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Anastrozole Before T and HCG Injections or Anytime

I’ve been trying to learn the best way to take Anastrozole. I understand that it blocks the enzyme that converts T to E2. However, if theoretically my E2 was very over 70 would taking Anastrozole help lower my E2 ? Also, I’m taking 250 IU HCG daily and I was thinking that .25 Anastrozole E3D would be about the right place to begin, and adjust from there. I’ve learned that TRT is more of an art, than it is a science, ironically. Additionally, I haven’t found lab results that helpful, for the day to day of TRT. Although,they 're great for the big picture, but soon enough I seem to be to high or low, so I was hoping for some helpful input.

Thanks!

I would start once weekly AI dosing and see how it goes for 10 days (steady state), if you tolerate it well and still not quite feeling right, you could either try reducing the HCG dosage or increase to two times weekly.

Since you are on daily HCG, I don’t think it will matter much when you take it, but generally you take it with your T injections. You will still have intratesticular estrogen in your system that is untouchable by anastrozole.

I just got off anastrozole after 4 months. It was mixed with my shot so I was taking 1mg a week. I can tell you that it’s nasty stuff and should be taken as little as possible. My teeth were getting soft and my skin was super dry AF. Just 2 shots without it and skin is night and day bouncing back.

Thanks for the input, I appreciate it. Do you think it makes sense that if you go to the gym and loose 20 lbs. that you could have less of an E2 problem since you now have less aromatase enzyme, which meand you would convert less T to E2?

That’s crazy I never heard of such a thing it’s good you were smart enough to get away from that doc!

Good luck

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My guess is you probably don’t really have an e2 problem. If you’d stop the ai for 6-8 weeks, maybe 3 months, your hormones would stabilize and you’d not need an ai at all without losing weight. Though losing is a good thing for most people.

@dbossa has a good video on “high e2 issues”, the executive summary is that for 99% of people they don’t just don’t or what is perceived as high e2 issues will resolve on their own.

I would agree. Most guys who are taking TRT levels doses and are doing at least 2X weekly dosing, simply do no need to use an AI. My experience is that it way to difficult to dose anastrozole and you end up crushing your E2.

Also, to the OP, what is your dosing protocol. You speak of HCG but not T dose. It is important for us to know to give good advice. Further, you mentions that your E2 was 70. What test method was used and what is the normal lab range. These are important factors to know. Many docs simply do not understand that there is a difference between the standard E2 lab that is typically administered to women than the ‘sensitive’ assay designed for men. You will always test high on the women’s assay, no matter how low you drive your E2. Also, there are 2 different ‘sensitive’ assays and it is highly recommended that you avoid use of the direct (immunoassay) test method in favor of the LC/MS test method. The LC/MS test method is much more accurate and eliminates the cross-reactivity problem with the immunoassay (e.g., ELISA).

That is not correct. Below are some examples showing the opposite. One is mine.


IA LC 50-68
IA LC 38-52

That is not true either.

The ECLIA test (aka immunoassay or IA) for E2 management is commonly used for those on TRT. It is not an incorrect test or a test for women, but simply one way to check estradiol levels. The other commonly utilized test is the LC/MS/MS method (aka liquid chromatography dual mass spectrometry, sensitive or ultrasensitive). It is the more expensive of the two. There are inherent advantages and disadvantages to each of these two methods. I have been fortunate to be able to speak with professionals who work with both methods. One is a PhD researcher for Pfizer and the other is a medical doctor at Quest. I’ll summarize their comments.

The ECLIA method is the more reliable of the two in terms of consistent results. The equipment is easier to operate thus accuracy is less reliant on the skill of the operator. If the same sample were to be tested twenty times, there would be very little, if any, difference in the results.

The ECLIA method is not as “sensitive” in that it will not pick up E2 levels below 15pg/mL. If your E2 level with this test is 1-14pg/mL, the reported result will be “<15”. Because of this, it is not recommended for menopausal women, men in whom very low levels of E2 are suspected, or children. In other words, if your levels are below 15pg/mL, and it is important to know if the level is 1 or 14pg/mL, you do not want this test. For us, this is likely moot, since if you are experiencing low E2 symptoms and your test comes back at <15, you have your answer. For a woman being treated with anti-estrogen therapy for breast cancer, it may be necessary to know if the E2 level is zero or fourteen because therapeutically, they want zero estrogen.

A disadvantage to IA testing is that it may pick up other steroid metabolites, which in men would be very low levels, but still could alter the result. Another potential disadvantage is that elevated levels of C-reactive protein (CRP) may elevate the result. CRP is elevated in serious infections, cancer, auto-immune diseases, like rheumatoid arthritis and other rheumatoid diseases, cardiovascular disease and morbid obesity. Even birth control pills could increase CRP. A normal CRP level is 0-5 to 10mg/L. In the referenced illnesses, CRP can go over 100, or even over 200mg/L. Unless battling one of these serious conditions, CRP interference is unlikely.

The LC/MS/MS method will pick up lower E2 levels and would be indicated in menopausal women and some men if very low E2 levels are suspected and it is desired to know exactly how low, children and the previously mentioned women on anti-estrogen therapy. It will not be influenced by elevated CRP levels or other steroid metabolites.

While some may believe the ECLIA test is for women, on the contrary, as it pertains to women on anti-estrogen therapy, such as breast cancer patients, the LC/MS/MS is the test for women as CRP levels are a consideration and it is necessary to know if the treatment has achieved an estrogen level of zero.

On the other side of the coin, LC/MS/MS equipment is “temperamental” (as stated by the PhD who operates both) and results are more likely to be inconsistent. Because of this, researchers will often run the same sample multiple times.

It is not clear if FDA approval is significant, but this appears on Quest’s lab reports: This test was developed, and its analytical performance characteristics have been determined by Quest Diagnostics Nichols Institute San Juan Capistrano. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes. This statement is on LabCorp’s results: This test was developed and its performance characteristics determined by LabCorp. It has not been cleared by the Food and Drug Administration.

It is unlikely that any difference in the same sample run through both methods will be clinically significant. Estradiol must be evaluated, and it should be checked initially and ongoing after starting TRT. It obviously makes sense to use the same method throughout. Most important are previous history and symptoms related to low or high E2. Those are correlated with before and after lab results. Any estradiol management should not be utilized without symptoms confirmed by lab results.

Really, it’s just a number and should not be the driving force behind any E2 management. Whatever test you use, as long as you use it consistently, is not as relative as symptoms which may be correlated with significant changes in E2 levels.

For example, you’re starting TRT, with whatever test, and your E2 is 28. You seem to be experiencing some adverse symptoms. On your follow-up labs, E2 is 58. Changing something to alter estradiol seems reasonable. On the other hand, your E2 comes back at 35. Might be better to look elsewhere for the cause of your symptoms.

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Are you on testosterone, or just hCG?

First you should be in the gym staying metabolically active anyways, but loosing visceral belly fat can only help lower E2, by how much is very individual.

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I lost 20+lbs the first year on TRT and I can tell you TRT is a while different experience when you are in shape. You feel it more and there’s much less side effects. The actual level of estrogen doesn’t matter. My labs had E2 at 80. I too started off using anastrozole and completely believed I had high E2 issues when I wasn’t feeling ideal. Turns out I was just not in shape and my diet was shit. Hopefully you don’t waste a year figuring that out like I did. The anastrozole causes its own issues.

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Hello Youthful,

Regarding my T dose it’s a testosterone cream, (TC) (30ML) 200MG/ML applies twice a day. Previously I was on a slightly higher dose at 25%, and I responded well except where E2 was concerned. I was so high that climax was out of the question on several occasions and there were other high E2 symptoms, but I’m sure you get the picture. No AI was used. After trying to manipulate the TC dose the doc recommended I drop to a 20% TC, which I’m currently using. By it’s self it seems ok, but I’ve only been on the new dose about 2 weeks. However, I thought with the lower dose I would have “room” for an HCG protocol. I wasn’t sure where to start with the HCG, since in the previous protocol of TC at 25% I wasn’t taking any HCG, I was to busy just trying to get the TC 25% to work without and AI. I should point out that this all came about when my doc recommended I drop my AI, and just let things be, since at the time my TRT had been a roller coaster.

As I mentioned I’m now at a lower dose of TC, so I thought I could introduce a modest level of HGC, which I do enjoy. I’m dosing 200IU daily, and it seems to be to high after a few days which is a bit concerning to me since I lowered the TC I thought I would have “room” for the HGC, at 200 IU daily, but as it seems it requires an AI about 1mg weekly. I’ve read that many guys are using 200IU HGC without an AI and with a cream for T a lot less spiking I though I should be able to handle the HCG, but not yet. So I was thinking it’s more about me and E2 than the dosing of the medication, and thought I would just put “it” out there for some productive input.

Thanks.

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Hello Highpull,

You and me both. I’ve gotten to the point where I bought a gram scale, and I weigh my AI so I can vary the dosing more freely, than just cutting it with a razor. Regarding my T dosing, its testosterone cream, (TC) (30ML) 200MG/ML applied twice daily. Which I thought work well with HCG, since it eliminated spiking and it’s being doses twice daily. But, my 200IU HGC is still causing a high E2 problem. I know I can go to a lower dose, but I don’t think that’ actually addressing the consistent problem of high E2. I will tell you that I’ve been non active since I hurt my Knee at the gym, so I’ve been sitting around a lot and my diet has been less restrictive, so I was thinking more body fat = more aromatase enzyme = more T conversion to E2 =high E2. But I wasn’t sure if I was correct, so I though I’d see what you guys thought.

Thanks

Dexter,

That’s very interesting. I think you proved what I was suspecting, although I didn’t think that 80 on E2 would be in the cards, while working out since by burning off the fat, you lower the aromatase enzymes and therefore, lower the T conversion to E2 hence a lower E2 score. But you lived it and I haven’t… yet. I have always been active at the gym, but I injured my knee working out about six months ago so I became a bit of couch potato. I’m hopeful that I will be returning to the gym late this week, or early next week.

My Lord,

Very true, but not if you screw up you knee while working out…… :blush: So simply put you believe that once I get back on my feet, I can perhaps solve my high E2 problem, with my gym routine, cardo and weight training etc.? I hope that’s what your saying, since it’s what I think and it should solve my problem.

Thanks.

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you can train more than half of your body without using the knee. I’ve been working around a knee issue for the last few months. No squats, sadly, but trap bar dead lifts seem to be relatively pain free, and the upper body is full go. Not sure how bad your knee is, but there are many ways to train around injuries and keep the habits in place.

Hey Dsmith,

I understand I’ve been doing this for decades. The details I’ve choose to leave out, are it’s back related which ultimately is effecting e my knee, which for the purposes of this forum, I would have thought sufficient. I just need to let things rest for the time being. I do appreciate your input. Did you have any thoughts on the central E2 problem I posted?

Thanks for your response.

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Hello Wolf,

I find your statement very interesting. In fact, I’m in the camp that agrees with you. However, when I’m high on E2 I find it very unpleasant. As an example, it’s almost impossible to get off, I get some ED, I gain bely weight, sleeping is disturbed, and my face is red as a beat, energy is lower, and over all I feel like crap. Going up to 3 months without an AI, or adjustment in dosing seems very unlikely for me, when considering the side effects of high E2. I’m guessing that you had a better experience, than I’ve had.

Thank you for your response, it was helpful. Maybe I’ll give it another try, with some dosing adjustments.

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Yes, when you see a skinny fat older guy, you can make a safe bet he’s low test and high estrogen. Visceral fat is possibly our biggest enemy.

Do you have to take hCG?

How often do you inject testosterone?

Regarding my T dosing, its testosterone cream, (TC) (30ML) 200MG/ML applied twice daily. I don’t understand your question about having to take HCG. I guess the correct answer is yes, if you want to keep your nuts for the rest of your life. Also, I like the libido bounce, and additional fullness, and of course there is the increased load factor. So yep! Do you use it?

Thanks