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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Still not dialed in after 2+ years on TRT. Labs included. Help?
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<blockquote data-quote="Dr Justin Saya MD" data-source="post: 49251" data-attributes="member: 12687"><p>I would try the L-tyrosine. If you are who I think you are based on the clinical story, we've suspected all along that you were "E sensitive" in the sense that you are likely going to do better with TIGHT control of estrogen...however the question remains WHERE to set that bar for tight control. The E2 is now tightly controlled within a tight range, but may not be your optimal range. </p><p></p><p>It's looking more and more like you are going to be a guy that does better with either a slightly HIGHER estradiol or a slightly LOWER estradiol (again with tight control to minimize fluctuation) than what most consider normal/optimal. We can head "up" or we can head "down" from here to rule out/in which you respond better to. You felt good previously with E2 at ~20-24 (although once weekly shots and other variables different). You felt good some days and bad some days when E2 fluctuated in a range 16 - 35 (the question is were the "good" days closer to 16 or closer to 35). You're now more tightly controlled with E2 consistently 27-28, but this appears to not be your sweet spot (assuming E2 is the issue, more likely than not assuming your DHT comes back okay - I would check this before our consult). </p><p></p><p>To go up on estradiol is simple, do a trial of stopping the anastrozole. To go down we would need a slight dosage adjustment on the anastrozole. We can discuss both during consult. For now would try the L-tyrosine and get DHT checked (note this lab takes a particularly long time to return results...sometimes up to a week).</p></blockquote><p></p>
[QUOTE="Dr Justin Saya MD, post: 49251, member: 12687"] I would try the L-tyrosine. If you are who I think you are based on the clinical story, we've suspected all along that you were "E sensitive" in the sense that you are likely going to do better with TIGHT control of estrogen...however the question remains WHERE to set that bar for tight control. The E2 is now tightly controlled within a tight range, but may not be your optimal range. It's looking more and more like you are going to be a guy that does better with either a slightly HIGHER estradiol or a slightly LOWER estradiol (again with tight control to minimize fluctuation) than what most consider normal/optimal. We can head "up" or we can head "down" from here to rule out/in which you respond better to. You felt good previously with E2 at ~20-24 (although once weekly shots and other variables different). You felt good some days and bad some days when E2 fluctuated in a range 16 - 35 (the question is were the "good" days closer to 16 or closer to 35). You're now more tightly controlled with E2 consistently 27-28, but this appears to not be your sweet spot (assuming E2 is the issue, more likely than not assuming your DHT comes back okay - I would check this before our consult). To go up on estradiol is simple, do a trial of stopping the anastrozole. To go down we would need a slight dosage adjustment on the anastrozole. We can discuss both during consult. For now would try the L-tyrosine and get DHT checked (note this lab takes a particularly long time to return results...sometimes up to a week). [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Still not dialed in after 2+ years on TRT. Labs included. Help?
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