T Nation

A-dex Not Enough for High E2?


with my T cyp 1ml (200MG) sc divided into 2 doses and taking 1.5 mg anastrozole in 3 doses (1/2 pill 3x a week) E2 down from 79 to 68 in 4 weeks... is 68/22 simplified to add 2.5-3mg a week more? Im coming down on the body fat but still 345# and 47 yo man. Strength back up benching 405 easy again. Hoping to begin the Hcg protocol as well and I know that can raise E2.

I have considered lowering T by 20% but TT is at 658 (205-781) on 1ml and FT at 180 (22-227) or 2.8% (1.60-2.90)Didn't post complete labs since in the past 20 weeks and 4 labs we have gotten all else in "T-Nation" recommended values. DHT at 400 (106-719) Dr says fine I'm not terribly concerned but maybe I should be? she suggested Proscar a possibility..... I don't like that advice either Thanks


Why are you concerned about: "DHT at 400 (106-719)"

Liver might not be clearing E2 and other estrogens. SHBG might be elevated as a result.

Post all OTC and Rx drugs as well as supplements.

Labs for AST/ALT?

Normally LH and FSH on TRT are at or near zero. Wondering if something is activating your testes. If your testes are now small[er] from TRT, and/or scrotum is up tight, we would then know that LH is very low and not a concern re E2 production.

Who makes those anastrozole tabs. Could they be under dosed?


Ksman....What is AST/ALT? sorry
Also high BMI might be a contributing factor?
I wasn't concerned about DHT till Dr said less is better nearer to 200 would suit her. Generally Dr's treat DHT as evil. I think otherwise....
I do have crown baulding but that was before TRT and Dad is same way and never on TRT
Shave every day 5 oclock shadow since on TRT
chest hair not an ape but full very little back hair but some
Testes 1/2 size as 34 weeks ago constant pain in them and up tight like 12 yo.
SHGB 20.1 (13.3-89.50)
TT 636 (205-781
FT 2.83 (1.60-2.09)
FT calculation (180 (33-227)
Bio T 413 (131-662)
estradiol 67 (20-47..............high
cortisol 8.3 (8.7-22.4)............low (low DHES sulfate)
DHEA sulfate 91 35-430)..........low
pregnenolone 46 (22-173)
DHT 400 (106-719)

FT4 0.79 (0.56-1.64)
FT3 2.85 (2.00-3.30)
TSH 2.85 (0.34-4.00)
RT3 15 ( 9.0-27)
This is 12 week after IR (50mg for 3 weeks) 4mg a day since. could be why TSH a little high
Basil temps still 97.2 average
98.6 by 10am till 2-3pm
98-98.6 always on treadmill
hematicrit 50.9 (40.4-52.4) Up from 46 20 weeks ago
PSA 0.6
DRE 2x no issues
no piss issues
Nocturnal wood every night every morning
ED still persists, Viagra gives good erection to start lost in 2-3 min (leakage issue I think)
low libido
Muscle gain and strength awesome
mood steady no anger no crying
No more anxiety
Very few body ache only from hard training days
D3 1600 mg a day
Iodine 4mg a day
selenium 800mg a day
Calcium 1000mg
magnesium 1000mg
potassium 200mg
Meloxicam 15mg a day for knee pain arthritis
T cyp. 100mg .05ml 2x a week SQ ichy painful injection issue gone
1/2 anastrozole 3x a week Wal-Mart pharm.
BP 140/78 average
cholesterol up to 164 (75-200) from 155 2 months ago trying to get 180-200
hdl 44 (40-131)
non HDL cholesterol 120 (0-129)
LDL calculation 109 less than 101
Blood draw was 2 days after T injection, 1 1/2 days before next injection due 8 am draw after 12 hr fasting


yeah, you need to get E2 down. You could lower your T dose and have the same free t levels if you get that under control. KSman is right to question liver issues. No reason you should have to take 3mg of Adex. You could try any of the popular liver support supplements. Maybe some calcium d-glucarate too.

DHEA-s is easy to fix but will might add to your E2 issues. Best to look at your adrenal situation as a whole if that test was in the morning. Unfortunately the toughest to address without HC.


An adaptogen, good b-complex and some licorice root might be a good idea and retest cortisol after a month or so.


AST/ALT? - see technical definitions in the advice for new guys sticky.

Iodine replenishment did not resolve body temps and thyroid labs are poor. Suggest that you get on Rx thyroid meds and dose to restore body temperatures. I think that this and E2 levels are your major concerns and reason for elevated E2 might be significant concern as well.

Testes are small, so we can safely assume that they are not creating your high E2 and LH/FSH are very low.

Some other things may change with thyroid meds.


AST/ALT wow brain fart....
done first labs
ALT 68 (7-52)
AST 32 (13-39)
Dr said "fatty liver" I've heard that for years
20 years ago had great Ins. so Dr. did in depth liver study...Cat scan ultrasound all kinds of stuff I didn't understand and when done said "Fatty Liver"
Should I avoid the HCG? since will raise E2? Dr says would help with Testicular pain


That's A LOT of Adex for you to still be that high. I'd think your E2 would be in the basement on those doses, >1mg/week. What Estradiol test are you getting...the standard for pre-menopausal women or the sensitive/ultrasensitive more suited for men?


I'm taking 1.5 mg a week taking 1/2 a-dex 3x a week. I need to ask the lab which test being done? not printed on the results. my BMI is still pretty high. that might be a factor. I'm getting with a new Dr. next week who's repetition is very knowledgeable with all things male. He is a GP but works out hard has done a show or two and I think he can help. My current has learned all she can and that's from me so we must part company. I believe the thyroid issue is not helping so he may be inclined to supplement thyroid as well. Thanks guys... might try the dhicky suggestions as well, liver could be an issue. Adrenal issue... Hgc could help, but E2 battle harder once I go there, I'll get it straight soon.


Fatty Liver


Liver issues explain low E2 clearance. Try increasing AI by a factor of 67/22

See what hCG does. Will eliminate testicular ache if a result of HPTA shutdown.


thanks dhickey for the link, great read.... The f--king Dr's have made the fatty liver comment for years like "nothing to be concerned about". Will address with natural supplementation since vit E, omega 3, milk thistle etc. make a big difference. Meloxicam is particularly hard on the liver but Dr showed no concern with the addition of that Rx. Well it's our responsibility to figure it all out anyway. Thanks again, explains some issues and could prevent further damage. also considering lowering TRT dose to 100mg a week and see if I still feel as good as 200mg. I wont tell Dr or could be difficult upping dose if needed. This will help E2 as well. up AI too if idiot Dr will prescribe more, going to new Dr soon anyway new guy understands more about protocols for TRT according to Pharmacist friend and several body builders I know under his care.


Update, this week I thought I bottomed out my E2, 1.5mg a week for the past 5 weeks. I woke up one day could barley get out of bed, by the next day joint aches, severe back ache, no pump in the gym, weak, brain fog, anxiety, want to sleep all day, face on fire. (WTF) I cut AI dose (skipped 1 dose) and had blood draw day after shipped dose, just for E2, and still at 50 which is going down from 79.

1 week of this and it reminds me of pre TRT but far worse. Any insight? I've read some threads about hitting a wall but I don't know? morning wood good, still no improvement with ED, skipped 1 work out to give a three day rest, that felt worse. I don't know if it matters but 2 weeks before this started the Dr. refused to start me on Hcg (said too hard to get and at my age it wont help anything plus too expensive for what it will do)but he had me start taking 50mg a day DHEA and 1800mg Saw palmetto a day? could that start trouble?


In for updates


Im going to suggest again that you obtain the sensitive Estradiol test that is proper for males. The standard test is closer for females and just not appropriate for males. Many people test high on that standard test and then get the sensitive test and find out that they're low E2, all the while they're shoveling Anastrozole and just exacerbating the problem of treating (false) high E2.
In your situation, I think you/we have id'd other issues with liver and BMI that I'd confront those (I know you are) before I started taking more AI.


I don't get it when a Dr says a drug cost too much, their not the one paying for it. I have found they will come up with all kinds of excuses not to give it to you, but didn't you say the Dr was the one that said hcg would help your testicular pain? Looks like you really need to work on your liver issues and I would look into which E2 test was done. You may be able to lower your T dose and still benefit more. Have you got results back from your last blood draw?


Results back,
at Lab-Corp
E2 at 31 20-47
TT 493.14 205-781
SHBG 22.3 13.3-89.5
FT % 2.57 1.60-2.90%
FT calculation 127 33-227
Bioavailable 297 131-682

2 weeks earlier the private lab "CK labs
did ultra sensitive and
E2 53.4 1-47

Dr today upped my script from 1 Ml (200mg) a week
1.5ml a week (300mg)
and increase Anastrozole from 1.5mg to 2 mg a week spit into even doses

said the E2 is under control but with increase T we increase AI equally.
Said at my weight the increased dose should bring me to a 700+ TT which should help my continued symptoms of low energy, low libido. and possibly help Ed problems.
He Still thinks Hcg is a waste of time and money at my age and increased T is better approach.
Testicular pain has stopped the last couple weeks, he said that would eventually happen.
but if I took Hcg my testes will reactivate, E2 would be harder to control (due to testicular Test.) and if I stopped taking Hcg the testicular pain will start all over again and last until complete shut down. Makes sense there?
BUT doesn’t 300mg a week sound a bit high for TRT? or since my other blood labs are great just try it and see how I do?