HRT: Anyone Else Been Through This?

Training Over 35 Lifter
1

As I have posted before I have been on TRT for about 3.5 years.
I am now 38,
Last year I was on 1.5 CC of 100mg per ml every 2 weeks, this was raised because my energy was just crap, come to find out that the hyper tension med I was on was just zapping my energy…

My Urologist saw that I had developed Polycythemia, we surmised that my hormone level intake was too high, we reduced it to 1cc eow, but I changed it to .5 weekly and it seemed to stabilize my energy, all was good.

I was tested a few months later and my levels had dropped a bit, he did not seem overly concerned about it, I live at relative high altitude and was on hormones is what he said could be the cause.

FFD to 3 weeks ago and my numbers are back up again to 63.6, I was told they should be around 47.

I go to see my Gen Prac and she sees the numbers and unlike my Urologist gets 30 shades of concerned, she is a bit hyper about everything but she is a really good doc.

I get refereed to an Oncologist and saw him on Monday.

He tells me that it is all because of the hormones, he recommends me to get MORE blood work and Therapeutic Phlebotomy for the next 4 weeks, the blood draw is to check my levels, if they are still up then I get a pint taken out of me.

He wants me not to take any vitamins as to deplete my iron and that should take my levels down where they should be and keep them there… There may be another cause of my kidneys putting out a hormone that would cause this also he said, he ordered lab work.

THEN he goes on to tell me that we need to get my HORMONE LEVELS AS LOW AS POSSIBLE, a level I could live with…>??>?

Ok here is the deal,

I have a major PT test and Police academy coming in August, I have been hired on pending this test to go to FLETC.

MY issue is that if you start jerking around dropping my hormone levels really low a few things will happen…

My training will be almost useless, running weights etc, I will rebound with weight gain and have crap for energy, basically throwing me back to the way things were 3 years ago, NOT ACCEPTABLE. My current job is over in August as they are doing away with my department, I can not afford not to get this Police job.
I have worked around Gyms when I was younger and know what happens when you go off this stuff cold, your body does not take it well. I can not afford this as close as I am.

I did my first blood draw yesterday and it sucked big time, The Onco sent a memo that if this does not clear up I would have to go weekly… Ain’t gonna happen, I will not do this weekly for god knows how long.

Also now I am afraid of getting DQ’d by the med board at FLETC for my blood counts etc…

Also I do take 1/4 of a Armimidex 1 mg tab very few days, would this contribute to the problem? Does Adex have side effects of long term use?

Has anyone else been through this?
Were there alternatives?

What happened…

Feel free to email me or message me if you do not wish to tell in public…

As always I appreciate the knowledge and help I have always found here…

Have a great day…

Teufey

2

Well damn!
The only input I can give is that I do know what it’s like going off T cold turkey and I would not wish it on anyone.

Another idea is to post this in the Steroid thread as well.

Good luck.

3

You might have to go underground. I have been on TRT w/a Dr. for 6 months now, and I know I am not going back. even if I had to take matters into my own hands

4

I just had a Therapeutic Phlebotomy a week ago and have not seen my new lab results yet. I was told I had to cut back on my doses also. I presently take 120mg a week and will cut back to 100mg a week if this does not work. I know Arimidex will raise your T levels. I cut this back to .25 every 4 days. I can do this now because I am taking a lot less T-CYP. I would cut back slowly and see if you can cut back on the arimidex as well. I also do HCG 2 times a week. I would also cut back a little bit for 4-5 weeks and see how things are and if needed keep doing this untill things come down this way it isn’t a big drop and you will get use to it slowly. I think for myself at least it will take a little while longer to get all things going good and get dialed in.

5

[quote]jakeman124 wrote:
I know Arimidex will raise your T levels. [/quote]

I thought A-dex would control E2 levels and provide a better T-E2 ratio, not actually raise T levels. Am I wr… wr… wr… - incorrect on this?

7

[quote]Chushin wrote:
63longroof wrote:
jakeman124 wrote:
I know Arimidex will raise your T levels.

I thought A-dex would control E2 levels and provide a better T-E2 ratio, not actually raise T levels. Am I wr… wr… wr… - incorrect on this?

Adex used alone has been shown to increase T. Not sure what happens if it’s used WITH T.[/quote]

When normal, adex reduces E, that increases gonadotrophins, T&FT increases. Less E also reduces SHBG that then allows for higher FT ratios.

When on TRT, the HPTA is shutdown and the above will not happen. Lowering E still lowers SHBG - improving FT. T should not change by any significant amount.

In both cases, lowering E can improve the T:E ratio. That alone can have strong effects on mental and libido aspects, as well as sensitivity of the penis. If natural and hypogonadic, T is low and E could also low for some. In that case, adex should be used with caution or not at all. It might backfire and make one feel worse. For those with low T and moderate or high E, adex could do wonders by providing relief from estrogen dominance. The same can happen for those on TRT with high T and elevated E [35pg/ml or higher.

When T is very low, nothing but TRT will provide relief from a cascade of morbidities created by this state. If things are left in this state for a long time, permanent damage can occur. Otherwise many pathological states and processes caused by low T can be reversed by effective TRT; which must include control of estrogens.

Note that E blocks T at [some?all] T receptors. Less E simply makes what T one has work better. This should apply to anabolic reponse as well.

8

[quote]Chushin wrote:
63longroof wrote:
jakeman124 wrote:
I know Arimidex will raise your T levels.

I thought A-dex would control E2 levels and provide a better T-E2 ratio, not actually raise T levels. Am I wr… wr… wr… - incorrect on this?

Adex used alone has been shown to increase T. Not sure what happens if it’s used WITH T.[/quote]

To the OP
A hematocrit of 63 is an impressive accomplishment. In fact, too impressive to attribute casually to T alone.
Care to share your white blood count and platelet count?–it is important for my next post to you.

Yes, phlebotomies because you are dangerously high.

Yes, more lab work because your doc wants to get a JAK2 genetic test. Don’t worry, it will be normal.

Re: Chushin and arimidex. I have personally raised men’s red count to polycythemic levels–unintentionally–with arimidex alone. Their T levels return to normal mid-range levels, without T, and they can get abnormal red counts. And yes, Arimidex with T further raises the T level, because of decreased conversion, and, decreased local estrogen in the hypothalamus and pituitary.

Which raises a question for the OP–after 3 years, you may need T, but did you need T initially? Can’t fix it now, but some men need just a brief exposure to an AI like arimidex, and they are no longer hypogonadal.
I would consider, with your doc, holding the Arimidex…continue taking the T to eugonadal levels, and see if your red count eventually comes down to, say, 58. (It would take 3 weeks or more without the phlebotomies, if it would work at all: hence my recommendation for the bloodletting.)

Why?
Without intending to cause a firestorm here, it is not all about circulating estradiol.

We choose to measure circulating estradiol, as though it was the proximate moderator of tissue effects, but a more important function of aromatase may be as a paracrine modulator. By this I mean that in tissues, T turns to E locally, and causes changes. The physiologic (not pharmacologic) levels of circulating E are not important in many tissues. For example–no proof offered–how could Arimidex cause polycythemia without elevating T to supraphysiologic levels? Estradiol itself directly lowers red cell production. I speculate that Arimidex is lowering a local aromatase, leaving T unopposed to potentiate erythropoietin in the marrow. Zippo! Polycythemia!
(If anyone is interested, Arimidex does not commonly cause polycythemia in women. By my speculation, they do not have enough T to potentiate the erythropoietin.)

(If asked, I will provide other examples–proven–but just consider for a moment: it is possible that estradiol serves as a surrogate measure of events, mediated by aromatase inhibition, that happen within certain tissues, and circulating E level is not the cause of those events directly.
(As for KSman’s thoughts about estradiol blocking T-receptors, I would like to review some examples–which tissues and so forth. Receptor chemistry tends to be very specific, with little crossover, except when it isn’t.)

9

Dr. Skeptix,

Based on my interpretation of your post, b/c the estradiol is specific to certain tissue and their receptors one who suffers from high estradial symtoms could treat these symptoms w/ nolvadex?

Am I right in assuming that the nolvadex blocks reception of the estradiol and would therefor eliminate the high estradiol symptoms without the risk of knocking estradiol too low, the way we sometimes see w/ arimidex treatment?

10

I’m not the Dr. but it would depend on what “symptoms” you’re talking about.

One of the biggest issues with estradiol is its action as an androgen receptor antagonist and SERMS have no effect on that.

11

[quote]til_i_die wrote:
Dr. Skeptix,

Based on my interpretation of your post, b/c the estradiol is specific to certain tissue and their receptors one who suffers from high estradial symtoms could treat these symptoms w/ nolvadex?

Am I right in assuming that the nolvadex blocks reception of the estradiol and would therefor eliminate the high estradiol symptoms without the risk of knocking estradiol too low, the way we sometimes see w/ arimidex treatment?

[/quote]

As generalities go, the answer to both questions is no.
Tam acts like a weak estrogen on many tissues.
It has different blocking effects for alpha and beta estrogen receptors.
Different tissues have different tamoxifen effects–in men. So it depends what we are talking about. The effects are not always predictable, so one looks up the literature for particular questions.

12

[quote]happydog48 wrote:
I’m not the Dr. but it would depend on what “symptoms” you’re talking about.

One of the biggest issues with estradiol is its action as an androgen receptor antagonist and SERMS have no effect on that.[/quote]

On that first paragraph, agreed.

This is where I need to broaden my education.

Can you give me specific examples, since as a general rule, it is more often a question of weak competition than of antagonism?

If E2 is a competitive binder with T or DHT for a receptor site, say in a glass-dish experiment–it may be much weaker–less avid–in real tissues. So at physiologic levels (not pharmacologic doses) E2 may not have any discernible effects.

I could not, for example, find a direct study of E2 blocking androgen receptors in muscle, under physiologic conditions. I would appreciate it if you could show me your sources.

(Then, as usual, there is issue of definitions. For example, in a man’s brain, E2 is a greater inhibitor than DHT of LH secretion; but we don’t call those brain receptors androgen receptors.)

13

Teuf, this is both an interesting thread and I feel your pain having to have stopped HRT cold recently due to high PSA.
All sorts of smart guys here giving you feedback but a couple basics seem overlooked. First, are you a smoker? If so, STOP immediately as this increases Hct significantly.
Second, nobody discussed your T levels. If your 1.5cc T cyp shots were getting you up around 1000-1200, then if the phlebotomies got your hct down to high 40’s you could probably get by short term with HALF your former dose. That would leave you, on a rough guess, near a 500 T level and still be functional.
Third, and especially if you have to do this “underground,” you would want to cut that dose in half and take it weekly instead of bimonthly, giving yourself a more stable blood level.
Of course, you will have to decrease your adex dose if you do this or you might bottom out your E2. Doc