Another E2 question..Help please!

DreamyVod · Sep 8, 2018

Bloodwork pic below..

31 yr old Male on 300/mg test cyp a week... twice a week injections on Wed/Fri...

I started trt at 200 mgs but upped it cuz imma maniac yes i know...My TRT doc now has me on 1mg Anastrozole Mon/Wed/Fri... is my E2 level too low?? Do i need the SENSITIVE estrogen test? Should i even be taking an AI at all on this Testosterone dose?

Struggling somewhat with libido/erections... they seemed better on 200...maybe my E2 was higher then?

Thanks

BigBamBoo · Sep 8, 2018

Wow...that is a large dose. I am guessing this is not for replacement treatment but for gym gains?

Taking that much Anastrozole is...hmmm....”brave”?

Not the way I would do things, but each to their own. Good luck.

Systemlord · Sep 8, 2018

This has got to be the most insane protocol I've ever seen, a massive weekly dose and no SHBG testing and no clue. The roche ECLIA is for women, the LC/MS/MS for men. There isn't much time spent going over hormones in medical school, so there are a lot of so called hormone doctors out there when TRT is concerned know almost nothing.

After only a four doses of .125 anastrozole, estrogen was 12 pg/mL. I got lucky and recovered after only 2 days.

SHBG will guide your injection frequency and dosing is usually 100mg weekly unless SHBG is higher in the range.

MarkM · Sep 9, 2018

Welcome to the forum.

Well you surely aren't on TRT at 300 mg per week and it is doubtful a doctor would prescribe such a dose. You'd probably be better served on a "blast and cruise" type forum.

Your injection protocol doesn't make sense of Wed and Fri? How did you pick those two days? Like @Systemlord stated, you must know what your SHBG is for any protocol otherwise you are just throwing mud up against a wall hoping some sticks.

The Estradiol test is the wrong one. The Roche ECLIA is for women and you need the Estradiol Sensitive LC/MS/MS assay which is more sensitive and designed for men because we have lower levels of estradiol. Your estradiol is already low on the non-sensitive test and therefore, actually be even lower with the sensitive test.

Are you just trying to get jacked for the weekends? You must be having some huge peaks and valleys. It is no wonder you are having issues with libido. You are taking an excessive amount of testosterone and then trying to counter it with a ridiculous amount of anastrozole.
Are you looking for just gym gains or are you interested in your health.

I'm going to be blunt here................If you are using a doctor, he/she has no clue what they are doing If you are self medicating then you really need to gain more knowledge so you do not do harm to yourself.

DreamyVod · Sep 9, 2018

Well i posted here because i go through a TRT clinic in San Diego area...I really didn't think cruising on 300 mgs/week of test cyp using twice a week injections was that absurd... Sure my AI dosage might have been off and i didn't get the proper estrogen test but besides that doesn't seem too crazy...but yes i'm aware 300 mg is not even close to TRT dosage

Somehow you need to know your SHBG to know which days of the week you want to inject??

Thanks for help/replies

Systemlord · Sep 9, 2018

TRT clinics we refer to as T-mills and they do not staff actual doctors, these wannabe doctors know virtually nothing about hormones or even know what tests to order or what they mean.

Their goal is to sell a high quantity of drugs for profit and they need to be shut down. Everyone's injection frequency will be different, mine is best every other day or everyday, twice weekly and it feels like I'm injecting water.

These T-mills give TRT a bad name, if you hadn't found this forum you would be thinking TRT doesn't work and you would have eventually quit TRT.

CoastWatcher · Sep 9, 2018

DreamyVod said:
Well i posted here because i go through a TRT clinic in San Diego area...I really didn't think cruising on 300 mgs/week of test cyp using twice a week injections was that absurd... Sure my AI dosage might have been off and i didn't get the proper estrogen test but besides that doesn't seem too crazy...but yes i'm aware 300 mg is not even close to TRT dosage

Somehow you need to know your SHBG to know which days of the week you want to inject??

Thanks for help/replies

You're welcome to do what you want, of course, since it's your body. Your missing an essential test, SHBG - without it you and your doctor have no idea how well your body is sustaining the amount of injected testosterone over the course of the week. You're taking an AI based on an incorrect lab test. In short...an absurd protocol. You're being treated by a T-mill; the doctors don't really know what they are doing and they put you on a cookie-cutter protocol with red lights blinking like crazy.

MarkM · Sep 9, 2018

DreamyVod said:
Somehow you need to know your SHBG to know which days of the week you want to inject??

Thanks for help/replies

You need to know what your SHBG is so you know what protocol will work best for you. If you have low SHBG one really needs much smaller doses and more frequent injections, every day (ED) or every other day (EOD). If someone has high SHBG they normally need one larger injection a week. Mid range SHBG E3D or E3.5D.

Right now you inject on Wed and Fri. So you inject Wed and two days later again on Friday. After the Friday injection it's another 4 days or so until the next Wed injection. To get the best benefit from TRT there needs to be an even or equal distribution to reduce the peaks and valleys.

If you inject twice a week wouldn't it make since to split the week in half and inject every 84 hours or close to that. Something like Monday 6AM and Thursday 6PM, Sunday PM and Thursday 6AM, or something similar.

Hope that makes sense.

DreamyVod · Sep 9, 2018

Bizarre because this guy seems reasonably sharp...

His initial prescription of 200mg of test cyp injected once a week with 1mg of Anastrozole is that crazy?...

TBF to him i was the one who asked to up it cause i wasn't seeing gym gains like i had hoped...

FWIW the reason he agreed to put me on (albeit with little resistance) was a total Testosterone test of around 400 that i got from my PCP...yes i know this isn't that low but i was approaching my 31st bday and wanted to begin the optimization process

DreamyVod · Sep 9, 2018

Thanks Mark

Yeah i was injecting Wednesday night and Saturday when i woke.. Yeah i guess that should have been Tuesday night huh lol....

MarkM · Sep 9, 2018

Starting someone off on 200 mg a week is old school before we understood the peaks and valleys that would create in how we felt, our energy levels, and our moods. Your test spikes and so does your estradiol. But it is the easy way out for doctors because they don't truly understand TRT and proper protocols when prescribing.

Prescribing 1 mg of anastrozole right off the bat is a sign to worry about. Why prescribe 200mg of test and know off the bat that a huge dose of anastrozole is needed with the proper estradiol test? That's not to say you may not need it once your proper dose is determined but none of us should want to take a cancer drug for women with breast cancer if we did not have to. 3 mg a week of anastrozole would be a dose they might give a woman with breast cancer. I hate to see you do that to yourself needlessly.

Your doctor might be sharp about many things, TRT just isn't one of them.

BigBamBoo · Sep 9, 2018

MarkM said:
Your doctor might be sharp about many things, TRT just isn't one of them.

This ^^^

I will add...your still younger. When you are young, many folks feel bullet proof.
Taking large doses of T and AI can have long term consequences and effect your health years from now.

Yep...I am being that old guy. But life goes by fast. And if you have any self awareness, at some point you might wake up and regret not listening to those who have gone down the path before you.

But...in my early 30’s, I was literally parting with rap stars....my best friend is a famous old school rapper...and no one could to me anything at that time.

So.....good luck to you. Hope it works out.

Systemlord · Sep 9, 2018

DreamyVod said:
Bizarre because this guy seems reasonably sharp...

His initial prescription of 200mg of test cyp injected once a week with 1mg of Anastrozole is that crazy?...

TBF to him i was the one who asked to up it cause i wasn't seeing gym gains like i had hoped...

FWIW the reason he agreed to put me on (albeit with little resistance) was a total Testosterone test of around 400 that i got from my PCP...yes i know this isn't that low but i was approaching my 31st bday and wanted to begin the optimization process

The problem is there's almost nothing written about TRT, doctors learn through trial and error and don't share in the knowledge to stay competitive, unless your doctor gets the training from someone more knowledge, sharp minded or not he won't know what to do.

200mg weekly and 1mg AI is a cookie cutter protocol that allows doctors to spend minimal amount of time with you, so he can move on to the next cash cow.

If you want to get optimise it isn't going to happen with this clinic, no proper testing (SHBG), no optimization. Your doctor will properly say you don't need SHBG and wouldn't know how to interpret it.

DreamyVod · Sep 9, 2018

So you're saying a total testosterone of 400 at 30 while being lean and in the gym and in good shape with all lifestyle factors essentially dialed in isn't a good enough reason to start the journey of "TRT"...

lowe2sucks · Sep 9, 2018

no hcg? this protocol is dangerous! testosterone yes seems high but taking it shortterm no biggie but no hcg and such high dose AI its nuts!! also no dhea preg?
why are you doing this to yourself.. you will feel like crap later on after all the damage that this insane protocol will do to you

Systemlord · Sep 9, 2018

DreamyVod said:
So you're saying a total testosterone of 400 at 30 while being lean and in the gym and in good shape with all lifestyle factors essentially dialed in isn't a good enough reason to start the journey of "TRT"...

If you made a solid attempt to optimize your life and 400 was the best you could do, that's a perfect reason to start TRT. The average testosterone for a 30 year old is 679 ng/dL, that means there are 30 year olds higher than that who are fit and healthy. This puts you well below your peers and at risk for a shorter life according to the studies.

Measure SHBG and only then can you begin to optimise yourself.

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men

These data showed that a testosterone threshold of 440 ng/dL was associated with increased Framingham 10-year CVD risk in middle-aged and elderly men. Poor sexual performance, decreased morning erection, and loss of libido had an impact on the testosterone threshold for CVD risk. The threshold level was higher in men with sexual dysfunction. Further study is required to evaluate the validity of these testosterone thresholds for CVD risk.

lowe2sucks · Sep 9, 2018

DreamyVod said:
So you're saying a total testosterone of 400 at 30 while being lean and in the gym and in good shape with all lifestyle factors essentially dialed in isn't a good enough reason to start the journey of "TRT"...

mine is 373 at 22

if free T is normal it's ok TRT isn't always a solution but may improve your quality of life a bit but there are downsides

RaidersTwix · Sep 10, 2018

Lower your arimidex to 0.5mg mon wed fri.

Gl

DreamyVod · Sep 10, 2018

So on 300/mg a week we can safely assume you're gonna need an AI...right?? i skipped my AI this past Saturday... i was thinking maybe i'd take the week off and then finally get an accurate sensitive E2 test and also SHBG test (although i'm still not sure what this one is for)

DreamyVod · Sep 13, 2018

OK guys i've gotten squared away by talking personally with Jay Campbell... last question... I want the sensitive E2 test... i inject wed/saturday... i assume i should wait till the morning before an injection to get the test, right?

Thanks