Before I get started, I apologize if I’m posting this in the wrong place. I’m new to both TRT and forums.
Hoping to get some advice on a couple things from all of you lovely T Nation members.
Some background on me - I’m 29, have been lifting religiously for about 11 years, with a 1–2-year hiatus that ended about 6 months ago. I’ve always had fairly low T but wanted to stay away from HRT as long as I could, while also seeing how high my T could get naturally through a well-rounded plan as it relates to diet, exercise, etc.
At the end of 2022 low T symptoms were still present, and arguably getting worse, so I decided to get my levels checked and they came in at 201 ng/dl with estradiol at 11.2 pg/ml. Decided to move forward with TRT and have been taking 200mg of Test C weekly split into two 100mg doses and 75 units of HCG weekly split into three 25-unit doses.
I’ve now been on for about 9 weeks, and had my levels checked again to see where I stood before my prescription refill since my symptoms have slightly improved but nothing drastic.
My most recent bloodwork was done about 24-30 hours after my last injection so should be close to peak ranges based on what I was able to gather about peak vs trough ranges online. Everything came back solid, and T was at about 896 ng/dl. The only concern that came back was that estradiol came in a bit elevated at 72.7 pg/ml.
My question is primarily surrounding taking an AI or not considering my estradiol is a little higher than ideal. I’ve done plenty of research and have heard the arguments against blocking estrogen, especially if no symptoms are present, but wanted to get some educated opinions based on the context of my situation.
My doctor is recommending taking .25mg of Anastrozole twice a week to get my E in reference range.
It takes more time, and it isn’t a cure all. I expected more TBH. The biggest thing was the impact to my physique. I didn’t get better focus, or much energy that I wanted.
It’s a reasonable starting dose. I wouldn’t be adverse to trying it and seeing.
I’d also recommend that when starting you just use Test. That way you know what Test does for you. With HCG you have two variables. HCG can raise E2.
So if it was me, I’d drop the HCG for now, and hold off on the AI for now. I’d do another few months on just Test and see the labs and how you feel. From there adjust. BTW, my E2 is similar and I don’t have negatives from it. High E2 seems to cause more issues if Test isn’t also high. With Test at good levels many do fine with high E2 (but not all).
Please do not take this wrong. You’re nine weeks in and you have a doctor advising you. Your first labs are back and you turn to the internet for “research” and advice from strangers. You should have this conversation with your doctor, and, together, come up with a plan after considering the available options. If you have, then this was not explained well to you or you simply do not trust your doctor. If so, get another one.
I’ve experienced this with a few guys. Not often, but I address this at initial consultation now so it does not come up later. Previously, I’ve told guys they need to decide who they want to be their doctor. This, of course, would be dependent on what crazy idea they have obtained from the internet.
Having said that, I would not take a drug if I was feeling good with no symptoms. I would try to get a good explanation as to why I should. If I cannot, or if it does not make sense, I’d move on. Good luck with whatever you decide.
Men on TRT who have no symptoms with high estrogen usually report a decline in the way they feel after starting an AI. Some men are born with a genetic component that allows for high estrogen without issues.
I appreciate your response and can see what you’re getting at. Like most things in my life I follow the philosophy of - if I don’t know something, I take expert advice and “trust but verify”.
I posted this to get personal opinions and anecdotal information, so that when having this discussion with my doctor or any other healthcare provider I’m better equipped to have a productive conversation that also includes other patient’s experiences.
Doctors can miss the mark, just like anyone else in any other profession. So, I try to take in all the information I can, to make an informed decision that I feel is best for me.
It’s a little more complicated than missing the mark, there is no sex hormone training in traditional medical schools. They talk about male reproductive symptoms for less than an hour and move on to other stuff. You can’t learn much in the span of less than an hour.
Sex hormones, TRT is a niche market and pales in comparison to other more common diseases.
There’s a saying, if your medical problem isn’t in your doctors top 10 greatest hits, your experience is most likely going to be a bad one.
While your overall point is not off base, this is not close to being accurate. Of course more time and detail on the subject would be nice, but it is taught. The problem is what is being taught.