Hot Flashes and Low E2

[pm3405]

I have felt hot flashes throughout the day for as long as I've been on HRT the last 2 yrs., (Sub Q T Enanthate .4ml x 2 per week). I was soon put on anastrozole, (0.5mg x 3 week), when my estradiol went up. Last results a week ago showed estradiol at <2!!! Prior to that it had ranged between 20-30. My doctor's PA thought that it's great while I think it's now too low. I asked if I should cut out or cut down the anastrozole and he hesitated. He was going to ask the doctor and get back to me. I had quit taking it for a week while waiting for the PA to call me back and it seemed like the "Furnace" was off! I decided to take a dose today and after awhile the heat is back! I googled hot flashes and anastrozole and I got a positive on hot flashes side effects at everydayhealth.com
The other apparent side effects I've had since HRT is ankle swelling as well as face and stomach swelling and gynomastia. The ankle swelling is now pretty much gone and the face and stomach swelling are a bit better.

The prior PA put me on Ibutamoren 25mg x7 at bedtime with the idea that I could lose weight and gain muscle. I have gained some muscle and more weight as it boosts my appetite quite a bit. It was supposed to help me sleep better but it didn't. In fact I was sleeping horribly until recently starting melatonin.

So for now, I'm going to quit the Anastrozole and let the Estradiol come back for awhile and look for alternatives should it rise above 20-25. Any suggestions/comments on the protocol?

Last results:
Estradiol <2ng/dl
free T Calc. 22ng/dl
Testosterone 790ng/dl

Forgot, I also take HCG 1 x week sub Q inj.

 

[Leesto]

I have felt hot flashes throughout the day for as long as I've been on HRT the last 2 yrs., (Sub Q T Enanthate .4ml x 2 per week). I was soon put on anastrozole, (0.5mg x 3 week), when my estradiol went up. Last results a week ago showed estradiol at <2!!! Prior to that it had ranged between 20-30. My doctor's PA thought that it's great while I think it's now too low. I asked if I should cut out or cut down the anastrozole and he hesitated. He was going to ask the doctor and get back to me. I had quit taking it for a week while waiting for the PA to call me back and it seemed like the "Furnace" was off! I decided to take a dose today and after awhile the heat is back! I googled hot flashes and anastrozole and I got a positive on hot flashes side effects at everydayhealth.com
The other apparent side effects I've had since HRT is ankle swelling as well as face and stomach swelling and gynomastia. The ankle swelling is now pretty much gone and the face and stomach swelling are a bit better.

I can tell you that when I had crashed E2 I had hot flashes and night sweats - along with other symptoms. Never when E2 was high. Some people will tell you those come from high E2 but they don't have any good evidence to back that up. I'm sure other members here will pipe up about the symptoms they have experienced when E2 is low.

Certainly you'll have to find the E2 range which works well for you, but 2 is dangerous for your long term health. I am assuming you had the sensitive E2 test.

 

[pm3405]

Thanks Leesto, that is my understanding as well, so i'm off the Anastrozole. Not sure what kind of test is used at Baylor's lab.

 

[CoastWatcher]

You just proved, painfully, how important estradiol is to a man's health. It's not a waste product, it's essential for sexual health and general stability. It concerns me that your practice is out of touch when it comes to e2 managment - you deserve better care.

 

[Vince]

You can have your sensitive estradiol test through discount labs, if not offered by Baylor's lab.

 

[pm3405]

CYCLING OFF T ENAN WITH HCG FOR ONE MONTH
Thanks for everyone's comments. It seems that the heat is decreasing somewhat since stopping the Anastrozole. In the meantime, my doctor's PA suggested I cycle off T for one month and increase the weekly Hcg from 1500 to 5000iu. (it may actually be higher, like 4 times what I was taking. There's been some confusion because they keep revising the prescription at empower Rx ... I'll know for sue in a couple of days when I finally receive it).

 

[Vince Carter]

CYCLING OFF T ENAN WITH HCG FOR ONE MONTH
Thanks for everyone's comments. It seems that the heat is decreasing somewhat since stopping the Anastrozole. In the meantime, my doctor's PA suggested I cycle off T for one month and increase the weekly Hcg from 1500 to 5000iu. (it may actually be higher, like 4 times what I was taking. There's been some confusion because they keep revising the prescription at empower Rx ... I'll know for sue in a couple of days when I finally receive it).

You
You need to run, not walk, but run from this Dr. Seriously. They gave you 1.5mg (total) Anastrozole per week... a half mg is a whopper dose for a man, now oh you should cycle off for a month...this makes my head hurt its so very very WRONG.

 

[pm3405]

So,it's been over a month since I got off Anastrozole and cycled off T (T enan, .4ml 2xwk) and bumped the HCG to 3000IU 3x week) I just got my test results from Labcorp:

Total T: 332ng/dL (348-1197)
Free T: 8.4pg/mL. (6.6-18.1)
Estradiol, Sensitive: 33.9pg/mL (8-35)

for comparison, here are my previous results from Baylor lab, (note that all units are ng/dL vs pg/mL for freeT and Estradiol in the Labcorp tests)

Total T: 790 ng/dL
Free T: 21.98ng/dL
Estradiol: <2ng/dL on a scale of 0.5-5ng/dL

The Good: Extreme hot flashes I felt while taking Anastrozole .5mg 3 x week are thankfully gone, so is the extreme scalp oilyness.
The Bad: Energy and libido are down and getting a few pimples on my chest and back.

So, I'm starting back the T enan, (.4ml 2xweek) and the Hcg, (1500IU 1x week) and retest in 30 days. That's my plan, I assume the PA at Baylor Urologist will agree after seeing the new test results. After reading some of the posts regarding disappearing Estradiol from too much dex, mine came back nicely in a short time. I assume that once back on T, I'll convert T to higher Estradiol levels... And maybe need to block it with a lower dose of Dex than I was taking.

As always, any comments or suggestions are welcome!

 

[Nelson Vergel]

I have felt hot flashes throughout the day for as long as I've been on HRT the last 2 yrs., (Sub Q T Enanthate .4ml x 2 per week). I was soon put on anastrozole, (0.5mg x 3 week), when my estradiol went up. Last results a week ago showed estradiol at <2!!! Prior to that it had ranged between 20-30. My doctor's PA thought that it's great while I think it's now too low. I asked if I should cut out or cut down the anastrozole and he hesitated. He was going to ask the doctor and get back to me. I had quit taking it for a week while waiting for the PA to call me back and it seemed like the "Furnace" was off! I decided to take a dose today and after awhile the heat is back! I googled hot flashes and anastrozole and I got a positive on hot flashes side effects at everydayhealth.com
The other apparent side effects I've had since HRT is ankle swelling as well as face and stomach swelling and gynomastia. The ankle swelling is now pretty much gone and the face and stomach swelling are a bit better.

The prior PA put me on Ibutamoren 25mg x7 at bedtime with the idea that I could lose weight and gain muscle. I have gained some muscle and more weight as it boosts my appetite quite a bit. It was supposed to help me sleep better but it didn't. In fact I was sleeping horribly until recently starting melatonin.

So for now, I'm going to quit the Anastrozole and let the Estradiol come back for awhile and look for alternatives should it rise above 20-25. Any suggestions/comments on the protocol?

Last results:
Estradiol <2ng/dl
free T Calc. 22ng/dl
Testosterone 790ng/dl

Forgot, I also take HCG 1 x week sub Q inj.

Ibutamoren can create edema and may have been the reason for your swelling.

Why HCG once per week and how much?

 

[CoastWatcher]

So,it's been over a month since I got off Anastrozole and cycled off T (T enan, .4ml 2xwk) and bumped the HCG to 3000IU 3x week) I just got my test results from Labcorp:

Total T: 332ng/dL (348-1197)
Free T: 8.4pg/mL. (6.6-18.1)
Estradiol, Sensitive: 33.9pg/mL (8-35)

for comparison, here are my previous results from Baylor lab, (note that all units are ng/dL vs pg/mL for freeT and Estradiol in the Labcorp tests)

Total T: 790 ng/dL
Free T: 21.98ng/dL
Estradiol: <2ng/dL on a scale of 0.5-5ng/dL

The Good: Extreme hot flashes I felt while taking Anastrozole .5mg 3 x week are thankfully gone, so is the extreme scalp oilyness.
The Bad: Energy and libido are down and getting a few pimples on my chest and back.

So, I'm starting back the T enan, (.4ml 2xweek) and the Hcg, (1500IU 1x week) and retest in 30 days. That's my plan, I assume the PA at Baylor Urologist will agree after seeing the new test results. After reading some of the posts regarding disappearing Estradiol from too much dex, mine came back nicely in a short time. I assume that once back on T, I'll convert T to higher Estradiol levels... And maybe need to block it with a lower dose of Dex than I was taking.

As always, any comments or suggestions are welcome!

I don't understand why it was necessary for you to discontinue your testosterone therapy. That said, you did, and you are now ready to resume TRT. But going forward, what are your doctor's plans? Stop therapy in order to return to your hypogonadal state every time lab values and symptoms are challenging and then restart the process? I don't mean to be snide, I really don't understand this approach. Can you offer some thoughts on how you plan to manage this?

 

[pm3405]

1500IU once a week. The original PA at the time started me at that dose and it seemed to do the trick In controlling testicle shrinkage. I'm off Ibutamoren now and the ankle swelling is gone...

 

[pm3405]

It seems that some of their patients question HRT benefits after awhile and the month long "reset" is frequently prescribed. In my case, I hope I learn to better recognize the "good and the bad" effects from HRT after this reset and strive for better control. I've definitely learned by my experience and you guys about low Estradiol issues. I'm going to try Defy regardless of the Baylor PA's actions or inactions after the reset. I was successfully treated for PCa at Baylor and will remain their patient for awhile but recognize that HRT requires closer monitoring than am getting from their rotating PA's.