I have ongoing problem with my TRT. I’m currently taking Glucophage for reactive hypoglycemia (1x750mg XR), Concerta (36mg, I have an ADHD) and Nebido 1mg/4ml every 8 weeks. I’ve been on Sustanon, 250mg every 3 weeks, and enanthate 100mg every week. I’ve tried pinning more oftern but it was even bigger nightmare. My natural level is 270, so very low. I’ve started TRT few years ago, and since then I have abolutely no idea how to get it right with my estradiol. No matter what I do, my estradiol goes nuts. I need to take even 2.5 mg of Anostrozole to just stop high E2 symptoms. If stop, my hear rate and pressure is up in the sky ( avg rate 100 BPM, BP 160/100), all bloated, losing muscle mass, getting fat over stomach and even boobs are getting visible bigger after only 1 night. Libido does not exist if don’t take a lot of Anostrozole. I’m on Nebido, that supposed be stable, and not exceed testosterone level of 1000. currently, I weight 80kg which is not bad for someone who’s 178cm high. I walk 15k steps a day and I’m a climber, so I have proper amount of movement. My last lab results on nebido showed 790 ng/dL testosterone and 24 Estradiol ng/dL (after taking almost 2mg od anastrozole!) and I was feeling, like I could use another tab. I’m waiting for my appointment currenlty, 3 weeks of waiting sadly, so I’ve decided to ask you, what may casue that incredible estradiol response, to low amount of testosterone?
What were your numbers on this protocol? This seemingly seems to be the best of all the protocols you mentioned.
It’s not that stable, even though it’s a slow ester there is still a surge of test in the beginning with a drop off to below normal ranges before your next pin for most people.
It got worse, it was even more unstable. Every pin, my e2 was getting high, so I had to take AI, but I couldn’t dose it properly. That ups and downs were horrible for me mentally, and physically.
My doctor decided, that the rise of T level after injection causes that high E2 spikes.
I’m sorry to hear you’re having such a tough time. You seem to be on the very unlucky side of the spectrum of dialing in your TRT. This is beyond my scope of knowledge and hopefully someone with more experience can chime in.
You got it all wrong! Estrogen is the main driver of fat loss on TRT. Estrogen affects how your body distributes fat, low estrogen levels can contribute to gaining fat in your belly area.
TRT increases aldosterone produced in the adrenal glands, which tells the kidneys to absorb more sodium and sodium carries water. This leads to fluid retention → blood pressure spikes and anxiety.
The AI is basically works like a diuretic, or water pill. You can still have fluid retention without any visible bloating or indications of fluid retention.
You could try pinning more frequent smaller doses of ethanathe to counter the fluid retention. This will shorten the hormonal spikes and may cure your problem and you may not need medicine to manage the fluid retention.
You may not even need high normal levels to achieve symptom resolution if you can get a near constant (550-650) hormone level.
But what about growing boobs and abolute problems with ED and libido? Aren’t they connected to high E2?
Nebido was supposed to solve that problem. Pinning often is kind of problematic for me, since I’m not able to do this IM injection on my own. I have problems with collagen, and after every injection I have a new pretty scar in that and it hurts like hell.
I’ve tried it, but still got high E2 sympotms, maybe I will lower the dose and try again. I was pinning 50mg of Testosterone every 3 days.
That’s not a very scientific assessment, that’s a conclusion that you have high estrogen symptoms with no evidence that you are, in fact, experiencing high estrogen symptoms.
Correct, so it’s more about the dosage at this point.
Gynecomastia is rare in men with high testosterone, which usually occurs with low testosterone to estrogen ratios, high IGF-1, and genetics are contributing factors.
It also sounds like these wild swings in hormone-levels hurt you: as you stated, you need to find a steady state that works.
First of all you don’t have to do intra-muscular injections, you can do it sub-q with insulin-needles. I recommend you to watch vigorous steve’s youtube-channel on the subject and watch his video on estrogen and estradiol.
Nebido is poor when it comes to steady state and doesn’t work for you it seems. You somewhat need to reboot, get rid of the inhibitors and see where you start of. 150 mg/week t enanthate with bi-weekly injections sub-q, see where the estradiol lands as an example, and then go from there if inhibitors is needed or not. It’s the bloodpressure that’s the real killer over time, that’s the one you need to be most careful with. Just my 2 cent.
And cardio and diet needs to be on point as well, but you already know that.
Ok, little update. On 1000mg/4ml Nebido I’ve had T level 1500… It is waaaay to much. I’ve went back to Enanthate, sadly, my doctor said, that injections have to be IM every 5 day. This drug is very oily and need to be injected with bigger needle into muscle. In my country, we don’t have much of a choice. Currenlty, I’m on Enanthate 50mg every 5 days, and It is slightly better. After injection I feel ok for a day, next day, I have problems with short breath, high BP, ED and I cannot sleep. I’m waiting for my lab results, but it seems that I’m hyper responder. With 100mg Enanthate I’ve got over 1400 t level, I really don’t understand what is happening with my body. I will probably try to inject even less T, and see what are the results. I’ve once tried 150, and it was a nightmare. I’ve had to use a lot of Anastrazole to survive
I’m still on 50mg every 5 days and my doctor says that the form my testosterone is (very thick and oily) should not be injected due to very high density. It hardly goes through smaller needles like 0,5x25. I’ve tried to go without any Anastrzole for a week and after few days I started to grow a nice pair of boobs. I’ve uploaded my results on 100 mg every 5 days. Currently, even on 50mg every 5 days I need to take at least 0.5 mg Anastrazole daily to keep my boobs from growing and gaining fat. Feeling anxionus, weak, ED and almost no urination when I’m not taking any AI. I’m slowly losing hope, that it will ever work. In my country, there are very few doctors that are specialized in men’s hormones, so my options are heavily limited. Same goes for available drugs. Any ideas?
Estrogen doesn’t increase fat mass. A study at Harvard had three groups of men, with low normal testosterone, mid range testosterone and supraphysiological testosterone.
All three groups were given aromatase inhibitors and all three groups gained more body fat, most notably around the midsection.
This proves estrogen is the main driver of fat loss on TRT, but only when other hormones are in balance.
An increase in all steroid hormones, TRT increases aldosterone produced in adrenal glands, which enters the kidneys, and tells the kidneys to absorb more sodium and sodium, carries water.
This leads to fluid retention. This occurs, especially after dosing changes!
The supraphysiological testosterone is the cause of your symptoms, as your estrogen isn’t high in relation to your testosterone, the rato is spot on and where they should be as we men convert 0.2-0.3% of our testosterone to estrogen.
The estrogen normal ranges were derived from men with total testosterone <500 and not from men with high testosterone, or in your case supraphysiological testosterone.
The use of an aromatase inhibitor may have the same effect as a diuretic, then treating the fluid retention.
Little update, turns out, I have very very low prolactin due to ADHD medication. The lower it is the better I feel, I’ve done labs last week, and turns out, my prolactin is 1. How it may impact my therapy?
Anywany thank you for responding to my topic
