Starting AI - Need Input

[Moogie]

Hi TRT Team:

I have started my 7th week of TRT and with last weeks labs and Doctors appointment I was prescribed an AI.

I am prescribed to take .125 Anastrozole EOD.

My initial first labs for E2 was 38 pg\ml (men’s test) and 6 weeks into TRT it went up to 45 pg\ml.

I feel crappy have very low SHBG and I’m taking 40mg Test C SQ twice a week and 500mg HCG twice a week.

My initial TT was 220 and FT 49 - after six weeks TT was 317 and FT 107.4.

SHBG was 8 on initial test. Stupidly low!

Will this AI protocol crash my system?

Thanks in advance for your input.

 

[Vince]

Men with low shbg need more frequent injections of testosterone. Many members inject daily with Easy Touch syringes. I do not have low shbg but I do daily injections. I was somewhat hesitant to start because I wasn't sure if I could be disciplined enough to continue this protocol. It's been almost 2 years for me now and I've only missed one injection.

 

[fifty]

Do you have E symptoms? If it were me, I would try it 2x/wk taking it right after your injections. If you tested in your trough (blood test right before next injection) then a doubling in free T is pretty good.

I take .125 anastrozole 2x/wk and my sensitive estradiol is currently 47. Prior to TRT, my sensitive estradiol was 22. Note that I am a high shbg guy though (67).

 

[Moogie]

Yes - I have E2 symptoms. And the blood work was right before my Test pin. What exactly does trough mean?

My doctor was thrilled that my FT was doubled to 107.4

I guess TT doesn’t mean all that much if FT is high - I asked for higher dose and he said FT was doing just fine. So I am at the same starting dose.

Also to note - yesterday, I started daily injections - divided 80mg by 7 days. With low SHBG I must be highly sensitive to E2 because HCG puts the hurt on me with chest tightness, heart palpitations and everything else that comes with E2. Hopefully taking daily Test will bring E2 down also.

I have also noticed my anxiety has skyrocketed and I am hoping it is all E2 related. Anyone else have anxiety rise when TRT was started?

 

[fifty]

I tried no AI when I started TRT and had pounding chest & hard to breathe at times (anxiety). I felt better when I took the AI.

If you have reservations about taking it, I would try 1 .125mg pill per week and see how that goes (ex: Monday). If you feel better then consider adding a 2nd pill halfway through the week (ex: Mon & Thurs) then work up or down from there.

That being said 45 sensitive E isn't a problem for a lot of people. I'm just saying if your doctor recommends it, one .125mg pill is worth a shot. If it's going to help you will likely notice some improvement quickly.

 

[Moogie]

Fifty and Vince -

Thank you for your input. Also, good to hear that I’m not alone when it comes to the symptoms of E2. My AI arrived today and I took one .125 - if you say they are fast acting, I should probably notice changes in a day or so?

Thanks again for your response.

 

[fifty]

I noticed some improvement within a few hours.

Remember, it also makes a difference when you take it. If you take it at the same time you do your shots then it can help blunt the spike/peak in E2 you may be getting from the hcg or test.

 

[Moogie]

One more question concerning AI.

Does the AI stop the process conversion of FT into E2? Does it therefore leave the FT for better use?

What I’m getting at is, will I access more FT if it is not being converted into E2?

 

[Jiu Jitsu Dude]

That's a great question. Too bad I have no idea what the answer is lol. But I can't wait to learn from someone. Great question.

 

[fifty]

It increases T in normal men...possibly due to an increase in LH. I’m not sure how that differs in trt men where the hpta axis is shut down.

FreeT is a function of total T and shbg.

Effects of aromatase inhibition in elderly men with low or borderline-low serum testosterone levels. - PubMed - NCBI

 

[Moogie]

Ahhhh - that makes sense. I would have to extrapolate that the reason there is more T is it hasn’t been converted into E2 - therefore, according to you article, there is more T that is bio available. Nice . I would think it would not make a difference if it was natural or TRT.

Also, I felt amazing this morning after taking .125 AI yesterday. Tightness of chest was gone and anxiety was virtually nonexistent.

I was diagnosed 3 years ago with Generlized Anxiety Disorder and the Docs treated with Ativan when the entire time I was low T - low SHBG and more than likely highly sensitive to E2 which caused my panic attacks. We will see if this light dose of AI will remove all panic - I bet it will. I can’t wait to take another .125 AI tomorrow! Amazing

 

[Systemlord]

Doctors find it easier to treat the symptoms instead of looking for the cause of the symptoms, and in most cases the medications will mask the symptoms for a while, but once the symptoms become severe it becomes clear that your issue is low hormones.