3 Months In, Sky-High TT and E2

Pharma / TRT Testosterone Replacement
1

In October I posted the typical “first-guy” post and began searching out providers.

Unsurprisingly, every internist, urologist, and endo said my lethargy, depression, bone pain, muscle weakness, loss of libido and erectile strength weren’t backed up by evidence. They ignored my 5 different blood tests consistently showing sky-high SHBG, low E2, and rock-bottom free testosterone. They recommended I take ED drugs for the rest of my life.

Luckily, after two of these tests, I was able to get Test-C injection covered through insurance. I’ve been on since January.

Prior to treatment, my relevant bloods looked like this:

Total T: 455.3 ng/dL [175-781 ng/dL]
Free T: 23.07 [35.0-92.6]
SHBG 68.48 nmol/l [13.3-89.5 nmol/L]
Estradiol 12.06 pg/mL [10.0-42.0 pg/mL]

The clinic wanted to start me on 220mg of Test-C once per week. I thought it was too high, and asked for a reduced dose, which they gave - 160mg 1/week. The first two weeks, I felt fantastic. The next four, I felt like absolute shit, although I was still able to gain strength, which had been impossible pre-treatment. After 8 weeks @ 160, my values were:

Total T > 1500 (probably above 2000, but the scale stops at 1500)
Free T 22.9 pg/mL [8.7-25.1]
SHBG 59.7 nmol/L [16.5-55.9]
Estradiol 43.9 pg/mL [7.6-42.6]

My pet theory is that the first two injections brought me into the “Goldilocks zone,” and the subsequent four pushed me into the stratosphere, hence feeling like shit. Unsurprisingly, they lowered my dosage to 130mg/week. After 6 weeks my labs looked like this:

Total T > 1500 ng/dL
Estradiol 50.0 pg/mL [7.6-42.6]
Limited labs were collected since it was only a 6-week course, so no SHBG, no free T.

They’ve now lowered me to 100 mg/week, and prescribed Arimidex .5mg, to be taken once weekly the day after my injection.

Those who are in the know - is the Arimidex a correct prescription and dosage to control high E2? Also, is there some reason I’m getting sky-high serum and E2 increases to TRT doses, or is that merely the (un)luck of the draw?

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A lot of guys, me included don’t have symptoms from high E2, so no treatment necessary. It’s the guys treating the numbers without any symptoms that create problems for themselves.

Even those with high E2 symptoms, controlling E2 with AI’s is futile, they trade high E2 for low E2.

Anastrazole is power stuff and wasn’t intended for use in men.

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I would not start with that high of an anastrozole dose, however, at this point, I would not use it at all.

I’m not sure I would lower the testosterone dose, and add anastrozole at the same time. If E2 is a problem, lower testosterone may take care of it. I think I would want to see how you responded to the 100mg/week before anything else. When, relative to your injection, were the labs obtained?

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Labs are always taken at trough, prior to the week’s injection. They draw, then shoot me up afterward.

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Don’t you inject yourself at home?

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OK, those are pretty good levels with that dose and seven days post injection. I would definitely see how I did at 100mg before adding the AI.

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You’ve got high SHBG that may come down over time on TRT. If this were me I wouldn’t change anything, considering FT is in a good place. I think changing up your dose and adding in such a large AI dose is just going to lead to weeks and weeks of you trying to figure out why you don’t feel good

8

So there are no success stories with AI is what you are saying? It’s also always trading high E2 for low E2 and nothing in between? I wonder where do you get this information from?

How do you get away with statements as such that and others like “TRT won’t make a difference in physique” and still post advice to people up and down this forum?

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I wouldn’t suppress conversion to E2, unless there’s a real reason to. E2 is supposed to go up when injecting testosterone. Converting T to E2 is the body’s way of protecting itself.

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I said guys trade high E2 for low E2 with AI use, it’s common, but I wasn’t talking about everyone on planet earth.

That’s not what I said, you’re taking the entire prior question about advantages of naturally high T versus TRT out of context to prove your own point and a prior grudge.

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Actually, that is what you said. And my response to you on that comment started a poop show on that thread.

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Not interested in picking sides, but this is what you said…

We all put our foot in our mouths sometimes :man_shrugging:

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I have not seen any data or information that would get me to believe someone on TRT has an advantage to someone with equally high testosterone naturally.

Anecdotal experiences aren’t going to cut it, I need cold hard facts. You could argue that the person in question never had good or consistent testosterone levels to begin with, so they go on TRT and experience what they perceived to be an advantage in physique.

So I stand by my statement until such data, facts present themselves.

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I wish. They only do injections at the clinic, administered by the NP.

@ highpull - so should I avoid taking the Arimidex entirely, and see how I respond to the reduced dose until my next round of labs?

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The question was someone on TRT vs someone not on TRT. And you said it didn’t matter. NO, it doesn’t matter if the person on TRT sits on the couch eating cookies and hamburgers without ever lifting a weight. In that case, you are correct, TRT does not make a difference.

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Thia practice is stupid and only benfits the clinic.

That’s 52 injections per year, kind of puts a damper on a vacation and life.

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This is incorrect advice. I appreciate your willingness to help all the time. But I find your advice incorrect about 50% of the time.

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Yeah, but if i made a thread saying I had symptoms of low T and my bloods came back within range, you’d be recommending TRT based on the intangible ‘feel’, no?

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Diagnosing a testosterone deficiency is a challenge without proper testing not readily available to the average person, but yes if no other medical condition can be found to explain the symptoms, and your levels are in the gray area (low normal or slighly higher), yes I would recommend a trial of TRT.

Obviously if your Free T is high normal, no way would I recommend TRT under any circumstances.

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My thinking is that decreasing testosterone (and yours was plenty high) by decreasing your dose may decrease estradiol as well. It should anyway. If the reason you’re not feeling well is either high testosterone or high estradiol, that may do the trick for you.