Would Aromasin Be Overkill?

Pharma / TRT Testosterone Replacement
1

Hi guys. Long time lurker, first time post. I am 41, been working out for about 25 years now. After having a vasectomy and vericosile removal, my testosterone dropped to just over 150. My doc put me on Androgel and due to lack of results moved me to a compounded T 150mg with progesterone added. Soon after starting this I started to feel weird. Man I was and still am so exhausted, depressed, libido is pretty much nil, erection is there but will not last. I had a recent lab done in where both my T and Free T were off the charts at >1500 and >360. As my doctor went down the labs he noticed that my E2 is also above range at >75. My DHT is also kinda high at 250.

He is now starting me on Avodart and a compounded anastrozole (0.5mg Daily). I feel like a lab experiment to say the least. I have ordered from research sites…and was thinking of ordering Aromasin to add to the others. Is this overkill? What can I expect when my E2 and DHT begin to drop? Will the high test cause any problems for me? Thanks!

Randy

2

With your numbers that high, I’m very surprised your doctor is keeping you on the same T dosage. You are beginning to talk steroidal T levels. They will likely rise a bit as you lower E2. You may want to ask your doctor to lower your test dosage.

Why the progesterone added to the test? I’m not familiar with the benefits of that.

The E2 is most likely causing all your negative symptoms–with E2 that high I’m surprised you don’t cry watching The Bachelor. That’s actually the highest level I’ve ever personally seen in my research into the subject.

Is the Avodart for enlarged prostate? You didn’t mention prostate issues in your thread.

The anastrozole will start to control E2. .5 mg/daily is about 3.5 mg/week, which is over twice the recommended value for someone taking 150 mg of test, but given your ridiculously high E2 levels that may be appropriate.

3

Crying while watching The Bachelor. LOL. Not quite that bad but very depressed and no interest in doing the things I normally like to do. Like I said, libido was tanked.

They are keeping the same T dosage but removing the Progesterone from the compounded cream. The current dose is 150mg Testosterone/5mg Progesterone per 0.5ml cream. Supposedly the progesterone increases the T levels. Not sure on the chemistry here, maybe someone else will chime in. The doc I am seeing is 100% HRT so I trust them. On my refill I will ask if I should be dropped to 100mg of T.

The Avodart was to keep my DHT fairly low and hopefully prevent hair loss. Even with Avodart 3x a week my DHT is still 230 or so.

If the oral anastrazole does not lower it enough, they are talking about adding more to my compounded cream as well.

Just for the record…another lab value I have that was extremely high was DHEA. It was 450 on my last test. This could be another reason my T got so high as this converts to T, as well as E2 I believe.

Here is what I was on prior to my last lab, for those looking to get higher levels. It obviously worked for me, a little too good it seems.

Testosterone 150mg/5mg Progesterone cream (AM and PM)
Pure Encapsulations DHEA 50mg BID
Pure Encapsulations 7-Keto DHEA 200mg AM
Pure Encapsulations Pregnenalone 30mg

Thanks for the reply.

4

WTF is wrong with all of these doctors. I swear none of them have a clue. Drop the T dose and get within the normal range of bioavailable T. Total T is really a useless lab.

Run follow up labs in a couple of weeks and see where you’re at before starting Adex and don’t touch the Avodart with a 10 foot pole. No need for it. E2 will probably still be somewhat elevated so after the labs start with a low dose of Adex. 1-1.5 mg a week.

5

I would reduce your T dosage.

Arimidex can cause a rise in T levels, and you are already too high.

plus it is possible that your excessive DHEA (50mg is normal I believe) could be contributing to your DHT and E2 problems.

a doctor mistakenly prescribed me Avodart at one time (he meant to write me a script for Arimidex). luckily I did some research first before taking the first pill. I can’t remember why, but I was definitely strongly against taking it.

have you tested for anything else - like Vit D, pregnenelone, DHEA, cortisol, ferritin, etc?

Do you know what the root cause of your problem is or are you just treating/masking symptoms?

6

Pure Chance,

They are reducing my T cream dose to 100mg in AM and again in PM. They are also taking the Progesterone out of the compounded cream. My HRT doc and the pharmacist feels my T shot up so high due to the Progesterone. I was on the same 150mg BID T dose prior to adding the progesterone and my T was at 587. With progesterone it was >1500.

DHEA was tested in both my last two labs. It was over range both times, at 450 and 458 (with a lab range of 89-427). At that time I was taking DHEA 25mg BID. I have since been taken off it.

My cortisol was and still is HIGH but in range at 10.6 (range is 2.3-11.9). With my T so high I am confused about this somewhat as I thought high Cortisol knocks your T down. My doc put me on two cortisol lowering OTC meds, Cortisol Manager and Seriphos.

The root cause of my T issues, I have been told is my vasectomy. This was not a simple V, I had a epididymal cyst on one testicle, and severe varicosile on both testicles. I first noticed both issues when a early teenager and the docs then said to hold off until I had children. There was concern about fertility as my sperm count was very low due to the heat put off by the veins, but I was still able to have three children.

I was put on Vit. D liquid drops as it was low. On my last lab it came up to 86 (range of 32-100). Prior to using the Vit. D. drops it was only 28).

All other labs seemed normal. Pregnenalone was 83 (range of 23-173), Progesterone was 0.8 (range of 0.2-1.4), IGF-1 was 142 (range of 70-307), insulin fasting was 12 (range of 3-19), FT4 was 1.15 (range of 0.93-1.70, T3 FREE was 3.4 (range of 2.2-4.0).

In regards to taking Avodart. I have taken 1 cap 3x a week for over 2 years now. Since I have been taken off it for the last few weeks, I am noticing more then usual hair loss which concerns me. Is Proscar or one of the others safer then Avodart? With my T and probably DHT so high I am concerned about this.

Thanks again for any and all input!!

7

Ok, this seems pretty messed up situation, and my post is kind of jumbled. I tried to group things, but there were just too many points to hit.

Can you give us a timeline on when you started your various treatments in reference to the 587 T levels and the 1500+ T levels?

Like:

150mg twice daily Compounded T

Blood Test:
-587 T
-10.6 Cortisol
-83 Pregnenelone
-458 DHEA-S

started 250 DHEA
started 5,000iu Vit D
started Avodart
started Cortisol Manager
started zinc, or whatever?

4 weeks later
Blood Test:
-1500 T
->75 E2
-?? Cortisol
-?? Pregnenelone
-450 DHEA-S

Basically what else could be driving the increase? Progesterone could do that maybe, but that seems like an extreme swing. Is there any chance that the DHEA, Vit D, or something else is also contributing to it?

BID = twice daily, right?

This is all just speculation on my part so please take it for what it is worth, but 200mg T daily still seems like way too much. You are OD’ing on T and DHEA so of course you have problems with excess DHT and Estradiol I would think the solution would be to lower your DHEA and T and stay away from Avodart. Avodart just leaves the excess T there to aromatize to estrogen. Arimidex just pushes the T back to convert to DHT - so you will have a war of escalation between the two.

If you reduce your DHEA and T dosage to the appropriate levels then your DHTand E2 should level out somewhat. Why not try 150mg once daily? I thought that it was ideal to mimic the natural biorhythms of your natural T production by dosing lotions once daily before bedtime? I have never heard of doing lotions twice daily. Most people still find that they need Arimidex to get their E2 levels around 22. You may need Avodart as well as because of our unique genetic makeup. You may convert T to DHT too easily, but first start by lowering your dosages down to get your T levels under control. Then look to control DHT and E2 if needed.

I was on 100mg DHEA/100mg Pregnenelone compounded at one point and had DHEA-S levels of 618, 554, etc. now I am in the lower 400s on 50mg DHEA daily.

Also 10.8 am Cortisol doesn’t seem high to me (heck I am trying to get my levels up past 10 from 5.5). I am still new to the whole cortisol arena, but I thought the normal DAILY range was 5 to 20 with the average morning reading being near the 15-20 range? I would definitely do some more research on this. Lowering your Cortisol can have massive repercussions. I just see warning bells blaring here.

Hardasnails - can you chime in here about the cortisol (if you see this that is)?

as a side note, here is a great article about cortisol and thyroid connection - www.virginiahopkinstestkits.com/cortisolzava.html

Also your Pregnenelone seems low. Are you on HCG to maintan your testicles (and along with that your natural Pregnenelone production)? According to the various good doctors I have seen, 100+ is ideal. It is pretty easy to boost up with 30-60g of Pregnenelone (I like PURE brand myself - but any health store source will probably work just fine).

IGF seems a little low (isn’t 200+ ideal?)
Thyroid looks good. (3.3 - 3.9 ideal fT3 again according to doctors I trust)

8

Ok let me try to put my labs and meds into a timeline.

05/2009

On nothing at this time. Went to doc for severe fatigue, depression, and lack of libido.
Dont have initial labs in front of me, but Total T was 187, Free T was 20.

Was put on Androgel 2 packets daily
DHEA 25mg BID
7 Keto DHEA 200mg QAM
Pregenalone 30mg daily

10/2009

Total T 311
Free T 69
SHBG 21
DHT 226.8
Estrone 14.9
Estradiol 41.4
Progesterone 1.1
FT4 1.15
FT3 3.4
DHEA 450
Pregnenalone 83
Vit. D 30
CRP 6.6
Homocystine 8

Was not happy with Androgel results and doc changed to compounded T, 150mg morning and night on weekdays only.
All OTC meds stayed the same
Added Avodart 3x a week
Added Pure Encapsulations Vit D drops (7 drops a day)
Added Pure Encapsulations DIM PRO 100 BID
Added Pure Encapsulations Mens Ultra Pure Pack multivitamin.

02/2010

Total T 587
Free T 130
SHBG 25
DHT 287
Estradiol 32.2
Progesterone 0.8
DHEA 458
IGF-1 142
Cortisol 6.8
Vit. D 66

Still on compounded T 150mg Am and Pm and they added 5mg Progesterone to each .5ml dose.
All meds stayed same, took me off Pure Encapsulations DHEA, Pregnenalone and 7 Keto DHEA due to high DHEA.
Not sure if this is relevant, but they also added some OTC meds for adrenal fatigue…ADREN-ALL, and an RX of Hydrocortisone 5mg daily, Red Rice Yeast for high LDL, Vitalzyme X, I added LPP Concentrated Predigested Protein 1000mg in AM to raise my protein intake as my diet is not very good.

06/30/2010

Total Test >1500
FREE T >360
SHBG 31
Estradiol 62.7
Progesterone 0.7
Cortisol 10.6
Vit. D 86

Now my cream will be reduced to 100mg T, NO PROGESTERONE, still AM and PM on weekdays only.
They added Arimidex 0.5mg QAM, Cortisol Manager and Sephiros to help reduce cortisol some.

I have been off Avodart for close to a month, and I am losing more and more hair. I see it in my hands when I shampoo and when I brush my hair. I would like to go back on it. They did not run my DHT last time but I am sure it is sky high. Supposedly the normal range is 155-719 according to the labs.

So let me ask this. If I need to bring my T and FREE T down, what would be an ideal level for someone my age (41)? What would be an ideal E2 for my age?

Thanks for the responses. I hope this timeline helps to understand where I have been and where I am now.

Randy

9

so wait a minute… your doctor put you on 5mg hydro-cortisone when you were at 6.8 AND THEN he put you on Cortisol lowering supps when you were at 10.6??? what the heck???

your doc’s ideal range for cortisol must be 7.75 to 8.25 I guess?!?!?

your doctor is seriously messing up your system here in my opinion. wow. just plain wow. This would make for a great warning story for others - if only you didn’t have to be the one going through this.

start major DHEA dosage
then off ALL DHEA (and then no test to see the impact of the removal - what?!!?)

he does not believe in small incremental steps it appears. no lets start off slow and build to the right levels. All or nothing is a pretty dangerous approach.

start cortisol
then off all cortisol AND start cortisol reducing supps
???

I am just boggled here. No wonder your levels are all over the place. How in the heck are you suppose to track the impact of each change when you make five or six MAJOR changes between each blood test?!?!?

I thought I was bad making a couple of small tweaks between tests, but I have nothing on this doctor.

why not try:
150mg Compounded T every PM (I think that was the ideal routine when I was on creams)
25mg DHEA
30mg Pregnenelone
5mg Hydro-cortisol (10 for an AM reading is still low from what little I know - someone else please correct me if I am wrong here)
200iu HCG EOD
1mg Arimidex weekly (or compounded to .25 EOD) - you may need more, but best to start off slow.
keep the 7,000 iu Vit D
drop the DIM (the arimidex will take it’s place - no need for double medication)
keep the multi
maybe add 25-50mg zinc (to help with aromatase and DHT conversion).

I have no idea about ADREN-ALL, Red Rice Yeast, Vitalzyme X, LPP Concentrated Predigested Protein 1000mg

If you are on hydro then not sure if you also need to ADREN-ALL. I have no idea here.

I also don’t know all that much about DHT and ideal ranges. That is something you would have thought I would have picked up by now.

Have you had your ferritin/iron levels checked?

ideal T is 750-1000 I believe.
ideal E2 is 22 (per Ksman - and it seems to be a pretty good guide that has worked for me)

I am probably overlooking several things because this is so messed up, but this is the best I can do for now. I will reread and maybe post more later.

have you read through all of the stickies and through the other major threads on this forum? There is a wealth of information there.

10

and just one more WHAT THE HECK?!?!?!?

In October your doctor was good with your 450 DHEA-S results, but in February he is panicked by a reading of 458 so he pulls you off all DHEA?!?!?!

So just how have you been feeling through all of these changes?

11

I have been feeling like crap! Actually worse then I was when I started it all. My doc is one of those who like to rx something to fix a side effect of another med. I have a box full of stuff I have been on.

The pharmacist involved is the one that said for me to go OFF everything except for the T cream and the Arimidex. I will be getting a FULL lab in a couple months to see where it puts me.

12

so you are going to wait for a couple of more months feeling like crap?

I agree with simplifying things, but I would not stop everything besides T and Arimidex. Moderation is key.

Scale back, limit some things down.

Focus on your core issues:

it seems like you are low on cortisol - so why not keep going with 5mg time released Cortisol first thing AM?

it looks like your DHEA is good - but 25mg DHEA is a low dose and could help support your system.

your Pregnenelone looks low - so 30mg Pregnenelone could help (again a faily moderate to low dose).

100mg T Cream twice daily still seems like a lot. The twice daily is different (from what I know or have learned) - why not 150mg T Cream first thing AM or last thing PM? (I had to take mine at night. If I did it in the morning, I became exhausted. - even though the gel/cream never bumped up my blood tests results and I never really felt good on it after the first 2 months - but it seems like you don’t have problem absorbing T through your skin which is great for you.)

DIM can effect different people in different way. I would stop that and start your Arimidex low dosage (but know that there is a pretty good chance that you may need more - up to 1mg a day is possible)

Vit D support is needed and 7,000iu sounds good. I wouldn’t stop that.

A good Multi is always good, and I would start on Fish Oil and Probiotics.

I would stop all of the other supplements for now. Try it for a month and see how you feel. If better great, maybe tweak one or two things to see if that makes it even better or worse - it is kind of like an eye exam. Is 1 better or 2? ok how about 2 or 3? and then 2 or 4? etc. It just takes us a bit longer, but if you are feeling the same after a month there is no point in waiting another month or two just to get blood tests results to tell you that you don’t feel good - you already know that. Just try and not make any drastic changes within 30 days of your test.

Once you start feeling better (hopefully after the first month) I would recommend Ubiquinol, Revertastol, and Green Tea - again for overall health and optimum cellular function (but that is just my preference).

Have you ever had your ferritin or iron checked? I have low iron which means my red blood cells can’t transport the hormones as effeciently as they should. I have seen huge benefits in taking iron supplements, and someone else just posted about a possible iron issue.