I’ve been on trt for about 15 months. My doc had me taking 1/2 anastrazole 1/week with my test. 6 months ago had blood test come back and e2 was 22. Perfect. Test was 495. Up from 180. Doc had me increase my dosage of test to one vial a week. No increase of anastrazole. Just got blood work back and e2 was 79!! Explains the irritability and a few other negative side effects (headache etc) I’ve felt the last 3 months. Doc said bump up to 3/4 anastrazole and break it into 1/4 pill 3x week.
Any thoughts on if that is enough? Also, how long should it take to bring the e2 back into the 20’s?
One vial a week, that tells us nothing. What’s the Dosage? Do not describe protocol in units, only mgs.
Example I inject .5mL twice weekly from a 100mg vial which is 50mg twice weekly. What is the testosterone score where E2 is 79 pg/mL and is it using the E2 sensitive LC/MS/MS method designed for male estrogen testing?
You don’t want to base your AI dosing on estrogen labs designed for females.
Hi Mike sounds like you have a pretty smart doc.
anastrazole is very powerful. I would do what he said. You will know if it is enough you have already stated you have high E2 feeling. Those feeling will subside when you hit the right amount on your AI. I’d give 3/4 5-7 days if you don’t feel better up it to 1.
To my previous post I was switched to 200 mg of test per week. 1 injection per week. Total test about 700. I forget my free test. All other numbers were in line. Yes, in line for a male.
We never change the AI dose based on a feeling, we back up our suspicions with the labs because High E2 and low E2 are very similar and if you haven’t experienced both it’s hard to tell which one of those you’re experiencing.
Did he test your SHGB? That is the best way to determine how many shots you need a week. If your SHGB is very high one big shot works best and if your SHGB is low EOD and sometimes everyday is required for best results.
You should be injecting everyday 8-10mg, 15-20mg EOD or TRT won’t work for you… I have low SHBG (18) and if I’m not injecting EOD my results are underwhelming. The only type of person who can get away with injecting once weekly is someone with very high SHBG. Twice weekly is for someone with middle range SHBG.
What happens to a low SHBG guy who injects large infrequent doses is you end up urinating most of the testosterone that’s injected within a 1-2 days and you’re left swimming in estrogen. Estrogen sticks around in the body much longer than testosterone.
If I am not wanting to do an injection daily, what do you think about pellets? They are way more expensive, but vs 365 needles a year, I may reconsider.
Pellets are garbage, your levels will get too high and there won’t be anything you can do about it expect suffer for several months until the pellets wear off. Doctors basically guess how many pellets to insert, hardly ideal. It only cost $12 for 100 syringes, I use the East Touch 27 gauge syringes and inject in shoulders. You could use 29 gauge for daily injections, completely painless.
Another quick question- I’m going to shift to 2x week, and based upon your feedback may jump to EOD.
Looking at the easy touch, do you still draw with a different needle? I just checked what my doc prescribed and I’m drawing with 21g and injecting with 23g, 1 inch.
For shoulders, the 1” seems pretty deep. For shoulders and thighs- can I get away with 1/2”? Also, with the 27 or 29 g- is there a concern with bending? Thanks- just a bit surprised my doc would say 23 g- when it seems 25g is the common size on this site.
27 gauge insulin syringes are typically 1/2 inch which is fine for IM in shoulders and outer quads, I’m 33% body fat and hit muscle no problem. There’s no wasted test either.
Reached out to my doc- inquiring about breaking my T dosage up and potentially doing 2x week, or EOD. Nurse practitioner called back, stated that “they don’t do that”- and that increasing the frequency of my shots will not affect my E2.
Inquired about moving from a 23G to a 25 G needle or 27 G-1/2” so I could alternate in my shoulders. They stated not to do that. They called me back and stated that the injection can only be given in the thigh, glute or “flank” area. That the 25G and 27G are too thin for T, and T is too thick to be injected in those.
This doc specializes in TRT and has been very good up to this point. Any ideas why they would push away from shots in shoulders and push back on changing the G size. Very confusing.
What do you mean they don’t do that, aren’t you self injecting at home? Your doc specializes in TRT and doesn’t even know the basics. This clinic is way behind the times.
Great tactic tying the patient to the clinic like that, they must get compensated by insurance every time an injection is administered.
Over time you will feel less relief with each injection. Throwing that much testosterone into your system it’s no wonder you need so much AI to control estrogen.
Lower more frequent doses could lower the requirements for an AI or eliminate the AI altogether.
I do the injections myself. However, as my medical provider I wanted to inform/ask about any changes before changing the prescribed protocol. Also wanted to know how long the anastrazole should take to bring down my E2.
I’m thinking the nurses are making these calls on their own.
Going to call and try to speak with him directly- as he has always been very good.
To your point- I’m on TRT for over a year now. First 6 months to year- felt amazing. Last 6 months have not had the same benefits.
