More info needed regarding high E2 on TRT

[Gramps]

Again, I'm 50ish, 250-260 pound before TRT, and not a lot of exercise due to a spinal condition taking out my legs.

I've been reading, but so far haven't come to any reliable answer to my own issue with E2. I now realize I've had high E2 "symptoms" all my life, although never tested until recently. Bloating (increases DRAMATICALLY on TRT by 30+ pounds), emotional in the last few years when previously I could hold a poker face regardless of which prank I was pulling but no longer, brain fog before TRT as well as during TRT, cold morning type nips that last all day and slightly sensitive, and so on. My TRT routine is self medicated (due to quack doc) at 120mg/wk lowered from 150 due to latest blood work which was 1394 total test (started at 291) and 96 E2. So... after tons MORE reading, I've been taking "Etane" (Exemestane from all day chemist - Natco labs) with very little results. I've upped dosage to 25mg/day which SHOULD be killing my E2 as well as trashing ME, but after 1 week, it just isn't showing. My plans WERE to start high, then drop to 25mg twice/week, but that ain't working as I'm stuck at 25/day with little to show for it. I've lost about 5 pounds, am peeing a bit more, but that's it. I'm leery of keeping this dose going, but I gotta do something. What are some suggestion??

 

[Mprtz]

How do you know it's not killing your E2? You're not seeing a change in the symptoms you attribute to high E2?
I wouldn't overdo it on the dosage, better to schedule another blood test soon and see what your levels are.

Keep in mind you made 2 changes: reducing your T dose and adding the AI. There is a risk of overshooting your goal.

 

[Gramps]

How do you know it's not killing your E2? You're not seeing a change in the symptoms you attribute to high E2?
I wouldn't overdo it on the dosage, better to schedule another blood test soon and see what your levels are.

Keep in mind you made 2 changes: reducing your T dose and adding the AI. There is a risk of overshooting your goal.

I agree. The problem is I've been lead to believe the results of exemestane were more noticeable than what I've seen which is what's forced me to "over do it". I'll be planning more blood work at 4-6 weeks after making changes, but only after I see "something" change, otherwise I may be wasting money.

 

[Megatron28]

I am sure the exemestane is working. It doesn't happen overnight though.

You need blood work!!!!

 

[Gramps]

Does anyone have any idea on the timeline I should be "feeling" or seeing results? Based on what I've read I should be crashed in a week (been a week by now) and should be on a lower dose by now, but I'm not seeing a thing other than a couple of lost pounds that fluctuates anyway. If it takes longer, no sweat, I just don't know if I'm on the right track or if I need to look elsewhere for an E2 fix. I WILL be getting bloodwork, I just need to find a "happy place" on dosing and ride that for a week or 2 before bloods so I'm not wasting money. If I did bloods now, and came back at, say, 50 E2, would that mean the numbers are dropping, or bottomed out? That's why I need to ride it a while to get a steady number.

 

[Mprtz]

The half life of exemestane is 24 hours. The general rule is 2.5 half lives until stable serum concentration is reached with regular dosing.
So it should only take a few days (two and a half) for exemestane to be built up. Since E2 levels are somewhat of a secondary effect, it's harder to predict when those levels reach a stable level, but given that E2's half life is shorter (13-17 hours), a week should be enough time for final results. That's my amateur analysis anyway.

 

[Gramps]

Yeah, we're pretty much finding the same answers, which means either I'm not effected by aromasin like most (story of my life) OR, I may have gotten underdosed aromasin. I've dealt with AllDayChemist a few times in the last year or so, but I don't know if they have any shady habits. Supposedly Indian pharmacies are up to speed and also "supposedly" many of our medicines are produced in India. Whatever... I may go looking for some domestic adex to rule out 2 theories - bunk gear or lack of response to aromasin.

 

[Megatron28]

Too much guessing and too little blood work. Spend the $50 for labs.

 

[Therealkozmo]

Get the labs!!

 

[Gramps]

Labs will be done in a few weeks. I just need to have a steady dose by then to know what works. Peeing 5 times last night is the first sign of progress.

 

[muscletank]

Here are some target values for blood tests while on TRT
Testosterone replacement therapy- Target Blood Test Limits


Hematocrit under 53

PSA under 3 (4 is max since doctors will not prescribe TRT at this number)

Estradiol (ultrasensitive) between 20-50 pg/mL

Blood pressure under 135/85

Estimated Glomerular (eGFR) (kidney function) over 60

Liver enzymes not elevated over 20 percent of top value of reference range

TSH under 2.5

Total Testosterone over 500 ng/dL

Free Testosterone equal or above 2 percent of total

If donating blood to bring hematocrit down, ferritin never under 30 ng/mL or micrograms/liter

Free T3 (if hypothyroid and on treatment) in the upper quartile of range. (depending on range it can be 3.7- 4.2 pg/mL)


HDL over 40 mg/dL



OPTIMUM REQUIRED LAB WORK (Preferred but not mandatory)

discountedlabs.com/compare/

1 ------- Estradiol- ultrasensitive via LC/MS test (not EIA!) [Quest Labs code 30289]
(Labcorp code: 140244) (baseline, week 6 or 8, month 6)

GOAL: 20-50 pg/mL

2 ------- Testosterone, Free, Bio/Total (LC/MS/MS) (baseline, week 6-8, month 6, then yearly)

GOAL: Total testosterone oer 500 ng/mL and free T 2 percent or more of total T.

3 ------- DHEAs (baseline, month 6, month 12 (if supplementing))

4 ------- Comprehensive ********* Panel w/EGFR (baseline, week 6-8, month 6 and then once a year)

GOAL: Normal CBC including liver enzyme elevations under 20 percent and eGFR over 60

5 ------- CBC w/ diff/PLT (baselines, week 6-8, month 6 and then once or twice per year)

GOAL: Normal CBC

6 ------- Lipid profile (fasting sample) (baselines, month 6, then once per year unless high)

GOAL: Normal lipids

7 ------- T3, free (for those with low thyroid symptoms)

GOAL: Upper quartile free T3

8 ------- T4, free (for those with low thyroid symptoms)

Goal: Normal free T4

9 ------- Ultrasensitive TSH (baseline, month 6, yearly after that depending on value and treatment)

GOAL: TSH under 2.5

10 -------- Prostatic Specific Antigen (PSA) (Baseline before testosterone treatment, 6-8 weeks after and then yearly)

GOAL: PSA under 3

11-------- LH and FSH (for men not on testosterone yet)- Used to diagnosed primary or secondary hypogonadism. Do not waste money testing your LH and FSH if you are on testosterone since they will be undetectable.

For those with excessive fatigue: Saliva Cortisol + DHEA (4 specimens during one day) (you can wait for after 6 weeks on TRT). Ferritin is also a test that can be considered.

GOAL: Normal cortisol graph and values along with proper cortisol/DHEA ratios


Optional Tests:

Vitamin D (25 (OH)D test)- Most people have low vitamin D, so spending money on this may be optional. Taking 5000 IU per day brings blood levels up to desired range in most people.

Folate and Vitamin B-12- Low only if you suffer from malnutrition or malabsorption.

 

[Gramps]

Many thanks! Is there a "package" of these, or most of these tests available through either of the online sites? I've taken the female panel converted to male from privatemedlabs and it didn't cover hardly ANY of these. My Thyroid numbers have always been middle of the line with a quack doc pushing them around with levthyroxine and only considered TRT once "I" suggested testing that since shoving T3 numbers around only made me worse. Anyhoo... most of the other numbers above weren't included in ANY testing I've done, with or without a doc.

On a side note: I think I finally crashed my E2 as I do feel like crap, or at least, a lower level of crap than usual. It took nearly a week and a half of daily dosing? I can't really notice a difference in joint pain - hell, I suffer with joint pain daily (degenerative joint disease) although what is normally a 4 on the pain scale is more like a 6 now, but overall, I feel lousy, no energy, don't even care if I get wood, etc. I wanted to hit the gutter in order to know the meds were working, and to have a starting point so I can get a routine of TRT plus occasional aromasin (25mg 1x or 2x/wk) to establish a usable baseline for blood work in a few weeks. I can't afford to get it wrong as money is too tight for too many wasted tests.

 

[juced_porkchop]

Again, I'm 50ish, 250-260 pound before TRT, and not a lot of exercise due to a spinal condition taking out my legs.

I've been reading, but so far haven't come to any reliable answer to my own issue with E2. I now realize I've had high E2 "symptoms" all my life, although never tested until recently. Bloating (increases DRAMATICALLY on TRT by 30+ pounds), emotional in the last few years when previously I could hold a poker face regardless of which prank I was pulling but no longer, brain fog before TRT as well as during TRT, cold morning type nips that last all day and slightly sensitive, and so on. My TRT routine is self medicated (due to quack doc) at 120mg/wk lowered from 150 due to latest blood work which was 1394 total test (started at 291) and 96 E2. So... after tons MORE reading, I've been taking "Etane" (Exemestane from all day chemist - Natco labs) with very little results. I've upped dosage to 25mg/day which SHOULD be killing my E2 as well as trashing ME, but after 1 week, it just isn't showing. My plans WERE to start high, then drop to 25mg twice/week, but that ain't working as I'm stuck at 25/day with little to show for it. I've lost about 5 pounds, am peeing a bit more, but that's it. I'm leery of keeping this dose going, but I gotta do something. What are some suggestion??

I rec getting quality from a known source like RUI and getting DEX, 0.25-0.5mg EOD of dex. that and some blood work after a month is what I rec

 

[Megatron28]

Many thanks! Is there a "package" of these, or most of these tests available through either of the online sites? I've taken the female panel converted to male from privatemedlabs and it didn't cover hardly ANY of these. My Thyroid numbers have always been middle of the line with a quack doc pushing them around with levthyroxine and only considered TRT once "I" suggested testing that since shoving T3 numbers around only made me worse. Anyhoo... most of the other numbers above weren't included in ANY testing I've done, with or without a doc.

On a side note: I think I finally crashed my E2 as I do feel like crap, or at least, a lower level of crap than usual. It took nearly a week and a half of daily dosing? I can't really notice a difference in joint pain - hell, I suffer with joint pain daily (degenerative joint disease) although what is normally a 4 on the pain scale is more like a 6 now, but overall, I feel lousy, no energy, don't even care if I get wood, etc. I wanted to hit the gutter in order to know the meds were working, and to have a starting point so I can get a routine of TRT plus occasional aromasin (25mg 1x or 2x/wk) to establish a usable baseline for blood work in a few weeks. I can't afford to get it wrong as money is too tight for too many wasted tests.

Go to Privatemdlabs and search their site on the word "panel". Pick the one that has the labs you want. Perhaps the Hormone Panel for Males will meet you needs and fit your budget.