Ditching the AI (Update) And Attempting Clomid Restart with Endo

Pharma TRT
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Hey everyone. It’s been a while since I’ve posted or even read through any of the threads in this forum, mostly because I’ve been pretty dialed in with my protocol and enjoying life. I decided to take a peak to see if there’s any new advice out there or if I could possibly share my experiences to help out others.

To my surprise, there seems to have been a major shift in thinking about the use of AIs and controlling E2 levels. I viewed the video that one of the members posted about the importance of estrogen in the health and wellbeing of men on TRT. I must say, the evidence-based data is pretty compelling.

I’m not 100% sold on the idea of ditching the AI, but I’m willing to give it a try. I do believe that it is probably HEALTHIER to allow your body to balance out the T with the E. However, I’m not convinced that it will make me FEEL better, but there’s only one way to find out.

My current protocol consists of subcutaneous injections of 11 ml (22 mg) of Test Cyp EOD, or 77 mg per week. I also take 3 drops of liquid Arimidex every day… slightly less than 1 mg/wk. That puts my TT at about 600 ng/dL to 700 ng/dL, and my E2 at about 15 - 25.

I’m 40 yrs old, 5’9", 177 lbs, 12% BF. I have good muscle definition and I’m really vascular for some reason. On a hot day, I’ve got veins popping out of my biceps, calves, thighs, and even my abs. I’m also taking creatine, and I think that’s when other people started noticing all the veins. There’s definitely an interaction taking place between creatine and TRT (but I digress). I feel good. My libido is good, mood is good, and I’m sleeping pretty good. I work out regularly, and I’m probably in the best shape of my life. Prior to TRT, I had two blood tests that showed my morning TT was 238 ng/dL and then 170 ng/dL. I felt terrible at the time. I’ve been on TRT ever since.

I’m dropping the AI. In fact, today is day 1 without an AI. I’ll post my labs after 6 weeks to show if there is an improvement to my LDL/HDL numbers. My current numbers are:

Total Cholesterol = 127
HDL = 46
LDL = 66

I’ll also describe how I feel before and after. I’m predicting that I might start retaining some water, probably most notably in the face. I’ll talk about that as well, and anything else I might observe.

Anyway, I’ll keep you posted. Thanks for reading!

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Okay so it’s been one week without an AI. I can’t say I feel any different. No bloating or any ill effects. Still to early for blood work. That’s all for now.

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There are going to be changes from letting e2 rise and then level off. They are transient. The way I went about it was to just use less and less ai the times I felt I needed it until I used none. It’s been about 7 months now. Seems like such a no brainer at this point. That is regardless of dose as well.

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Don’t panic if you get transient symptoms. Just ride it out. If its continuous days of nipple itching, then address it.

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Thanks for the feedback. What kind of transient symptoms should I expect?

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maybe a little emotional, maybe some slight nipple itch (not a big deal as long as it doesn’t continue for a multiple days, id be concerned after 1 full day), maybe your dick isn’t working perfectly.

Your e2 should balance on its own. Just don’t use an AI.

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Good to know. Thanks for the advice.

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Okay. I promised to follow up with bloods so here they are. Also, I honestly don’t feel much different with elevated estrogen, maybe a tad more emotional. Energy levels are great. Libido is great, maybe even slightly improved. I went to a new endo for the blood work and he didn’t test my cholesterol levels unfortunately. He also tested my total estrogens instead of E2. Anyway, here they are:

Total Testosterone, Equilib: 701 ng/dL (264 - 916)
Testosterone, Free: 21.52 ng/dL High (5.00 - 21.00)
*Estrogens, Total: 159 ng/dL High (40 - 115)
Cortisol AM: 9.0 ug/dL (6.2 - 19.4)
FSH: 0.1 mIU/L Low (1.5 -12.4)
LH: 0.1 mIU/L Low (1.7 - 8.6)

*Note: Based on my math, my E2 would be approximately 54 ng/dL (<39), assuming proportionality.

This is on 77 mg of Test Cyp per week divided into EOD sub q injections. My endo’s comments were that my dose is too high as reflected by the elevated free T and estrogens. Not surprised, coming from an endo.

On a side note, this new Endo wants me to try a Clomid restart before he treats me with testosterone injections. I began the restart 1 week ago. I’m not hopeful, but if my levels come back below normal as they were when I started this journey 6 years ago, then I’ll have a much more affordable option for TRT compared to using my anti-aging clinic. I’ll create a seperate post for the restart attempt.

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So you will put yourself on this restart torment to get it covered by insurance? Hope in that case the restart dont work too well, because if you test 300 and something you will be screwed

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You measured total estrogens, not E2 (estradiol).

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This is not normally a test we men use to test estrogen, we use the sensitive estrogen testing.

Maybe next time your doctor can the the appropriate estrogen testing.

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My total testosterone will have to come back below 254 ng/dL in order to get treatment from this Endo. If it doesn’t come back under range, I will have a decision to make… continue on TRT with my anti aging clinic or come off TRT altogether. This decision will be based on how I feel. Based on my initial test results from 6 years ago (which came back below range), I’m pretty sure I’ll still have hypogonaism. If not, that would be pretty amazing.