T Nation

6 Week Anastrozole Adjustment


#1

I've been on TRT for 6 weeks now. I'm taking 100mg T once per week, and .25mg anastrozole EOD. I got blood drawn at the midpoint between shots, and this is what I am looking at now.

Free Testosterone 13.05 ng/dL (5.2-18.0) Normal
Estradiol 12 pg/mL (11-44)
SHBG 26 nmol/L (12-59) Normal
DHEAS 546 ug/dL (140-484) Above high normal

(No TT was test done)

My doctor was looking at my DHEAS number and wanted to bump up my anastrozole dose to .5 EOD. That doesn't sound right to me, because with Estradiol at 12, I'm already too low, right? Isn't the suggested target for E2 around 22 pg/mL? Obviously I'm super new at this, but I think the appropriate move for me might be to lower my anastrozole dose to .25 every two days.

What do you say? Listen to the Doc and raise anastrozole to 1.5-2mg per week? Stay where I am at 1mg per week? Lower the dose to .5-.75mg per week to let Estradiol levels increase?


#2

Based on my experience with myself and TRT, I’d ease up on the Anastrozole, not add more.

<--------- not an MD


#3

I agree with your idea on dose reduction. Anastrozole does not change DHEA levels.

DHEA levels typically start to drop in one’s 30’s. So your age is part of this picture.

Any other possible adrenal issues? You could test AM cortisol, do the lab at 8AM.


#4

DHEA-S has nothing to do with anastrozole. Anastrozole is used to reduce excessive estrogen, not DHEA(S). Anastrozole won’t reduce DHEA(S).

Your estrogen (E2) is actually pretty low, probably too low for optimal health. You should take less anastrozole (or maybe none), not more.


#5

Thanks guys. I thought that was the case. I’ll shoot for .75mg per week.


#6

Personally I’d rather just attempt to eliminate the need for Anastrozole altogether. I’d try splitting your testosterone dose to 50mg e3.5d and stop taking the Anastrozole. Retest in 6-8 weeks and evaluate the need for an AI. You may not even need to be taking it on that protocol and if you did, it would be a very small dose.

It’s potentially a win/win situation. Your hormone levels will be more stable and you might be able to eliminate a medication.


#7

Luckily, in Colorado you don’t need a prescription for a 100 pack of 29 gauge 1/2cc 1/2 inch insulin syringes available at Walmart’s pharmacy for $12.50. I’ll change to the suggested SC bi-weekly injections this Sunday. Still no luck on the hCG, but I have an appointment in a couple of weeks, and I will try again.

I’m 41. Any idea what a good FT number would be? My test above was take exactly 1 week after my last 200mg (2-week) shot was administered in the doc’s office. I know the next time I get blood drawn I am going to ask for both TT and FT.


#8

[quote]Parf wrote:
Luckily, in Colorado you don’t need a prescription for a 100 pack of 29 gauge 1/2cc 1/2 inch insulin syringes available at Walmart’s pharmacy for $12.50. I’ll change to the suggested SC bi-weekly injections this Sunday. Still no luck on the hCG, but I have an appointment in a couple of weeks, and I will try again.

I’m 41. Any idea what a good FT number would be? My test above was take exactly 1 week after my last 200mg (2-week) shot was administered in the doc’s office. I know the next time I get blood drawn I am going to ask for both TT and FT.[/quote]

Your original post said that you were on 100mg/wk, not 200mg E2W.

I’m confused.


#9

If you take 1/2 of your current anastrozole dose, you should get near E2=22pg/ml


#10

[quote]AlwaysUp wrote:

Your original post said that you were on 100mg/wk, not 200mg E2W.

I’m confused.
[/quote]

I’m a newb.

My Dr. started me on 200mg shots every two weeks for the first 6 weeks (because I have a huge insurance co-pay), and transitioned me to self-injection 100mg IM shots 2 weeks ago. That’s when we did the blood tests. I asked him for the insulin needles suggested here, but he didn’t believe you could use them because the Test is so thick, and wasn’t comfortable prescribing Test for SC administration.

I gave myself my first 50mg SC shot this morning, after going to Walmart yesterday.


#11

[quote]KSman wrote:
If you take 1/2 of your current anastrozole dose, you should get near E2=22pg/ml[/quote]

So, .25 anastrozole on injection days then. That works, thanks KSman.


#12

I feel like an idiot. I was missing a page from the printout of my test results.

Total T 532.7 ng/dL (196-782) Normal

Does that change things? Do I want to look at increasing my T injection dose? I have 10.5 weeks left (out of 12) until my next appointment and 9.25ml of test cyp 200 left.


#13

Total T 532.7 ng/dL (196-782) Normal

I agree, with you testing 1/2 way between injections… but if you increase dose, you will need you doc to work with that.

Looking at TT and FT, you could double you dose. You really need to inject twice a week and take anastrozole only at time of injections.

I have seen other doctors state that T will not flow through an insulin needle. From a doctors perspective, they expect to load and deliver in seconds. #29 1/2" 0.5ml [do not get 1.0ml!!!]


#14

So, I’m 16 weeks in now. After meeting with my Doctor and getting his approval, I switched to an every three day (7 shots per 3 weeks) schedule.

Every three days means 2.33 shots/per week. I’m taking .27ml of 200mg/ml Test Cyp per shot, for an approximate 125mg/week.

I’m taking .5 Anastrozole with every injection for a weekly total of 1.165mg.

Here are my lab results from April 6, 2015 (taken about 12 hours before an E3D scheduled injection):

TESTOSTERONE, TOTAL, LCMSMS 955 NG/DL 250-1100

TESTOSTERONE, FREE 244.9 NG/DL 35.0-155.0 ABOVE HIGH NORMAL

ESTRADIOL, SERUM 24 PG/ML MALE: <=39 PG/ML

So, I’m feeling really good.

I’ve gotten a little nipple sensitivity, usually a couple of times a week. I’ve realized that I need to split only 1 single Anastrozole pill at a time, so I take both halves sequentially. I had previously split all my pills in advance, and probably was taking multiple small ones or larger ones during the course of a week, instead of 1mg every 2 shots.

I’m still working on my Doctor to get prescribed the 250iu HCG/EOD. I gave him a copy of the study about low dose HCG, and he said he is going to talk to some colleague of his about it, but he felt that it was a bit out of his lane. We will see. I’m pretty happy with him, since he brought up TRT with me after a blood test, instead of me seeking someone out for this.

Thanks for all the help and guidance, both in this thread, and in this forum in general. When my doc offered me TRT, he told me to go do my homework before making a decision. I don’t think he expected me to learn this much, thanks to you guys!


#15

E2 looks good. Your SHBG is been pushed down by a combo of high T levels and the lower E2 levels. That then allows FT to increase. Based on FT lab work, your dose could be considered a bit high.

We do not know your age or much else.


#16

So it’s been 8 months on TRT now, and I’ve finally gotten my doc to prescribe me hCG. I had to source it from a compounding pharmacy out of state, and I just recieved it today.

My current protocol was:

E3D Test Cyp 126mg/week, .625 Anastrozole/shot (1.46mg/week)

My BostonHeart lab results were taken the morning of an injection day (I do 9pm injections):
Total T: 681.2 | 249.0-836.0 ng/dL
Free T: 158.0 | 50-210.0 pg/mL
Estradiol: <25.0 | 27.1-52.2 pg/mL
SHBG: 27.3 | 16.5-55.9 nmol/L

I’ve felt good, excepting the testicular atrophy and concomitant aching.

My new plan is:

EOD Test Cyp 112mg/week, 250iu hCG, .5 Anastrozole/shot (1.75mg/week)

Does that sound like a ballpark reduction in Test Cyp to account for the hCG? I’ll be getting new blood work in 8 weeks, but I’ve been enjoying nice consistent results and hate to start up with side effects.


#17

[quote]KSman wrote:

We do not know your age or much else.

[/quote]

Sorry, I’m 42 years old. 5’10", 315lbs, down from a high of 370lbs last November. I’m on Atorvastatin, CoQ10, and 2000mg niacin for cholesterol. I finished IR in May, and continue to take 1-2 Idoral per week. Vit D is finally testing in the normal range at 50ng/mL. I’m taking a multivitamin, fish oil, flax oil, magnesium, Vit D, melatonin, and omeprazole nightly.


#18

I’d love to hear if the hCG makes you feel any different. Better, worse, or the same…