Based on the labs you supplied your e2 may be the culprit as it’s relatively high. Most feel best in the low to mid 20’s. Your FT is on the low end which would likely increase by decreasing your e2. You may want to look at your gut health before adding in pharmaceuticals like arimidex/anastrazole.
I added in a massive amount of fermented foods which nearly eliminated my need for an aromatase inhibitor in anastrazole although I’m injecting 50 mg test cyp EOD. Estrogen is metabolized initially in the liver and then second in the gut. If either aren’t optimal, e2 won’t be cleared and will be elevated.
Other blood work like CBC, thyroid and cortisol would be helpful to see as well.
Start researching topics of gut health, leaky gut, intestinal permeability. If you don’t want to see if that could be a contributor, get an ai like anastrazole and dissolve in vodka for micro dosing.
My e2 before fermented foods was around 22-30 pg/ml taking 50 mg test cyp EOD and 1/4 adex EOD. Once I started eating around 1/2 cups of sauerkraut every day (what I prefer, I think Kimchi is gross. I’ve had some fermented carrot blends that aren’t bad as well and plan to begin fermenting my own veggies soon. I also used to drink Kefir, but dairy and I don’t mix all that well, so I dropped it. I also get around 6 tablespoons of nutritional yeast every day, along with 1 cup of raw uncooked buckwheat) and loads of other prebiotic veggies, without making any other changes, my e2 dropped to around 10 pg/ml. My need for adex has drastically reduced the “healthier” I’ve become. By “healthier” I mean reduction of stressors, increasing fermented and prebiotic foods, eliminating toxins and inflammatory foods and reducing body fat.
I added other blood work that i already had done. I do not eat much if any fermented foods. It was not something I had considered. Any other advice given the new lab results I added to my original posting? Thanks @Hostile
Sounds amazing you were able to lower estrogen that much with diet. I was assuming estrogen was the bane of all my problems when i saw that 39 score. Thanks @Hostile
When we see low FT and high E2 we suspect that the problem is impaired liver clearance and AST/ALT labs are of interest. See the highlighted sticky below re effects of some medications.
I do not think that a HPTA restart can work if this is damage from 5-alpha-reductase inhibitor.
But odd to have that and this high E2, so there are two problems.
With TRT you will still need to beat that E2 problem.
Thyroid labs?
Do you use iodized salt to support thyroid hormone production?
Starvation diets can be damaging and can stress the adrenals and elevated rT3.
Note references to thyroid in the stickies.
I did read the sticky regarding damaging hormones. I was having ED problems before propecia though. I am assuming something else is going on. I think my iodized salt intake is low. My cortisol maybe jacked up given im a coffee fiend and dont always sleep well yet exercise a lot. Thyroid maybe messed up? Can you delineate the specific labs needed? Tell me what to do and I will listen. Thank you @KSman
Probiotics have been shown to be ineffective as they rarely make it past the stomach to the intestines. One serving of fermented veggies has the same # of organisms as an entire bottle of probiotics plus they make it all the way to the large intestine.
I agree about attempting to avoid pharmceuticals. I could probably see a 600 total T score naturally if optimized some things and im relatively young (well under 40) so lifelong commitment to TRT is probably overkill and I have never used any steroids or TRT in the past. Is yogurt a good source of fermented food for the gut? and what about Liver Health? Do you think it weighs in as heavily as gut health? Thanks @Hostile
Please measure oral body temperatures to eval overall thyroid function as per the thyroid basics sticky. This is often more useful that thyroid labs. If temperatures are good, labs may not be needed.
If KSMan says to get the liver tests, that’s what I would do. Looking at your numbers, E2 is what I would be concerned about. If KSman thinks it’s possibly due to a liver issue, I’d research that before going straight to arimidex.
Your temps are actually a little low. If I were you I would get 6 readings from 3 days and avoid taking your temp after an afternoon nap which will suppress your body temp.
Post those 6 numbers please to assess if you should pursue thyroid numbers. I would urge you to read and do everything you can to reduce systemic inflammation in your body. That alone will help your gut and liver operate optimally and reduce your e2.