10 week draw, after increase Arimidex from 1 Mg per week to 2 Mg per week.

[tom1959]

Patient is Fasting

[TH="width: 35%"]Description[/TH] [TH="width: 15%"]Out-of-Range[/TH] [TH="width: 15%"]In-Range[/TH] [TH="width: 10%"]Units[/TH] [TH="width: 20%"]Expected[/TH] [TH="width: 5%"]Status[/TH]
[TD="colspan: 5"][/TD]
[TD="colspan: 6"]	[/TD]
[TD="colspan: 6, align: left"]322000 - Comp. Metabolic Panel (14)[/TD]
Glucose, Serum	102		mg/dL	65-99	F
BUN		18	mg/dL	6-24	F
Creatinine, Serum	1.28		mg/dL	0.76-1.27	F
eGFR If NonAfricn Am		63	mL/min/1.73	>59	F
eGFR If Africn Am		73	mL/min/1.73	>59	F
BUN/Creatinine Ratio		14		9-20	F
Sodium, Serum		143	mmol/L	134-144	F
Potassium, Serum		4.1	mmol/L	3.5-5.2	F
Chloride, Serum		102	mmol/L	97-108	F
Carbon Dioxide, Total		27	mmol/L	19-28	F
Calcium, Serum		9.2	mg/dL	8.7-10.2	F
Protein, Total, Serum		6.2	g/dL	6.0-8.5	F
Albumin, Serum		4.2	g/dL	3.5-5.5	F
Globulin, Total		2.0	g/dL	1.5-4.5	F
A/G Ratio		2.1		1.1-2.5	F
Bilirubin, Total		0.2	mg/dL	0.0-1.2	F
Alkaline Phosphatase, S		63	IU/L	39-117	F
AST (SGOT)		25	IU/L	0-40	F
ALT (SGPT)		18	IU/L	0-44	F
[TD="colspan: 6"][/TD]
[TD="colspan: 6, align: left"]140103 - Testosterone,Free and Total[/TD]
Testosterone, Serum		1190	ng/dL	348-1197	F
Free Testosterone(Direct)	25.9		pg/mL	7.2-24.0	F
[TD="colspan: 6"][/TD]
[TD="colspan: 6, align: left"]140244 - Estradiol, Sensitive[/TD]
Estradiol, Sensitive	<3		pg/mL	3-70	F

 

[tom1959]

Appreciate your feedback. 8 week draw showed high Estrogen level. Doc increased Arimidex from 1 mg to 2 mg per week. Feeling tired now.....

 

[Gene Devine]

Your estrogen levels are dangerously low and the increase in dosage, 100%, was way way to much.

AI's are very powerful antagonists in men and dosages should be increased in much smaller doses.

Many shitty symptoms when levels are this low like fatigue, low/no libido and ED to name just a few.

What was your E2 serum level before you increased your dosage?

Total and Free T look fantastic.

You're still missing some important labs like Hematocrit as one example.

Stop the AI for 6 weeks and let your estrogen levels rebound and get retested.

 

[tom1959]

Hey Gene,

(2) weeks ago my estrogen was at 86

(2) weeks ago Hematocrit was 45

I had a complete profile at (6) weeks and then the latest draw (2) weeks later.

 

[Gene Devine]

Hey Gene,

(2) weeks ago my estrogen was at 86

(2) weeks ago Hematocrit was 45

I had a complete profile at (6) weeks and then the latest draw (2) weeks later.

When you had your E2 tested last time did they use the Sensitive assay?

Hematocrit should be fine.

Clearly the 100% increase in AI dosage tanked your E2.

If you inject twice a week you may have been fine with .5 mg 24 hours after each injection of the AI.

In my opinion you need to get E2 to rebound and it should in about 6 weeks.

If not now, split your injections to twice weekly or even better SQ as well.

Take the AI, if and when you have to go back on it, 24 hours after each injection.

Just goes to show how 1 additional mg of an AI can impact a man's E2 levels does it not?

 

[tom1959]

Gene

I'm concerned that my last test was not accurate. Meaning, the test was for total estrogen and not specifically Estradiol. I was not feeling as well as I thought I should. Experiencing some of the symptom you had mentioned. Doc thought that my estrogen was high, tested and increase Arimdex dose. In the (2) week period of increased dosage, I can feel my energy fading.

I was taking .25 Mg of Arimidex EOD, prior to the increase.

I have pellets, not injecting.

 

[Vettester Chris]

Retake your E2 lab if there's any doubt, but I'm leaning to believe you probably crashed your estro. If so, I've been there, it's not fun, and the rebound can play havoc with the receptor sites in the nipple region. A small amount of Nolvadex can mitigate that issue, but first thing first .. Confirm where your labs numbers are at. Gene's advise on splitting the injections via SubQ is spot-on like normal. If it were me, I might reduce the dosage a bit and drop the serum number down a few hundred points, but that's just my .02. Do what's best for you and follow the plan with your physician.

 

[Gene Devine]

Try supplementing Flax Seed and Soy as these are estrogen mimics and will help with the rebound.

 

[Kelly]

I can't imagine someone on TRT using 2 grams of adex per week! Op, for example guys who run a 500mg testosterone cycle normally run .25 adex EOD.
I'm curious what your estimated BF% is?

 

[Nelson Vergel]

I agree. More than 1 mg per week of anastrozole is usually overdosing. Basing anastrozole dose on total estrogen is wrong. Only if anastrozole by ultrasensitive testing is over 50 pg/mL I would consider starting only 0.5 mg anastrozole per week and then retesting again for E2 3 weeks after that if possible. I would adjust dose so that estradiol is not under 20 pg/mL and over 50 pg/mL. I would also look at interventions like losing fat, decreasing alcohol and recreational marijuana intake, reviewing medications that can increase aromatase activity in the liver, etc

By the way, there is no single study in human males that has determined what estradiol level is too high (or what testosterone-to-estradiol ratio). The use of 50 pg/mL is just anecdotal and speculative. Some clinics use 35 pg/mL instead.

There is also still a lot of debate on what the best estradiol test is.