High levels on testosterone gel with AI

[trtthings]

I did a morning test where my total testosterone was 880 ng/dl.

I'm on 75mg of testosterone gel, with 0.5mg anastrozole every other day.

I took the test BEFORE applying the gel for that day.

Does anyone have an explanation for why the levels would be this high? Is it just because the anastrozole is making the pituitary make more LH? Or is it gel from the day before? Seems inconsistent with the researc.

 

[Bryan_K77]

How long have you been on trt for? Once daily application? Where do you apply the gel? That is a very high total t if you applied around 24 hours prior. That is a hefty AI dose, why so much? I’m 100% against the use of an AI unless one is a rare breed who’s body over aromatizes. It was designed as a breast cancer drug, can’t be healthy to use long term

 

[trtthings]

How long have you been on trt for? Once daily application? Where do you apply the gel? That is a very high total t if you applied around 24 hours prior. That is a hefty AI dose, why so much? I’m 100% against the use of an AI unless one is a rare breed who’s body over aromatizes. It was designed as a breast cancer drug, can’t be healthy to use long term

Respect your view.

Around 4 months. Once daily, in the morning. The AI as well (not daily, just in the morning).

When my levels were at around 700 ng/dl I measured E2 at 62 pg/ml.

When my E2 is moderately elevated I feel terrible, I feel so emotional I cannot be interacted with, so depressed and anxious. I've repeatedly seen this come on without AI and subside with it.

According to a review I read most men on TRT don't exceed 42 pg/ml. However some do and feel great, not me.

 

[trtthings]

But having said that I'm guessing my levels must be too high after having applied the gel. I've felt a deterioration in my sleep (but not necessarily energy in the day, it's better).

 

[Cataceous]

There is some chance that the massive AI dose is keeping your HPTA active and providing an endogenous contribution to total testosterone. Estrogens provide the primary negative feedback at both the pituitary and hypothalamus. The AI could be keeping this in check. You could confirm this by measuring LH. There is still some negative feedback from androgens at the hypothalamus, but the effect seems to be weaker than what's seen with estrogens.

 

[trtthings]

There is some chance that the massive AI dose is keeping your HPTA active and providing an endogenous contribution to total testosterone. Estrogens provide the primary negative feedback at both the pituitary and hypothalamus. The AI could be keeping this in check. You could confirm this by measuring LH. There is still some negative feedback from androgens at the hypothalamus, but the effect seems to be weaker than what's seen with estrogens.

Thanks for your response Cataceous, I've read some of your replies and you seem to be very well read on these things.

I've been considering switching to injections (E or Cyp) in order to see if I see more benefits faster. I've read some of the systematic reviews explaining the onset of the therapeutic effects of testosterone - and all the research that looked at gels or Nebido showed results considerably slower than E or Cyp.

The same goes for muscle growth, a lot more with E or Cyp.

I'm not taking testosterone for muscle growth but just for insane fatigue which has gotten maybe 50-60% better ont he gel.

However this latest lab makes me wonder if I even need to switch, this is a very high level pre-application (and I've only been taking AI at this level for a week).

But I guess I don't know if I'm getting the same amount of free T as I would be from the injections. I read somewhere that that was higher as well with the injections but I need to explore it further.

 

[Cataceous]

For better or worse, injections make it easy to deliver a lot of testosterone quickly. All too often guys measure trough serum testosterone at 3.5 or 7 days post-injection and titrate doses based on that number. This neglects that peaks may be as much as 50% and 200% higher, respectively.

My impression from some of @madman's posts is that while physiological testosterone levels can improve muscle condition compared to a hypogonadal state, significant gains require much higher levels.

Free testosterone is largely a function of total testosterone, SHBG and albumin. The Tru-T calculation predicts it from these parameters. It can also be measured using one of the accurate methods, such as equilibrium dialysis. The method of testosterone delivery doesn't matter unless high post-injection peaks are not accounted for. Testosterone cypionate can be dosed EOD or daily to greatly smooth out serum testosterone and avoid large swings in free testosterone, DHT and estradiol.

Your serum testosterone level is probably plenty high, but I would have concerns about continuing with that much anastrozole. The topical use of testosterone may be creating a lot of DHT, which has anti-estrogenic properties of its own. You should monitor SHBG and lipids, which hopefully act as canaries in the coal mine, warning about an imbalance that is otherwise not causing symptoms.

 

[trtthings]

For better or worse, injections make it easy to deliver a lot of testosterone quickly. All too often guys measure trough serum testosterone at 3.5 or 7 days post-injection and titrate doses based on that number. This neglects that peaks may be as much as 50% and 200% higher, respectively.

My impression from some of @madman's posts is that while physiological testosterone levels can improve muscle condition compared to a hypogonadal state, significant gains require much higher levels.

Free testosterone is largely a function of total testosterone, SHBG and albumin. The Tru-T calculation predicts it from these parameters. It can also be measured using one of the accurate methods, such as equilibrium dialysis. The method of testosterone delivery doesn't matter unless high post-injection peaks are not accounted for. Testosterone cypionate can be dosed EOD or daily to greatly smooth out serum testosterone and avoid large swings in free testosterone, DHT and estradiol.

Your serum testosterone level is probably plenty high, but I would have concerns about continuing with that much anastrozole. The topical use of testosterone may be creating a lot of DHT, which has anti-estrogenic properties of its own. You should monitor SHBG and lipids, which hopefully act as canaries in the coal mine, warning about an imbalance that is otherwise not causing symptoms.

Out of curiosity, what is your own regimen currently?

Enanthate EOD was what I planned to move on to. But if my "trough" gel levels with this level of anastrozole are 880 ng/dl it seems I can stand to lower either the gel dose or the anastrozole ever-so-slightly.

I appreciate the warning about anastrozole and will continue to monitor my blood levels as you suggest.

 

[Cataceous]

Out of curiosity, what is your own regimen currently?
...

Regarding my protocol, I've been plumbing the depths, so to speak, testing how low I can go. I've been injecting 2.8 mg testosterone enanthate and 2.1 mg testosterone propionate daily. This amounts to 3.7 mg testosterone daily, even on the low end for normal guys, and microscopic by TRT standards. It's equivalent to 37 mg testosterone cypionate a week. Even so, my serum peak is in the 500s ng/dL, so not abnormal by natural standards. Subjective results have been surprisingly good, though somewhat less consistent than at higher levels. So I will probably be going up a little from here.

There's another reason for trying such a low dose. Like you I've been stimulating some pituitary activity, but by a different mechanism—direct application of GnRH pulses. I used a SERM to prevent possible negative feedback from estradiol. I've recently gone without the SERM to see how necessary it is. Going with a lower dose of testosterone gives things a better chance of continuing to work, because estradiol is as low as I can take it without resorting to an AI.

 

[ghce]

I have tried an AI in various combinations and concentrations from daily, eod and e3d micro dosing to thumping levels of .25mg e3d and surprisingly I found that for me what worked best was about .25mg e4d my "what worked best" for me criteria was EQ, ED, nocturnal erections and libido.

I too found that with some of the various protocols I have used over the last few years that an AI was essential as if I didn't take it I was extremely irritable and easy to anger ( Road Rage etc).

 

[trtthings]

Regarding my protocol, I've been plumbing the depths, so to speak, testing how low I can go. I've been injecting 2.8 mg testosterone enanthate and 2.1 mg testosterone propionate daily. This amounts to 3.7 mg testosterone daily, even on the low end for normal guys, and microscopic by TRT standards. It's equivalent to 37 mg testosterone cypionate a week. Even so, my serum peak is in the 500s ng/dL, so not abnormal by natural standards. Subjective results have been surprisingly good, though somewhat less consistent than at higher levels. So I will probably be going up a little from here.

There's another reason for trying such a low dose. Like you I've been stimulating some pituitary activity, but by a different mechanism—direct application of GnRH pulses. I used a SERM to prevent possible negative feedback from estradiol. I've recently gone without the SERM to see how necessary it is. Going with a lower dose of testosterone gives things a better chance of continuing to work, because estradiol is as low as I can take it without resorting to an AI.

Sounds interesting. I started with clomiphene myself. Felt a little better for a bit and then absolutely horrible. Symptoms I now associate with my E2 level going up. On top of that I read that sometimes guys take clomiphene for a while and it stops working as well for them. I guess I'd liek to keep it in my arsenal if I do want to come off at some point - but it's unlikely.

 

[trtthings]

I have tried an AI in various combinations and concentrations from daily, eod and e3d micro dosing to thumping levels of .25mg e3d and surprisingly I found that for me what worked best was about .25mg e4d my "what worked best" for me criteria was EQ, ED, nocturnal erections and libido.

I too found that with some of the various protocols I have used over the last few years that an AI was essential as if I didn't take it I was extremely irritable and easy to anger ( Road Rage etc).

Sounds interesting, I measure the same. Incidentally the morning wood / libido days are also the days I feel best. I do not get those without AI, and I don't believe that's because I need to reduce the testosterone dosage. My E2 goes high and I feel crap on relatively modest dosages (below the one I am at now).

Edit: Out of curiosity, what dosage of testosterone are you taking?

 

[Cataceous]

Sounds interesting. I started with clomiphene myself. Felt a little better for a bit and then absolutely horrible. Symptoms I now associate with my E2 level going up. On top of that I read that sometimes guys take clomiphene for a while and it stops working as well for them. I guess I'd liek to keep it in my arsenal if I do want to come off at some point - but it's unlikely.

Clomiphene consists of two isomers, enclomiphene and zuclomiphene. Zuclomiphene is estrogenic and has a very long half-life. It seems likely that zuclomiphene is responsible for a decent fraction of the cases in which guys don't do well with clomiphene.

 

[ghce]

Sounds interesting, I measure the same. Incidentally the morning wood / libido days are also the days I feel best. I do not get those without AI, and I don't believe that's because I need to reduce the testosterone dosage. My E2 goes high and I feel crap on relatively modest dosages (below the one I am at now).

Edit: Out of curiosity, what dosage of testosterone are you taking?

I have used the AI on 2 different protocols 1: Topical T cream 100mg/gm once daily aprox 125mg daily and 2: Clomid 12.5mg eod.

Currently taking an daily oral dosage of 160mg Andriol ( split in 2) but not taking an AI with that though I might in the next week to see if I can get some improvement in libido and ED EQ.

 

[trtthings]

I have used the AI on 2 different protocols 1: Topical T cream 100mg/gm once daily aprox 125mg daily and 2: Clomid 12.5mg eod.

Currently taking an daily oral dosage of 160mg Andriol ( split in 2) but not taking an AI with that though I might in the next week to see if I can get some improvement in libido and ED EQ.

I'm talking to a testosterone clinic in Europe today to see about switching to injections. I don't know whether it's the right decision or not, but I feel like it's more reliable than the gel and contaminating my partner with testosterone is annoying as well.