Got labs back:

Sterling · Oct 10, 2013

Total T was 1089, Free 32.5
Estradiol 6.9
DHEA 105.9
LH 0.1

The doc suggested I back off a little on the Anastrozole from 1mg 2x/wk to 0.5mg 2x/wk to bring the Estradiol back up. In addition, he added 40mg of dhea/day. Other than that, he said all was good. When I looked at the Luteinizing Hormone being so low, I was concerned. I'm assuming that's a direct result of using 200mg of test cyp per week.

Do these numbers look ok? Anybody with an opinion can chime in. FYI-I had backed off my test for a couple weeks because it accelerated my hair loss. I'm adding 5% minox plus 12.5% azelaic acid hopefully to get me back on track.

Gene Devine · Oct 10, 2013

Sterling said:
Total T was 1089, Free 32.5
Estradiol 6.9
DHEA 105.9
LH 0.1

The doc suggested I back off a little on the Anastrozole from 1mg 2x/wk to 0.5mg 2x/wk to bring the Estradiol back up. In addition, he added 40mg of dhea/day. Other than that, he said all was good. When I looked at the Luteinizing Hormone being so low, I was concerned. I'm assuming that's a direct result of using 200mg of test cyp per week.

Do these numbers look ok? Anybody with an opinion can chime in. FYI-I had backed off my test for a couple weeks because it accelerated my hair loss. I'm adding 5% minox plus 12.5% azelaic acid hopefully to get me back on track.

Hi sterling!

When posting lab results it's always best to include the labs ranges as they are all different.

I need to know what type of TRT Protocol you are on? Are you injecting, transdermals, using HCG...things like that.

When did you get the blood drawn relative to your last injection (assuming you are injecting, if not ignore).

Okay that said, the Doc is right in reducing your AI; in fact if it were me, I would have asked to stop for at least 6 weeks to get your E2 serum level back to a stable normal levels again. Right now it's in the tank and with that comes some bad side effects like ED and no sex drive among other ugly things.

I can't comment on DHEA-S because there are no ranges. That said, what type of DHEA supplement are you taking?

You should also add in 50 mg of Pregnenolone daily as well. You need to back fill your pathways when on a TRT protocol and both are necessary.

LH and FSH will be tanked because you are taking exogenous testosterone as such you are now HTPA suppressed...it's totally normal.

Sterling · Oct 10, 2013

Hi Gene, Thanks for responding. T was 1089ange of 348 - 1197
Free T was 32.5 with a range of 6.8 - 21.5
Estradiol

Gene Devine · Oct 10, 2013

You look good but remember, when you reduce your AI your Free T will go down as some of it will aromatase into E2, which is normal. You are elevated in Free T because your E2 is so suppressed.

Like I said, if it were me, I'd ask to just stop the AI for 6 weeks and get retested.

You need E2 to rebound and even 1 mg per week is a lot for a man...AI's are very powerful antagonists in men.

Just my $0.02.

Sterling · Oct 10, 2013

Hi Gene, Thanks for responding. T was 1089 with a range of 348 - 1197
Free T was 32.5 with a range of 6.8 - 21.5
Estradiol 6.9 with a range of 7.6 - 42.6
DHEA 105.9 with a range of 71.6 to 375.4

I'm was doing IM injections twice weekly. 100mg on Mondays and Fridays. I was taking hcg at 350 units on the days following my T shot and Anastrozole was 1mg twice weekly. I switched companies for a reason I'd rather not disclose but I'm with Defy now. The new protocol will keep the T the same while to doc upped the hcg to 500 units the day before each T shot and dropped the AI to 0.5mg to be taken the same day as my T shot. I don't know what kind of DHEA they will send as my new meds have not arrived yet.

I'll ask the doc about stopping the AI altogether until I get the E2 back up. No wonder my sex drive tanked. I was through the roof until the AI was raised to 1mg twice weekly. I was good at 0.5mg twice weekly. I don't know anything about Pregnenolone so I'll ask the doc about that too. I'll have new labs drawn in 3 months so we can tweak things.

Gene Devine · Oct 10, 2013

What surprises me is that the would continue your AI when you are so dangerously low!

Men need E2! Go into the Fact & Question forum and start to read.

Also, look for my paper on HCG in there you will read why you need both DHEA and Pregnenolone.

BTW, 200 mg per week is a lot and at the very top for what is recommended for TRT in men.

Some of the best TRT Docs are now starting men out on 60 to 80 mg per week and getting great results as a comparison!!!

Sterling · Oct 11, 2013

Hey Gene,

I sent my question about temporarily halting my use of Anastrozole. I'm awaiting my response from Dr. Saya at Defy Medical. It was just yesterday that he reviewed my labs with me and made the recommendations I posted for my new trt protocol. I knew something was wrong when I was using 200mg of test per week and only 0.5mg of Anastrolzole twice per week with good results. I don't have labs to back that up but my libido was through the roof. Maybe it was in combination with my high T levels too but I couldn't figure out where my libido went and I have an idea now thanks to you...the increase in AI to 1mg twice a week crushed my E levels. I guess I can discuss lowering my T protocol too. Perhaps I can try 100mg per week and see how I fair...with the combo of 500 units of hcg twice a week, the added DHEA and perhaps the Pregnenolone. The doc wanted new lab work drawn 3 months after starting this new protocol. And Gene, I looked for your articles. Did you mean in the FAQ section. Please direct me, could you? Thanks for your input from a 48 year old newbie.

Kelly · Oct 11, 2013

Sterling for some perspective the average dose of adex for a 500mg test cycle is .25mg EOD.

Sterling · Oct 11, 2013

Kelly said:
Sterling for some perspective the average dose of adex for a 500mg test cycle is .25mg EOD.

I'm confused so please bear with me. I'm to start a cycle of 200mg per week. That said, .25mg EOD would equate to about 1gm or so per week for someone taking 2 1/2 times the T I'm dosing. Given what you've said, it would seem that .25 mg twice weekly would be sufficient for me. Are you in agreement with Gene that the large dose of Anastrozole is what crippled my E2 and sent my libido and caused mild Ed? I'm hoping the doc will respond and take these things into account. Thanks for your input.

Kelly · Oct 11, 2013

I am in agreement with GD. You need to elevate your E2. A reduction in dosage would be prudent. I'll go further to say that you may consider trying DIM and Zinc to combat E2 instead of jumping right on to adex at .25 the day after injections. Less is more here. Your free T number is high. Titrating back won't hurt you a bit.

Sterling · Oct 11, 2013

Kelly, Is there a number where my E2 should be? Obviously we're all chemically a little different but I'm guessing it's better to be on the high end of the normal (7.6 to 42.6) than where I'm at now with my level of 6.9. Are you suggesting I use DIM (doseage?) and Zinc (dosage?) when I begin my trt and hold off on the Adex until new labs are drawn in 3 months? Other than that, carry on with the other meds in the therapy?

Sterling · Oct 11, 2013

Gene, Dr. Saya from Defy Medical gave me the ok to stop the AI pending my labs in 3 months from the date I start my new program. He simply recommended that I watch for side effects from high E. Can you direct me to the reference material you mentioned in an earlier post. I went to the Frequently Asked Question-FAQ section and couldn't find the data. Thanks again.

Nelson Vergel · Oct 11, 2013

Just try not to lower your estradiol below 25 pg/ml

The upper limit before high estradiol effects are seen have not been determined in any study in men. Some speculated anything above 50 pg/ml is too high.

Read these posts:

https://www.excelmale.com/forum/thr...-greater-mortality-in-men?highlight=estradiol

https://www.excelmale.com/forum/threads/427-Estradiol-in-Men-A-Must-read?highlight=estradiol

Low estradiol can be linked to increased fat: http://testosteronewisdom.blogspot.com/2013/09/groundbreaking-study-testosterone-and.html

Gene Devine · Oct 11, 2013

The 2 mg of the anastrozole tanked your E2...plane and simple.

The 1 mg per week could/may still keep it down but possibly not tanked.

I am glade to see the Doc is agreeing to halting the AI till your next BW or if you present with symptoms (learn the symptoms of high E2 so you know what to look out for).

Your E2 will rebound to baseline and you will feel your libido come back and erection quality as well.

Let me find my paper on HCG in here and I will post. In it I have written on the virtues of supplementing both DHEA and Pregnenolone while on a TRT protocol.

Both are highly favored by many of the top anti aging clinicians.

BTW, you got a good Doc there! He listened to you and agreed with you...that's very good indeed

Nelson Vergel · Oct 11, 2013

I think it is crazy to start any man on testosterone and anastrozole at the same time without seeing the man's response to testosterone and its aromatization after the first month. Many men's estradiol does not go up above 45 pg/ml even when their total testosterone reaches levels close to 1000 ng/dl. So why load up a man with an extra drug if they have not seen how his liver/fat cells handle testosterone aromatization first? Even if estradiol is high during the first 4 -8 weeks, that usually is not enough time for detrimental effects like gynecomastia to occur.

The current cookie cutter practice by most men's and anti-aging clinics of prescribing anastrozole from day one will one day prove to be wrong. We are getting closer and closer to the time when that data will be available. At least now we now low estradiol can be linked to higher body fat and other issues. What we do not know is what a safe upper limit is.

Everyone should wait for blood tests after at least 6 weeks of TRT before deciding to bring in anastrozole. My two cents that I know one day will be proven to be correct.

Sterling · Oct 11, 2013

Thank you Gene. I'm going to stop Anastrozole during the first 6 weeks of my new trt therapy in an effort to allow my E2 to recover. Then, given what I've learned here thus far, I'll likely add .25mg twice per week for the remaining 6 weeks leading up to my new labs. I will ask Dr. Saya about Pregnenolone too.

Sterling · Oct 11, 2013

Nelson Vergel said:
I think it is crazy to start any man on testosterone and anastrozole at the same time without seeing the man's response to testosterone and its aromatization after the first month. Many men's estradiol does not go up above 45 pg/ml even when their total testosterone reaches levels close to 1000 ng/dl. So why load up a man with an extra drug if they have not seen how his liver/fat cells handle testosterone aromatization first? Even if estradiol is high during the first 4 -8 weeks, that usually is not enough time for detrimental effects like gynecomastia to occur.

The current cookie cutter practice by most men's and anti-aging clinics of prescribing anastrozole from day one will one day prove to be wrong. We are getting closer and closer to the time when that data will be available. At least now we now low estradiol can be linked to higher body fat and other issues. What we do not know is what a safe upper limit is.

Everyone should wait for blood tests after at least 6 weeks of TRT before deciding to bring in anastrozole. My two cents that I know one day will be proven to be correct.

Thanks Nelson. I know you're a fan of Dr. Saya and he is the one who initially decreased my AI from 1mg twice per week (another clinic recommendation) to .5 twice per week. As I mentioned to Gene, I will stop AI for the first 6 weeks of my new protocol and then add .25mg twice a week for the remaining 6 weeks leading up to new labs. I did well when I was dosing .5mg of AI twice a week but I guess in this case, less is likely more. I hope this protocol gives me the numbers right for me. Perhaos right enough so that only a little tweaking is necessary and not the major changes I'm making now with tanked E2.

Gene Devine · Oct 11, 2013

Sterling - Attached is my paper on DHEA and Pregnenolone.

You will see Dr. Neal Rouizer's presentation in here as well.View attachment DHEA & Pregnenelone - What you should know..pdf

Sterling · Oct 14, 2013

Thanks for the info. Gene. I'm definitely going to get some Pregnenelone to supplement my new trt protocol. That said, you read where the doc has prescribed me to continue the 200mg of T per week spilt in two day per week doses of 100mg. As you see my current test level is almost 1100. I'm going to be 49 years old near the end of the year so I'm wondering if I really need a T level so high. I was actually thinking of going to 50mg/week split in two doses on Mondays and Fridays. Care to share your $.02? I will also refrain from starting the AI when I begin the new trt. I'll wait 6 weeks and ask the doc to have me retested. Do you think I should stay at 200mg/wk or go with the 100mg/wk with no AI and see what the labs show at 6 weeks? Is 500 units of hcg 3x/week ok too? That's what's been prescribed? I'm certain the doc knows what he's doing but I do like others feedback. Especially from those who've been down that road before me. Thanks Gene.

davidloc · Oct 14, 2013

The 200mg /week with the HCG @ 1500ui per week seems high to me. I am one year older than you and 210 pounds in pretty good shape. I take 45 X 2 per week and start 250 X 2 HCG per week tomorrow and will post the panel results when I get them done in 6 weeks. 160 mg enanthate per week made me really irritable and the E2 levels were through the roof (58 1 year ago). Follow your docs advice but I would really question the need for such a high dose.

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