Should I start taking AI with first pin of TRT?

[MidwestNomad]

I’ve been reading all the posts about members crashing their E2 and it horrified me.

My E2 levels are currently at 30 and Total Test at 450, however, my skin is on the drier side and my joints feel creaky. I know 30 for E2 is supposed to be in the upper range though.

My TRT regiment will be 160mg Test C split up every 3.5 days. HCG 500iu every 3.5 days.

Here’s where I’m scared. The facility recommended starting my AI at .125mg every 3.5 days since I already have a “higher” E2 level.

Should I wait for the side effects before starting? Labs aren’t due for 3 months, however, I was thinking of getting a Test/E2 Test at 6 weeks if I didn’t start AI.

What would you all do? I have labs if needed.

 

[Vince Carter]

I would wait I think that that will be the universal response you get from us. Where you're at now with E just isn't relevant to what is or may happen once you start treatment. Though .125mg is rather unlikely to do anything to detrimental. This .125mg dose is a catch all for guys that think they have to have it, or balk if its not given to them so it's so reduced that it's pretty hard to hurt yourself with that twice per week.

 

[Nashtide]

I’m one of the few advocates for the use of small amounts of an AI when it’s necessary and I agree with Vince Carter. I would wait until you have labs.

 

[stx359]

Horrified is the proper emotion to feel in this case and your caution is justified. We men are the worst hypochondriacs when it comes to estrogen. I think many are victims of their own minds - attributing any little thing (bad workout, below average sexual experience, bad day) to estrogen when it is really just what it is. Most of us are not young anymore. I personally don't think a 30 is high or worthy of an AI even at a low dose.

Your E may creep up with treatment but it is really dependent on your SHBG. If it's high you are lucky. If its low your E will be higher. I typically run a SHBG in the mid 40's (decently high) and a sensitive estrogen in the high 30's and my regimen is similar to yours. I take no AI whatsoever and have no estrogen symptoms. I one point I tried to attribute the fact that I don't perform like a 20 year old anymore to estrogen (I am 49). I even ordered the AI. It sits on my shelf unused. I ordered a free estrogen on discounted labs only to find that it is perfectly mid range. Had I taken the AI I shudder to think what might have happened.

Before you go with any AI I personally would wait two months and see what your numbers are specifically your SHBG. If you want to be 100% sure before you leap order the free estrogen test. It costs money but its better than ending up on the crashed estrogen team.

 

[Gman86]

I mimic exactly what Nashtide said. Ai’s can be useful for some guys in small doses, but I would 100% not take one from the start. I would definitely start your protocol, and see how you feel first. If after 4-6 weeks, you don’t feel good, I would implement the small dose of ai. I would get your sensitive E2 tested after the 4-6 weeks, and before starting the ai. Not so much to tell you how much ai to take, but just to have that E2 lab result while on no ai. It will be good to have as a reference the next time you get labs after implementing the ai. You can see how much the small dose of ai dropped your E2. It will be good for your to know how much that specific dose of ai effects your E2, as everyone is different in how their body responds. But without a doubt, try to wait until around the 6 week mark and see how you feel, before implementing an ai. You might not need it at all, which would obv be nice. One less thing to worry about.

 

[MidwestNomad]

Thanks everyone! I’ll hold off on AI until blood-work is done at 6weeks showing T/E2 levels!

Also, my SHBG level is at 23.7, which is kind of on the low side of the scale. Hopefully I don’t convert too much T!

 

[Gman86]

With a SHBG that low, and might possibly go lower on TRT, you have a decent chance of eventually needing an ai, especially considering your E2 is already 30, and your weekly dose of 160mg is on the higher end of TRT doses. Regardless, still waiting around 6 weeks to see how you feel before implementing it would probably be the best plan of action. And lowering your dose after you get your 6 week labs back is always an option as well. Implementing an ai should always be the last option, imo.

 

[MidwestNomad]

With a SHBG that low, and might possibly go lower on TRT, you have a decent chance of eventually needing an ai, especially considering your E2 is already 30, and your weekly dose of 160mg is on the higher end of TRT doses. Regardless, still waiting around 6 weeks to see how you feel before implementing it would probably be the best plan of action. And lowering your dose after you get your 6 week labs back is always an option as well. Implementing an ai should always be the last option, imo.

I’m not sure if this will make a difference, but my E2 level of 30 is after a failed Clomid restart for 3 months. Prior to the Clomid protocol my numbers were as follows:

Testosterone: 279
Free Test: 10
E2: 10
SHBG: 23.6 (didn’t change)

My LH didn’t move at all and stayed the same at 6.4

What does SHBG and LH not fluctuating on a Clomid restart tell you?


Either way, Ill hold off on the AI and will be posting actively on the forum, logging the beginning of my journey until I hopefully get dialed in!

 

[Gman86]

This makes a lot of sense! I was gonna say, your E2 of 30 was fairly high for someone with such a low test level. So ya, you will probably do better without an ai after 6 weeks than I originally thought. Time will tell. But ya, even more reason to not start with an ai considering your E2 is probably somewhere in the 10-30 range.

 

[Dr. John Crisler]

You may feel things bouncing around the first few weeks, but I would hold off until you have been on at least a month before determining whether you have an elevated estrogen issue. Merely changing hormone levels can bring both positive and negative subjective reports as things are stabilizing.