Dialing in estradiol

[bluezebra5]

Just curious as to what your doctors have to say about all of this? The very same doctors that were using the wrong E2 test to base their dosage (or should I say, overdosage) of Adex that you were taking before. Did you change your protocol on your own, and get their blessing, or are you just doing this all by yourself now?

Personally, I would stop the Adex, or at least go down to .15mg BIW (from a compounding pharmacy), as your sensitive E2 is still pretty low.

They are not in the loop on this, so unless this level of compounding is available at Walgreens without specific instruction from the physician, I'm stuck dealing with .25mg increments for the time being.

I realize the situation isn't ideal. It took me years of frustration to find a clinic willing to acknowledge my hypoganadism. As a lifetime athlete who never so much as considered PED use, I was faced time and time again with presumptuous sighs and rolling eyes. They "knew" they were looking at AAS induced hypoganadism before I opened my mouth.

So now, I'm at a clinic (which at least used to be VERY highly regarded on this forum) where I am at least given the tools to recover. My medications are covered by insurance. I hope it's understandable that I'm not exactly looking to get out anytime soon.

This is in no way directed at you Jackie, I just felt the need to elucidate the situation. Thank you for your advice. I really appreciate it.

 

[Jackie Treehorn]

They are not in the loop on this, so unless this level of compounding is available at Walgreens without specific instruction from the physician, I'm stuck dealing with .25mg increments for the time being.

So now, I'm at a clinic (which at least used to be VERY highly regarded on this forum) where I am at least given the tools to recover. My medications are covered by insurance. I hope it's understandable that I'm not exactly looking to get out anytime soon.

If you're at this "highly regarded clinic," then I don't understand why you can't go to them with your latest lab results, and show them that they've been overdosing you on Adex, and then ask them for a script at .15mg BIW to take to a compounding pharmacy. It should still be covered by your insurance. Show them how you've adjusted your protocol, and how things have improved. I gotta be honest man...your entire doctor situation doesn't sound optimal.

If your doctors aren't responding to what you are showing them in the form of lab results and how you feel, then you need to find a new doctor/clinic. You've come a long way since your days of taking 2mg of Adex a week. Your doctors should be helping you, not hindering you to achieve optimal results from your protocol.

 

[bluezebra5]

If you're at this "highly regarded clinic," then I don't understand why you can't go to them with your latest lab results, and show them that they've been overdosing you on Adex, and then ask them for a script at .15mg BIW to take to a compounding pharmacy. It should still be covered by your insurance. Show them how you've adjusted your protocol, and how things have improved. I gotta be honest man...your entire doctor situation doesn't sound optimal.

If your doctors aren't responding to what you are showing them in the form of lab results and how you feel, then you need to find a new doctor/clinic. You've come a long way since your days of taking 2mg of Adex a week. Your doctors should be helping you, not hindering you to achieve optimal results from your protocol.

I do plan to explain the situation the next time I go in, hopefully having achieved a better T/E balance by then.

The issue isn't so much the 2mg/wk of AI. This was prescribed by a previous doctor when I was on HCG monotherapy, and I was experiencing pre-gyno all the way up to that dose.

The issue is that they still believe in the standard E2 ELICA. My first labs with this doctor showed high E2 even on 2mg per week. I'm only trying to avoid confrontation until it's necessary.

 

[CoastWatcher]

I do plan to explain the situation the next time I go in, hopefully having achieved a better T/E balance by then.

The issue isn't so much the 2mg/wk of AI. This was prescribed by a previous doctor when I was on HCG monotherapy, and I was experiencing pre-gyno all the way up to that dose.

The issue is that they still believe in the standard E2 ELICA. My first labs with this doctor showed high E2 even on 2mg per week. I'm only trying to avoid confrontation until it's necessary.

I must be frank, if they are not relying on the sensitive assay to measure your estradiol, they are not current with androgen replacement in men. You probably aren't far from having a balanced protocol, but the failure of your medical provider to order the appropriate test should be a flashing light warning you that their advice should be subject to careful evaluation.

 

[JPB]

Are you feeling better with the lower AI dose? As others have said, it looks like you could lower the AI dose further.

 

[bluezebra5]

Are you feeling better with the lower AI dose? As others have said, it looks like you could lower the AI dose further.

I have been feeling essentially the same since the first set of labs, which makes sense now seeing that the E2 value hasn't budged much.

I am going to go .25mg E4D for a couple of weeks, and barring a surge of high-E2 symptoms, I'll stop the AI completely and retest in 3 weeks.

 

[ERO]

That is a sound plan. Please do let us know how it goes after your next round of blood work.

 

[bluezebra5]

That is a sound plan. Please do let us know how it goes after your next round of blood work.

I absolutely will. Thanks ERO.

 

[bluezebra5]

I must be frank, if they are not relying on the sensitive assay to measure your estradiol, they are not current with androgen replacement in men. You probably aren't far from having a balanced protocol, but the failure of your medical provider to order the appropriate test should be a flashing light warning you that their advice should be subject to careful evaluation.

I agree with you. I'm curious though; besides Defy, is there really an appreciable number of practices that insist on using the LC/MS test for estradiol in males?

I've considered myself very lucky to have even found a doctor willing to prescribe HCG alongside testosterone. Perhaps the HRT landscape has changed recently, but it sure didn't used to be that way.

 

[CoastWatcher]

I agree with you. I'm curious though; besides Defy, is there really an appreciable number of practices that insist on using the LC/MS test for estradiol in males?

I've considered myself very lucky to have even found a doctor willing to prescribe HCG alongside testosterone. Perhaps the HRT landscape has changed recently, but it sure didn't used to be that way.

Estradiol mgt is the last frontier in TRT. That said, more and more doctors - who have read and discussed this issue - realize that the standard test, designed for women, does overestimate estradiol in men. It takes time, but it's happening.

 

[Vince Carter]

I was with 2 of the major clinics...one that does weekly injections in the office, and the other a close cousin to the telemed model with self injections. Both refused to use the sensitive LC/MS/MS assays and we're overdosing me on Anastrozole. It was a factor in leaving each one and eventually coming to Defy.

 

[CoastWatcher]

I was with 2 of the major clinics...one that does weekly injections in the office, and the other a close cousin to the telemed model with self injections. Both refused to use the sensitive LC/MS/MS assays and we're overdosing me on Anastrozole. It was a factor in leaving each one and eventually coming to Defy.

That kind of attitude has always baffled me. The patient is paying for the test, why not write the order for the preferred assay? Bizarre...

 

[Vince Carter]

That's exactly what I said at the second place, "that's only prescribed by the Dr"...I'm paying for it, what's that matter...I left not long after that.

 

[CoastWatcher]

That's exactly what I said at the second place, "that's only prescribed by the Dr"...I'm paying for it, what's that matter...I left not long after that.

Were they providing/charging you for the AI? That might explain it.

 

[Vince Carter]

Were they providing/charging you for the AI? That might explain it.

With the in clinic my insurance was covering those, I'd get like 6 1mg tabs for <$2.50
The other though, you pay them full retail price for all meds but so perhaps there's a layer there of how they make money.