T Nation

58 YO Male, BHRT for a Year, Test >1500!

Started TRT August 2016 with 200mg of test cyp per week in one injection and one letrozole every two weeks.

November 2016 lab tests came back with <5 estradiol, >1500 serum test, 40.1 free test. Was also having some ED by the end of each week. Stopped taking the letrozole and switched to two injections a week with same total amount of cyp.

January 2017, I started getting really sensitive nipples, so the doc put me on anastrozole, one tab per week. (Half tab with each injection.) Still having some ED, so doc gave me sildenafil to use as needed.

February 2017, my wife observed that my balls were almost gone and that bugged her a bit. Called the doc and he offered me either hcg or clomid. I decided on the clomid, mainly because it was a pill, not an injection. (I’m taking one pill with each injection.)

May 2017, I had more blood work done. Everything was within range. Test was 1136, estradiol was 27.3. My hematocrit also dropped a bit from the last time, so I think that’s good. (Was 49.1, now 47.9.) Seemed like things were sorted out pretty well. I’m training pretty hard trying to fight my age, so at that point, my joints were hurting a lot. Doc put me on 100mg/wk of nandrolone. This really helped, my joint pain is almost completely gone!

October 2017, more blood work. Back over 1500 on the test and up to 38.6 free test (less than the November number), but this time, my estradiol is up to 52.9 and my hematocrit is 51.5, just over the upper end of the range.

Now honestly, I’ve been feeling great lately, and I’ve made some nice gains in the hypertrophy department (same overall weight for a year now, but my body composition has changed for the better), so part of me wants to stay on this protocol. At the same time, I’m mostly concerned with quality of life, not necessarily just getting big, so I wonder if I should change some things.

I do have a follow up appointment with my doc at the end of the month, but I want to be prepared. One thought is to try backing off to 160mg of cyp and 80 mg of nandrolone (.4 and .2 ml per injection instead of .5 and .25) and maybe move up to a full anastrozole with each injection. Another option is to go off the nandrolone to see if I can get back to the May levels. I’m a little worried about how my joints will do though. I’ve had arthritis for about 30 years and I really like how I’m feeling lately! I don’t want to lose that…

Thoughts anyone?

Your clomid dose is too high and LH/FSH are then too high causing high T–>E2 inside the testes where anastrozole/letrozole cannot work.

Everything is not good.

Before clomid your AI dose was too high with very low E2 which causes joint pain for some with healthy joints.

Need doses in mg’s, not tabs pills.

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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.

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Yes, I know the letrozole dose was too high (sorry, don’t know the amount) and that’s why my estradiol was undetectable at the three month test. At that point, even with no detectable estradiol, my joints didn’t feel any different than they ever did before.

I thought the clomid (two 50mg pills per week) and anastrazole (one 1mg tablet per week, split in half) doses were ok since the doctor seemed to be happy with the 1136 serum test and 27.3 estradiol in May…

Is hcg a better choice than clomid?


Clomid works well for most, but a few get bad estrogenic side effects.
25mg EOD may work fine, LH/FSH should be tested to see what is going on.

Letro can be harsh in that dose-response seems a bit unpredictable.

Inject 100mg T twice a week and take 1mg anastrozole at time of injections.

Do read those stickies.