Hello I would like to get some input from the experts here. I’m 54, in okay shape working out a few times a week. I’m currently on TRT and have been for about 1 1/2 Years. I have felt great up until the last few months and starting to loose energy again. I take 0.3 ml of test c twice weekly. My test is now in the normal level but my estrogen is high. I have also noticed my sperm production is very low. My DR does not believe in prescribing Arimidex. I’m looking for suggestions.
Here are my latest test results:
Estradiol - 45.9 pg/ml
Hemoglobin - 16.5
Hematocrit - 48.2
Testosterone, Serum (Total) - 770
% Free Testosterone - 1.2%
Free Testosterone, S - 92
Sex Hormone Binding Globulin - 39.5
I look forward to the input.
Your SHBG is very high and binding up all your Free Testosterone. You need to switch your protocol to 1 large shot weekly.
Others will chime in tomorrow. @systemlord is very knowledgeable
Please describe your protocol in detail, do not list in mls, but in mgs. Example I inject .16 mL from a 100mg vial which is 16mg EOD or 64mg weekly.
I’m going to guess its 60mg twice weekly, if doctor refuses AI you have two options, (1) lower dosage to 50mg twice weekly or (2) locate another doctor, (3) inject EOD which will lower estrogen since the testosterone peaks will be smaller.
When injecting smaller doses you need to decrease.the total weekly dosage as injecting more frequently requires less testosterone to reach the same levels.
An example, when I was injecting 50 mg twice a week I reached levels of 667, yet injecting 25 mg EOD (same weekly dosage) every other day got me to 1000.
Injecting one large weekly dosage will drive estrogen conversion and it will be higher than it is now. I went for option 2 and found a private clinic who will do what’s necessary, I felt as if I was running the show with the Kaiser endo’s.
Working with a private Clinic has its advantages, you can get custom compound of doses of anastrozole, this is especially important if you are an AI over-responder.
An aromatase inhibitor may be nessecary for some, however I would like to point out that using an aromatase inhibitor in conjunction with TRT can have a significant, negative effect on HDL cholesterol which is fine but may cause problems say a few decades down the line. If one has to use an AI I would suggest periodic monitoring of lipid profiles.
I’ll find the studies again and post them but using an AI with test caused a drop in HDL by something like 25 percent. Using SIX HUNDRED MG’s of test/week alone caused less of a drop in HDL
How fat are you? If even slightly overweight, this is your number one issue. Fat produces aromatase.
How much do you drink? Medications? All and any.
Your diet should include lots of broccoli/cruciferous veggies. Zinc also helps (needs to be taken with copper).
I would take natural approach before arimidex. However, even those can be dangerous.
I have tanked my e2 on Sam-E , DIM, and Tumeric/Curcumin. (these affect e2 liver metabolism, and increase E2 clearance)
There is probably another issue with why its high.
How do you feel??? Physiolojik (endocrinologist) on here states that he never puts anyone on an AI unless it’s absolutely necessary. He states High T with Low E is bad, High E with Low T is bad but high E with High T is totally normal and fine. I’ve read about the the T/E ratio of Total T/20 and Total T/ 14 and if you’re with in those two numbers you’re fine.
But I’m a newbie here and still learning…so take anything I write at face value only.
Low semen volume has been a high estrodiol symptom for quite a few members of this forum, myself included. Follow the suggestions and you should see it come down and volume increase.
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I inject Test E at 60 mg twice weekly on Sunday and Thursday. I know I put Test C in my original email but I looked again and it’s Test E.
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Alphhagunner right to the point with how fat am I. I’m not some 20 yo that’s 8% body fat. However, for a 54 yo I’m not in too bad of shape but do have a dadbod. I do take zinc and fish oil. No meds and drink socially maybe every couple of weeks.
Trifive I’m have that tired feeling like before I started TRT except it’s not as bad. Up until a couple of months ago I had been feeling great. I just feel like my test is out of balance right now. I’m ready to get back to how I was feeling a few months ago. The TRT has definitely helped with a lot of things.
Unreal thanks for the advice. I have my cholesterol checked regularly. My HDL has always been great. If it has a negative effect decades down the road then at 54 I should be okay 
Are you on HCg? If only 25mg of sustanon eod got me to 1000 while keeping estrogen low that would be awesome. My SHBG is mid-range tho at 25 (16-55 range)
123k I am not on HCg. Thanks for the input.
Higher bodyfat = higher aromatase and in turn higher estrogen. There was a point to his asking. 
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Could try lower dosage of test to something like 50mg e3d. This will lower the e2 a bit and test level still should be in a decent range.
Cant hurt to try and see how you feel after awhile
@physioLojik given you dont prescribe AIs with your patients have you heard this complaint and do you do anything about it?
I understand why the question. I just thought it was a little funny how it was asked.
I guess I’m going to have to cover it with my dr in more detail. Maybe my only option is to start taking lower doses more frequently
@NH_Watts tamoxifen helps with this. There is a lot that goes into semen volume. I would lean more towards pre diabetes as a cause.