T Nation

3 week Aromasin Monotherapy Blood Results


#1

Background:
-21 year old male dealing with hypothyroidism, low free T, high SHBG
-Currently on Naturethroid for thyroid.
-Original thread posted here: 21, On Thyroid Meds. Low FT, High LH, High SHBG. Read All Stickies (Figured this deserved its own thread since AI Monotherapy reports are few and far between).
-KSMan was kind enough to examine my previous bloodwork. Among his suggestions, he recommended dosing an Aromatase Inhibitor to potentially lower estrogen/SHBG and raise free test.

Original Hormone Values:
Total Testosterone: 788 ng/dL (348-1197)
Free Test: 17.4 pg/mL (9.3-26.5) (This was decent on this blood test. On all 5 previous blood tests, however, my free test has been in the 9-12 range.)
DHEA: 548.2 ug/dL (164.3-530.5)
LH: 13.3 IU/mL (1.7-8.6) (This was very concerning as pointed out by KSMan)
FSH: 8.9 IU/mL (1.5-12.4)
Estradiol: 37.3 pg/mL (7.6-42.6)
SHBG: 54.5 nmol/L (16.5-55.9)

For three weeks, I ran Aromasin. I started off with 6.25 mg/day for the first 1.5 weeks, felt nothing, and upped the dose to 12.5 mg/day for the final 1.5 weeks. Here is my new bloodwork.

All my values have improved significantly. SHBG is still to high. Also, I meant to test IGF, not IGF binding protein 3. Apparently IGFBP3 is also a good indicator of growth hormone status though. My LH and FSH have also remained high and I’m concerned about that. Can that be attributed to the aromasin, or am I primary hypogonadal?

I feel no different. Not one bit. My energy, brain fog, low libido, and body composition haven’t changed one bit. My strength has been steadily increasing, but nothing that I don’t attribute solely to my consistent diet/training routine.

Thoughts anyone?


KSman is Here
#2

Your LH was high previously also when you were not on aromasin. In my opinion you do not seem primary also since you have decent T levels now while on aromasin. If you were primary then your T levels would have been lower even if your LH was out of range. There can be partial primary hypogonadism. Do you have only one testes?
I am also on anastrozole but on very low dose of . .5 mg/ week and not feeling any significant effects aàfter seeing your response I will also increase my dose and see how things goes. My values are kind of similar to yours but your SHBG and Lh was higher than mine.
Haven’t you lowered your thyroid dose???
Please do not create New threads this same mistake I have committed in past but is of no use.
I have doubt you really were on 6.5mg/day and 12.5mg/day???


#3

My LH had never been high before my previous blood test. I have a feeling that was just an abnormal pulse for a few reasons:

  1. I had a great meditation session that morning. Meditation and power posing have been shown to affect blood serum testosterone levels.
  2. I had been abstinent for an entire month before that blood test.

As I’ve mentioned before, all my previous blood tests before the last one had perfectly normal FSH/LH.

I have both testes. However, my left testicle does have a varicocele which was operated on but seems to have returned. The testicles are both normal size as confirmed by an endocrinologist as well as an ultlrasound. Both testicles have healthy blood flow according to the ultra sound.

I have lowered my thyroid dose by half a grain and seem to have a little more energy in the past week.

I’m absolutely taking 12.5 mg/day. Remember, Arimidex and aromasin have very different dosages. Aromasin requires larger amounts than arimidex to lower estrogen. My pills were prescribed by my doc so they are legit. Arimidex pills are only 1 mg. Aromasin pills are 25 mg. I’ve been using a pill cutter to take half of one pill/day. Keep in mind, when one is not on a steroid cycle, they can consume much higher amounts of an AI and be fine due to the open feedback loop. The HPTA senses the lower estradiol and raises testosterone so that more estrogen will be created through aromatization. There’s a government study detailing a group of males who took 25 mg aromasin/day and were absolutely fine. I’ll post it later.

I’m going to continue the Aromasin until I get my blood drawn again at the end of May. Perhaps, just like with TRT for some men, the effects of increased Testosterone via an AI aren’t immediately noticeable. Many TRT guys have reported not experiencing libido/muscle gain until 2-3 months into treatment.

I’m pleased with the fact that my testicles seem to be responding quite to the aromasin. This minimizes the possibility of primary hypogonadism in my mind and points back to low cortisol and thyroid issues being at the root of my problems. I’m glad I didn’t go on TRT when offered the chance by the endocrinologist I saw.

I’ve tested my temperatures throughout the day and they are in the 97 range. I’m currently dosing iodine at 5 mg/day with 200 mg of selenium. Also taking Tyrosine and Ashwagandha which are supposedly beneficial for the thyroid. Throwing in some pregnenolone as well for the low cortisol. I’ll report back in May once I get a complete cortisol/thyroid panel done.


#4

IMO You are definitely not primary so do not worry about that , just workout on your thyroid. I am taking altraz that is brand name of anastrozole produced by local pharma in my country it comes in 1mg may be I will try to increase dosage to see effects. Libido depends upon many factors other than T levels so try to find out what things you are lacking because your T levels looks perfectly to me.
You can lower your SHBG more since your e2 is at good level now and SHBG is still 38 something is still not on track. Maybe liver or you have become hyperthyroid.


#5

E2 is in a great spot.

With less E2 negative feedback on HPTA we expect to see more LH/FSH. FSH has increased. LH changes a lot as released in pulses with short half-life, there is no measure of average LH in natural guys, but FSH is a good proxy for that. FT has increased.

Normally guys report results from lower E2 in this time frame.

SHBG does not fall quickly. It is made in the liver and is not part of a regulated feedback system. The liver has its own time frame. We can hope that SHBG will decrease and FT will improve. Lower E2 helps this as well as increasing FT.

Your lack of response to this could easily be from thyroid issues.
Your body temps can be a thyroid med dosing guide.

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.

Lack of response to thyroid meds can mean that fT3 is low, Nature Thyroid should be helpful. If body temps are low and fT3 labs are mid-range, we suspect elevated rT3 which leads to a discussion of stress and adrenal fatigue.


#6

KSman, thanks for the detailed response.

I’ve taken my temperatures today and they have all fallen in the 97 degree range, obviously to low. Guess it’s pretty clear I still have thyroid issues despite the high dosage of Naturethroid I’m taking.

I talked to my doctor yesterday. She agreed that the focus moving forward should be my adrenals and my thyroid and that fixing those should potentially improve SHBG, Estradiol, and testosterone.

I’m currently dosing 5 mg/day of Lugol’s iodine with 200 mg selenium. Also added Tyrosine and Ashwagandha for additional thyroid support. Regarding cortisol, I’ve added pregnenolone which seems to give me a slight energy boost throughout the day.

I’m getting additional bloodwork done at the end of May for my adrenals and thyroid. Will be getting TSH, FT3, , RT3, and FT4 for my thyroid. Will be getting four point salivary cortisol, DHEA, aldosterone, ACTH, and Renin for my adrenals. Anything else I should request from my doc regarding future thyroid/adrenal blood testing?

Thank you.


#7

Test ACTH to find out why Cortisol is really low or quite high. Otherwise does not make much sense.

Assume elevated rT3 for a moment… consider what are your stress factors and major events are.

My doc and I assumes rT3 when Nature Thyroid did nothing for my body temps.