Briefly: 44 years old, fit but not muscular, have had low T symptoms and numbers for a few years. Started taking Androgel a few years back (through my family doc), and gradually upped the dose until my total T level was in normal range (max was 577 ng/dL). However, started having symptoms of excess estradiol, so started taking Arimidex 1 mg three times a week (I’m a doc, so I can prescribe myself that, but not the Androgel). Through all this, never checked any labs except total T.
Moved cities, and ran out of Androgel and didn’t have a new doc, so finally went to go see him and have labs checked. I used no T replacement for 1 month prior to my labs, although I continued the Arimidex as above. I thought this was interesting:
Total T 598 ng/dL (ref range 240-950). This is actually higher than it ever was when I was on T!
Free T 12.4 ng/dL (ref range 9-30)
Estradiol <15 ng/L (ref range 15-40 for male)
So, I’m clearly blocking Test>>>Est quite well. The total T looks reasonable to me, but why is my free T so low in comparison (near bottom of range)? And am I blocking aromitase too much (very low estradiol)? Should that worry me?
Now of course my doc (who knows exactly what I’m doing) is reluctant to prescribe Androgel because my total and free T are “in range”. If I could, I’d start taking a lowish dose of Androgel and back off on the Arimidex a little to try to bring total and free T into the upper ends of the range and sneak the estradiol into measurable at least. Ideas?
Do you have any issues with your joints aching or low libido with your E2 below 15 ?
The 1mg, 3x per week with no T sounds really high. Everyone reacts differently as I am sure you know, but most guys on HRT or higher doses of Test use .25mg every other day or .75mg per week total. The formula in the stickies on E2 points to about 21 as the sweet spot for E2, yours being lower than 15 could be the problem.
You should definately take a look at SHBG. It’s a pretty inexpensive test If it looks ok you should be good to go. You could test BAT if you really wanted some reassurance. BAT would probably be a good replacement for Total T, Free T, and SHBG, but it just doesn’t seem to be as common.
Adex is not a long term solution finding it why it could be elevated would be the most logical steps. Adex it self has been show not to be successful used alone . Proper evaluation of thyroid, adrenals, and lifestyles would probably were you would find your answer most likely.
Thanks for the replies. I will definitely back off on the Adex as you suggested, PKNY. I thought I had read about people taking 1 mg/day, just like the breast cancer patients do, which is why for a stab-in-the-dark I started at about half of that.
I’m having levels checked again in 3 months, so we’ll see if that brings my E2 back up into (low) range, and what happens to the other numbers (I’ll get him to add either bioavailable T or SHBG as well). If the E2 comes up, but the free T drops, then I’d probably be able to convince him to put me back on Androgel while I continue the Adex as supplemental, not primary, therapy.
BTW - the symptoms were low libido and trouble recovering from exercise, both of which are as good if not better now than they were when I was on T, but maybe not where I’d like them to be.
[quote]tbartman wrote:
Thanks for the replies. I will definitely back off on the Adex as you suggested, PKNY. I thought I had read about people taking 1 mg/day, just like the breast cancer patients do, which is why for a stab-in-the-dark I started at about half of that.
I’m having levels checked again in 3 months, so we’ll see if that brings my E2 back up into (low) range, and what happens to the other numbers (I’ll get him to add either bioavailable T or SHBG as well). If the E2 comes up, but the free T drops, then I’d probably be able to convince him to put me back on Androgel while I continue the Adex as supplemental, not primary, therapy.
BTW - the symptoms were low libido and trouble recovering from exercise, both of which are as good if not better now than they were when I was on T, but maybe not where I’d like them to be.[/quote]
Everyone has different reactions to adex. I take the liquid version and over respond to it.
Using Androgel 4pmps 1.62 per day I use only 4 adex (1/8 of a pill) drops every other day. I followed the ratio described in the ESTRODIAL sticky when I first started with the adex, and the amount recommended crashed my E2. Aching joints, and low libido. When my E2 is between 20-30 I feel really good, emotionally, and my libido is back to where it was when I was about 25.
If you search the forum you can find people talking about their experience with adex, how it effects them and at what does. The posters KSMAN, VTBALLA, BBB and BROOK are especially knowledgeable on the subject.
Getting my E2 down with liquidex made a huge difference for me. The increase in T might have been modest, not sure. Total T went up 100pts and free T doubled, but I also added Mag gel and Vit D between tests that included T.
Just doing the liquidex and getting E2 from 41 to 20 was a noticeable difference. The biggest being that I was no longer crashing every day around 4pm. This was annoying when not traveling for work and downright dangerous when traveling (by car). Someone with otherwise healthy hormone levels may not have seen the same relative improvement.