Help Me Dial In My Test and E2 Levels

Pharma / TRT Testosterone Replacement
1

hi all first time poster long time reader

i am 40 years old and recently started trt. my labs and protocol as follows

PRE TRT (27 Feb 16)
Oestrogen 60 pmol/L (range <160)
Total Test 15.7 nmol/L (range 9.9 - 27.8)
SHBG = 28
Free Test = 350 pmol/L (range 170-670)

After 8 weeks of Testosterone Enanthate Injections IM - 125mg every 5 days (which is 25mg day) with AI (Anastrozole) at 1mg every 3 days. I found that my oestrogen felt too high (sensitive nipples and other perceived symptoms) so i moved the AI to 1mg ED for 10 days and had bloods done at the end of 8 weeks and these were the results. You can see that I am clearly not an overesponder to anastrozole. Note the below test was taken 5 days after my test shot (i.e. the day I was due for my next shot so as low as I would be in the 5 day cycle)

Oestrogen 49 pmol/L (range <160). Note that this equates to 13 pg/ml (which I understand is lower than optimal)
Total Test 35.8 nmol/L (range 9.9 - 27.8)
SHBG = 24
Free Test = 1071 pmol/L (range 170-670)

my problem after 8 weeks was I wasn’t happy with nut shrinkage so wanted hcg. Also lipid profile. i have always had high cholesterol (genetic) from the age of 20 it was been at least 6 (5.8 being upper range). but my hdl/ldl ratio is very good so doctors were not concerned. 8 weeks of anastrozole at the above dose my HDL was smashed lower by 30% and LDL increased by 30% ! so my theory was I need higher amounts of Anastrazole than would be healthy long term so that is not sustainable

Took a break for a month then wanted to go back on trt and my doc said I should lower my test dose. we moved this to 125mg every 7 days (so 17.85mg a day which is a 30% reduction from previous dose) still IM. also we added HCG at 250iu (2 days before and day before my weekly test injection). so 500iu in total a week. after 6 weeks I had bloods done again. I note that the HCG has kept my nut size so i will definitely stay on the HCG!. I stayed with the original arimidex profile of 1mg twice a week (and every now and then I would throw in a bit more when the nipples were sensitive). after 5 weeks I got a box of aromasin as i understand it is not as harsh on lipid profile. I took 25mg a day of aromasin for 5 days waited 2 days then had a blood test (in this case it was 4 days after my test shot).

Oestrogen 132 pmol/L (range <160). Note that this equates to 35 pg/ml (which I understand is higher than optimal). and i can see the water retention
Total Test 31.2 nmol/L (range 9.9 - 27.8) - still too high I suspect, although I do note that this was day 4 of a 7 day IM cycle so it would have declined prior to my next shot
SHBG = 23
Free Test = 977 pmol/L (range 170-670)

MY QUESTIONS

  1. Based on the above total and free test levels, It looks like i can lower my test dose even further. I was thinking moving to 100mg every 7 days. And from what i have read I should move this to 50mg every 3.5 days and go SUBQ (instead of IM) as this lowers aromatisation. Is this correct? does sub-q create less E2. i have no issue with IM shots, happy to stick with IM unless Subq is better to lower E2???
  2. Given this revised protocol, should I move my HCG injections to the day before each shot or the day of each shot? from what i read on here it doesn’t really matter? also As HCG increases E2 and my nuts feel big enough onn 250iu twice a week, can I lower this to 150iu twice a week instead?
  3. I aromatise like a bitch and I shocked that the 25mg day of aromasin still had my E2 so high! i hear aromasin has a short half life so needs to be dosed daily. I would prefer to use aromasin long term due to me needing so much Anastrozole and what it does to my lipid profile (and potential clotting issues). I was thinking using 12.5mg a day of Aromasin? anyone else who has high e2 use that level. Will try this 4 weeks then retest bloods

I do note that with higher E2 my libido is much better than lower e2. so i would rather be on the higher side (but lower than i am now!)

2

Ok so your post is a little confusing. If I’m reading this right, it seems like you change your protocol a lot and then test. That will not give you a good picture of what’s happening. We also find that injecting once per week makes labs difficult to interpret as they are largely dependent on timing.

So you should inject sq twice per week with 50mg. This will give smoother levels of T and makes keeping E2 in range easier. I would stick with 500iu of hcg per week. I don’t fret over timing of the injections. I do E3D. I have no experience with aromasin. So no advice. E2=22 is where most guys want to be, but it sounds like you might feel better at higher levels. You won’t know for sure until you choose a good protocol then STICK to it for 4-6 weeks then re test. Do labs halfway between injections.

3

Thanks I hear you re consistency. I have been consistent with test shots, just reducing dose given high levels. I will now move down to 100mg every week and split this in 2 shots

I did my first subq test shot this week. I am not adverse to either subq or IM. Nether hurt with thin enough needles. I guess the absorption rate of subq is slower. Is this why aromatisation is less? Or is it merely due to taking more frequent and lower dose shots (in which as aromatisation via IM would also be less if shot twice a week)

Ideally I would like to get to the stage where I can use minimal AI. But suspect this will be hard given the way I aromatise

4

Yes on the sq injections. A more steady release leads to less T->E2.

5

Injecting 125 mg/week T
2mg Arimidex/anastrozole per week
Results: E2=49, target is 80 pmol/L

Calculated new anastrozole dose is 2mg/wk x 49/80 = 1.225mg/week

With 125mg/wk T, expected anastrozole dose is 1.25mg/wk. So you are a normal responder.

Inject 50mg T twice a week, SC is smoother
Take 1/2mg anastrozole at time of injection
250iu hCG SC at time of injection
Do labs halfway between injections, always, to eliminate timing artifacts

SHBG will change slowly and affect FT:TT ratio.

6

Thanks Ksman

I should note that the e2 reading of 49 pmol/l was pulled after I did 1mg of adex a day for 10 days.
On 2mg a week of adex with 125mg of test every 5 days I was having high estrogen issues (nipples) hence I took the adex daily then tested (test was day 11 after days on 1mg day)

This is why I felt I don’t respond well to Adex

So I now have adex and aromasin

My last bloods my e2 was way higher after doing 5 days of 25mg day of aromasin

Do you have a preference for adex or aromasin. From the perspective of negative impact to lipid (hdl), but also impact on libido

I have this week moved the t dose to 50mg every 3.5 days. I hope this causes less aromatisation lower dose

I have been taking the aromasin daily. will retest in 4 weeks

I

7

Also I will follow this protocol from now as you have specified

50mg t every 3.5 days
250iu hcg same time

I will try the aromasin for now at 12.5mg every other day and see how I go on this …

If this is not feeling right I will switch back to the adex at the time of t shot