordered some Calcium D Glucarate.

    I agree that an AI seems excessive and I have been avoiding it but I am looking for a way to level everything out only when needed. It effects my relationships and work. This has been a loooooooooooong process and journey but I am inching closer and closer to what works for my body.

    I'm open to any other suggestions. Thanks again.
    I too can tell it and don't feel as well when my e2 gets toward the top of the scale. I definitely feel better when my level is more to the low side of the "accepted range."

  12. #11
    Quote Originally Posted by Country23030 View Post
    I too can tell it and don't feel as well when my e2 gets toward the top of the scale. I definitely feel better when my level is more to the low side of the "accepted range."
    Thank you.

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