2.5mg/day is the suggested recommended dose when using it as an antineoplastic in women with breast cancer. As an off-label prescription for estrogen control it seems excessive. You should consult with your physician about the dose and/or his rationale for starting you at that dose. From his response maybe you can make the best choice about how much to take and when.
Here are a couple of articles I found that do agree with 2.5mg/day for treatment of infertility associated with hypogonadism secondary to obesity.
The second one does make it seem like E2 went all the way to 0 at that dose, which from reading here I know isn’t ideal overall. But I don’t think my endo will care because it’s a secondary concern to restoring fertility which is the only concern really that he and I are on the same page regarding in terms of treatment goals.
New lab results:
T 406 (348-1197)
E2 7.1 (7.6-42.6)
FSH 15.9 (1.5-12.4)
Since FSH is high, HMG will not be added, and I will have a sperm analysis in one month.
I haven’t been taking the letrozole every day, more like twice a week alongside my twice a week injection.
Looks like you’ve got it working in the right direction. Are you feeling any better? Notice changes in body composition?
You e2 is to low. Try and keep it in the 20-30 range. HCG mono thearpy will produces much more estrogen than exogenous test does. You should try intermittent fasting and increase your physical activity. One easy way to implement the fast is follow your regular square 3 meals (30g+ high quality protein per meal) plan on DAY 1, skip breakfast and launch on DAY 2 and have a huge bowl of veggies, two slices of salmon and two to three spoons of olive oil for dinner and an optional protein shake as a dessert. Repeat day 1 and day 2 for as long as you need to get your weight down. If your not a gym person then get you a treadmill and make it a habit of walking on it for 45 mins 3 or more times a week while u watch your favorite reality show. 
Namenda? Isn’t that for Alzheimer’s disease?
[quote]C27 H40 O3 wrote:
Looks like you’ve got it working in the right direction. Are you feeling any better? Notice changes in body composition?[/quote]
I sort of have this feeling of being on the cusp. I feel better in ways and worse in ways. But mostly I feel like sustaining this as a new normal will lead to positive improvements, such as in body composition. I haven’t been weighing myself or anything, but I do think that my body has been responding to the change. I can’t really say I feel like I have more energy, but I do feel stronger. And I do feel like I’m losing fat.
Mostly by being on the cusp I feel like I’m close to being able to turn some sort of corner and really just grab life itself by the horns, to have enough of the bullshit out of the way to really express personal agency over my life in a way that has been escaping me. So, improvements.
[quote]jb13 wrote:
You e2 is to low. Try and keep it in the 20-30 range.[/quote]
At the moment I’m dropping again from 2.5mg letrozole twice a week to once a week. I don’t really think that makes the most sense, but the pills are so small that splitting them would be tedious. And to think that doc’s orders were one per day! I’d be at 0 if I was doing that. I also think I’m going to change the 2000iu HCG 2/week to 1000iu 4/week to try to smooth out some of the dips and valleys.
I know a whole lot about intermittent fasting and pretty much any other dieting technique. Getting myself to follow them on the other hand is a much different struggle. I know that when I try to go to some extreme of being perfect on some plan then the moment I break adherence I’m lost for months. So at the moment I’m trying to just get myself back to a default of lowish carb/0 fructose. That will help with food cravings generally, and then I’ll be able to keep trying to clean up the diet.
As for exercise I’m still looking at options. Almost joined a nearby crossfit gym that focuses more on the lifting side, but they meet at 7AM which is the dead middle of the night on my schedule. I’d really just like to find a cheap gym with free weights and a pool and go back to a sort of Starting Strength program. Or even just like a water aerobics class to start with something.
[quote]jb13 wrote:
Namenda? Isn’t that for Alzheimer’s disease?[/quote]
I’m taking it off label. I wanted to add an NMDA receptor antagonist, and my psychiatrist was game.
A new sperm analysis was performed Wednesday, still no sight of swimmers.