When to get new bloodwork?

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I understand a lot of people on this sub are against using an AI. However, I know some also do well on a low dose AI. I want to preface the post with some history, I have been on TRT for almost two years now. Like many I have had ups and downs with it. Ive been stable on the same protocol for over a year now. My estrogen is always slightly high in the mid 40s at trough, and I deal with symptoms. I started this whole journey with almost no e2 naturally, and that was hell. Ive also taken too much arimidex before and put myself right back into that hell, hence why I have stayed away from it. However, I have never tried a very low dose. I have looked at every other angle for fatigue ( multiple sleep studies, full thyroid panels, and I mean full, every recommended test and my levels are close to optimal in all those areas). I am very active, and have used diet to feel better, but it has never quite done the trick. I have also tried every supplement known to man as well.

Symptoms:
night sweats
low libido
bloating
fatigue


Protocol:
Mon morning and thur night:
test cyp 58mg
wednesday night and sunday morning:
HCG 125IU

Latest Labs:
total test always 750-900
free test upper end of the range
Shbg: 23.9 (16-55)
Dht: 61 (30-85)
Dhea: 346 ( 138-475)
Last two e2: 45 and 41 on sensitive test. I have never been in range for this as long as Ive been on.

I also regularly have cbc, cmp, psa, and other labs drawn. I manage hematocrit with blood donation.

New AI dose:
.125 mg on testosterone injection day. So far I am two doses in, had one day with spontaneous libido and desire, but could have just been placebo. I have also had better energy on days after the AI.

My question: I know how long to wait for labs with changing testosterone dose, but not with adding an AI. Do I still need to wait 6 weeks to draw bloods, or can it be sooner?
 
Defy Medical TRT clinic doctor
You could probably be assured with the SHBG ~24 that you have a fair amount of Free E in your system which the LC/MS/MS test isn't going to show. Like your Free T being over the lab range (you say) you can be pretty assured that Free E is the same. I would shoot for your LC/MS/MS sensitive E to be closer to what your SHBG is.
 
You could probably be assured with the SHBG ~24 that you have a fair amount of Free E in your system which the LC/MS/MS test isn't going to show. Like your Free T being over the lab range (you say) you can be pretty assured that Free E is the same. I would shoot for your LC/MS/MS sensitive E to be closer to what your SHBG is.
Thanks Vince. I read elsewhere where you talked about the same thing and was curious about free E. I will see if its feasible to add it to my next round of bloodwork.
 
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