New to this, Hormone Replacement Therapy (HRT) lost it's effect, estradiol high, started Anastrazole, ...

[WasHousebound]

New to this, HRT lost it's effect, estradiol high, started Anastrazole, ...

Forgive me if this has already been asked, there are too many resources with the same keywords to find an answer:

*** Does exercise reduce excess testosterone? In other words, do testosterone cypionate injections require a workout regimen to be effective? ***

Background:
My doctor first prescribed compounded testosterone cream (equal to 50mg/day testosterone, but bioavailabilty is maybe 1/10th as much as injections) with immediate benefits to my 'vascular tone' so my balance (ability to stand and walk) returned, and I started working out daily at a gym. I even started to have morning wood for the first time in many years. (this is anonymous, right?) Being sedentary to begin with, I made huge gains immediately. After a couple months I switched to injections (Testosterone Cypionate in Sesame Oil, 200mg/ml strength, inject twice a week) equal to 100mg/week. I soon complained of tender nipples which was ignored, but eventually I now have a grape-sized left tit, my skin is flush like a continuous mild sunburn, I quit being able to workout, my serum level of total testosterone dropped to the 400's, and my doctors (one that prescribes is into 'anti-aging' and I confirm his actions through a University of California Urologist) both concurred to raise my injections to equal 150mg/week. Estrogen was only 38 on that test, so I was retested at another lab in less than two weeks with startlingly different results: total testosterone of 1095ng/dl, and estradiol of 81pg/ml. Yesterday I took my first anastrazole (0.5mg x 2 per week) and realize that will take time to effect me.

*** Even though I don't feel like it, do I push myself to start daily workouts again, and will that lower my total testosterone?
*** Maybe wait a week so the serum anastrozole has time to increase?
*** Are laboratories that inaccurate, or could these levels have really jumped that much in two weeks of inactivity?

Perhaps I'm asking too many questions in one post, but not sure what part to leave out. More relevant detail listed in my profile.
Serious help would be appreciated, as my doctors don't seem to know nearly as much as the average steroid-using athlete about testosterone HRT.

 

[SolomonGrundy]

exercise will not lower your levels, in fact by exercising you will lower body fat and that will lower the estrogen conversion , stay on the Aromatase inhibitor (AI) meds, you definitely are converting a lot of test to estrogen , has the lump gotten hard ?

 

[methos]

If you went up to 150mg per week of Test then yes you could absolutely test in the 1000's for total T. Labs can vary, time of day influences labs etc etc. Too much to list.

To answer your question. YES, get your butt in the gym. Working out is proven to actually raise your Testosterone when you are still producing your own. But either way, it should help you to feel better. When Estrogens are too high or low they can effect sleep. Working out can combat this a bit and help your body get the sleep you need.

I drag myself into the gym no matter how I feel because it always makes me feel better. Your Estrogen should start dropping within a few days.

 

[methos]

I would also ask your doc about Nolvadex to help combat the lump. When it goes away, you can drop the nolvadex and stick with your Aromatase inhibitor (AI) protocol.

 

[WasHousebound]

I forgot to mention this quote found on this forum:
from: The Testosterone:Cortisol Connection, by Dan Gwartney, MD
"One study examining rugby players over the course of a tournament found that though testosterone lowered and cortisol rose by the end of the tournament, a compensatory anabolic state occurred during the following days of rest, returning to normal after five days."
I indirectly infer that being sedentary may be allowing my total testosterone to climb, and working out will 'use' this testosterone. But it is all very complicated, with so many interactions.
Time of day: Yes, the total testosterone last time was tested at a different time of day than ever before: 7:40AM, fasting, no coffee, eight hours after 20mg of prescribed diazepam (used nightly for many years), 21 hours after testosterone injection. So the level may be the highest my body ever goes; I can't be sure.
lump hardness: hard as a firm grape, but not a stone; hurts to squeeze. Is there medical justification for having the breast material removed? (my nipples would still be hard with excess estrogen)
Nolvadex: I'd strain my relationship with my doctor if I ask for anything before getting results from my next blood work in a month. He'd want to see if the Aromatase inhibitor (AI) does the job, and what changes occur in my whole complex panel (not just t testosterone). If it is still present, I could get away with asking for enough for a few weeks, but my UC Urologist is against any such prescription because of neurological effects.

Body Fat: reasonable for age to begin with, lost fat and gained weight in last few months so I even have loose skin on belly, overly skinny face at the moment, started at ~15%, reduced to ~10%, intend to maintain ~8% (was at 6% in early 20's when athletic). Fat related excess aromatase isn't a cause for me.

Yeah, I'll force myself to the gym today. I'll start going every day regardless of how I feel, to establish the habit even if I can't do much on a given day.

 

[WasHousebound]

Update:
Started anastrazole .5mg x 2 per week, reduced testosterone cypionate injections to equal 100mg/week instead of 150mg/week.
Changes have been very slow, but quite conclusive:
gynomastia: going away slowly. Nipple sensitivity lower; left breast seems deeper, smaller, and less defined.
back zits - nearly gone, and they were getting pretty bad
after change - skin dried out too much on other parts of my body temporarily, even had to use lotion, that was temporary
Skin was so flush it was like a mild sunburn before the change, that has very slowly but completely gone away

Keep in mind I've been very ill for well over a decade, and the strain before the new protocol put me into a crash from which I seem to be mostly recovered about now. My physical balance (called orthostatic tolerance / vascular tone) (before testosterone I could black out on standing) might not have stayed as good as it was before estogen increased, but has returned. Morning wood was a distant memory for years, testosterone changed that temporarily, now the anastrazole has that up to where it probably should be at my age. Some article referenced heavily (on this forum, I believe) says to use that to judge optimal anastrazole.

Last attempt at going to the gym was 2/14, before starting this thread, and I crashed at 30 minutes even with breaks, at a lowered capacity than previous. Hope to start again soon, but when I do I'll start by staying under 75% of my previous, and try to get through my whole routine. I dread going, but more accurately I dread the possibility of a crash.

I'm scheduled to do another blood draw in about four days, may take a week to receive results. That may initiate another adjustment.

For me, working out is a luxury I never expected so if I cannot continue, that's okay. Several months ago, walking without needing a cane, handrails, or extreme care was a luxury. Just having normal balance and relative endurance is adequate; but it would be a blast to get to be powerful again as I was in my 20's.

(I've no questions at this time, but am sharing this for anyone similar, plus context if/when I do have questions later)

 

[WasHousebound]

Following up to say - all is well.

100mg/wk (divided into two injections)
& custom compounded anastrazole (equivalent of 0.1mg per day) from local pharmacy

quite a while now. Swings are gone, strength is reasonably up, gynomastia gone, effect of low estrogren (crashed thyroid and affected other systems) gone.
I'm not working out, nor intend to. I am level - with testosterone around 1200 and estradiol somewhere around 30.

end of thread, I guess, just following up to state that everything worked out - custom anastrazole from highly reputed pharmacy was key (I didn't want to buy 'research purposes only' stuff):
30ml of "Anastrozole in almond oil with lemon flavor 0.5mg/ml, take 0.2ml (0.1mg) daily by mouth" will last me six months for $60.
Warning: squirting right on tongue caused swings - easily resolved by holding a tiny bit of liquid (water, milk, yogurt, juice) in mouth and squiring into that, then chasing with more liquid.

 

[WasHousebound]

I'm compelled to follow up:
I'm housebound again. Testosterone replacement increased to 160mg after car crash (arms couldn't hold a cane!), and for cause unknown (may be the T), my blood is so far off kilter my doctor says I'm at serious risk of a stroke. I haven't worked out in over a year. I can barely walk and fatigue in about 20 seconds of anaerobic exercise. Doctors have said that T replacement has done more good for me than makes sense, so is likely masked something else. That something else appears to have come out to bite me. If I had to do it over again, where the alternative was to remain this way for four years without a reprieve, I would. That is, as long as it doesn't end up killing me! So now I must inject, yet am as poor of condition as I was before T replacement. Gynomastia never came back: a few drops of custom ordered compounded anastrazole each day for a week resolves it, but I haven't even had to do that in a long time.

As an afterthought, here are the test results that have everyone worried, and forced me to go down to 140mg T/wk until it gets figured out:
RED CELL COUNT 6.36 M/MM3 4.5 - 5.9 M/MM3 H
HEMOGLOBIN 18.4 g/dL 14.0 - 18.0 g/dL H
HEMATOCRIT 55.6 % 40 - 52 % H
MONOCYTES ABS 0.55 K/MM3 0.2 - 0.4 K/MM3 H
METAMELOCYTES ABS 0.09 K/MM3 0.00 - 0.00 K/MM3 H

 

[DucBase]

Man that really looks like you need to donate some blood.

 

[WasHousebound]

Good answer!!! Nobody will accept my blood, and my doctor set my "therapeutic phlebotomy" at 250ml every two months (half the rate a healthy person donates), which is not enough to change my blood com-pos-ition. I see a blood doctor soon (Hematologist). Man, I check with doctors and can't get answers. I check here, and the first comment matches the best medical advice so far, including the Mayo Clinic!

 

[DucBase]

Well...your blood is thick. I can't imagine your doc won't come around after seeing those numbers.

Do you think there is any way you could be suffering from sleep apnea? I think that may be part of what made me hypogonadal. It also jacked my red blood cell count up to where Lance Armstrong would be super jealous.

 

[WasHousebound]

I was tested for sleep apnea last year; again, great idea!

My white cells and platelets have not increased, but if I read correctly, excess T results in excess red and white blood cells, and platelets. Do these high numbers look like they are from the T? I'm under the impression something else is going on, but my doctor lowered my T injections anyway. My T is maybe 800. My estrogen is stable (around 20-30) as I can tell from markers.

The cause of my situation is unknown, but my current results are consistent with leukemia (WTF?), major infection, and major inflammation. (monocytes, metalocytes) Along with the blood tests, I'm feeling bad in ways I've never felt before. I can't imagine they neglected to find leukemia long ago, if that's the cause of 16 years of getting sicker and sicker.

I'd love to find out I've got some secondary steroid related issue that requires adjustment.

Doc told me I'm at serious risk of stroke a few months ago! Why they aren't doing anything, your guess is as good as mine. They may blame the T just because I can't prove them wrong.

 

[DucBase]

Yeah I don't know. It seems like everyone on TRT has issues with RBC/hematocrit to some degree. I donate every time red cross comes to my office (every 2 months) and that keeps me in good shape. Some guys on here have had trouble even when donating as often as they can. It's hard to say if that's due to TRT or some other factor. I'm sure the TRT probably has something to do with it.

800 seems like a pretty reasonable number but everyone is different. I would be thinking about reducing the dose a bit...who knows, some guys are perfectly happy with lower levels. I have a buddy who is on TRT but seems to be perfectly happy at 350. I would want to kill everyone that moves or makes noise at that level but he loves it.

I've been dealing with some thyroid issues that my doc can't figure out so I know the feeling, it's pretty frustrating when you can't get an answer.

 

[Milton]

did you find a place to donate blood?