Arimidex Advice on Dosage and Timing

[Xerxes]

So I've been going through some really bad high e2 symptoms over the last week and a half. My blood work, which I posted in other threads last week had my e2. My blood work, which is posted below is from last week:

e2 42 on a range of <40 HIGH
total t = 693 range 160-853
free t = 18.2 range 3.5-15.5 HIGH
shbg = 20.7 range 10-57
albumin = 4.7 range 3.2-4.8
dhea = 168 range 80-560
prolactin 4 range 2.1-17.7

I begged my urologist to call in a script and he did. 14 1 mg pills. His email stated:

"So now you have Arimidex 1 mg, #14, and you can take it however you'd like.
I expect to see you in the office within 4 weeks to recheck your levels."

Any advice on how to dose and when? I was doing 80mg on Tuesdays and Fridays, (160mg week). After reading that lower doses and higher frequency keeps e2 lower I decided to do 40 mg on Mon/Wed/Frid. My last injection was this Friday at 40 mg. I plan to do 40 mg tomorrow (Monday) and then start the new dosing and frequency. Now the I have to figure out how to dose the arimidex in terms of amount and timing. Any advice?

Thank you for all your help and support.

I really don't think this urologist in my long term solution in terms of a doctor to monitor this stuff, since he kind of got me into this in a slip shod way only based on total T numbers.

I have an appt with an endo on aug 24, but I am not sure if she has any speciality in TRT. Probably not, but at least she'd know more about hormones that my urologist or primary. My primary was reluctant to give the arimidex, b/c he had no familiarity with it. If anyone has suggestions for Long Island doctors that are knowledgable about TRT please let me know. Please! I have searched high and low and really can't find anyone with any expertise. Some people talk about using Defy Medical, but do you have to go to Tampa? Just very confused and want to feel better.

 

[OMI100]

I am sure others will give better advise BUT to have a DR. tell you "So now you have Arimidex 1 mg, #14, and you can take it however you'd like.
I expect to see you in the office within 4 weeks to recheck your levels." is utterly amazing.... Are you even sure he is a real DR.!!!!
You can call Defy in the morning and see what they can do for you if no one has any recommendations for you locally.. BTY get Nelsons book from Amazon and educate yourself a bit better. GOOD book with a LOT of GOOD information that will help you out (if you have not already got the book)....

 

[Re-Ride]

Xerxes, 160 E31/2D then 120 + AI MWF? Stick with one regimen making only slight tweaks every three weeks. Careful with the Arimidex.
Others will be a better guide. I started with 1/4 E3D then gradually increased weekly until nipple pain and sensitivity receded. Use Defy by phone/mail if you need to but you do have cooperative docs which is all you really need other than a willingness to be consistent and patient.

 

[CoastWatcher]

So I've been going through some really bad high e2 symptoms over the last week and a half. My blood work, which I posted in other threads last week had my e2. My blood work, which is posted below is from last week:

e2 42 on a range of <40 HIGH
total t = 693 range 160-853
free t = 18.2 range 3.5-15.5 HIGH
shbg = 20.7 range 10-57
albumin = 4.7 range 3.2-4.8
dhea = 168 range 80-560
prolactin 4 range 2.1-17.7

I begged my urologist to call in a script and he did. 14 1 mg pills. His email stated:

"So now you have Arimidex 1 mg, #14, and you can take it however you'd like.
I expect to see you in the office within 4 weeks to recheck your levels."

Any advice on how to dose and when? I was doing 80mg on Tuesdays and Fridays, (160mg week). After reading that lower doses and higher frequency keeps e2 lower I decided to do 40 mg on Mon/Wed/Frid. My last injection was this Friday at 40 mg. I plan to do 40 mg tomorrow (Monday) and then start the new dosing and frequency. Now the I have to figure out how to dose the arimidex in terms of amount and timing. Any advice?

Thank you for all your help and support.

I really don't think this urologist in my long term solution in terms of a doctor to monitor this stuff, since he kind of got me into this in a slip shod way only based on total T numbers.

I have an appt with an endo on aug 24, but I am not sure if she has any speciality in TRT. Probably not, but at least she'd know more about hormones that my urologist or primary. My primary was reluctant to give the arimidex, b/c he had no familiarity with it. If anyone has suggestions for Long Island doctors that are knowledgable about TRT please let me know. Please! I have searched high and low and really can't find anyone with any expertise. Some people talk about using Defy Medical, but do you have to go to Tampa? Just very confused and want to feel better.

You need a different doctor. To prescribe a potent medication, at the request of the patient, and tell him to "take it however you'd like" is simply irresponsible. The Defy model does NOT require you to travel to Florida. Contact them as soon as you can and ask them to explain their practice model. I am not a Defy patient, but if I had not been happy with local medical care, I would have turned to the,.

The TRT journey is a unique one, every patient has to find the right balance of medicines and dosing. That said, it will take very little Arimidex to send your estradiol levels crashing - and if that happens you will be miserable. You are injecting a lot of testosterone per week; I think your decision to split the dose is a wise one. In and of itself, that may be enough to lower your estradiol levels. Should you feel that you must use Arimidex, take no more than a quarter mg (.25mg) twice a week. A pill-splitter is available at your pharmacy to help you cut the tablet. Call Defy...and good luck.

 

[Ab037]

Typically ive seen for TRT the average around .25 the day of or after injection. The new method is 2 injections a week subq.
When guys runs cycle and inj upwards of 500-600mg a week they do around .5 EOD. As food for thought. Arimidex is potent better to start low and titrate up as needed. No need to tank E2

 

[Xerxes]

Should I continue to take my dim and calcium d glucarate? Or is that just asking to go too low?

 

[CoastWatcher]

At best, products sold OTC for AI control have a modest impact on E2 levels. You won't risk driving your levels too low by using them with Anastrozole.

 

[Xerxes]

thanks so much for the info and advice. Just took 1/4 (.25 mg). Injected 40 mg early today (about 5 hours ago). Will inject again o Wednesday 40mg and then Friday 40 mg. Would taking .25 with each injection be too much? Up until last week I was doing 80 mg on Tuesday and Friday and reduced dose and increased frequency to try to get E2 down...Wondering if the addition of the AI and the other protocol changes are too much at once...

 

[CoastWatcher]

thanks so much for the info and advice. Just took 1/4 (.25 mg). Injected 40 mg early today (about 5 hours ago). Will inject again o Wednesday 40mg and then Friday 40 mg. Would taking .25 with each injection be too much? Up until last week I was doing 80 mg on Tuesday and Friday and reduced dose and increased frequency to try to get E2 down...Wondering if the addition of the AI and the other protocol changes are too much at once...

I'd take the AI no more than twice a week (a total of .5mg). It is a potent medicine and you're E2 is not really "that" high. You don't want to knock it down into the range where misery results. As importantly, you have to now wait and see how you feel and what your labs tell you in no fewer than four, preferably six, weeks. It's a balancing act with a lot of moving parts. Oh, and find a doctor who doesn't abandon you to your own devices when it comes to estradiol management.

 

[Vince Carter]

My advice to you is managing your E2 with smaller but more frequent injections. I do not think 40 is high. If you're having negative symptoms that you can draw to E2, then it's high. But you're in a desirable ratio of T:2 of ~17. Range being 14-20. This is Nelsons theory that I subscribe too.

You're SHBG of 20 is on the cusp of being low. The smaller dose will aromatize less and may bring your E2 down. I do not recommend Anastrozole unless you just have to have it. I would not start taking it because you feel high E2 for a week and half. I think you should go with the M/W/F 40mg per and reevaluate at no less than a month.
If you feel you must have the Anastrozole, .25mg once per week is all that I'd take, looking at your numbers.

With that M/W/F and your SHBG, take note of how you feel on Sundays...when I was on that I was low T on sundays and felt like crap trying to make it to Monday.

But again, week and half is pretty well in the space of body adjusting and sometimes that period is a few weeks that you have to ride it out.

 

[Xerxes]

First let me apologize for posting so many threads basically on the same topic in the last week or so. I was just feeling so awful and really wasn't getting any guidance from my medical professionals. You guys should know that it meant a lot to be able to get others' opinions and to know other guys are going through and went through the dialing in process and have come out on the other side feeling good. Thank you! I will continue to use Excel Male as a community of support and and resource for information as I continue on the TRT journey.

Just a small update. Took .25mg arimidex on Monday with my 40mg test cyp. Anxiety decreased through the day, felt half normal for the first time in 2 weeks. Still anxiety inched up toward the evening. Tuesday no injection, no arimidex. Felt best I have in a while. Motivated to accomplish things, go for a run, much less anxious and irritable. Took 1 DIM before bed. Actually slept through night w/o any rx help for first time in 2 weeks. Today (Wed) woke up with morning wood for first time in 2-3 weeks. Did 40 mg test and .25 arimidex. Felt pretty good with minor anxiety. As day continued felt less and less anxious. Got a nice gym workout in and was motivated.

I know that I need to tread lightly with the AI and I really have no guidance from my doctor. I am just happy to have some relief. I am not going to over do it. I think I will do .25mg on injection days and monitor morning wood and anxiety levels and nipple sensitivity (which I had a little of but thought it was in my head, but now is gone).

I will keep you updated. I appreciate the advice and the time you guys take to read my rambling posts. I'm very new to TRT (3 months or so) and never realized how individualized it is and how difficult it could be to get dialed in (especially with doctors that really do not know much).

My primary is having me in to look at some extra blood work he pulled last week (he wanted a pm test # as well) and the DHT that wasn't ready from first blood test. I'll share them when I get them.

Part of my thinking is that my SHBG is lowish and that reflected in my free Test being above range by 20% while my total test is mid range makes me think that my free E2 must be equally elevated. So my thinking is that I need a lower E2 number than most to avoid having too much free E2 working in my system and could deal with a lower total test number because my SHBG seems to make more of it free. Does this theory make any sense?

e2 42 on a range of <40 HIGH
total t = 693 range 160-853
free t = 18.2 range 3.5-15.5 HIGH
shbg = 20.7 range 10-57

 

[CoastWatcher]

You'll need to accept a simple fact about TRT: it takes time. Time to get a proper diagnosis. Time to initiate a protocol and wait for your blood levels to balance. Time while you await test results. Time while you adjust and wait for the next round of blood tests. But, if you give it the time, there is a very good chance that you'll be feeling better. As for the levels you posted, yes, your SHBG is lower than you might like (though not nearly as low as many men have to deal with). Given your split-dosing change, I would expect to see a higher total testosterone value when you test again. I know that when I split my dose to 60mg/twice weekly, my peak went to 1035 from 810.

But you must give it time. There are simply too many moving parts in this business to make multiple, sudden changes. All the best!