Trying to wean off of AI

[anestizzle]

TT 836 (264-916)
FT 21.3 (6.8-21.8)
E2 sensitive 20.1 (8-35)
SHBG 31 (16-55)
Prolactin 8.7 (4.8-23.3)
DHT 54 (30-85)
DHEA-S 574 (71-375)
Thyroid panel good

Test C 34mg EOD, HCG 300 EOD, DHEA 50 mg daily, anastrozole 0.25mg twice/week.

I’ve been on TRT for this past year. I’ve lost a good amount of weight and my energy is good. Unfortunately, my libido hasn’t been consistent since I’ve started TRT, and neither has my morning wood, erection quality, etc. I’ve tried a couple of different protocols in the past like twice weekly and varying doses. I’m trying to wean off of anastrozole 0.25mg twice/weekly to see if this could make a difference especially since there is a lot of discussion lately of higher E2 levels being beneficial. However, I’ve noticed if I go longer than 5 days or so without an AI I start to experience decreased penile fullness, small glans with erection, delayed orgasm, decreased libido and increased sweating while sleeping. I’m assuming my E2 is getting too high at this point with these symptoms and have been somewhat alleviated when I take a dose of my AI in the past. My question is could these symptoms could just be temporary as my body is adjusting without having an AI and would these symptoms resolve after my body gets adjusted over a few weeks being off an AI. Any suggestions?

 

[Vince Carter]

When you consider your E at 20 and think that maybe that's too low, did you consider that that is merely a snapshot of it's lowest point and that your E in reality is higher? It is not static, as it were.
You can fall in to this trap of whats in vogue, this let E go uncorrected trap if you like but it's a flawed concept and all the symptoms you remarked about fall farther in the elevated E side of things than being too low.

 

[Joey786]

Tbh if you really want to see if you don’t need the ai, you need to drop it completely. You might feel symptoms for a couple of weeks or you could feel great. Give you body time to adjust.

 

[Nashtide]

I have always wondered why the gold standard of testing is to draw labs during the trough. As VC stated above, that only reveals a tiny snapshot in time. If we only ever look at trough values then we never know what our hormones look like the other 99% of the time. What if the OP has high E2 most of the week but treats his E2 based on the low reading during trough? His inclination would be to drop his AI which could make his E2 go through the roof. He’d never know because he only has trough labs. I see this phenomenon with diabetics. They will tell me they take their blood glucose every morning before breakfast. Well, that is great that they test everyday, but what about the blood sugar the other times during the day?

 

[Vince]

I don't believe the percent of estrogen to testosterone changes. So of course when your testosterone is higher your estrogen will be higher.

 

[Nashtide]

If you are only going to test once that week it makes the most sense. When I used to inject weekly days 6 and 7 were when I felt off. Number indicated the dose needed to go up. Sure having 3 tests that week would be better, but most people aren’t up for that.

You don’t need to test three times per week. If your protocol is consistent, you could test at trough one month, at peak another month.

 

[Gman86]

I have always wondered why the gold standard of testing is to draw labs during the trough. As VC stated above, that only reveals a tiny snapshot in time. If we only ever look at trough values then we never know what our hormones look like the other 99% of the time. What if the OP has high E2 most of the week but treats his E2 based on the low reading during trough? His inclination would be to drop his AI which could make his E2 go through the roof. He’d never know because he only has trough labs. I see this phenomenon with diabetics. They will tell me they take their blood glucose every morning before breakfast. Well, that is great that they test everyday, but what about the blood sugar the other times during the day?

Luckily diabetics have the Hemoglobin A1C test to use as a reference. It tests the average levels of blood glucose over a 90 day period, which include 90 days of fasting blood sugars, 90 days of peaks, and everything in between. So knowing both your fasting, peak, and postprandial blood sugars aren’t completely necessary. It would be nice if we had a similar test for testosterone levels.

The OP injects EOD, so his peaks and troughs shouldn’t be that different. I obviously get what you’re saying though, and I agree. It would be nice to know what our hormones are doing the rest of the time. Not just at trough.

 

[Nashtide]

Luckily diabetics have the Hemoglobin A1C test to use as a reference. It tests the average levels of blood glucose over a 90 day period, which include 90 days of fasting blood sugars, 90 days of peaks, and everything in between. So knowing both your fasting, peak, and postprandial blood sugars aren’t completely necessary. It would be nice if we had a similar test for testosterone levels.

The OP injects EOD, so his peaks and troughs shouldn’t be that different. I obviously get what you’re saying though, and I agree. It would be nice to know what our hormones are doing the rest of the time. Not just at trough.

I understand about the A1C. It still helps diabetics to know what their sugars are at different times during the day so they can adjust their meds and lifestyle. I see folks that say my blood sugar is good then have an A1C of 8.