Need advice on Anastrozole dosage

[Mike9876]

I've been on TRT for 3 months. My current protocol is:

100mg Test Cypionate per week, injecting EOD.

Blood test just over a month ago revealed my Estradiol was 226 (Range 50-150)

So I started on 0.25mg anastrazole E3D.

Another blood test on 10/8 showed Estradiol of 141 (Range 50-150)

So I keep going with the Anastrozole as I seemed to be on the right track.

The past 4-5 days I have been having bad anxiety. I do have something going on in my life which I figured may be causing it, however in 45 years of life I've never really had anxiety at all. So I figured I may have pushed my Estradiol too low. Whilst I realise that many of the symptoms of both high and Low Estrogen are the same, anxiety is one that only seems to be mentioned when talking about low Estrogen.

So I had a blood test yesterday. Here are my results:

Testosterone - 29nmol/L (Range 8.3-29) (835ng/dL)
Free Testosterone - 783.1pmol/L (Range 255-725)
Oestradiol 190pmol/L (Range 50-150)
SHBG 21nmol/L (Range 11-71)

So I need advice what I do here. I haven't taken any Anastrozole since last thursday. I was due to take it on Sunday however I skipped it in case I was already on low Estradiol. However my results from yesterdays test show that I'm high.

Should I perhaps lower my testosterone dosage? While I realise 100mg/week isn't a high dose, test and free test are now high. I started with a test level of 240, I'm now at 835. Maybe I don't need to be anywhere this high. Maybe I'd feel good at 500 or 600?

Advice?

 

[Vince]

You really need to right Sensitive estrogen test LC/MS/MS for men.

 

[Mike9876]

Hi Vince, we don't have that test here in Australia unfortunately. We only have plain old Estradiol.

 

[Vince]

If you can't get the right estrogen test then go by how you feel, it better to be too high then too low.

 

[Mike9876]

I don't feel great. Like I said I've never really had anxiety before. My pre-trt Estradiol was 97, now it's 190 (same lab). It makes me think it is high even low anxiety only seems to be mentioned as a low estrogen symptom. I did see one poster on here say he gets anxiety when his estrogen gets too high. So basically I'm really confused and not sure what to do..

 

[Blackhawk]

You are doing a good thing EOD with your SHBG level. 100mg/week looks like it could be high. EOD dosing keeps peaks lower and troughs higher, so you are in effect running at a consistently higher more steady state with the frequent doses. There are at least a few low SHBG guys on this forum doing significantly lower than 100mg/ week EOD or daily. The free T number is the one to focus on.

 

[Mike9876]

So maybe drop down to 75 or 80mg per week then? Or lower?

Would it be advisable to take 0.25mg anastrazole now and see how I feel later in the day. If I feel better, this would probably be an indication my Estrogen is high?

I really just feel that given my blood test yesterday shows it to be high, then surely it is correct? Also, all my bloods have been done by the same lab. Started with Estrogen 97, now 190. Surely it can't be low, even if we had the sensitive test here?

 

[MarkM]

Hi Mike,

I'm with you in that normally it seems anxiety happens when E2 is depressed and gets too low but you feel like you are experiencing it with high E2. These symptoms can effect each us us differently depending on our own body chemistry. The EOD injection protocol is probably good with SHBG of 21 but you might try injecting ED and see if that helps. With low SHBG you are also going to be having high Free Estradiol too. That may be where the anxiety is coming from.

A lot of low SHBG guys seem to do better when they run Total T in the 600 to 700 range and they Free T just closer to the mid range to 3/4 mark of the upper limit verse being over the top of the upper limit like you are. With that high Free T you are getting high Free E. Injecting daily might help the estradiol from spiking as high. The non-sensitive E2 test is not very accurate for men but regardless you seem to have symptoms. I believe the Estradiol Sensitive test in Australia is called "Oestradiol LCMS".

If you have the sensitive test available, which I believe you do, that would help. It's hard to extrapolate what the non-sensitive would equate to in sensitive estradiol terms. My non-sensitive E2 is 91 and sensitive is 35. @Vince Carter a low SHBG forum member believes that low SHBG guys need their E2 close to their SHBG.

@Vince Carter has looked into this more than anyone else and maybe he will chime in.

Right now, if you are feeling bad, go back on the AI in hopes of feeling better until you get this worked out. I am not a fan of AI's but I realize some people need them and if they need them they should take them.

 

[lowe2sucks]

do you feel any better that pre trt?

 

[Mike9876]

MarkM, thanks very much for that info. I have done a search to see who has the Oestradiol LCMS test. I can find info on the test, just not anywhere that actually performs it. I will keep looking.

lowe2sucks, in many ways I do feel a lot better, in relation to physical energy and other things like this. In the recent weeks I have noticed I get tired a lot more during the day, sometimes only and couple of hours after waking.

I have taken 0.25mg of Anastrozole and I will see how I'm feeling as the day goes on.

 

[Systemlord]

That standard E2 test should be ignored, in general the higher the standard E2 test the more inaccurate it tends to be.

Me being low SHBG I can't handle high normal levels, estrogen becomes a problem. Probably a good idea to cut the dose to 80mg weekly split up EOD or you might even consider every day injections. That would help you better control estrogen.

 

[Mike9876]

Systemlord, thanks for that. I will continue to look to see who does a sensitive test here in Oz. I am going to cut my dose to 80mg or even 75mg, seeing my free test is so high. That will hopefully help. I really would rather avoid going to ever day injections just for the convenience factor, however if it's going to be better then I will surely give that a try.

 

[Mike9876]

Hey guys, I just found this -> https://imedical.com.au/order/blood-tests/sport-hormone-private-blood-tests/E2-LCMS-sport-tests

Is this the same as you guys in the US and Canada have? Or if not, is it still much better than the standard Estradiol test?

 

[Mike9876]

Sorry for the multiple posts. I just emailed the place I've had all my previous bloods done asking if they do the sensitive test. This is what they replied with:
------------------------
Hi Michael

Regarding the sensitive oestradiol assay - this assay is only relevant where oestradiol levels fall below the lower limit of the machine’s sensitivity (which is usually 70pmol/l). Given your result didn’t fall below that level, then this test wouldn’t be relevant in your case, and would yield the same result.

Please let me know if you need any further information.

Thanks!
------------------------

Thoughts??

 

[Vince Carter]

You have to get the correct test, that's kind of the cut and dried part of this and the clinic is wrong in their statement, it's not are you under the threshold but the test is more sensitive(! key word) for the levels found in males.

Obvious E problem no matter how you spin it though.

I would stay the course .25mg E3D to knock it down some but anything else needs to wait until the proper test is run.

You should given your SHBG run two tests if money allows you to do so:

(Ultra) Sensitive LC/MS/MS
Estradiol, Free

 

[Vince Carter]

I’d bet money you are experiencing low e2 symptoms. Only 100mg/wk doses eod. Anxiety. Literally the odds are so far against high e2.

You can fix high e2 pretty damn quick. Tank your e2 and you feel like shit for weeks usually. I’d stop the ai and wait it out. Keep a diary of symptoms on the back of your labs printed out.

Did you even read his labs? Even factoring in the wrong test you're so far off base here. Let alone you completely ignored his SHBG. You should think about the advice you're doling out because you're not being helpful on subjects you know little about.

 

[Mike9876]

Ok, so I've just been and had my blood taken. On the test form it said:

E2 Sensitive by LCMS method

I'm hoping this is what I need?
It said on the form that results are usually delivered in 24-48 hours, but that rarer tests will take longer. I'm not sure if this is considered a rare test or not.

So now I will just wait for the results and go from there.

Thanks again for all the advice and comments. It's helping me a lot.

 

[MarkM]

Sounds like you got the right test now Mike.