TRT and Estrogen

Pharma / TRT Testosterone Replacement
1

Hello everyone
i’m new to TRT 5th week
looking for your input recommendations
specially for estrogen as it seems i will have to monitor it

i started 1 ml per week (100mg per week some call it)
after 3 weeks on day 6th my blood test showed
Testosterone, Total, S 435; free 20.9
estrogen
Estrogens Total Calculation 86.1
Estrone By TMS 47.8
Estradiol by TMS 38.3

after that doc put me on
1 ml per twice a week total 2 ml (200mg)
anastrozole 1mg tablet = 1 per day
clomiphene citrate 25 mg 1 per day

i dont really seem to be losing weight, feel fat and bloated with water
i did put some muscle on
would this work to control my estrogen?
should i do anything different?
Thanks Guys!

2

Your T and AI protocol looks great. Actually, it’s exactly what’s recommended in the stickies. The Clomid is the likely cuprit for the water retention and bloat. 25mg per day is a very high dose, most guys usually take 25mg EOD, and probably the most common dose is 12.5mg E3D. Keep at it.

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3

1mg anastrazole looks excessive… I think the typical amount most recommend here is 1 mg per week, broke up into doses to be taken with your injections.

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4

doc said i can do anastozole 1 mg every other day
repeat test in 6 weeks to see where i’m at
should i continue or lower the dosage of both?

5

Missed this in my first read. That much AI will absolutely crash you. Women with breast cancer who need E2 to be zero typically take 1mg a day. The goal of an AI in regards to TRT is to control E2, not eliminate it. I’d get clarity from your dr and a fix asap. Unfortunately prepare yourself to feel unbareably terrible until it gets sorted out.

6

Thank you guys soo much
Should i switch to anastozole 1 mg per week splitt to 2 ?
Take it same day as T or just before?
Somewhere i read that anastozole takes sometime to work
Thanks again

7

You should be able to test a little earlier than 6 weeks - If you’re messing around with stuff, 3-4 weeks should be good enough to go get your bloods re-measured so you aren’t needlessly feeling poorly for additional time trying to dial in.

I can’t speak exactly to the TRT since I’m just on clomid + anastrazole right now, but the half life of anastrazole is 46 hours, so if you’re injecting twice a week, you may just take it with your injections.

I haven’t noticed any difference in the first two weeks I’ve been on the AI with clomid yet, have heard mixed reviews on how long it takes to notice the effects of the AI kicking in.

8

The general rule that I’ve read is 1mg AI per every 100mg of T. Also, taking the AI at the time of injection seems to be the most common protocol primarily because it’s easy to remember. In your case, you’d most likely inject 100mg on Monday and take 1mg AI, then inject the remaining 100ml on Friday and take another 1mg AI.

One complication that you may want to look into is the AI vs Clomid. When used alone Clomid stimulates the HPTA which in turn stimulates LH production within the testes which in turn stimulates natural T production. When LH gets too high the T produced converts to E2 within the testes, and unfortunately an AI can’t help at that point. Read the stickies it’s all covered there. However, since you’re injecting and only using Clomid to keep your testes alive you may be fine but something to read up on.

Whatever you do, listen carefully to your body. If you pay attention it will tell you what direction to go in. Again, based on my understanding I would expect your E2 to crash based on the high AI dose. Read up on low E2 symptoms, pay attention to your body, talk to your Dr., hopefully you’ll get dialed in soon.

9

As other have already stated, be careful about crashing your E2. Know your low e2 symptoms because if you crash it, your gonna feel like crap, not to mention you WILL get sick.

10

Some guys feel like shit with clomid, quite quickly.

Too much of a SERM [clomid] can really increase T–>E2 inside the testes and anastrozole cannot manage that inside the testes.

Try 12.5mg clomid and test LH/FSH later to see what it is doing. If these >6.0, reduce dose.

Get T as 200mg/ml and inject .25ml twice a week. You can inject subq for smoother levels and less muscle damage.

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

11

thank you guys for the info.
i been reading a lots of great info on this side, it scary how little doctors know and want to help you
i will post all my tests here maybe you see something off
i will monitor my temp to see my T3 ok
i will post tests after TRT 3 weeks and test before i went on T replacement

Few things about me: before TRT
gaining weight easy- diet, workout program, nothing helped went from 205 to 270, lost 10 gain 12
lack of energy and desire to do stuff, some depression?
im 43, active, body fat 30%, 180 lb muscle, strong bones (dexta fit scan)
sleep apnea- using machine cpap and oral device
problem sleeping, insomnia, waking up with headache
sex ok- loosing interest
hard time losing weight, felled like jello and fatty around neck, hard to put muscle on

hope im doing it right, as i dont want to waste you time with my BS
@KSman

12

TEST AFTER 20 days on TRT 1ML per week

Testosterone, Free, S 20.9 4.46 - 17.1 ng/dL
Testosterone, Total, S 435 240 - 950 ng/dL

Estradiol by TMS 38.3 10.0 - 42.0 pg/mL
Estrone By TMS 47.8 9.0 - 36.0 pg/mL
Estrogens Total Calculation 86.1 19.0 - 69.0 pg/mL

FSH 0.6 1.3 - 19.3 mIU/mL
PSA 0.6 0.0 - 4.0 ng/mL
LH 0.6 1.2 - 8.6 mIU/mL

HDL Cholesterol 39 mg/dL Final
Cholesterol, Total 229 110 - 200 mg/dL Final
Triglycerides 166 1 - 149 mg/dL Final
Non HDL Chol 190 <130 mg/dL Final
LDL Cholesterol 157 0 - 99 mg/dL

WBC 7.5 4.0 - 11.0 K/UL Final
RBC 5.28 4.50 - 5.90 M/UL Final
HGB 15.8 13.5 - 17.5 g/dL Final
HCT 47.6 41.0 - 52.0 % Final
MCV 90.2 80.0 - 100.0 fL Final
MCH 29.9 27.0 - 32.0 pg Final
MCHC 33.2 32.0 - 37.0 g/dl Final
RDW 13.8 11.0 - 15.0 % Final
PLT 213 140 - 400 K/UL Final
MPV 7.5 7.4 - 10.3 fL Final
Neutrophil % 58 % Final
Lymphocyte % 31 % Final
Monocyte % 8 % Final
Eosinophil % 3 % Final
Basophil % 1 % Final
Neutrophil Absolute 4.3 1.8 - 7.7 K/UL Final
Lymphocyte Absolute 2.3 1.0 - 4.0 K/UL Final
Monocyte Absolute 0.6 0.0 - 1.0 K/UL Final
Eosinophil Absolute 0.2 0.0 - 0.7 K/UL Final
Basophil Absolute 0.0 0.0 - 0.2 K/UL Final

13

test before TRT

2017
Testosterone, Free, S 13.6 4.46 - 17.1 ng/dL
Testosterone, Total, S 310 240 - 950 ng/dL
2016
TESTO (tfs), FREE 7.95 1.26 - 16.81 ng/dL
TESTOSTERONE TOTAL 241 240 - 950 ng/dL

thyroid-stimulating hormone (did this in europe 07-2017)
TSH 1630 ulU/ml 0,27-4,2
FT 4 1,11 ng/dl 0,93 1,71

magnesium 2,02 mg/dL 1,6 2,6
iron 103,00 ug/dl 60 160
sodium 144,00 mmol/l 134 145
potassium 4,77 mmol/l 3,3 5,2

Glucose 95 70 - 99 mg/dL Final
Sodium 140 136 - 144 mmol/L Final
Potassium 4.2 3.3 - 5.1 mmol/L Final
Chloride 106 95 - 110 mmol/L Final
CO2 27 22 - 32 mmol/L Final
BUN 22 8 - 20 mg/dL Final
Creatinine 1.16 0.50 - 1.50 mg/dL Final
Calcium, Total 8.9 8.5 - 10.5 mg/dL Final
ALT 36 17 - 63 U/L Final
AST 27 15 - 41 U/L Final
Alkaline Phosphatase 46 32 - 100 U/L Final
Bilirubin, Total 0.6 0.3 - 1.2 mg/dL Final
Total Protein 6.7 5.9 - 8.4 g/dL Final
Albumin 3.9 3.5 - 4.8 g/dL Final
Globulin 2.8 2.5 - 3.7 g/dL Final
A/G Ratio 1.4 1.0 - 2.0 Final
Anion Gap 7 0 - 18 Final
BUN/CREA Ratio 19.0 10.0 - 20.0 Final
Calculated Osmolality 293 275 - 295 mOsm/kg

Lipase 25 22 - 51 U/L
Glucose 104 70 - 99 mg/dL
CERULOPLASMIN (S) 18 17 - 54 mg/dL
FERRITIN (S) 323 24 - 336 ng/mL
Sed Rate 5 0 - 15 MM/HR

HDL CHOLESTEROL (P) 38 mg/dL Final
Cholesterol, Total 243 110 - 200 mg/dL Final
Triglycerides 166 1 - 149 mg/dL Final
LDL Cholesterol 172 0 - 99 mg/dL

AST 49 15 - 41 U/L Final
ALT 84 17 - 63 U/L Final
Alkaline Phosphatase 51 32 - 100 U/L Final
Bilirubin, Total 0.8 0.3 - 1.2 mg/dL Final
TOTAL PROTEIN (P) 6.9 5.9 - 8.4 g/dL Final
ALBUMIN (P) 3.9 3.5 - 4.8 g/dL Final
Bilirubin, Direct 0.1 0.0 - 0.2 mg/dL

14

i been checking my temp
one thermometer shows 96.5 +/- other 97
morning and afternoon
been like that for few days now
i got few days ago
iodoral as supplement
multivitamins with selenium 100 mcg and iodine 150 mcg
should i take them both?
did you have a chance to look at my lab test?

15

I would’ve expected a little better total testosterone boost on the TRT after 20 days at 100 mg per week (but free looks good). Estradiol is still coming in high. I’m going to go out on a limb and guess you are still feeling bloated and still having some trouble shedding weight?

Did the doc suggest any changes to your regimen based on the tests you reported 5 days ago? How are you feeling in general?

16

yes, still not feeling the big wow of TRT

i went with recommendation here
100 ml twice a week of T
12.5mg clomid per day
1mg AI per every 100 mg of T (twice a week)
doc agreed

will try repeat test 3 weeks after the switch to AI and SERM and extra T