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Nelson Vergel
Founder, ExcelMale.com
Have you tried testosterone without anastrozole? How about adding HCG to it?
CoastWatcher
Moderator
I have not, Doc put me on anastrozole right at start, now not sure why as Estradiol was not initially tested, though it is one of my labs ordered for tomorrow.
I plan on asking about HCG.
Thanks CoastWatcher! I have been somewhat of an exercise fanatic most of my life, focus on bodybuilding early on and then also mixed things up with cycling and swimming, kind of a mixed bag. At one time I was at 245 lbs. with sub 10% bodyfat in my early 20's (I'm 6'2"). When I was more into the aerobic stuff, weight was down to 220. I am now at 245 but way over 10% 
. Gains in the weight room have really fallen off. My brother who is 12 years younger has been on TRT for several years, he really built up the response to therapy so I might have been expecting too much. I have lost a few pounds and have improved libido, but not the rush he spoke of. Even Doc seemed to build this up, said I was a perfect candidate in that I had maintained exercise over the years and should really respond.
. Gains in the weight room have really fallen off. My brother who is 12 years younger has been on TRT for several years, he really built up the response to therapy so I might have been expecting too much. I have lost a few pounds and have improved libido, but not the rush he spoke of. Even Doc seemed to build this up, said I was a perfect candidate in that I had maintained exercise over the years and should really respond.CoastWatcher
Moderator
Your protocol, and the failure to perform essential testing, raises a number of red flags (as many here will tell you), but given that you're testing...that will tell the tale. What tests are on the list?Thanks CoastWatcher! I have been somewhat of an exercise fanatic most of my life, focus on bodybuilding early on and then also mixed things up with cycling and swimming, kind of a mixed bag. At one time I was at 245 lbs. with sub 10% bodyfat in my early 20's (I'm 6'2"). When I was more into the aerobic stuff, weight was down to 220. I am now at 245 but way over 10%
Vettester Chris
Super Moderator
Welcome to EM! It definitely takes time, so be patient, and keep in mind that balance throughout the body and endocrine system should be the goal. Glad you joined!
CoastWatcher
Moderator
It's fairly well established that adding anastrozole in the absence of confirmed, elevated e2 levels (relying only on the sensitive/LC/MS, MS lab test) is tempting fate. In fact, even elevated lab values - if there are no symptoms associated with high estradiol - don't necessarily merit intervention. It's fairly easy to lower estradiol but it can be a nightmare to raise it should it be crashed.
Where does your SHBG sit?
Vince
Super Moderator
When I started trt, I've only used testosterone and HCG. I did Labs at 12 weeks and never needed an AI.
OK, makes sense. SHBG was at 50 before beginning TRT.
CoastWatcher
Moderator
Did that SHBG, certainly a higher value, figure into your doctor's decision about protocol design - shot frequency and the amount injected?
Doc did describe the protocol as the best approach in his experience with the lab values I presented, though he did not directly refer to the SHBG when we did consultation. I was so thrown by the low T values that I focused my questions there, as total T had dropped from 652 in the fall of 2015 to 188 for the initial testing 10 weeks ago. I did not have free T values from the 2015 test, but free T was at 2.7 in the test just this spring.
CoastWatcher
Moderator
Was your brother's hypogonadism determined to be primary or secondary? Did he have a similar presentation as you? My father was diagnosed with hypogonadism shortly before his death, didn't really start treatment, so familial patterns interest me.
Family patterns interest me as well. My dad 1 million percent has low T, but will not go get checked. And my younger brother is now having all the symptoms, but can't get him to get checked either. Stud consider urself lucky that you have your brother to use as a loose guideline. Everyone's different obv, but if he's feeling great I personally would ask him what protocol is working for him and see how it compares to the protocol you're on.
Pretty sure brother's diagnosis was secondary and related to normal aging, I'm checking with him. I know he has had sort of roller coaster ride with estrogen levels but only in last couple years of 10 years total treatment.
Only recently as estradiol levels were always relatively low for him. He says he doesn't like the effect of the AI (anastrozole).
I would say most of the time when someone says they don't like the effects of an AI, they are just using too much. AI's are very strong. On just a 1/4 of a tab of anastrozole EOD, my E2 went from 71 to 9. That's only 0.94mg/ week. Slightly less than 1mg/ week. And most doctors prescribe at least 1mg per week. In regards to an AI, definitely the less the better. Always start very very conservatively.
Man I wish I had a brother or father that has been on TRT for 10 years. You can learn so much from them. I would literally be asking my brother a thousand questions about it every time I see him lol. All the mistakes he has made, how he felt throughout the 10 years, all the protocol changes he has made over the years and any advice he would have for someone just starting out, or any advice he would give himself when he first started if he could go back in time. That's just a few of the questions I would ask! Definitely take advantage of the fact that you have someone so close to you that has been through it, especially considering he has a lot of the same genetics/ DNA as you.
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