Adjusting Anastrozole dosing based on morning wood?

Guys, I noticed that morning wood is not always there. My CURRENT Test Cyp dose is .5ml/week split into two although my script is for 1ml/week; Mondays and Thursdays. I purposely backed off my dose because I notice significant hair thinning about 2 weeks of being on 1ml/week. When I do half the prescribed dose I notice the hair near my crown is not AS thin.

I don't take my AI consistently because when I do I start getting morning wood for a couple of days and then it just goes away. This happens even splitting .25mg into two doses per week. This really makes me ANXIOUS because I cant get the AI protocol right!

I am wondering how to troubleshoot myself based on morning wood. I am thinking of discontinuing AI for about a week and start taking it again and wait for morning wood. On that day, would it be wise to go to the lab and have the E2 sensitive test sample drawn? Would that give me an indication of MY optimal E2 levels?

Thanks!

a_crossfitter said:

Guys, I noticed that morning wood is not always there. My CURRENT Test Cyp dose is .5ml/week split into two although my script is for 1ml/week; Mondays and Thursdays. I purposely backed off my dose because I notice significant hair thinning about 2 weeks of being on 1ml/week. When I do half the prescribed dose I notice the hair near my crown is not AS thin.

I don't take my AI consistently because when I do I start getting morning wood for a couple of days and then it just goes away. This happens even splitting .25mg into two doses per week. This really makes me ANXIOUS because I cant get the AI protocol right!

I am wondering how to troubleshoot myself based on morning wood. I am thinking of discontinuing AI for about a week and start taking it again and wait for morning wood. On that day, would it be wise to go to the lab and have the E2 sensitive test sample drawn? Would that give me an indication of MY optimal E2 levels?

Thanks!

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In essence, you're answering your own question in bolds above. Labs are the route to when you need the truth! Sometimes there's no complete way around hair thinning and other factors related with increased hormones. In this case, DHT could be your culprit. In some people like myself, it seems like more hair started coming out. Good to know I can let it grow and weave a rug if we hit an ice age anytime soon!

Run labs my friend, run labs. That and don't get too fixated on just the whole test and E2 thing. Look further upstream, make sure components like your thyroid, adrenals, Vitamin D, iron, ferritin, mag, B12, etc., are in order. Restoring balance in other areas of the body and endocrine system is vital to achieve the well being you desire.

The body seeks homeostasis, so keep that in mind that when trying to get all of this dialed in. In many cases andropause/hyogonadism also leads to the need to back fill other hormonal pathways and supplement accordingly, which will impact the body's function with mood, stamina, energy; shifting towards stronger promotion of ATP, GABA ... etc.

Also, in closing, always factor your SHBG and free test into the equation when considering what adjustments need made. You may already be doing this, which is good practice for fine tuning your protocol. If you get some lab results please post them up. Sadly, the E2 margin in men can be fairly narrow, and many times we see similar E2 related symptoms when E2 is both lower and higher than that infamous "optimal" zone you are seeking, which is different for each person.

Vettester Chris said:

The body seeks homeostasis, so keep that in mind that when trying to get all of this dialed in. In many cases andropause/hyogonadism also leads to the need to back fill other hormonal pathways and supplement accordingly, which will impact the body's function with mood, stamina, energy; shifting towards stronger promotion of ATP, GABA ... etc..

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Chris,

This really struck my interest. Is there any technical information, articles or links that details the back filling?

Here's one particular write-up from Michael McEvoy, which IMO really provides some excellent insight on how the hormonal pathway subject functions, and how various imbalances and deficiencies can chain react one hormone to the next, as in the case with pregnenolone steal, or even in estrogen dominance, which is noteably evident with women in peri/post menopausal phases.

-Michael McEvoy , FDN, CNC, CMTA

"Hormones are cell messengers that carry important signals to different cells in the body. There can be a lot of things that go wrong in their communication, and these problems can be due to a multitude of factors, including: nutritional inadequacies, stress, toxicity, organ toxicity/malfunction, mineral deficiencies.

This article is going to investigate some of the basic steroidal hormones, the pathways they inhabit and problems that can interfere with their utilization. There are 5 classes of steroidal hormones: glucocorticoids, mineralcorticoids, androgens, estrogens and progestagens. The steroidal hormones have regulatory functions in major parts of the body, including: immune function, inflammatory processes, metabolic processes, fluid dynamics and sexual functions and characteristics.
Glucocorticoids are vitally important for the metabolism of carbohydrates. The most important glucocorticoid is cortisol, a powerful adrenal hormone that has multiple functions in the body. Cortisol is a powerful anti-inflammatory hormone that turns down immune responses.
Mineralcorticoid hormones such as aldosterone are hugely responsible for water/electrolyte dynamics through the control of sodium and potassium.
Adrogenic hormones such as DHEA and testosterone are critical for libido, as well as maintaining bone density. Studies have shown that low levels of DHEA correlate with poor bone density and osteoporosis. DHEA is also critical for memory and anti-aging,
Progestagens such as progesterone are vitally important for regulating women's menstrual cycles and are the ‘gestation' hormones. Progesterone converts into the major glucocorticoid adrenal hormone cortisol.
Estrogens such as estradiol are critical for sexual development and have various functions for bone and brain health.
Vitamin D is technically a sterol, but functions similarly to a steroidal hormone. Vitamin D is converted in the liver and has hundreds of vital immune supporting functions. Vitamin D is also critical for calcium regulation in the blood.
[h=2]ALL Steroidal Hormones Are Made From Cholesterol & LDL[/b] The steroidal hormones are all derived from cholesterol and circulating LDL particles in the blood stream. Cholesterol is made in the liver and then is used to make pregnenolone, which is the primary “master” steroidal hormone. Without adequate cholesterol or LDL, steroidal hormone production can be significantly impaired.
Once pregnenolone is synthesized, it is then converted into other hormones, which unveils the breadth of the steroidal hormones and their pathways. The chart below illustrates the major steroidal hormones and the pathways.

We'll break down the pathway as having a “right side” and a “left side”. The right side includes pregnenolone > DHEA > Testosterone and the 2 estrogens. The left side involves pregnenolone > progesterone > cortisol and progesterone > aldosterone.
Then we see at the bottom of this chart something called the “pregnenolone steal”. This takes place when pregnenolone is preferentially taken away from the right side of the pathway in order to feed the left side of the pathway. Consequently, DHEA production suffers because less pregnenolone is available for the right side of the pathway.
This is bad news because the body can only make DHEA from pregnenolone and if it is being “stolen” or used to make cortisol the body cannot make DHEA, Necessarily hormone production is going to suffer.
A potential problem from low DHEA is a diminishment or abnormal testosterone production. Instead of using DHEA to make testosterone, hydroxyprogesterone > androstenidione > testosterone is the back-up system. The problem with this scenario is that if progesterone is being used instead to make testosterone and/or the estrogens via androstenidione, it can impair the viability of progesterone to cortisol production. These are some common examples of how hormone deficiencies can cause “non viability” to the steroidal hormone principal pathways.
In some extreme examples, a tremendous amount of progesterone can be made, and a very small amount of that actually converts into cortisol. A person could have very low cortisol levels and very high testosterone and estrogen.
[h=2]Estrogen Dominance & Copper Toxicity[/b] Estrogen dominance is an increasingly problematic issue, for many women especially. Estrogen dominance occurs when there is a high amount of estrogen relative to progesterone. During a normal menstrual cycle, estrogen is the predominant hormone leading up to the beginning of ovulation. After ovulation, the estrogen should be balanced by progesterone. When “estrogen dominance” ensues, there is inadequate progesterone to counter estrogen's effects.
Estrogen dominance will also tend to cause copper toxicity. Progesterone will tend to reduce copper in the body. But in estrogen-dominant women, copper levels remain elevated, because progesterone is not available to counter copper's effects. As copper and estrogen build, they will give way to many symptoms including PMS, irregular menstruation, fibroids, migraines, ovarian cysts, insomnia and many other symptoms.
Zinc is a critical mineral that balances copper. Zinc is closely related to testosterone in men and progesterone in women. Zinc is one mineral in particular that is deficient in many people's diets. It is found abundantly in organ meats, red meat and in smaller amounts in pumpkin seeds. But there are not too many other places to get adequate zinc into your diet. On the flip side, there are many exogenous sources of estrogen, including xenoestrogens, which are found in chemicals, fertilizers, petroleum products. Xenoestrogens are abundant in the environment, and virtually all people are exposed to them in high amounts.
Environmental copper is also quite common Copper pipes will eventually erode and accumulate in water. Copper is also found in birth control devices, copper cookware, swimming pools, and in certain wood preservatives. Vegetarian diets tend to be high in copper and low in zinc, especially if soy and legumes are the primary protein sources being consumed.
[h=2]Adrenal Fatigue & Burnout[/b] Adrenal fatigue is a textbook alternative health diagnosis. It is characterized by exhaustion, fatigue, and generally excessively high or low cortisol levels. There can be many, many causes of adrenal fatigue. Adrenal fatigue can be thought of as one of a multitude of symptoms that arises when health falls apart. Adrenal fatigue is indeed an excellent opportunity to get your life back in order, and to become honest with the way one has been living their life.
Typically when there are high levels of cortisol, this is characterized as hyper adrenal activity. When low levels are present, this can be characterized as hypo adrenal function. One of the primary influencing factors with adrenal fatigue is inadequate electrolytes and poor hydration. Other primary factors that can interfere with normal cortisol production and adrenal function are heavy metal toxicity, poor diet and nutritional deficiencies. Low conversion from pregnenolone to progesterone can also augment cortisol production.
Most often, adrenal fatigue is not considered a real problem by medical diagnostics. This likely has to do with the fact that blood testing is not reflective of true adrenal hormone levels. Steroidal hormones such as cortisol are bound to proteins in the blood and therefore these levels do not necessarily reflect the actual bio-available levels of certain steroidal hormones. Many believe that the preferred method of testing adrenal hormone levels is in the saliva.
The ratio of certain electrolytes such as potassium and sodium have a lot to do with adrenal function. When these electrolytes are augmented, adrenal function is certainly going to be less than ideal. Since the balance between these two electrolytes is so critical for normal, cell membrane electro-conductivity, a variety of health-related issues may ensue beyond adrenal fatigue.
Other electrolytes that have a critical role to play in adrenal function are calcium and magnesium. Magnesium has an anti-stress effect by its way of inhibiting the sympathetic nervous system (the branch of the nervous system that controls adrenal activity).Magnesium is one mineral in particular that tends to be deficient in many people's diet. Calcium will tend to stimulate the sympathetic nervous system.
[h=2]Restoring Viability To The Steroidal Hormone Pathways[/b] In the alternative world, many practitioners jump right into bio-identical hormones such as progesterone creams and DHEA supplements. While there can be a lot of benefit with this therapy, it should be noted that hormones are powerful substances. If bio-identicals are going to be used, their dosage should be closely monitored. In many instances, their use may not be necessary if other fundamental therapies are implemented. One may think of bio-identical hormones as “training wheels”, instead of permanent support.
Restoring viability to hormone pathways can be achieved through individualized diet, proper hydration and mineralization, enhancing basic detoxification, rest and exercise. Knowing how to use minerals such as sodium, magnesium, zinc and copper is tremendously important for helping regulate hormone rhythms.
The importance of getting to bed between 10PM-12AM can have huge beneficial effects for those with adrenal fatigue issues. If sleep is an issue, another hormone to investigate is melatonin. If melatonin levels are found to be abnormal, consider investigating gut function, as the majority of melatonin is made in the gut."