Questions and Advice Required

New to forum and looking for any pointers on my situation. I have been on trt for 4 years, .5ml weekly, in the 800-1000 range 24 hrs after when tested. Over the last few months have been feeling like crap and was like trt wasn't working, I had skipped a couple weeks and when I did take injection didn't feel any better. I am 5ft8 260lbs, yeah I know the overweight isn't helping but am working on that as well. I went to my uro the other day and here are results from blood work taken a day and a half after injection, main complaints were bad back acne, less to no sex drive, moody.
Estradiol-55
free test-232
Test-858

after this he has kept me at the .5ml weekly and added anastrozole 1mg daily, what are your guys thoughts? From what I have read 1mg is fairly high? How will I know if the anastrozole is to much when I'm taking it?

thanks for any input.

I hope that 1mg daily was a typo and you really meant 1mg weekly.

Also - is the Estradiol result from the "SENSITIVE" e2 test or standard?

Any other blood work you can share?

RDWRDW

13.8

Low In Range High
11.0-15.0 %



MPV

8.4

Low In Range High
7.5-11.5 fL



PLATELET...

202

Low In Range High
140-400 Thousand/uL



MCHC

32.9

Low In Range High
32.0-36.0 g/dL



MCV

84.6

Low In Range High
80.0-100.0 fL



MCH

27.8

Low In Range High
27.0-33.0 pg



HEMOGLOBIN

15.8

Low In Range High
13.2-17.1 g/dL



RED BLOO...

5.69

Low In Range High
4.20-5.80 Million/uL



HEMATOCRIT

48.1

Low In Range High
38.5-50.0 %



WHITE BL...

5.9

Low In Range High
3.8-10.8 Thousand/uL



PSA, TOTAL

0.6

In Range High
< OR = 4.0 ng/mL




No no typo on the script sheet says take 1 mg tablet by mouth daily

Not sure on the estradiol test which one they used. Here is everything else I have.

You're E is far too high, and 1mg daily is a mega overdose for a man. You'll go from 55 to 0 in a matter of days, which is just as detrimental. .25mg twice per week is what I would recommend for you. You'll want E in the ~35 range with the UltraSensitive LC/MS/MS test that is for males. The "standard" estradiol test is for women and overestimates E for men.

Vince Carter said:

You're E is far too high, and 1mg daily is a mega overdose for a man. You'll go from 55 to 0 in a matter of days, which is just as detrimental. .25mg twice per week is what I would recommend for you. You'll want E in the ~35 range with the UltraSensitive LC/MS/MS test that is for males. The "standard" estradiol test is for women and overestimates E for men.

Click to expand...

Please heed the advice that Vince Carter and Fireproof have given - dial the Anastrozole way back. What is the range on the estradiol results? That will give us insight into which test was ordered.

You are injecting once a week? Can you confirm your dose in milligrams (ml is an expression of volume)? More frequent, smaller injections may be able to bring your estradiol down.

i see on the lab request said lc/ms/ms. I am injecting .5ml weekly, would I be better to split it in half and do 2 a week?

Agree totally with what's noted above!! Honestly, if I had a say in it, I'd suggest nobody take over 1.5mg per week. Your E2 will crash like Black Monday (even worse), and you can open yourself up to a litany of other issues, including leaving your immune system vulnerable! To boot, estrogen rebound can also be problematic, there's nothing about "balance" when going through this!

I think the "other" blood work request from Fireproof meant more than just a general CBC panel. Full thyroid would be a good start, metabolic, lipids, adrenals, D3, iron, ferritin, B12, ...

Thanks, keep us posted

Brettski99 said:

i see on the lab request said lc/ms/ms. I am injecting .5ml weekly, would I be better to split it in half and do 2 a week?

Click to expand...

In almost every case, men do much, much better with smaller more frequent injections. You minimize the peak and valley response and hopefully minimize the aromatization of estradiol. Every 3.5 days - Monday morning/Thursday evening or Tuesday morning/Friday evening are typical schedules. Half your total weekly dose in each injection.

You did have the sensitive estradiol test. Your results can be relied on.

if it was LC/MS/MS then its usable in that respect.

an mL is measure of volume, it's not a dose. Cyp vials come in 100, 150, and 200mg (most common) vials, we use doses...milligrams..."a 1/2ml" could be three different doses depending on the vial strength.

The test is the 200mg strength.

I agree with the above.

Looks like your e2 test was "sensitive" which is good. But the results are high and could very likely be the cause of moodiness and acne. It is for me...as well as bloating...

If you have 1mg tablets of Anastrozole - I would suggest getting a pill cutter and cutting one in half - and take 0.5mg twice per week. That'd probably be as aggressive as you need. If you want to be more conservative - cut into 4ths if possible and do 0.25mg twice per week like Vince Carter suggested. Or if you continue to inject weekly, then do 0.5mg once/week on injection day.

But moving to twice/week injections would be good and result in more stable levels, lower e2, etc. So do something like 0.25ml Monday morning and 0.25ml Thursday night. If you are using 200mg/ml strength - you are using a conservative dose of 100mg Test Cyp per week and moving to 50mg twice per week would be a lot better and in that case probably could use the lower Anastrozole dose of 0.25mg twice per week...

Here the rest of the tests my regular DR ran. I will be starting a vitamin b, and a d supplement. I have some of the ones asked for in above posts but not all. let me know what I should be doing as not a lot of faith in my endocrinologist at this point. I am in Northwest Houston if anyone has a good endocrinologist they could recommend.

TOTAL CHOLESTEROL 203
Low In Range High

125-200 mg/dL

HDL CHOLESTEROL HDL CHOL...

35
Low In Range

> OR = 40 mg/dL

CHOL/HDLC RATIO CHOL/HDL...

5.8
In Range High

< OR = 5.0 (calc)

NON HDL CHOLESTEROL NON HDL ...


168

HEMOGLOBIN A1c HEMOGLOB...

5.7
In Range High

<5.7 % of total Hgb

VITAMIN B12 VITAMIN B12

380
Low In Range High

200-1100 pg/mL

VITAMIN D,25-OH,TOTAL,IA VITAMIN ...

41
Low In Range High

30-100 ng/mL

IMMUNOGLOBULIN A IMMUNOGL...
264
Low In Range High

81-463 mg/dL

TRIGLYCERIDES TRIGLYCE...

123
In Range High

<150 mg/dL



SODIUM SODIUM
136
Low In Range High

135-146 mmol/L

CREATININE CREATININE
1.10
Low In Range High
0.60-1.35 mg/dL



GLUCOSE GLUCOSE
95
Low In Range High
65-99 mg/dL

The www.PrimeBody.com network has 3 doctors in Houston. Fill out the form on their site and they will send you info.

I would agree with the guys sentiments above.
1mg daily would be something a body builder would take who's on a considerable amount of anabolics!

Nelson, as well as others, has stated on here quite frequently both the short term and long term effects of too low of estradiol in men.
There is a "happy place" for guys on TRT, typically greater than 20 though.

Video from PrimeBody: Estradio in Men: Freind or Enemy.
https://www.youtube.com/watch?v=DLrN7QIEPWs

Update.

for the first three week I have been injecting .25ml Monday am/ Thursday evening and taking a .25 mg at the same time. For the first weeks felt great, back acne gone for first time in don't know how long, also taking 1000mcg of vit b. Had tons of energy at work, but this last week have been feeling lethargic, run down, but have been battling cold for 2 weeks. Could the anostrozole be causing issues? Not able to get labs done as out of country for 3 more weeks. Any suggestions welcomed. Thanks.

Its possible, but unlikely as you are now on a more "normal" TRT protocol. It sounds like you are just battling a cold rather than anything to do with anastrozole - especially since you felt great at first. The only way to be sure though would be to get blood work.

Brettski99 said:

this last week have been feeling lethargic, run down, but have been battling cold for 2 weeks. Could the anostrozole be causing issues?.

Click to expand...

Like ERO said, don't read too much into it. Battling a cold likely had something to do with it, if you don't feel good and the next week or 10 days, address it then.

Here is an updated blood test results

HEMATOCRIT
48.7
Low In Range High
38.5-50.0 %

HEMOGLOBIN
16.2
Low In Range High
13.2-17.1 g/dL

TESTOSTE...
539
Low In Range High
250-827 ng/dL

ESTRADIOL
31
In Range High
< OR = 39 pg/mL

I have have an appointment with my Uro next week to see what he has to say. I have been taking a little more than a .25mg of the blocker per week to get me at this level. Been feeling great and back acne has almost all cleared up for the first time in I don't know how long.

Thanks for all the info and recommendations.

Brettski99 said:

Here is an updated blood test results

HEMATOCRIT
48.7
Low In Range High
38.5-50.0 %

HEMOGLOBIN
16.2
Low In Range High
13.2-17.1 g/dL

TESTOSTE...
539
Low In Range High
250-827 ng/dL

ESTRADIOL
31
In Range High
< OR = 39 pg/mL

I have have an appointment with my Uro next week to see what he has to say. I have been taking a little more than a .25mg of the blocker per week to get me at this level. Been feeling great and back acne has almost all cleared up for the first time in I don't know how long.

Thanks for all the info and recommendations.

Click to expand...

It's good to hear you're feeling well. Your testosterone is not at as robust a level as many of us require to be at out best, but each of us is different; if it works for you, that's what counts.