Dialing in estradiol

[bluezebra5]

Hey guys,

I posted way back about switching from HCG monotherapy to testosterone/HCG. Having been on some sort of HRT for almost 2 years, I'm beginning to develop a stronger intuition for when things "aren't right", and I'm beginning to suspect anastrazole may be the culprit behind malaise I've been experiencing for quite a while.

I've brought this up with 2 HRT docs, as well as an endo and 2 GPs, all of whom turn to the standard E2 lab and note that it is high-normal (even on 2 mg of arimidex per week).

Out of curiousity, I ordered a Total/free T and sensitive E2 panel through DL. I purposefully tested the day after T injection and administration of 1mg adex, as we usually test trough levels (2x/week injections).

The panel came back:

TT > 1500
FT 37
E2 15 (8-35)

WOW. Was not expecting such a spike on 2x per week given that my troughs have been ~800-900. And clearly the T:E2 ratio is blown. What would my best course of action be? Should I begin by cutting the adex into quarters (I currently take one 1mg tab after each injection)? That would put me at 7/8 of my current dose and possibly smooth things out. Given the half life of anastrazole, I'm tempted to just cut it to 1 or 1.5 mg per week and retest in 6-8 weeks.

Thanks as always friends.

 

[ERO]

I would cut your AI dose. 15 on the sensitive test is too low. Try 0.5 mg twice a week and re-test in 4 weeks with the sensitive test. 1.5 mg per week is a huge dose - many of use here use no AI at all or a very tiny dose like 0.15 mg twice a week.

Also, consider switching doctors to one that understands TRT. Seriously, not saying that sarcastically.

 

[CoastWatcher]

That's a whopping dose of AI. ERO's right - you need to find a doctor who knows the score.

 

[bluezebra5]

I would cut your AI dose. 15 on the sensitive test is too low. Try 0.5 mg twice a week and re-test in 4 weeks with the sensitive test. 1.5 mg per week is a huge dose - many of use here use no AI at all or a very tiny dose like 0.15 mg twice a week.

Also, consider switching doctors to one that understands TRT. Seriously, not saying that sarcastically.

I will go ahead and try this. I'm a bit gunshy, because the reason we wound up at 2mg was because I experienced refractory gyno very quickly after beginning HCG. My standard E2 wouldn't budge off of 40 even when the breast symptoms subsided, so he left it.

Unfortunately, as I'm sure you know many of the top TRT guys are clueless with E2 control. I was with a doctor who I truly owe my life, and now one of the top-recommended clinics on this site. NOBODY wants to use the ultra sensitive test.

 

[bluezebra5]

That's a whopping dose of AI. ERO's right - you need to find a doctor who knows the score.

I appreciate it. I will definitely try to titrate down and see where we get in a month or so.

 

[bluezebra5]

How often do you recommend dosing arimidex? Is .5 mg after injections enough? Or should I be breaking them into quarters?

 

[ERO]

Twice a week is fine with Arimidex. It has a 4 day half life. Taking it more often wont make it work any better.

Since you are sensitive to HCG you may want to consider a lower dosing on that as well. I dont know what you are doing now, but many guys don't need the fairly typical 500 IU twice weekly as they are fine with 250 IU twice weekly or even 100 IU daily. A smaller daily dose is less likely to spike your E2 as well compared to a large dose twice a week.

Have you considered Defy Medical and their medicine model? I am not affiliated but I am a patient as are many of us here. Top notch docs, great pricing and very easy to work with. They only use the ultra sensitive E2 test for men as they realize it is critical. Just something to think about...

 

[bluezebra5]

Twice a week is fine with Arimidex. It has a 4 day half life. Taking it more often wont make it work any better.

Since you are sensitive to HCG you may want to consider a lower dosing on that as well. I dont know what you are doing now, but many guys don't need the fairly typical 500 IU twice weekly as they are fine with 250 IU twice weekly or even 100 IU daily. A smaller daily dose is less likely to spike your E2 as well compared to a large dose twice a week.

Have you considered Defy Medical and their medicine model? I am not affiliated but I am a patient as are many of us here. Top notch docs, great pricing and very easy to work with. They only use the ultra sensitive E2 test for men as they realize it is critical. Just something to think about...

Thanks ERO. Where do you get the 4 day figure? I've been reading approximately 48 hours, but obviously I'd like to keep it at two doses per week for convenience.

I have looked into Defy. I get such a good price on the Rx's with my insurance it would really hurt to switch. Maybe I'll have to eventually. I will see what my E2 does on .5mg 2x per week, and potentially back off the HCG if it spikes back up, though given the last test I somehow doubt it.

its amazing how I could be high on the old test and low on sensitive E2

 

[ERO]

It is usually stated that the biological half-life is around 48 hours, but the effective half-life is longer because it takes some time for your body to ramp up conversion to E2 after being inhibited by the drug. Hence the 4 day figure.

This is why TRT docs that really understand TRT only use the sensitive test. Using a known to be inaccurate test and then basing drug dosages on the known to be inaccurate test is just bad care.

 

[bluezebra5]

It is usually stated that the biological half-life is around 48 hours, but the effective half-life is longer because it takes some time for your body to ramp up conversion to E2 after being inhibited by the drug. Hence the 4 day figure.

This is why TRT docs that really understand TRT only use the sensitive test. Using a known to be inaccurate test and then basing drug dosages on the known to be inaccurate test is just bad care.

That's very interesting. I really appreciate it. I'll report back once I get the next set of labs. At least in trying to bump up the E2, I've got a lot of options. If I could get off of the AI, I'd be a happy dude.

 

[Vince Carter]

a 24hr peak of 1500 isn't unusual or cause for concern. At one period as I was learning peaks and troughs and how my levels of TT and E2 varied I was drawing blood twice a week for three weeks. It was a good learning experience in that way.

I agree with others 1mg of Anastrozole is way too much. The problem isn't Anastrozole, the problem is guys take way to much and way to often. As above many of us use none or a tiny .15mg dose. E2 is a finicky thing and Anastrozole is a powerful drug.

 

[Vince Carter]

The best way most of us get off of an AI is to use an EOD TCYp injection routine. Smaller more frequent has less chance for excess to aromatize. Sometimes that has to play in with where your SHBG level is, too, but smaller more frequent is something to think about. Smaller as in 30/40/50mg EOD.

 

[bluezebra5]

The best way most of us get off of an AI is to use an EOD TCYp injection routine. Smaller more frequent has less chance for excess to aromatize. Sometimes that has to play in with where your SHBG level is, too, but smaller more frequent is something to think about. Smaller as in 30/40/50mg EOD.

Thanks Vince. I would be 100% willing to go EOD if it means no AI. I'll make sure my E2 doesn't spike after 4 weeks of .5 mg 2x per week. If I'm still in the middle I'll try to kick the AI, and do EOD injections to minimize aromatization.

 

[Vince Carter]

How much TCyp are you injecting on your present routine? Milligrams and times per week.

 

[CoastWatcher]

How much TCyp are you injecting on your present routine? Milligrams and times per week.

And - any changes to that injection protocol?

 

[bluezebra5]

How much TCyp are you injecting on your present routine? Milligrams and times per week.

100 mg twice per week.

 

[bluezebra5]

And - any changes to that injection protocol?

I switched from pure hCG to hCG plus testosterone around July. I have also recently changed from hCG three times per week to splitting it up into nightly doses, this could have decreased my peak E2 a bit

 

[CoastWatcher]

100 mg twice per week.

That is a sizeable dose. Many, that is, most, of us find success with far less testosterone. For example, I inject 60mg every 3.5 days. I've never needed an AI and maintain solid levels of testosterone (total and free).

 

[bluezebra5]

That is a sizeable dose. Many, that is, most, of us find success with far less testosterone. For example, I inject 60mg every 3.5 days. I've never needed an AI and maintain solid levels of testosterone (total and free).

I'm 23 years old, which I think was part of the rationale behind the high dose.

 

[Vince Carter]

There's no rationale behind 100mg 2x a week. It's FAR too much at any one time, lots of excess to be aromatized.