Time for symptom relief? Aromasin "kick in" hcg etc

[BaldEagle66]

General Questions I been having hard time with getting some anecdotal information on.

1) How long after starting an AI do you actually feel the benefits of it? I'm not gyno prone, but definitely bloated, mediocre sex drive, moodiness, erectile dysfunction and sexual sensitivity (when I can get a decent hard on with help from cialis i can't finish)?

2) if anyone has added HCG to just testosterone monotherapy, how long does it take for testicular size to increase? And for those of you experience sexual benefit from. Hcg How long does that take?

I ask because even though we know about half life etc that doesn't necessarily mean that's when we feel better. For example after injection of a long ester testosterone we still get a hug increase on serum test 24-48hrs after, but most don't feel much better until 3-6weeks later. So I'm wondering if something like this is true for AIs And HCG.?

some background:
Added Aromasin and HCG recently to 200mg test cyp trt. Aromasin 25mg 2x day after pinning (pinning 2x week 100mg each mon and Thurs, so aromasin 25mg Tues and Fri) and 12.5mg aromasin on Sunday to play it safe. I've always been a high converter, some years ago a urologist put me on clomid monotherapy which got my tt to 700 but e2 went between 45-65. I also added in 400iu hcg 2x week about two weeks ago and haven't really noticed much testicular site increase... Maybe slightly but it might be placebo effect.

 

[ERO]

From what I read here, it works fast. https://en.wikipedia.org/wiki/Exemestane"Exemestane is quickly absorbed from the gut, but undergoes a strong first-pass effect in the liver. Highest blood plasma concentrations are reached after 1.2 hours in breast cancer patients and after 2.9 hours in healthy subjects. Maximal aromatase inhibition occurs after two to three days.[SUP][[/SUP]"

Do you have blood work to post?

 

[Vince]

With HCG if your testicles are not fuller in a week, that dose is too low for you. I use 500iu twice a week.

 

[Nelson Vergel]

It would be nice if an AI would work to resolve one or all of your issues. I am looking forward to your report since I am not a believer on AIs at all. In fact, overdosing AIs can lead to worsening on sensitivity, ED, etc. But I want to be proven wrong so badly! In 5 years on here, I am yet to hear back from anyone who reports than an AI decreased water retention and improved mood and/or ED. But I am still open to the idea that I may be wrong since AIs have become so popular in men on TRT.

"1) How long after starting an AI do you actually feel the benefits of it? I'm not gyno prone, but definitely bloated, mediocre sex drive, moodiness, erectile dysfunction and sexual sensitivity (when I can get a decent hard on with help from cialis i can't finish)? "

Role of Estradiol in Men and Its Management

 

[Miironleg]

You're taking 37.5mg/week of Aromasin? I'd be willing to bet you crashed your estradiol pretty hard. While the drug can be gentler on estradiol, but not at the doses your taking. Stop taking it and get labs asap. I started it at 6.25mg e3.5d and it sent my estradiol to 6 on the sensitive test. I'm now at 12.5mg e10d, estradiol at 37. A good starting dose is 12.5mg 1/week and adjust after labs.

 

[Vince Carter]

It would be nice if an AI would work to resolve one or all of your issues. I am looking forward to your report since I am not a believer on AIs at all. In fact, overdosing AIs can lead to worsening on sensitivity, ED, etc. But I want to be proven wrong so badly! In 5 years on here, I am yet to hear back from anyone who reports than an AI decreased water retention and improved mood and/or ED. But I am still open to the idea that I may be wrong since AIs have become so popular in men on TRT.

"1) How long after starting an AI do you actually feel the benefits of it? I'm not gyno prone, but definitely bloated, mediocre sex drive, moodiness, erectile dysfunction and sexual sensitivity (when I can get a decent hard on with help from cialis i can't finish)? "

Role of Estradiol in Men and Its Management

Im as good as I've ever been on TRT with .25mg M/W/F. I'm much less of an irritable A-hole all the time but you may want to debate that

 

[Vince Carter]

General Questions I been having hard time with getting some anecdotal information on.

1) How long after starting an AI do you actually feel the benefits of it? I'm not gyno prone, but definitely bloated, mediocre sex drive, moodiness, erectile dysfunction and sexual sensitivity (when I can get a decent hard on with help from cialis i can't finish)?

2) if anyone has added HCG to just testosterone monotherapy, how long does it take for testicular size to increase? And for those of you experience sexual benefit from. Hcg How long does that take?

I ask because even though we know about half life etc that doesn't necessarily mean that's when we feel better. For example after injection of a long ester testosterone we still get a hug increase on serum test 24-48hrs after, but most don't feel much better until 3-6weeks later. So I'm wondering if something like this is true for AIs And HCG.?

some background:
Added Aromasin and HCG recently to 200mg test cyp trt. Aromasin 25mg 2x day after pinning (pinning 2x week 100mg each mon and Thurs, so aromasin 25mg Tues and Fri) and 12.5mg aromasin on Sunday to play it safe. I've always been a high converter, some years ago a urologist put me on clomid monotherapy which got my tt to 700 but e2 went between 45-65. I also added in 400iu hcg 2x week about two weeks ago and haven't really noticed much testicular site increase... Maybe slightly but it might be placebo effect.

Ill go out on a limb here and say wrong tests, wrong E test, overuse of AI based on "symptoms" and no/wrong labs.

 

[JasonLu]

You're taking 37.5mg/week of Aromasin? I'd be willing to bet you crashed your estradiol pretty hard. While the drug can be gentler on estradiol, but not at the doses your taking. Stop taking it and get labs asap. I started it at 6.25mg e3.5d and it sent my estradiol to 6 on the sensitive test. I'm now at 12.5mg e10d, estradiol at 37. A good starting dose is 12.5mg 1/week and adjust after labs.

I am in a similar situation

 

[Miironleg]

I am in a similar situation

Stop the aromasin until your body recovers.

 

[Gman86]

ALRIGHT MY FRIENDS, HERE'S SOME KNOWLEDGE THAT WILL CHANGE LIVES ON TRT FOREVER


This is how half lives work. For example, lets say you take 1mg of Arimidex EOD. The half life of Arimidex is 2 days. So in 2 days when you take another dose, you still have 50% of the the previous dose in your system. So if you took 1mg Monday, then took 1mg Wednesday, you have 1mg from Wednesday's dose, plus 0.5mg from Monday's dose. So 1.5mg total in your system. Then you take another 1mg Friday. You now have 1mg from Friday's dose, 0.5mg from Wednesday, and 0.25mg from Monday's dose. So on Friday you have 1.75mg in your system. Then on Sunday you will have 1mg from Sunday's dose, 0.5mg from Friday, 0.25mg from Wednesday and 0.125mg from Monday's dose. So 1.875mg in your system on Sunday. So on Tuesday you will have 1mg from Tuesday, 0.5mg from Sunday, 0.25mg from Friday, 0.125mg from Wednesday, and 0.0625mg from Monday. So in total on Tuesday you will have 1.9375mg in your system. So do this math one more time for Thursday's dose. Which will equal 1.96875mg, basically 2mg in your system on the 10th day. On the 10th day you have now reached a "steady state" of this medication. This means from the 10th day on if you keep taking 1mg of Arimidex EOD, you will always have roughly 2mg in your system at all times. The amount of milligrams in your system does not continue going up from this point.


So moral of the story is, 99% of people on TRT don't realize that after 5 half lives of any medication, you will have double the amount in your system. Just multiply the half life of a medication by 5, and this will give you how long it will take to reach a "steady state" of a medication a.k.a double the amount of that medication in your system compared to your first dose. For example, half life of Arimidex is 2 days. So 5x2 equals 10. So on the 10th day of taking Arimidex regularly, you will of reached the steady state of the Arimidex in your system. Here is how long it will take to reach a steady state for common medications


Testosterone Cyp (Half life 8 days) - Steady state in 40 days
Arimidex (Half life 2 days) - Steady state in 10 days
Aromasin (Half life 1 day) - Steady state in 5 days
HCG (Half life 2 days) - Steady state in 10 days.
Clomid ( Half life 6 days) - Steady state in 30 days.


Remember, 5 x half life of a medication = Steady state of that medication.


Also remember, when you reach a steady state of a medication, you will have double the amount of milligrams in your system of the dose you are taking in-between each half life. This is kind of complicated, but it doesn't matter how you space out the dosages or how often you take it. For example, 1mg taken EOD, or 0.5mg taken everyday. It's still 1mg taken within one half life or Arimidex which is 2 days. So another example is test cypionate. Doesn't matter if you take 100mg once per week or split that into 50mg twice per week or 14mg everyday. As long as it's 100mg within one half life, which is 8 days for test cyp. So by 5 half lives of the medication, which would be 40 days for test cyp, you will have double the amount of medication in your system. Which would be 200mg. This part is pretty complicated, but just remember, whatever the dosage you are taking of a medication, after 5 half lives you will have double the amount of medication in your system compared to starting.


This is why people say TRT started to work, and then it didn't. Or they say Arimidex worked when they first took a dose, but then it stopped working. If you take Arimidex and you feel great that first day, you are doing it wrong. You don't want to feel good when you first start taking it, you want to feel good after 5 half lives, when you reach a steady state of the Arimidex, which for Arimidex would be 10 days. So you want to feel good on the 10th day on, not on the first dose. If you feel good after the first dose, just know you will 100% not feel good soon. It's just a mathematical inevitability. Because the amount in your system on the first day is going to change. The amount in your system on the 10th day is going to be double what it was on the first day. So theres no way that you can feel good on the first day, and also feel good on the 10th day when the amount in your system is literally double that of what it was on the first day. Just think about it, let's say you feel good on the first day because you have 1mg of Arimidex in your system and it brought your E2 down to 25. You think when you have 2mg in your system on day 10 that your still going to have your E2 at 25, or even close to that?? Nope. Your E2 is going to of crashed. You can have good E2 on the first day you take Arimidex, or you can have good E2 on the 10th day of taking that dose of Arimidex, but it's literally impossible to have both. What you really want is to not really feel anything after 1-2 days. Start feeling decent/ pretty good after 3-6 days. Then to hopefully feel amazing at 7-10 days. Because after 10 days, this is the amount of Arimidex that's going to be in your system for the long haul, so obviously you want to feel your best at the amount of Arimidex that's going to be in your system for good. Those timelines of days and how you feel are obviously just rough estimates, but you get the point I'm trying to make. You basically just want to feel your best after you've reached a steady state of a medication, not when you first start taking it.


I could go on for days about half lives to be honest, but just know that it is the most underrated aspect of TRT that nobody really knows, nobody really gets taught, nobody really takes into consideration and nobody really talks about. But just know, that if you can get down how half lives of medications work, you will have basically zero problems with your protocol. Especially with AI protocols.


Here are the take aways:
-Consistency is key. Keep dosages the same. For example, BaldEagle66 needs to take the same dosage of Aromasin and at a consistent frequency. That random 12.5mg on Sunday compared to his usual 25mg will throw the math off and decrease his chances of success greatly. Keep Aromasin at the same dosage and take it consistently, for example ED, or EOD, or twice per week. NEVER, EVER take doses of an AI when you "feel symptoms", and then not take it when the symptoms go away for a bit. This will never work in the long run, and is an extremely common thing I see guys doing. Either take it consistently, or don't take it at all. People can obviously do what they want, I'm just saying this for guys that want to know how to be successful with TRT pretty much 100% of the time, and not leave it up to luck or chance whether it works or not.


-Always start low on dosages and work your way up. Slow and steady always wins the race. With AI's especially, always start off extremely conservative and work your way up. Always better to do it this way than to take too much, crash E2, and have to start over. Always start low dosage and be patient. It will save you so much time and aggravation, I promise.


-Only change medication dosage after you have reached it's "steady state". Always wait 5 half lives of a medication to adjust the dosage. See the steady state chart above for the most common TRT medications. Quick examples are, don't change Arimidex dosage until at least being on it for 10 days at that specific dosage and frequency. Test cypionate don't change dosage until at least on that dosage and frequency for 40 days.


-When you do adjust the dosage of a medication, do it by very small amounts. So for example, if you started taking 0.125mg of Arimidex twice per week (0.25mg total per week). After 10 days (5 half lives), if you still had symptoms of high E2, don't double the dose and take 0.25mg twice per week. Just take 0.125mg EOD for basically a total of 0.375mg per week instead of jumping the gun and taking 0.5mg per week. Then what you do if after another 10 days you still have high E2 symptoms, add another 0.125mg to your weekly total, and now go back to taking the Arimidex twice per week. So now your at 0.25mg twice per week (0.5mg total per week). Then if E2 symptoms are still there after 10 more days on this dose, add in another 0.125mg and take the doses EOD again. And just keep going like this, you obviously get the point. This also applies to aromasin as well but just with different milligram doses. But roughly 1mg of Arimidex = 25mg Aromasin. So 0.125mg of Arimidex would roughly be the equivalent of 3.125mg of Aromasin. Also, keep in mind the peak time of Aromasin is half that of Arimidex, and it's in and out of your system in half the time as Arimidex. So with Aromasin you probably want to take it either everyday or EOD. Twice a week is not going to be the best option for Aromasin. And you never really want to take Arimidex once per week. Twice per week is the lowest frequency you want to take Arimidex. EOD is preferable.


-Medication in system doubles when it reaches it's steady state (5 half lives of that specific medication). So if you took 100mg of test cyp/ week, the milligrams in your body would constantly be increasing until roughly 40 days go by. That means at 40 days, you will have 200mg in your system, not 100mg anymore. So if you don't feel anything that great even after a few weeks on a specific dosage of testosterone, just be patient. Your total testosterone should constantly be increasing from day one until day 40. So with test cyp, only make dosage changes after 40 days of being on that specific dosage and frequency. This is why people always say it takes testosterone sometimes 3-6 weeks to “kick in”. It has to do with your receptors getting acclimated to these new testosterone levels, but it also has to do with the fact that maybe that 100mg in your system when you started didn't really make you feel that great or raise your testosterone levels high enough, but after 40 days (5 weeks), you now have 200mg in your system and your total testosterone should now be doubled from when you first started, and this amount of milligrams in your system might be just what you needed to feel good and get your numbers where they should be. Just think about it, 5 weeks is right there in-between 3-6 weeks. It makes perfect sense that people start feeling it around then, this is exactly when your body reaches a “steady state” on testosterone cypionate.


Like I said, I could go on for days on half lives, how important they are, and how to apply them to protocols to increase their success rates dramatically, but I'll just end it here. Any questions just message me or reply to this thread, more than happy to help anybody out that needs it. We're all in this together. BTW I'm a nurse by trade. It's honestly not important in my opinion, because anybody in 2017 can know more than a doctor about this stuff in less than a year with the right amount of research. I just thought I'd add that so everyone can kind of rest assured I know what I'm talking about on this stuff. Just so they feel more comfortable if they decide to apply it to their own personal protocols.

 

[Miironleg]

Gman86,
Nice write up. I agree with you concerning half lives for testosterone and adex, but disagree on your assumption for aromasin. Aromasin doesn't build up in your system like Adex.

The difference between adex and aromasin are their interaction with the aromstose enzyme. Adex binds to the enzyme rendering it incapable of converting testosterone until it wears off. The enzyme can then start converting testosterone again. Asin binds to the enzyme and then "kills" it rendering it incapable of converting testosterone forever. The body needs to produce more enzymes to replace the ones "killed" by asin.

The half life of asin is 8 hours, 12 hours is when maximal estrogen suppression occurs. Asin removes a percentage of the aromstose enzymes with each dose. The body will replace the removed enzyme approximately 1-2 weeks afterwards.

Asin should be dosed starting at 12.5mg once per week and adjusted with lab data after 4-6 weeks. I also agree with you men need to be patient with their protocol, especially dealing with these powerful drugs. Too many times we read about men wanting to change our add something after only a week or so into their therapy when the body isn't even close to homostasis.

 

[BaldEagle66]

It would be nice if an AI would work to resolve one or all of your issues. I am looking forward to your report since I am not a believer on AIs at all. In fact, overdosing AIs can lead to worsening on sensitivity, ED, etc. But I want to be proven wrong so badly! In 5 years on here, I am yet to hear back from anyone who reports than an AI decreased water retention and improved mood and/or ED. But I am still open to the idea that I may be wrong since AIs have become so popular in men on TRT.

Nelson, first thank you for all your contributions to the field of Men's health. I have followed you among a select few others for a while now.

I would say regarding e2 management I have two counterpoints for your consideration. There is a study you often site where I believe only half of men getting either HCG OR Testosterone therapy reported improved sexual function. With that said, I specifically know that I am a "high-converter" from when I was on clomid monotherapy. I can honestly say while my sexual function was about 70%, my mood as absolutely terrible, but my urologist refused to put me on an AI because i hovered around 40-60, hi end of normal. The theory another Endocrinologist said that because I heavily used steroids between 18-21, my HPTA jacked up my "thermostat" in terms of how much aromatase I need because I had so much extra, and because that's not really set until 26yrs old or so, that's my set point I have to work with.

Most agree that men seem function best at 20-25mmol/dl of e2, if we're going to add the theory of sensor sensitivity, an e2 level of 45 is almost double optimal levels, and while may not be high enough to cause gyno or set off lab alerts, it can certainly cause changes in mood and other "subtle" ways.

My second counterpoint is more anecdotal, on many different forums men claim (again just from what i been reading so yes I can be wrong) that adding in either an AI or HCG really helped sexual function as compared to being on test alone. the commonality i see is that they tend to be on higher end doses like, me, 150. 180, 200 mgs of test per week.

 

[BaldEagle66]

Agree Miironleg it's the higher end. A while ago i tried adding arimidex (research liquid grade) 1mg per day to my clomid monotherapy. in about two weeks my joints were completely dried up and achey as can be, i mean i couldn't even do a set of squats. So I would argue that if my e2 levels are crashed my joints would tell me. I am 17 days in however and I cant say im doing much better though. mood, sexual function, bloat is all crap right now. The HCG does seem to have brought my boys back, but not getting the general pyschological benefits most of you report.

 

[BaldEagle66]

Gman thank you for this. I'm well versed in half-life info as well. My one question is many have said to take the AI approximately 24 hours after injecting test or HCG because that's when aromatase will be highest. That's why i take the highest doses the day after I pin 100mg test cyp and 400iu of HCG. The sunday dose is because i Know its a little bit of a shorter half life so just playing it safe. Again, I know my e2 levels are crashed when my joints start killing me. which they have not at all.

 

[Miironleg]

Agree Miironleg it's the higher end. A while ago i tried adding arimidex (research liquid grade) 1mg per day to my clomid monotherapy. in about two weeks my joints were completely dried up and achey as can be, i mean i couldn't even do a set of squats. So I would argue that if my e2 levels are crashed my joints would tell me. I am 17 days in however and I cant say im doing much better though. mood, sexual function, bloat is all crap right now. The HCG does seem to have brought my boys back, but not getting the general pyschological benefits most of you report.

TRT requires patience, consistency, and a decent protocol; which you really need right now. 17 days into a protocol and you essentially killed all of your aromstose enzymes without knowing if you needed it. Your not getting pyschological benefits because of your crashed estrogen. Continue with the test and HCG. Hopefully you recover from the crash fairly soon, can take several weeks before estrogen is restored.

 

[Gman86]

I definitely see the logic in doing it this way, and I completely understand why guys would do it this way. But this is playing the short game with TRT, which is the wrong way to do it. If you want to be successful with TRT, you have to play the long game. When your entire protocol has reached it's steady state, your levels of test and estrogen will all be very consistent, so taking different doses of an AI on certain days is pointless, and is just going to give you problems instead of solutions. It's a little complicated, and I don't want to make you or anyone else read another book of a post of me explaining it lol. But here is exactly what I would probably do. Stop taking Aromasin all together temporarily. I believe it will take about 1-2 weeks for your body to create more aromatase enzymes and for your estrogen to go back up, if it is in fact low. Either way, just stop the Aromasin and let your estrogen go back to whatever it is naturally on this test and HCG protocol. So wait about 1.5 - 2 weeks. Then start off very low dose with your AI. Your protocol should have your test levels pretty high, so starting off at like 12.5mg of Aromasin 24 hours after your test injection days should work well. So take 12.5mg of Aromasin 2x/ week. If it was me, I would do 6.25mg 2x/ week. Starting very low and working your way up is always the way to go. Plus, Aromasin has a half life of 24 hours, and some studies show a half life of about 12 hours in males. So at a half life of 12 hours, 5 half lives would put you at reaching a steady state at 2 1/2 days. Which is extremely quick. So this means you can adjust your dosage of Aromasin every 2 1/2 days based on your symptoms. So even if you start very conservative, it's okay. You can adjust your dosage every 2 1/2 days so you don't have to wait long to increase the dosage if the 6.25mg or 12.5mg 2x/ week isn't strong enough. Try this tho man, I promise you it will pay off in the end starting low like this. Just be patient. It sucks, but you'll be so happy you did it this way in the end. You always want to have your estrogen slightly high than slightly low when blood work time comes around. If it's slightly high, you just add in a little more AI. If it's low, you have to stop taking it and wait, and then start over with a new AI protocol. You could just adjust the AI dosage down a little as well, but it gets really tricky math wise. Either way, crashing estrogen will always be 10x more of a pain in the ass to correct than just having slightly high estrogen which is super super easy to correct when you know about half lives of medications.

 

[Miironleg]

Aromasin needs to be dosed sparingly because it kills the aromstose enzyme. I started taking aromasin at 6.25mg e3.5d, my estradiol went from 58 to 6 after 4 weeks. Adjusted dose to 12.5 e7d and my estradiol was at 21. I'm now taking 12.5mg e10d and my estradiol is at 37. Labs were taken at least 4 weeks apart from each adjustment, 7 weeks for the last one.

 

[Gman86]

Ya maybe you're right, maybe the rules of half lives gets all messed up with Aromasin due to it killing the aromatase enzyme to suppress estrogen, opposed to other AI's. You were never adjusting your dosage of testosterone/ HCG throughout all 4 blood draws? Also had you just started a testosterone protocol and maybe it was still building up in your system during all this time or anything?

 

[Miironleg]

Ya maybe you're right, maybe the rules of half lives gets all messed up with Aromasin due to it killing the aromatase enzyme to suppress estrogen, opposed to other AI's. You were never adjusting your dosage of testosterone/ HCG throughout all 4 blood draws? Also had you just started a testosterone protocol and maybe it was still building up in your system during all this time or anything?

Test and HCG remain constant, started TRT July 2016. Added HCG September 2016. Started taking anastrozole October 2016 @ 0.25mg e3.5d. Estradiol was 24 in November. Switched to aromasin due to not liking the way I was feeling. First blood test on aromasin was January, switched to 12.5mg e7d dose. February blood test was at 21. Switched to e10d dose. Blood work done 2 weeks ago to confirm blood levels. Very methodical and expensive but I'm also anal and like the data points.