I have been diagnosed with Idiopathic Secondary Hypogonadism. I am working with an endocrinologist to get this problem dealt with.
He first started me on Clomid dosed at 50mg on Monday, Wednesday, and Friday. This got my total testosterone up to 541 ng/dL. It also got my Estradiol up to 57 pg/mL which is just outside of the upper limit of 53.
He then put me on Nolvadex at 20mg ED, in addition to the Clomid. This got my testosterone up to 691 ng/dL. My Estradiol then went up to 67 pg/mL!
I have noticed that ever since I start treatment, my strength has been way down despite having nearly tripled my testosterone. I’m a competitive powerlifter and this is unacceptable. Are the elevated levels of Estradiol perhaps causing this? Should I look into getting an Aromatase Inhibitor?
Depending on what your starting level of estradiol was before any treatment, it might even be the case that all you need is the aromatase inhibitor at a dose putting you to low-normal.
However if you were low-normal or rather little above it in the first place, then that alone could not be expected to do the job in that case.
Depending on what your starting level of estradiol was before any treatment, it might even be the case that all you need is the aromatase inhibitor at a dose putting you to low-normal.
However if you were low-normal or rather little above it in the first place, then that alone could not be expected to do the job in that case.[/quote]
My starting level of Estradiol was 44 pg/mL which I believe is high-normal.
I’m going to look into an aromatase inhibitor. Would it be safe to use Arimidex with my current stack of Clomid and Nolvadex? What would be the best starting point for dosing?
In the case where someone has already used Arimidex and been pleased with it in their case, having no problems, then very good, there is no reason to switch to a different AI unless it is a reason such as cost or availability or simple curiousity.
But if that’s not the case, then I think it is better to use letrozole, as Arimidex has a signifant incidence of problems and it seems to me this is much less the case with letrozole.
With letrozole, if using the AG product, I’d start with 8 drops per day (about 0.36 mg) with 24 drops on the first day so as to promptly get levels to about the steady state level, and then after a few weeks test for estradiol and adjust as may be needed.
If using Arimidex, perhaps start at 0.5 mg every other day, but on first day take 1 mg.
Once you have a dosing putting estradiol at low normal, personally I’d try dropping either the Clomid or Nolvadex and after a few weeks test again for both E2 and free T, and see if this reduction worked fine. If it did, then as a next step I’d try dropping the other SERM to 50% dosage, and as a final step (if that worked out OK) try dropping it entirely.
In the case where someone has already used Arimidex and been pleased with it in their case, having no problems, then very good, there is no reason to switch to a different AI unless it is a reason such as cost or availability or simple curiousity.
But if that’s not the case, then I think it is better to use letrozole, as Arimidex has a signifant incidence of problems and it seems to me this is much less the case with letrozole.
With letrozole, if using the AG product, I’d start with 8 drops per day (about 0.36 mg) with 24 drops on the first day so as to promptly get levels to about the steady state level, and then after a few weeks test for estradiol and adjust as may be needed.
If using Arimidex, perhaps start at 0.5 mg every other day, but on first day take 1 mg.
Once you have a dosing putting estradiol at low normal, personally I’d try dropping either the Clomid or Nolvadex and after a few weeks test again for both E2 and free T, and see if this reduction worked fine. If it did, then as a next step I’d try dropping the other SERM to 50% dosage, and as a final step (if that worked out OK) try dropping it entirely.
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Isn’t it true that Clomid and Nolva can both raise SHBG?
I know that having high estradiol can affect this as well, but would it make more sense to trying taking something that will lower SHBG?
Unfortunately my doc didn’t test my SHBG levels.
In the case where someone has already used Arimidex and been pleased with it in their case, having no problems, then very good, there is no reason to switch to a different AI unless it is a reason such as cost or availability or simple curiousity.
But if that’s not the case, then I think it is better to use letrozole, as Arimidex has a signifant incidence of problems and it seems to me this is much less the case with letrozole.
With letrozole, if using the AG product, I’d start with 8 drops per day (about 0.36 mg) with 24 drops on the first day so as to promptly get levels to about the steady state level, and then after a few weeks test for estradiol and adjust as may be needed.
If using Arimidex, perhaps start at 0.5 mg every other day, but on first day take 1 mg.
Once you have a dosing putting estradiol at low normal, personally I’d try dropping either the Clomid or Nolvadex and after a few weeks test again for both E2 and free T, and see if this reduction worked fine. If it did, then as a next step I’d try dropping the other SERM to 50% dosage, and as a final step (if that worked out OK) try dropping it entirely.
[/quote]
Bill would this be a normal dosing protocol for letro dosing off cycle ?
Ive been interested in it for a while ever since you mentioned it, but I was unsure of the dosage when not on cycle.
If you’ve been displeased with definition/vascularity of the legs, chest, and/or upper arms you may be very pleased with the results of estrogen control.
[quote]Bill Roberts wrote:
If you’ve been displeased with definition/vascularity of the legs, chest, and/or upper arms you may be very pleased with the results of estrogen control.[/quote]
How long does a low dose AI like Arimidex have to be used to notice body composition changes? Also can Arimidex cause joint pains?
[quote]Bill Roberts wrote:
If you’ve been displeased with definition/vascularity of the legs, chest, and/or upper arms you may be very pleased with the results of estrogen control.[/quote]
How long can such a dose be used ?
If coming off, would you simply use an SERM to prevent any rebound effects, or would suppression not be significant at the dose ?
I don’t know of a reason why not indefinitely, particularly with letrozole.
I don’t think there is a rebound effect from discontinuing.
As for suppression, the reverse is the case. Free testosterone increases because the pituitary and hypothalamus are less suppressed with estrogen being low normal than mid or high normal. (Assuming that the comparison is to those values. If already low normal then no reason to do this.)
[quote]Bill Roberts wrote:
I don’t know of a reason why not indefinitely, particularly with letrozole.
I don’t think there is a rebound effect from discontinuing.
As for suppression, the reverse is the case. Free testosterone increases because the pituitary and hypothalamus are less suppressed with estrogen being low normal than mid or high normal. (Assuming that the comparison is to those values. If already low normal then no reason to do this.)[/quote]
I would intend to stay on indefinitely, but Id still like to know hypothetically about the suppression of estrogen rates that might lead to rebound.