Doctor does not want to Prescibe an AI

[Kevin_W]

I am 35 and started testosterone replacement therapy around December of last year. I am taking 100mg/week injections of Testosterone Cyp. After a few months I noticed things were going downhill and the better feeling and higher level of arousal and better erectile function seemed to have diminished. I made an appointment and told her that I feel my T2 levels were high and I would like to have my labs tested and wanted to get on Arimidex.

She said we will need to see the labs and go from there. They drew blood and drew an insufficient sample. I got a letter saying they didn’t draw enough to get the T2 checked after the other labs and the letter told me to just keep taking the 100mg/week and she didn’t send me a new lab request form or anything. I was frustrated and put it off but the week before last I finally called and complained and said I need the labs.

So I called today and they got the lab results. She explained the doctor wants me to change my dosage to 80mg a week and have labs rechecked in a month. I asked Why. I said that seems to be going the wrong direction with my problems and that I feel my problem is Estrogen. She explained that yes your Estrogen levels were high so the doctor wants to try lowering your testosterone and then check labs in a month. I explained that 100mg a week is no large dose and that I'd really just rather start taking an Aromatase inhibitor (AI) to control it.

She got back to me that the doctor insists that I do cut my dosages and that we recheck in a month and that if my testosterone is still in normal range and if my estrogen is still high that then she would look at adding the Aromatase inhibitor (AI) inhibitor.

I asked them to send me my lab and I can post them when I get them.

She has always checked my testosterone in the middle of the week between me taking my shots. Its been up there in the 600 and 700s range for total. Nothing off the charts and nothing I want to bring any lower.

I weight 240 right now and should be more like 185 so I know the extra weight is a contributing factor as well.

I had my SHBG checked as well on a previous lab and they were not high.

She also refuses ti prescribe Human Chorionic Gonadotropin (HCG) as well. I have brought in some research on that but she said she would only if me and my wife were trying to have a baby.

Any feedback would be appreciated on this. If you think she is on the right track and I should go with the flow please let me know.
I am thinking I really should look for another doctor

 

[Spunkey71]

Sorry to hear about your issues, there are many doctors out there prescribing testosterone replacement therapy (TRT) that just are not as up-to-date and educated on the subject as they should be. One thing you can do is break your 100mg a week dose into two injections 3.5 days apart, this will keep your test levels more stable and will reduce the amount of test that is converted to estrogen. You can also look for another doctor, if that is not an option then take getting an Aromatase inhibitor (AI) into your own hands and order it from one of the many reliable site sponsors.

Best of luck to you!

 

[cruiser1019]

What was the E2 level? high is a relative term.

 

[Kevin_W]

What was the E2 level? high is a relative term.

I asked them to mail me the lab. I should get it by tomorrow and can post. I certainly don't feel as good as I did in the first couple months though.

What about her thoughts on reducing the dose to reduce the estrogen? Just don't feel like I should have to look for a net source for something that is a lifelong thing having Secondary hypogonadism.

 

[Megatron28]

I asked them to mail me the lab. I should get it by tomorrow and can post. I certainly don't feel as good as I did in the first couple months though.

What about her thoughts on reducing the dose to reduce the estrogen? Just don't feel like I should have to look for a net source for something that is a lifelong thing having Secondary hypogonadism.

Let's see your numbers first to see just how high your e2 is.

I can tell you from personal experience though that going from injecting 100mg/week to 50mg every 3.5 days can solve your E2 problem potentially. I would try that before cutting your weekly dose if she won't give you an AI.

 

[DrHouse]

Try using DIM. In one of Austinites articles he suggested that it is the ONLY effective over the counter Aromatase inhibitor (AI) that could be used. He even states that the only Aromatase inhibitor (AI) he uses is DIM.

http://www.steroidology.com/forum/a...agement-gynecomastia-prevention-reversal.html

Oh, doctors always want to be the smartest one in the exam room so try to play it dumb, let them inform you. This will create a better patient/doctor relationship.

 

[JimiThing]

Well of course dose reduction very well may reduce estrogen however if you were satisfied with quality of life with test levels what they were there are other options as well. One is splitting inj to 2x/week. This may reduce e2 while keeping T levels at a place where quality of life is better for you. I do not think trying to avoid an Aromatase inhibitor (AI) is a bad thing and it is medically prudent if it is possible. There are things you can do like splitting to 2 injections , zinc supplementation and others that may accomplish the e2 reduction without an Aromatase inhibitor (AI) and alow you to maintain current T dose. Id explore them.

 

[bbbjames]

I wouldn't cut your dosage before getting labs. As you said your TT is not off the charts. Get your labs and see your estrogen levels. If they are high hopefully your doc will give you an Aromatase inhibitor (AI). If not try to find someone new. Good luck!

 

[Kevin_W]

I wouldn't cut your dosage before getting labs. As you said your TT is not off the charts. Get your labs and see your estrogen levels. If they are high hopefully your doc will give you an Aromatase inhibitor (AI). If not try to find someone new. Good luck!

Yea. I told the assistant I will do as the doctor requests on this but I am concerned it could be tough getting my levels back to 100mg a week after she drops them.

Yea I have read about doing Subq injections multiple times a week fo a more stable release without the peak. I would definitely be willing to try that. I will look into that OTC Aromatase inhibitor (AI) as well.

Really i just want to feel full of energy , better mood and have a strong sex drive etc. I had it for a short stent in the beginning. I am not happy with how things are now. Feel basically the same as pretreatment at this point and my level then was 169.

I appreciate all the input everyone and i'll post the labs when I get them.

 

[yellowballs]

I would say that since you are already under a Drs care its not a big deal to take all your info to another Dr for a 2nd opinion and to another for a 3rd. People do that all the time for all kinds of stuff. Sure maybe your Dr will get a little uppitty with you over it but in the end how can they give you any grief? This is your health and you want the best for yourself. If your Dr is doing the right thing then a 2nd & 3rd opinion will support it. But if one of those opinions differ.......well then you need to listen, especially if they are more qualified for this sort of thing.

Your Dr. doesnt sound like she is very knowledgeable about HRT. Even if you convince them to your way now how will the respond to the next situation that arises? Sounds like you will have more headaches down the road. Do you have time for that?

Also, try to avoid an Aromatase inhibitor (AI) if you can. I tried but I just couldn't get my E in check.

Good luck!

 

[Spunkey71]

I would say that since you are already under a Drs care its not a big deal to take all your info to another Dr for a 2nd opinion and to another for a 3rd. People do that all the time for all kinds of stuff. Sure maybe your Dr will get a little uppitty with you over it but in the end how can they give you any grief? This is your health and you want the best for yourself. If your Dr is doing the right thing then a 2nd & 3rd opinion will support it. But if one of those opinions differ.......well then you need to listen, especially if they are more qualified for this sort of thing.

Your Dr. doesnt sound like she is very knowledgeable about HRT. Even if you convince them to your way now how will the respond to the next situation that arises? Sounds like you will have more headaches down the road. Do you have time for that?

Also, try to avoid an Aromatase inhibitor (AI) if you can. I tried but I just couldn't get my E in check.

Good luck!

I agree, you are the patient and it is your health, find a new doctor. You can always give IMT a call, they are a site sponsor and they have a lot of satisfied clients on this board.


Best of luck!

 

[Kevin_W]

I got my labs in the mail today.

Free Testosterone 276
Total Testosterone 863

Estradial (says By TMS) 46.8

This Lab was taken on Monday and my weekly shot was on the previous Friday.

This was my highest testosterone reading I have had. No other has gone over the 700s. I have also had the symptoms of low T for months now when the other readings had been fine on T levels.

She wrote a note on my labs that says Estrogen is elevated most likely the results of high testosterone.

So she says to cut my 100mg a week to 80mg a week and to take labs again in a month to retest T and E.

 

[Megatron28]

I got my labs in the mail today.

Free Testosterone 276
Total Testosterone 863

Estradial (says By TMS) 46.8

This Lab was taken on Monday and my weekly shot was on the previous Friday.

This was my highest testosterone reading I have had. No other has gone over the 700s. I have also had the symptoms of low T for months now when the other readings had been fine on T levels.

She wrote a note on my labs that says Estrogen is elevated most likely the results of high testosterone.

So she says to cut my 100mg a week to 80mg a week and to take labs again in a month to retest T and E.

Split your injections into two times a week. That will lower your estradiol. You will be able to continue without an Aromatase inhibitor (AI) most likely and still keep your TT about the same.

 

[jomamma007]

I got my labs in the mail today.

Free Testosterone 276
Total Testosterone 863

Estradial (says By TMS) 46.8

This Lab was taken on Monday and my weekly shot was on the previous Friday.

This was my highest testosterone reading I have had. No other has gone over the 700s. I have also had the symptoms of low T for months now when the other readings had been fine on T levels.

She wrote a note on my labs that says Estrogen is elevated most likely the results of high testosterone.

So she says to cut my 100mg a week to 80mg a week and to take labs again in a month to retest T and E.

Take it from the guys on this forum. You want to do your best to avoid an Aromatase inhibitor (AI) and your estradiol doesn't seem high enough that you'd need one.

Like others said split your injections into 50mg twice a week. this should get you down a bit,
ALSO try DIM as suggested. 200mg ed seems like a good starting point.

Once you start the Aromatase inhibitor (AI) it's always a battle of finding your sweet spot which is more trouble then it's worth. I don't see how splitting your dose and adding DIM wont lower your estrogen significantly but if that fails going down to 80mg a week isn't the end of the world. The top trt docs are starting guys on 60-80mgs a week now with great success in all attempts to avoid an Aromatase inhibitor (AI). Plus if you had to stay at 80mgs for a while why you got your weight down, you could probably go back up to 100mgs per week once you dropped below 200lbs.

If it were my personally, I'd just split the dose into two injections and add in 50mgs zinc, 10k vitdamin d3, magnesium, 2mg copper daily. Should be enough to lower estrogen quite some, but everyone has a different sweet spot so you have to experiment. I'd try to avoid even DIM as it's basically an Aromatase inhibitor (AI) and you still have to find your sweet spot with it.

 

[Alpin]

Is she an mainstream Endo ?
Sounds like she doesn't have a clue...if she is telling you to lower your T shot from 100 mg/week to lower E2...she should not be in that line of work.
Most TRT docs won't go below 120 mg/week for TRT....
What do you expect??? she is not a man...she has no idea of what having higher or healthy T levels means....
think about it...you are poking a hole in your muscle or fat tissue with every T shot...(what ever the course of medication delivery you are using)
do you want the most from this treatment or the least?

 

[jomamma007]

Is she an mainstream Endo ?
Sounds like she doesn't have a clue...if she is telling you to lower your T shot from 100 mg/week to lower E2...she should not be in that line of work.
Most testosterone replacement therapy (TRT) docs won't go below 120 mg/week for TRT....
What do you expect??? she is not a man...she has no idea of what having higher or healthy T levels means....
think about it...you are poking a hole in your muscle or fat tissue with every T shot...(what ever the course of medication delivery you are using)
do you want the most from this treatment or the least?

I don't know where you're getting this from but the average starting dose for any true testosterone replacement therapy (TRT) physician is 100mgs per week. Some of the top testosterone replacement therapy (TRT) docs in the world are actually starting guys out on 60-80mgs per week. Lowering your dosage to avoid an Aromatase inhibitor (AI) is actually a great idea, as long as the dosage doesn't get too low. 80mgs per week isn't too low... Any lower then an Aromatase inhibitor (AI) would be needed but I'd try this first.

80mgs per week put me with a total test of 816, with estradiol sensitive of 19, not too shabby if you ask me.

 

[Alpin]

I don't know where you're getting this from but the average starting dose for any true testosterone replacement therapy (TRT) physician is 100mgs per week. Some of the top testosterone replacement therapy (TRT) docs in the world are actually starting guys out on 60-80mgs per week. Lowering your dosage to avoid an Aromatase inhibitor (AI) is actually a great idea, as long as the dosage doesn't get too low. 80mgs per week isn't too low... Any lower then an Aromatase inhibitor (AI) would be needed but I'd try this first.

80mgs per week put me with a total test of 816, with estradiol sensitive of 19, not too shabby if you ask me.

OK....

and how long have you been on 80 mg/week of T ?
How many days from the shot were you when you measured at 816?
Not arguing with you...816 is a great level.

 

[Alpin]

I got my labs in the mail today.

Free Testosterone 276
Total Testosterone 863

Estradial (says By TMS) 46.8

This Lab was taken on Monday and my weekly shot was on the previous Friday.

This was my highest testosterone reading I have had. No other has gone over the 700s. I have also had the symptoms of low T for months now when the other readings had been fine on T levels.

She wrote a note on my labs that says Estrogen is elevated most likely the results of high testosterone.

So she says to cut my 100mg a week to 80mg a week and to take labs again in a month to retest T and E.

How many days from shot did you go in for this lab?

 

[Kevin_W]

How many days from shot did you go in for this lab?

That was in the post you quoted. I had my weekly shot on the previous Friday.

I had it in the evening before bed and I had the test mid day on Monday so it was roughly 60 hours or two and a half days.



Thank you very much for your input everyone I greatly appreciate. Sounds like getting the dose down a little is not the end of the world and if it lowers the Estradiol then I could certainly feel better with that then with 100mg. Switching to twice weekly Subq or IM shots sounds like a good idea but the doctor has already had some resistance from me so I will follow through wiht her 80mg a week for now.

I did submit a free consult request form for IncreaseMyT because I really do wish she was more receptive on issues like taking HCG.

 

[Kevin_W]

And on the bodyweight yes I need to gt that down. That would certainly help as well.