51 Year Old Starting TRT

I’m a 51 year old guy that’s just started TRT. I went in for a physical and told my doc I suspected low T. I had the general symptoms… lower libido, poor sleep, general malaise, and loss of muscle mass. We had my blood work done (10AM after overnight fasting) and the results were:

TT 293 (2241-827)
Free T 46.0 (30-170)
Free T% 1.6 (1.0-2.7)
Bioavailable T 39.3L (110-575)
SHBG 45 (13-71)
Estrogens Total 170 (Reference range for total estrogens (E1+E2) less than 200) Note I didn’t know that I had to specify for my doc’s blood work order that I wanted specific estrogen markers. NEXT TIME.
Lab work attached

Doc’s oked Fortesta Gel @ 4 total pumps (40mg / day). I started on 10/31. Don’t feel any difference yet.

2nd page of blood work.

3rd page of 3 of blood work.

I had my follow up visit with my doc. After starting on Fortesta at 4 pumps/day, I’d started to feel a bit better all around. I’d noticed a slight improvement in my libido and instances of morning wood, but I thought it could get better. I discussed with my doc and he was good with me upping the Fortesta to 8 pumps per day.

I figured it was smooth sailing. Not so fast… Initially, Mr. Happy was diggin’ it, but then my libido dropped to nothing and no more morning wood. Along with the loss of libido, erections are even now a bit difficult to maintain. I went back to the stickies and started reading and figure my Estradiol is too high. The last blood results (at 4 pumps) have:

Total T = 529
Estradiol = 31.9

Now gonna’ push for a bit of Arimidex.

My doc originally had suggested that I do another blood test in March. I’m thinking to go ahead and ask for .5mg Arimidex 2x/wk and then test in March as was originally the idea. Remember, I’m now doing 8 pumps/day, so my T is probably up there in the high 700s or 800s.


What is the time frame that it takes for an aromatase inhibitor’s effects to be fully felt? I started taking .5mg 2x/wk about 2 weeks ago and haven’t noticed much difference. I don’t want to be jumping around with dosages if that’s not a prudent course of action, but since I don’t really know, maybe that would be fine. Any input would be welcomed.

I hope you read the label on the Fortesta.

I was quite overweight and had other stuff going on when I started using,it, but it attributed to my getting pulmonary emboli (blood clots), and Deep Vein Thrombosis (DVT - clotting disorder). At the time, this potential side effect was not labeled.

Since I already have the DVT, and need the T, I still use the stuff at 30ml/day. However, not everyone is aware of POTENTIAL side-effects, so thought I’d mention it.