TRT and anastrozole question

[johnnyv412]

Hey guys. I just started TRT for the second time. Long story short I went to the doctors back in 2014 with complaints of lethargy, and general unwell feeling. They tested for a bunch of things, one being Total Testosterone. My results came back at 88. They restarted early in the morning 3 weeks later at 230. Well they put me on 200mg every two weeks of cypionate then after about a month upped it to 150mg every week. I did ok for a while but eventually came into E2 problems. I asked for an E2 test and my idiot doctor ordered a "total estrogen" test. Regardless of it not being the sensitive E2 test I was 240 (reference range <120). Well she said she doesn't prescribe AIs because they were for woman with breast cancer. So I had to stop to avoid my panic attacks I was getting 2 days after every shot, and the massive amount of water I was holding. I'm 6'7" and about 290lbs while I'm in decent shape. I never had a problem bulking up and lifting, my pre trt symptoms were more energy and libido related.

Anyways, here we are 3 years later. Here's my pre trt bloods.

Before TRT

POTASSIUM 4.3 MMOL/L 3.5 - 5.3 MMOL/L
CHLORIDE 107 MMOL/L 98 - 110 MMOL/L
CARBON DIOXIDE 22 MMOL/L 20 - 31 MMOL/L
CALCIUM 9.2 MG/DL 8.6 - 10.3 MG/DL
ALK PHOS 44 U/L 40 - 115 U/L
SGOT/AST 19 U/L 10 - 40 U/L
SGPT/ALT 43 U/L 9 - 46 U/L
BILIRUBIN-TOTAL 2.3 MG/DL 0.2 - 1.2 MG/DL
GLUCOSE 99 MG/DL 65 - 99 MG/DL
BUN 15 MG/DL 7 - 25 MG/DL
CREATININE SERUM 1.10 MG/DL 0.60 - 1.35 MG/DL
BUN/CREATININE RATIO 13.5 6 - 22
PROTEIN TOTAL 6.6 G/DL 6.1 - 8.1 G/DL
ALBUMIN 4.2 G/DL 3.6 - 5.1 G/DL
GLOBULIN CALCULATED 2.4 G/DL 1.9 - 3.7 G/DL
A/G RATIO 1.7 1.0 - 2.5
EGFR NON-AFR. AMERICAN 88 ML/MIN/1.73M2 > OR = 60 ML/MIN/1.73M2
EGFR AFRICAN AMERICAN 102 ML/MIN/1.73M2 > OR = 60 ML/MIN/1.73M2

E2 34pg/ml. <39pg/ml
Lh 2.6miu/ml 1.5-9.3miu/ml
Fsh 3.0miu/ml. 1.5-8.0miu/ml
Free testosterone 51.22 35-155pg/ml
Total testosterone 230.11 250-1100ng/dl
SHBG 10mnol/l 10-50mnol/l
PROLACTIN 5.9 NG/ML 2.0 - 18.0 NG/ML



A different doc prescribed me 150mg per week but let me self inject so I started my self off at 50mg every 3.5 days in order to hopefully control my e2 levels. It looks like my e2 was high pre-Trt. I was feeling better and morning wood was popping up here and there until about 6 weeks in when my face was puffy, ankles starting swelling a bit and I became a little anxious. My classic high e2 symptoms. Here's my bloods 6weeks after starting. Taken 3 or four days after injection.

sodium 138 MMOL/L 135 - 146 MMOL/L
POTASSIUM 4.3 MMOL/L 3.5 - 5.3 MMOL/L
CHLORIDE 107 MMOL/L 98 - 110 MMOL/L
CARBON DIOXIDE 22 MMOL/L 20 - 31 MMOL/L
CALCIUM 9.2 MG/DL 8.6 - 10.3 MG/DL
ALK PHOS 44 U/L 40 - 115 U/L
SGOT/AST 25 U/L 10 - 40 U/L
SGPT/ALT 45 U/L 9 - 46 U/L
BILIRUBIN-TOTAL 2.3 MG/DL 0.2 - 1.2 MG/DL
GLUCOSE 99 MG/DL 65 - 99 MG/DL
BUN 15 MG/DL 7 - 25 MG/DL
CREATININE SERUM 1.10 MG/DL 0.60 - 1.35 MG/DL
BUN/CREATININE RATIO 13.5 6 - 22
PROTEIN TOTAL 6.6 G/DL 6.1 - 8.1 G/DL
ALBUMIN 4.2 G/DL 3.6 - 5.1 G/DL
GLOBULIN CALCULATED 2.4 G/DL 1.9 - 3.7 G/DL
A/G RATIO 1.7 1.0 - 2.5
EGFR NON-AFR. AMERICAN 88 ML/MIN/1.73M2 > OR = 60 ML/MIN/1.73M2
EGFR AFRICAN AMERICAN 102 ML/MIN/1.73M2

Estroidial 43pg/ml <36pg/ml
Total testosterone: 511ng/dl 250-1100ng/dl
Free testosterone: 142.1pg/ml 35-155pg/ml

So my doctor prescribed me .5mg of anastrozole every day. Me knowing that was a rediculous dose decided to take less and I upped my cypionate injections to 60mg e4d. When I received the pills (two days after an injection) I took .5 mg. With in a day all my bloating stopped and for two days I felt great. Morning wood both nights and everything was good. So my plan was to start .25mg 24 hours after injections (reading that's a good starting dose). Well my next injection comes around, 24hours later I take .25mg. Around this time I lost all my libido and became a little tired again like I was with high e2. So my question is could I have crashed my e2 levels off those two small doses or is it more likely I felt good on the .5 so when I took .25 the next time it didn't lower my e2 enough. But mind you my injection was a Thursday, I took the .5 on Saturday. Then my next injection was Monday so I took the .25 on Tuesday. So it was .75mg in three days. I'm asking cause I took my third injection yesterday and today is anastrozole day and I'm wondering if I should take the .25 or skip it for a few shots. I took the last .25 4 days ago.

 

[AverageMan]

Wow - lots going on. I'll focus on your post TRT labs and protocol.

You are a big boy - at close to 300lbs, you should be at 200mg (.5 CC) Cyp weekly - split bi-weekly. I'm 1/2 your size and am on MORE cyp on a weekly basis.

511 total test is still a little on the low side, as a direct result of your low CYP dosage. Folks will tell you the number doesn't matter and it's based on how you feel. Most docs, even those that are conservative, will shoot more for at least 800 for total test.

43 for Estroidial is withing range - most docs consider 20-40 perfectly fine. I typically stay on the higher side, at around 40.

Without a doubt you crashed your E2 - .5 Adex with an E2 of 43 is WAY too high of a dose. again 43 isn't really out of range for E2. I can't believe you are getting E2 symptoms with that E2 level.

STOP taking the Adex. Let your E2 rebound. Also, how long have you been on the new 150mg a week protocol? It takes about 30 days for a NEW protocol to saturate your body.

FYI - with the half life of Adex, you should be taking 2x a week with your CYP injection; no more than that.

 

[johnnyv412]

Wow - lots going on. I'll focus on your post TRT labs and protocol.

You are a big boy - at close to 300lbs, you should be at 200mg (.5 CC) Cyp weekly - split bi-weekly. I'm 1/2 your size and am on MORE cyp on a weekly basis.

511 total test is still a little on the low side, as a direct result of your low CYP dosage. Folks will tell you the number doesn't matter and it's based on how you feel. Most docs, even those that are conservative, will shoot more for at least 800 for total test.

43 for Estroidial is withing range - most docs consider 20-40 perfectly fine. I typically stay on the higher side, at around 40.

Without a doubt you crashed your E2 - .5 Adex with an E2 of 43 is WAY too high of a dose. again 43 isn't really out of range for E2. I can't believe you are getting E2 symptoms with that E2 level.

STOP taking the Adex. Let your E2 rebound. Also, how long have you been on the new 150mg a week protocol? It takes about 30 days for a NEW protocol to saturate your body.

FYI - with the half life of Adex, you should be taking 2x a week with your CYP injection; no more than that.

Thanks for your response. When I was at 511 with the e2 at 43 I was taking a little less than 100mg of cypionate per week. Those results were taken I believe either on an injection day or a day before (so prolly 3 days after injection). I definitely get e2 symptoms. The biggest is water retention. But when I was on trt last time I stayed at 150mg weekly for about 9 months so my e2 was prolly higher because after about 6 months I was getting powerful hot flashes and panic attacks (I'm not an anxious person). So I'm really afraid of that happening again. I have labs scheduled for oct 25th. When I took that .5 I felt fantastic. I was getting hard morning wood, lost all my bloating and everything. But I think it may have dropped to my sweet spot and kept going because about 3 days later I had soft erections, no more morning wood and a bit less energy. So how long should I wait to try .25 2x a week? I mean I feel ok now but still no morning wood or libido. I just can't tell if that's from too much e2 or lack of.

 

[AverageMan]

High and low E2 are very similar from a symptoms perspective. Only a blood test can tell you if E2 is high or low. Unfortunately, it's a bit of trial and error.

Troubleshooting 101 - Only change one things at a time , get blood work. If things are still off, do it all over again; change one things at get bloodwork again. Depending on the state you live in, you can order your own bloodwork.

Hate to say it, but it's VERY difficult to get dialed in on TRT just by how you feel - you need bloodwork.

 

[Megatron28]

43pg/ml for E2 really isn't what I would consider high. Most guys are happy in the 20-40 range. You took too much Arimidex andbit sounds like it dropped your E2 too low. I would try DIM first if you are going to stay on that low of a TRT dose rather than taking Arimidex. I think you are going to have a really hard time finding the right adex dosage and timing given how little room you have to play with.

Another option is to increase your test dose to 100mg twice a week and try .25mg of adex twice a week.

 

[johnnyv412]

43pg/ml for E2 really isn't what I would consider high. Most guys are happy in the 20-40 range. You took too much Arimidex andbit sounds like it dropped your E2 too low. I would try DIM first if you are going to stay on that low of a TRT dose rather than taking Arimidex. I think you are going to have a really hard time finding the right adex dosage and timing given how little room you have to play with.

Another option is to increase your test dose to 100mg twice a week and try .25mg of adex twice a week.

So you think 100mg e3.5 days may be a good number? I meet with him October 25. He seems to want to give me more testosterone. I told him how I have really good days and bad days and he said my numbers are probably teetering on functional. I thinks if he gives me more test my e2 will go out of control. That's why he prescribed the arimidex. My e2 levels went to 43 on like 45mg every 3.5-4 days. My prescription covers up to 75mg twice a week. But I don't think he'd have a problem with bumping me up to 100 twice a week. I was worried about taking more cause my e2 will respond (like it did last time). And should I be worried about my shbg taking that much?

 

[Entourage_Doc]

What! Who is this incompetent dr? All men typically ever need for TRT is 180-200mg of test cyp inject d one time a week or biweekly.

Dr B

 

[Megatron28]

So you think 100mg e3.5 days may be a good number? I meet with him October 25. He seems to want to give me more testosterone. I told him how I have really good days and bad days and he said my numbers are probably teetering on functional. I thinks if he gives me more test my e2 will go out of control. That's why he prescribed the arimidex. My e2 levels went to 43 on like 45mg every 3.5-4 days. My prescription covers up to 75mg twice a week. But I don't think he'd have a problem with bumping me up to 100 twice a week. I was worried about taking more cause my e2 will respond (like it did last time). And should I be worried about my shbg taking that much?

See post #5

 

[casanovaaa]

why not try HCG at 250 iu weekly on day of injection and some adex at .5mg PO Q Monday and Friday? should work for you.