Need a different AI

ta406

Member
Prior to my last blood test I was using 140 mg testosterone cypionate per week with .5mg anastrozole. TT, FT and E2 were all within a healthy range. My libido is still lacking so my doc and I decided to add hcg. Problem is that my last blood showed elevated liver enzymes. I have since switched to 50 mg test cyp, plus 500 IU hCG per week (same shot) along with .5 mg anast. twice a week (no blood work yet). What is a good substitute for anastrozole and what might a good starting dose be that would be comparable to my current dose?

I forgot to mention that my doc has been great to work with on all fronts except e2 control. I am doing that on my own.
 
I don't believe any of the drugs in your TRT protocol would have elevated liver enzymes.

Why do you believe it did?

BTW, there really is no good substitute for anastrozole as all AI's act the same in inhibiting aromatase synthesis.

Also, you would do much better spitting that 500 iu HCG dose into two 250 iu injections.
 
Do you really need anastrozole? Was your estradiol before starting anastrozole high (as measured by sensitive E2 test)? Low E2 can lower sex drive.

What liver enzymes go up and by how much? Have you measured GGT? Are you taking any supplements that could increase liver enzymes?

Here is an article about liver toxicity and steroids (or high doses of testosterone ) that explains how bodybuilding with or without drugs can increase ALT and AST. The main test that can detect liver damage is GGT. Working out can increase AST and ALT.

Commentary: Steroids and the Liver
 
Like stated above, I also don't believe .5mg of AI will be too problematic on the enzymes. Possibly there's a combination of alcohol or other prescription medications that could be contributing to it. How elevated were they?
 
I don't believe any of the drugs in your TRT protocol would have elevated liver enzymes.

Why do you believe it did?

BTW, there really is no good substitute for anastrozole as all AI's act the same in inhibiting aromatase synthesis.

Also, you would do much better spitting that 500 iu HCG dose into two 250 iu injections.

Thanks Gene
I had read a study involving women using anastrozole in which a low number experienced high serum enzymes. This was at 1mg per day which is much higher than the dose I am taking but I cannot figure out what else would be causing this issue. I don't recall if I had any alcohol the night prior to my test. If I did it probably wasn't more than a beer or two.

I have since changed my protocol to 50 mg test cyp and 250 iu hcg in the same injection every 3.5 days with .25 mg adex the day after my injection. I'm going to get blood work in a couple of weeks to see where I'm at.
 
Do you really need anastrozole? Was your estradiol before starting anastrozole high (as measured by sensitive E2 test)? Low E2 can lower sex drive.

What liver enzymes go up and by how much? Have you measured GGT? Are you taking any supplements that could increase liver enzymes?

Here is an article about liver toxicity and steroids (or high doses of testosterone ) that explains how bodybuilding with or without drugs can increase ALT and AST. The main test that can detect liver damage is GGT. Working out can increase AST and ALT.

Commentary: Steroids and the Liver

Thanks Nelson. My E2 was 56 at 140 mg per week sub q divided into 2 doses. That was using the standard labcorp estradiol test. Adding .25mg anastrozole the day of my injection took my e2 down to 32.

My ALT went from 25 (0-44 iu/l) before I started trt to 47. I have not tested GGT.

Supplements include glucosamine, vitamin c and d, dhea, occasional melatonin, and pregnanalone which I have since discontinued.
 
Like stated above, I also don't believe .5mg of AI will be too problematic on the enzymes. Possibly there's a combination of alcohol or other prescription medications that could be contributing to it. How elevated were they?[/QUOTE

ALT went from 25 just prior to starting trt to 47 (labcorp 0-44 iu/l). I wasn't using any other prescription drugs during that time. I'm going to make sure not to consume any alcohol for a week or two prior to my next blood test. Thanks for your reply.
 
OK, good to know. 47 isn't over the top and can get reeled back in pretty quick. Cutting back the alcohol like you mentioned will probably get that number where you want it.
 
47 is really not a reason for alarm. Working out and supplements can cause this slight elevation.



Exactly what the wise one said above!

Even OTC meds can cause this to happen or even a small unnoticed injury or inflammation in your body somewhere can cause it.

I wouldn't be overly concerned with it.

If you want to lower it try taking Inositol and Choline combined in one as this always lowers liver enzymes.
 

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TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

ℹ️ Input Parameters

Normal range: 300-1000 ng/dL

Predicted Hormone Levels

Enter your total testosterone value to see predictions

Results will appear here after calculation

Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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