Someone please review my numbers...

[Scram]

I've been on .25mg anastrozole per week for about six months. I am not taking any testosterone. I had low total and free testosterone also high estrogen. The anastrozole has brought my testosterone and estrogen into what would be considered a normal range though I still feel Rundown, low libido, cognitive difficulties and some depression. My urologist is willing to and has prescribed testosterone injections which I have not begun yet. I will list my current blood work below. Looking for opinions as to how I should proceed at this point. I'm taking trt very seriously. Thank you!
Total T 669
Free T 8.5
Total e 66
Estradiol 15. 4
They seem like pretty good numbers to me except maybe the free T is a little low along with possibly the estradiol being a little low also. I don't want to take more anastrozole as that may boost up my free T but it would further lower my estradiol.

Thanks in advance!!

 

[Scram]

I should say I am 46 years old and in fit condition...

 

[MarkM]

Hi Scram,

In order to have a really good discussion we really need to see your actual labs if you have them. It is more complicated than just looking at the little bit of information you have provided. Seeing full labs lets us know what was tested, the methodology of the testing, the ranges, and what test still need to be taken. Otherwise, we are just shooting in the dark and really can't provide you accurate information. If you post labs be sure to remove any personal information or black it out, such as name, address, DOB, so it can't be seen.

 

[MarkM]

I am having a hard time understanding a doctor prescribing anastrozole, even the small amount of 0.25 mg per week and you not being on TRT. If the Estradiol you showed in your original post is from the Estradiol Sensitive test, LC/MS/MS, that is pretty low and you sure don;t want it going any lower. Starting TRT will increase it but I don;t recommend any type of AI without symptoms. Were you have high estradiol symptoms 6 months ago?

 

[Scram]

Current bloods

 

[MarkM]

Why were you taking AI (anastrozole)?

 

[Scram]

Total t was 425
Free t was 5.1
Total e was 116

 

[Scram]

Took the ai to raise t and lower e

 

[MarkM]

The Total E is not something we are typically concerned with. We are concerned with the Estradiol component of the Total E.

Your Free T is very low. Did your urologist test SHBG? If he is going to put you on TRT then testing SHBG is a critical component to establishing a protocol. Your Total T is not out of line so my initial guess is that your SHBG is very high and binding up all or most of your testosterone.

 

[HealthMan]

Your FT is indeed low and given anastrozole brought your estradiol to the mid 10s additional anastrozole is not the way to go (what was your estradiol before starting Anastrozole?)
TRT might be the solution for you.
For those asking why Anastrozole only. Sometimes anastrozole only is used if someone has high estradiol levels and low testosterone in an effort to bring testosterone up and improve testosterone/estradiol ratio. It is not common but not unheard of.

 

[Scram]

Is there a way to lower shgb by itself if it is in fact elevated?
Thank you for your response!

 

[HealthMan]

Is there a way to lower shgb by itself if it is in fact elevated?
Thank you for your response!

Some people say nettle leaf and some other supplements can help. There are a few posts discussing that here. I never tried so can’t give you my opinion. But from what I heard trying to reduce SHBG with supplements is a difficult battle to win.

 

[MarkM]

Large injections of testosterone will help mitigate the SHBG. Normally, those with high SHBG have to inject once weekly to overcome the high SHBG so they can increase the low Free T.

I have read that magnesium and boron can reduce or has reduced SHBG in certain individuals. I can not attest to it though.

 

[HealthMan]

Large injections of testosterone will help mitigate the SHBG. Normally, those with high SHBG have to inject once weekly to overcome the high SHBG so they can increase the low Free T.

I have read that magnesium and boron can reduce or has reduced SHBG in certain individuals. I can not attest to it though.

Yup. Large injections usually help. But I think he is trying to avoid TRT

 

[MarkM]

I think he is hesitant and understand that because it is a life long commitment. However, it would be a shame to see someone crash their estradiol, which he is somewhat close to doing, especially if he increases the anastrozole.

 

[MarkM]

Scram, did you have any type of high estradiol symptoms or did your urologist place you on anastrozole for precautionary purposes?

 

[Scram]

I was having a lot of anxiety and depression... He originally prescribed me 1mg anastrozole EOD which made me want to hang myself and light myself on fire... Really screwed me up. Gave me severe anxiety. I decreased my dose to .25mg/week and have been at that dose for 5 or 6 months. I am cautious when it comes to trt but willing if it will help. I do not know my E2 level before anastrozole just that total e was out of range at 116 and has come down to 66 with the AI...

 

[MarkM]

Wow, 1 mg EOD of anastrozole is what they give women with breast cancer. I'm sorry you had to go through that. I would be cautious of anything that urologist wanted me to do going forward. Really bad care.

Curious, I know your Free T is low, but have you had a thorough thyroid panel run? An under performing thyroid, hypothyroidism, can give you very similar symptoms of low T. A thorough thyroid panel would include testing the following; TSH, Free T3, Free T4, Reverse T3, and the two thyroid antibodies.

 

[Scram]

I've never had any thyroid workups... Def something to consider having done. Yeah, I'm pretty nervous having this urologist follow me with trt seeing how he prescribed the AI... It's so incredibly difficult to find someone knowledgeable with trt... I had to beg and plead for the sensitive e2 test but they finally gave in to me.

 

[MarkM]

You really need to find someone that is an expert in TRT. You should consider contacting Defy Medical. They offer a free consultation and you might really like them. They are one of the forum sponsors but I have no ties to them but they are highly recommended. They have a banner on the forum website that you can click and follow instructions for a free consult. There is no obligation and you have nothing to lose and everything to gain. hey can assist you with TRT, thryoid, an other matters as well.

https://www.defymedicalstore.com/free-consultation