New Bloodwork — Test E and low dose Mast

Pharma
1

TESTOSTERONE, TOTAL
(ng/dL)
Range: 250-1100

Oct 2023 — 632

Feb 2024 — 3554

TESTOSTERONE, FREE
(pg/mL)
Range: 35.0-155.0

Oct 2023 — 79.6

Feb 2024 — 1199.7

SHBG
(nmol/L)
Range: 10-50

Oct 2023 — 48

Feb 2024 — 34.6

PROLACTIN
(ng/mL)
Range: 2.0-18.0

Oct 2023 — 5.7

Feb 2024 — 13.1

ESTRADIOL
(pg/mL)
Range: < OR = 39

Oct 2023 — 25

Feb 2024 — 86

I developed a knot in my lower left pec last week so I had blood work done. I am got back on “Trt” and wanted to try a new protocol after a two year hiatus. I have been administering 200 test e per week divided into 3 injections MWF. I have added 75 mg mast a week to the protocol. Initially - a month ago - I began with 175 test and 50 mg as I have never used mast. The goal here was to see if the mast gave me a boost in energy / mood / libido as I have seen many say it is great for doing so.

Obviously I am a high responder to the hormones as I did not foresee a total test level coming back above 1500. Much less in the 3000s. No AI during this time.

Should I drop both compounds to 125/125?

What should I take to mitigate the lump. I have tamoxifen, exemestame, and anastrozole on hand.

2

  1. I’d suggest dropping the test and increasing the mast… say 125+125. That should lower your E2 and alleviate the gyno.

  2. I’d suggest switching to daily subQ injections with an insulin pin, ie 18mg each for the dose above. This should be a very low volume injection, can mix together for about 0.15cc total oil.

  3. If your gyno doesn’t regress, add exemestane starting at 6.25 three times a week. It’s much easier to crash your estrogen on anastrozole and it can also rebound excessively when stopping it; it’s also worse on HDL.

  4. Raloxifene is the best SERM for gyno, consider buying some if needed. Tamoxifen is a complex prodrug with long lasting metabolites that act as both AI & SERM.

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3

I am surprised that MWF injections weren’t sufficient but I will make the switch.

I thought I had ralox sitting around somewhere but I can’t find it. I’ll
Order some today. Thanks for the insight.

I didn’t realize that about anastrozole. Should I wait a bit to begin the exemestane? Seeing that I took some of the anastrozole last week to know down the E?

Lastly do you think any of this could be caused by the elevated prolactin? I have prami here but am hesitant to take it as I know it can be harsh. I’ve never had a need for an AI before. Small of this is pretty new to me. After last week’s effort I did expect the know to do side a bit but now I think it’s still growing

4

Start using tamoxifen 20mg/day. Raloxifen is preferred but tamoxifen is nearly as effective. AI (aromasin, arimidex) won’t help with the gyno.

As gynecomastia in men presumably results from an imbalance between androgen and estrogen action, aromatase inhibition was tested as a treatment for gynecomastia in boys. Treatment with anastrozole daily for 6 months, however, did not result in a significant improvement compared with placebo [67]. This is in accordance with the data summarized in a recent review [68], describing similar responses to placebo, tamoxifen and anastrozole in a number of observational studies. Anastrozole was also studied in a group of prostate cancer patients treated with bicalutamide, an androgen antagonist. A dose of 1 mg daily appeared to be mildly effective against the appearance of gynecomastia. Tamoxifen was much more effective, however, in the prevention of gynecomastia in these men [69,70]. Due to these disappointing results, aromatase inhibitors are not recommended as a first-line treatment for gynecomastia in men.

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Thanks rusty. I began 40 per day (20 and 20) 5 days ago. I’ll use 20 moving forward. I took the anastrozole to knock down the circulating estrogen as I didn’t want it to “feed” the tissue in case the tamox didn’t bind or wasn’t effective.

Did you see my prolactin levels? Should I take anything to lower those?

6

Your levels seem to be in range. You could take caber for two weeks, 0.5mg twice per week and see how that makes you feel. Caber works quickly (within hours) and has a long half-life so I wouldn’t go above that dose and for too long. I personally associate high prolactin with libido issues.

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@rusty_hammer would You have any insight to why my total test levels got this high? I am assuming the gap between total test and estrogen facilitated the gyno?

I have primo, proviron and prami on hand btw. I do not have caber but I could order it.

When the knot appeared and I saw the bloodwork I considered switching out the mast for primo. I’ve run 150 test 200 primo before with great results and no issues with estrogen. What are your thoughts on making a switch

8

You respond very well to test. You probably don’t need anything above 100mg/wk.

Your estrogen isn’t particularly high in relation to your total and free T. I don’t know what facilitated the gyno. Are you absolutely positive it is actually gynecomastia?

I don’t think it’s wise to add any more drugs to the mix. Get your test dialed in to true TRT levels and take the tamoxifen for the gyno. It’ll take a while for it to work but it should, unless we’re talking about stubborn childhood gyno.

Whatever you choose make sure that your mast is really mast and primo is really primo. Are you using ugl sources or actual pharma grade? These two compounds (especially primo) are often faked with cheaper substances.

If I were you and had a total T level (measured at trough) over 3000 ng/dl on 175mg/wk I would definitely drop my dose to 100mg and see what numbers I get and how I feel. You are less likely to use an AI at a lower dose and your e2 will creep down to a more acceptable number.