New to Anastrozole

[Diggs]

I've been on TRT for about 2 years now and have recently switched docs to Rand McClain in L.A. Nice dude. While I've not used an A.I. in the past, he's prescribing me one now, as my E2 is 44. I believe he's wanting me down in the 20 to 30 range. (not that we're treating numbers!) He's changing my shot protocol now as well, so I'll be at 1x week @200 mg cypionate and anastrozole 1mg every other day.

Given the stuff I've been reading in the forums here, that amount of A.I seems high. While I know each person is different, can someone lay out the generally prescribed protocol for an A.I.?

On one hand, I don't wanna go against my new docs recommendations, but I wanna perform my due diligence to be informed. Much appreciated.

 

[James]

What did your protocol look like prior to meeting with Dr. McClain? He's a well respected guy in the trt world, but 1mg every other day seems awful high based on the info you provided. Did he give any particular reason why he would like you on a dose that high?

 

[cleverusername]

To me it sounds like WAY too much anastrozole. The 1mg should be broken into 4 pieces and take a total of half per week. Thats .5mg per week, not 1mg every other day! anastrozole is powerful and with E2 of only 44, you are surely headed for a crash.

 

[Vince]

Personally if I were you, I wouldn't even consider using an AI. Anastrozole 1mg every other day, is ridiculous.

 

[madman]

I've been on TRT for about 2 years now and have recently switched docs to Rand McClain in L.A. Nice dude. While I've not used an A.I. in the past, he's prescribing me one now, as my E2 is 44. I believe he's wanting me down in the 20 to 30 range. (not that we're treating numbers!) He's changing my shot protocol now as well, so I'll be at 1x week @200 mg cypionate and anastrozole 1mg every other day.

Given the stuff I've been reading in the forums here, that amount of A.I seems high. While I know each person is different, can someone lay out the generally prescribed protocol for an A.I.?

On one hand, I don't wanna go against my new docs recommendations, but I wanna perform my due diligence to be informed. Much appreciated.

First and foremost was your e2 the sensitive assay and are you experiencing any high e2 symptoms at 44? Also do you have high SHBG as 200mg once weekly is a hefty dose of testosterone to inject which will definitely spike your e2! That is also way too much anastrozole/week. What was your previous protocol without need for an A.I. and can you post most recent blood work from previous protocol?

 

[Vince Carter]

I've been on TRT for about 2 years now and have recently switched docs to Rand McClain in L.A. Nice dude. While I've not used an A.I. in the past, he's prescribing me one now, as my E2 is 44. I believe he's wanting me down in the 20 to 30 range. (not that we're treating numbers!) He's changing my shot protocol now as well, so I'll be at 1x week @200 mg cypionate and anastrozole 1mg every other day.

Given the stuff I've been reading in the forums here, that amount of A.I seems high. While I know each person is different, can someone lay out the generally prescribed protocol for an A.I.?

On one hand, I don't wanna go against my new docs recommendations, but I wanna perform my due diligence to be informed. Much appreciated.

I'm speechless. Nothing good to say about it so I'm not going to.

 

[Diggs]

Thanks for all the responses. Here's my former and NEW protocol w/labs:

Former protocol for 18 months: 40mg cyp injection IM every 3rd day. No A.I.

With this protocol, I felt pretty good, however was having some minor, yet admittedly annoying, side effects: a bit moody off and on thru the week, some minor amounts of anxiety that wouldn't normally be present, along with the bigger side effect of awakening in the middle of the night ruminating over meaningless things. I tolerated these minor side effects for about a year even after informing my former doc of them. While I'm certain he meant well, at the end of the day, he's just the kind of a dude who doesn't love when I question the protocol as it relates to how I feel. And I'm of the attitude of "life's too short," and I'll find someone who's both a cool dude AND who knows this stuff, treats a ton of guys, and listens to me.

That said, I made an appointment w/Rand McClain and brought my recent LabCorp labs reflecting my former above protocol:

Total T: 880 (264-916)
Free T: 13.1 (6.8-21.5)
E2: 44 (7.6-42.6) (NOT ultrasensitive assay) Note: 6 months prior, my Quest ultrasensitive E2 test was 32.5 (Quest range <29)
DHT: 100 (30-85)
IGF1: 233 (67-205)
LDL: 100 (0-99)
HDL: 40 (>39)
Hemoglobin: 16.9 (12.6-17.7)
Hematocrit: 49.9 (37.5-51.0)

Rand and I rapped for an hour about all this stuff. Again, he was a very cool dude and answered every question I had. He, like any good doc, mentioned multiple times we aren't treating numbers. His take was generally that he felt with a free T of 13.1 that I was still sub-therapeutic. And he felt with an adjustment in dosage I'd feel better and reap the intended benefits of TRT. He said most of his guys happen to do better with an estrogen somewhere around the low 20's. (while he did have some guys who felt better at higher ranges around 30.) He felt in order to get me up to a higher Free T, I should try moving to a 1x week 200mg cyp shot which would indeed spike my estrogen again, so he advised the 1mg A.I every other day. We agreed to meet again in 4 weeks for retesting, as he was most interested in dialing in my estrogen as it pertains to how I was feeling. Worth mentioning is he said, "you can always go back to where you were in terms of dosage, so give it try and nothing will be lost." He also suggested I donate some blood between now and the retest.

We hear the phrase "where the rubber meets the road," often as it pertains to Free T. But the phrase also applies to this forum, where 1000's of guys are sharing their experiences with what's working for them and what's not. And that's the reason I seek answers in this wonderful forum. So the heart of my question is not to second guess my doctor, but at least try and find some correlation between what I've been prescribed by my new doctor, and what a large sample size of guys are actually doing with their protocol- all while trying to keep in mind each individual has different responses to various protocols. But, honestly, I'm just not seeing where guys here are like, "yeah, 1mg A.I. every other day is the key."

Btw, in case anyone's interested, here's a video link with Nelson asking a pointed question about Anastrozol to Dr. McClain. It's about 7 minutes long. I didn't see this video until AFTER I had my initial consultation with Rand: https://youtu.be/7KQlq9bGO04?t=22m9s

So do I go against my doc's recommendation, and start lower at .5mg A.I. every other day, or give him a fair shake on the retest coming up in 4 weeks, and follow his 1mg every other day protocol?

 

[johndoesmith]

Thanks for all the responses. Here's my former and NEW protocol w/labs:

Former protocol for 18 months: 40mg cyp injection IM every 3rd day. No A.I.

With this protocol, I felt pretty good, however was having some minor, yet admittedly annoying, side effects: a bit moody off and on thru the week, some minor amounts of anxiety that wouldn't normally be present, along with the bigger side effect of awakening in the middle of the night ruminating over meaningless things. I tolerated these minor side effects for about a year even after informing my former doc of them. While I'm certain he meant well, at the end of the day, he's just the kind of a dude who doesn't love when I question the protocol as it relates to how I feel. And I'm of the attitude of "life's too short," and I'll find someone who's both a cool dude AND who knows this stuff, treats a ton of guys, and listens to me.

That said, I made an appointment w/Rand McClain and brought my recent LabCorp labs reflecting my former above protocol:

Total T: 880 (264-916)
Free T: 13.1 (6.8-21.5)
E2: 44 (7.6-42.6) (ultrasensitive assay)
DHT: 100 (30-85)
IGF1: 233 (67-205)
LDL: 100 (0-99)
HDL: 40 (>39)
Hemoglobin: 16.9 (12.6-17.7)
Hematocrit: 49.9 (37.5-51.0)

Rand and I rapped for an hour about all this stuff. Again, he was a very cool dude and answered every question I had. He, like any good doc, mentioned multiple times we aren't treating numbers. His take was generally that he felt with a free T of 13.1 that I was still sub-therapeutic. And he felt with an adjustment in dosage I'd feel better and reap the intended benefits of TRT. He said most of his guys happen to do better with an estrogen somewhere around the low 20's. (while he did have some guys who felt better at higher ranges around 30.) He felt in order to get me up to a higher Free T, I should try moving to a 1x week 200mg cyp shot which would indeed spike my estrogen again, so he advised the 1mg A.I every other day. We agreed to meet again in 4 weeks for retesting, as he was most interested in dialing in my estrogen as it pertains to how I was feeling. Worth mentioning is he said, "you can always go back to where you were in terms of dosage, so give it try and nothing will be lost." He also suggested I donate some blood between now and the retest.

We hear the phrase "where the rubber meets the road," often as it pertains to Free T. But the phrase also applies to this forum, where 1000's of guys are sharing their experiences with what's working for them and what's not. And that's the reason I seek answers in this wonderful forum. So the heart of my question is not to second guess my doctor, but at least try and find some correlation between what I've been prescribed by my new doctor, and what a large sample size of guys are actually doing with their protocol- all while trying to keep in mind each individual has different responses to various protocols. But, honestly, I'm just not seeing where guys here are like, "yeah, 1mg A.I. every other day is the key."

So do I go against my doc's recommendation, and start lower at .5mg A.I. every other day, or give him a fair shake on the retest coming up in 4 weeks, and follow his 1mg every other day protocol?

You do not have the sensitive Estradiol test, that's the standard test based on the range.

When were these taken relative to injection?

Did you have SHBG tested?

 

[Diggs]

You do not have the sensitive Estradiol test, that's the standard test based on the range.

When were these taken relative to injection?

Did you have SHBG tested?

You're correct- I just verified it was the Labcorp (82670) Estradiol test, not the ultrasensitive.

However, my prior labs from Quest ultrasensitive E2 test 6 months prior was E2 of 32.5 where Quest's range is <29. If that helps.

My most recent labs were taken on my trough day. I did the labs then wen't home and had my shot. I asked Rand about not testing SHBG and he said because it could easily be inferred by the other results.

 

[bm1981]

Rand is a well respected doctor in this field. on his you tube videos he says he is more aggressive with his estrogen management than some other doctors however he isn't trying to eliminate estrogen but keep it 15-20. He sees enough guys to know what works and what doesn't.

 

[James]

Diggs - With the horror stories we read on this site, the senior members are always telling guys to seek a competent doctor to help them with therapy. It appears you've done that as this guy is widely considered to be one of the best. But I just can't imagine why he would have you on such a high dose of anastrozole. It's mind-boggling to me. We all know we're different, but I'm currently taking 1/8 mg of Anastrozole twice a week and I can feel the difference if I miss a dose. That's how powerful this drug is.

 

[user_joe]

I've watched a lot of YouTube videos of his. Seems really knowledgeable. I can't imagine 200mg 1x/wk and 3.5mg anastrozole equaling e2 at 20. That's what gets me. My e2 would be 0.

 

[Vince Carter]

1mg EOD is irresponsible.

 

[bm1981]

I am sure Dr Rand would adjust if his estrogen crashed. Dr Rand sees thousands of TRT guys so just can't imagine he is guessing at this.
On the other hand lots of guys with personal experience saying it's not good.

For what it's worth about 10 years ago I developed gyno due to low test levels and my doctor at time prescribed me arimdex at 1mg a day for a month. I started a new job at the time and everything went fine didn't notice any adverse effects. It didn't get rid of the gyno but my test levels doubled. (Unfortunately didn't have estrogen labs run).

 

[Diggs]

I am sure Dr Rand would adjust if his estrogen crashed. Dr Rand sees thousands of TRT guys so just can't imagine he is guessing at this.
On the other hand lots of guys with personal experience saying it's not good.

For what it's worth about 10 years ago I developed gyno due to low test levels and my doctor at time prescribed me arimdex at 1mg a day for a month. I started a new job at the time and everything went fine didn't notice any adverse effects. It didn't get rid of the gyno but my test levels doubled. (Unfortunately didn't have estrogen labs run).

appreciate the words bm1981- it helps. You make a good point in that the guy's been doing this stuff for years. And yet, I value what the senior members of this forum say too. I'm certain I'll get it all on track within a month or so.

 

[Vince Carter]

For what it's worth about 10 years ago I developed gyno due to low test levels and my doctor at time prescribed me arimdex at 1mg a day for a month. I started a new job at the time and everything went fine didn't notice any adverse effects. It didn't get rid of the gyno but my test levels doubled. (Unfortunately didn't have estrogen labs run).

In trying to bolster his position you posed everything not to do...lol

 

[bm1981]

Sorry Vince ....I hope it works out for Diggs and I am sure it will. Maybe Diggs could speak with Dr Rand and explain his concerns as he has some good feedback from the community.