Is Anastrazole truly necessary?

[Luca_03]

Hi All,

I was on a really bad TRT regimen for many many years (inject 300mg once every 3 weeks). I did not take HCG with my dose either. I was never monitored nor had blood panels. I was taking this dose from 2010 until 2018. I never bothered to get blood panels or check my hematocrit or E2 or anything really. When I met my wife she did research and told me my regimen is bad. She said I need to do blood panels and get a better dose. Anyway, We found a doc who gave me a better protocol.

3 months ago he tested me and saw how bad my regimen is. My total testost. was 67, my free testost.(direct) was 5.3 and estradiol was 7.8. He suggested a new regimen (0.32ml TRT & 350IU HCG 2x a week (mon&thurs). I did this regimen for the past 3 months. Everything seems to be good. The testes are still atrophied though. Maybe because I was on such a bad dose for so long theyll take longer to become fuller. I dont know why they havent become fuller after 3 months on HCG.

So for the past 3 months I followed my docs new regimen did my followup panel a couple weeks ago and the results show some improvement: (total testost.=504, free testost.=15, estradiol sensitive=57 (labcorp results). I did my injection on thursd and had the blood panel on a monday pre-injection. Maybe the 504 represents the trough level not a peak level. Anyway I feel fine on this regimen, no issues with nipple sensitivity or any bad E2 symptoms. Doc says he can increase HCG to 500IU to help with atrophy and can increase TRT to 0.35ml to get more optimal numbers. He wants to slowly and gradually increase my levels. He suggested adding anastrazole to combat future E2 symptoms on the new regimen. But I am hesitant to add this due to its side effects. I dont know if E2 symptoms will arise with upping the TRT and HCG.

My question:

1. Do you think a person should wait for estrogen symptoms to arise before starting anastrazole OR should a person be put on anastrazole right away? The doctor said I can wait. But should I wait for symptoms to hit me or start anastrazole on my next injections?

2. If I start the new regimen of 0.35ml TRT and 500IU HCG 2x a week, when should I expect E2 symptoms to start happening? Would they happen after the first week? 2 weeks? Month? Basically will they happen beyond a reasonable doubt or is it possible I am one of the lucky few who wont have E2 symptoms on the new dose? My result showed estradiol sensitive level of 57 when I did the panel. Is that bad? I cant report any bad symptoms with a score of 57.

Thanks

 

[BigBamBoo]

Short answer....no you do not have to take an AI.

You can adjust your T dose to lower E2. I did that very successfully. Dropping it from 75 to less than 40 just by switching from every 3.5 days to M-W-F.

Now...do you know what your SHBG is? This is very important to know so you and your doctor can figure out your protocol.

And if you have high SHBG, then having higher E2 numbers is usually not as bad as it binds up some of the free E just like it does with T.

If you are not having symptoms, I would not take the AI.

I am sure others with more knowledge than me will chime in.

 

[Luca_03]

Short answer....no you do not have to take an AI.

You can adjust your T dose to lower E2. I did that very successfully. Dropping it from 75 to less than 40 just by switching from every 3.5 days to M-W-F.

Now...do you know what your SHBG is? This is very important to know so you and your doctor can figure out your protocol.

And if you have high SHBG, then having higher E2 numbers is usually not as bad as it binds up some of the free E just like it does with T.

If you are not having symptoms, I would not take the AI.

I am sure others with more knowledge than me will chime in.

My SHBG at the start of my regimen 3 months ago was 17.8. When I did my blood panel 2 weeks ago my SHBG was 18.2. The range is 19.3 to 76.4. My score is low I guess. How does this answer the question of whether I need to be put on anastrazole right away or wait until E2 symptoms pop up later?

 

[BigBamBoo]

Well most folks with low SHBG like you have go with every other day or every day injection protocols.

So you might start there. That also should lower your E2 and eliminate the need for an AI.

 

[Systemlord]

You can lower estrogen by injecting smaller doses by increasing injection frequencies, each time I would move injections closer together and smaller doses, estrogen decreased.

When my estrogen is high my testicles are pulled up tight, I took anastrozole and testicles dropped. Some men don't tolerate anastrozole well or over-respond to it, aromasin is another option.

Always start on the lowest possible doses when trying out an AI for the first time, you can always add more if needed.

 

[Luca_03]

You can lower estrogen by injecting smaller doses by increasing injection frequencies, each time I would move injections closer together and smaller doses, estrogen decreased.

When my estrogen is high my testicles are pulled up tight, I took anastrozole and testicles dropped. Some men don't tolerate anastrozole well or over-respond to it, aromasin is another option.

Always start on the lowest possible doses when trying out an AI for the first time, you can always add more if needed.

Interesting. That sounds better than having to go on an AI. I will first follow his regimen for now of injecting twice a week and monitor myself to see if I notice any E2 symptoms. If they happen Ill follow your advice of closer together frequent doses and get his Ok to do this.

Can you tell me how much to inject and on which days? The protocol he suggested is 0.35ml TRT 2x a week and 500IUs HCG 2x a week. Would I just divide 70mg TRT into 3 days and 1000IUs HCG into 3 days? Does it end up being like 0.23ml TRT mon wed fri and 333IU mon wed fri? Or should I keep HCG at twice a week only? Thanks

 

[Systemlord]

Daily 10-12mg, EOD 20-25mg, twice weekly 50mg, these are just starting points as everyone is different. Almost everyone here uses 29 gauge insulin syringe and injects in the shoulders and out quads rotating sites.

If you inject a total 100mg weekly and split it up into two injections and levels are 800 ng/dL and you split the 100mg up three ways 3 times a week, your levels will be higher than they were previously.

Work on a schedule that works for you, M/W/F is good and allows you to chill on the weekends without having to worry about injecting on days off when you're out having a good time.

 

[Luca_03]

I initially asked him if I can just inject once a week. He said its better to do twice a week. So I have been injecting twice a week for the past 3 months. But what you say makes sense about frequent smaller doses decreases estrogen.

I use 27 gauge needles and inject both HCG and TRT in the belly. He suggested belly fat for both of the TRT and HCG. I used to inject only in the buttocks region before meeting him. But he says I can do it in the fat of my belly region. Is this method wrong? Do I need to rotate between shoulder and quads like you guys do? Thanks for mentioning this, maybe im doing it wrong.

 

[Systemlord]

I initially asked him if I can just inject once a week. He said its better to do twice a week. So I have been injecting twice a week for the past 3 months. But what you say makes sense about frequent smaller doses decreases estrogen.

I use 27 gauge needles and inject both HCG and TRT in the belly. He suggested belly fat for both of the TRT and HCG. I used to inject only in the buttocks region before meeting him. But he says I can do it in the fat of my belly region. Is this method wrong? Do I need to rotate between shoulder and quads like you guys do? Thanks for mentioning this, maybe im doing it wrong.

There is no wrong method, SubQ works wonders for some people, when I inject SubQ it feels as if the entire shot converts straight over to estrogen and I can't form complete sentences for a couple of hours.

I just feel strange and I don't feel that way injecting IM.

Reason I suggest rotating injection sites is to minimize muscle tissue damage, but you are doing SubQ and therefore you avoid that issue altogether. Some guys estrogen levels becomes higher injecting SubQ and others report the exact opposite.

Injecting using an 1.5" 18 gauge syringe in the butt gets old fast, I still have those harpoons in the closet.

 

[optimizely]

There is no wrong method, SubQ works wonders for some people, when I inject SubQ it feels as if the entire shot converts straight over to estrogen and I can't form complete sentences for a couple of hours.

I just feel strange and I don't feel that way injecting IM.

Reason I suggest rotating injection sites is to minimize muscle tissue damage, but you are doing SubQ and therefore you avoid that issue altogether. Some guys estrogen levels becomes higher injecting SubQ and others report the exact opposite.

Injecting using an 1.5" 18 gauge syringe in the butt gets old fast, I still have those harpoons in the closet.

Dude I know exactly what you mean about injecting SubQ. I’ve been on a new daily protocol injection injecting SubQ for 12 weeks now and it feels like it’s literally made me retarded. Super hard to communicate and form proper sentences. Feels foggy and difficult to critically think. I never felt like that on twice weekly IM injections. Debating real hard about switching back tbh.

 

[fifty]

Subq injection of T feels much less effective than IM for me. I don't know anyone in the real world who injects T subq. It seems like an internet trend because someone read too deep into reddit or watched too many Dr. Crisler shirtless videos.

 

[optimizely]

Subq injection of T feels much less effective than IM for me. I don't know anyone in the real world who injects T subq. It seems like an internet trend because someone read too deep into reddit or watched too many Dr. Crisler shirtless videos.

Hahaha nailed it

 

[Airborne Warrior]

It's no internet trend but a valid method of administering testosterone and HCG. Whether IM is more effective or not requires more studies and (as you say) whether YOU feel it is more or less effective.

 

[BigBamBoo]

I inject sub-q. Have from day one.

 

[Moogie]

Me too on Sub-Q. That’s what my protocol started with.

 

[Airborne Warrior]

Subq for me too.

 

[Vince]

Hi All,

I was on a really bad TRT regimen for many many years (inject 300mg once every 3 weeks). I did not take HCG with my dose either. I was never monitored nor had blood panels. I was taking this dose from 2010 until 2018. I never bothered to get blood panels or check my hematocrit or E2 or anything really. When I met my wife she did research and told me my regimen is bad. She said I need to do blood panels and get a better dose. Anyway, We found a doc who gave me a better protocol.

3 months ago he tested me and saw how bad my regimen is. My total testost. was 67, my free testost.(direct) was 5.3 and estradiol was 7.8. He suggested a new regimen (0.32ml TRT & 350IU HCG 2x a week (mon&thurs). I did this regimen for the past 3 months. Everything seems to be good. The testes are still atrophied though. Maybe because I was on such a bad dose for so long theyll take longer to become fuller. I dont know why they havent become fuller after 3 months on HCG.

So for the past 3 months I followed my docs new regimen did my followup panel a couple weeks ago and the results show some improvement: (total testost.=504, free testost.=15, estradiol sensitive=57 (labcorp results). I did my injection on thursd and had the blood panel on a monday pre-injection. Maybe the 504 represents the trough level not a peak level. Anyway I feel fine on this regimen, no issues with nipple sensitivity or any bad E2 symptoms. Doc says he can increase HCG to 500IU to help with atrophy and can increase TRT to 0.35ml to get more optimal numbers. He wants to slowly and gradually increase my levels. He suggested adding anastrazole to combat future E2 symptoms on the new regimen. But I am hesitant to add this due to its side effects. I dont know if E2 symptoms will arise with upping the TRT and HCG.

My question:

1. Do you think a person should wait for estrogen symptoms to arise before starting anastrazole OR should a person be put on anastrazole right away? The doctor said I can wait. But should I wait for symptoms to hit me or start anastrazole on my next injections?

2. If I start the new regimen of 0.35ml TRT and 500IU HCG 2x a week, when should I expect E2 symptoms to start happening? Would they happen after the first week? 2 weeks? Month? Basically will they happen beyond a reasonable doubt or is it possible I am one of the lucky few who wont have E2 symptoms on the new dose? My result showed estradiol sensitive level of 57 when I did the panel. Is that bad? I cant report any bad symptoms with a score of 57.

Thanks

I think everyone should wait before they start an AI, low estrogen causes more trouble than high estrogen. Why go through all the grief of having low estrogen and I would have considered estrogen of 57 too high.

 

[Deleted member 16042]

Subq injection of T feels much less effective than IM for me. I don't know anyone in the real world who injects T subq. It seems like an internet trend because someone read too deep into reddit or watched too many Dr. Crisler shirtless videos.

LOL. Don't believe everything you think. It is one thing to have personal preference. It is entirely another to falsely categorically dismiss effective medical practice.

I also inject subQ, and you are welcome to look up my labs, posted elsewhere on the forum. SubQ is effective for many, and is in no way fringe or just trendy.

 

[Luca_03]

I think everyone should wait before they start an AI, low estrogen causes more trouble than high estrogen. Why go through all the grief of having low estrogen and I would have considered estrogen of 57 too high.

Thanks Vince! I am thinking of waiting before using anastrazole. With a score of 57 for estradiol I dont feel any bad E2 symptoms yet and its been 3 months. Perhaps when I up my TRT & HCG, I may start to feel estrogen symptoms arise. Until then, Ill maybe wait to see what symptoms will come about. Do you think my estradiol score will rise by upping my dose to what the doc suggested(0.35ml TRT & 500IU HCG 2x week) or will it stay around 50-57?

 

[Vince]

Thanks Vince! I am thinking of waiting before using anastrazole. With a score of 57 for estradiol I dont feel any bad E2 symptoms yet and its been 3 months. Perhaps when I up my TRT & HCG, I may start to feel estrogen symptoms arise. Until then, Ill maybe wait to see what symptoms will come about. Do you think my estradiol score will rise by upping my dose to what the doc suggested(0.35ml TRT & 500IU HCG 2x week) or will it stay around 50-57?

If you have secondary hypogonadism then it should rise. If you were primary like me it probably won't increase your estrogen.