T Nation

Attempting to Restart at 49


It’s been a while since my last post but trt and managing e2 has been quite a ride. My problems first began when my TSH reached 6.6 during a yearly physical exam. I was under extreme stress and I believe it was the cause of most of my health issues. A couple of weeks later after requesting Testosterone test it was at 153.
I began injecting test cypionate but e2 was always high or low no matter how much or how often I took arimidex or aromasin. I had been injecting 25mg 3 times per week which put me at total testosterone of 600 and free at 18.6. My SHBG ranged between 16-18 while on trt probably resulting in higher free testosterone.
Over the last couple of months I tapered my dose down to 30 mg per week with my last injection of 15mg on December 29th.
I received labs today that were taken on January 26th. I have been injecting Hcg at 250 IU eod since December 21st and would cycle hcg every couple of months during trt.

Total t 106 range 348-1197
Free t 7 range 6.8-21.5
SHBG 22.6 range 16.5-55.9 highest tested
E2 sensitive 3.4 range 8-35 taking 6.25 aromasin 2x per week, obviously too much.
TSH 1.06 range .45-4.5
Thyroxine t4 7.7 range 4.5-12
T3 uptake 29 range 24-39
Free thyroxine index 2.2 range 1.2-4.9
LH 4.5 range 1.7-8.6
FSH 3.4 range 1.5-12.4
DHT 20
I took my last 250iu of hcg on January 25th, the day before lab work. I began taking prescription Nolvadex on January 27th at 10mg per day. What do you think my chances are of recovering, so far I have had only some insomnia while on the hcg and waking up extremely hot but no sweating. Energy level still decent, mind clearer, less moody. I will note that when I was taking 20 mg on Monday and Thursday that I felt the best I had in a long time.


Please read the stickies found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc
  • HPTA restart

Thyroid: In the future, test TSH, fT3, fT4
uptake and index labs are obsolete


Thanks , KSman.
I did have rt3 checked last month.
It was 20.2 range 9.2-24.1
Vitamin d 25 hydroxy was 32.2 range 30-100.
While taking the hcg and waking up hot I would take 6.25mg aromasin and would usually be able to go back to sleep. Do you think that waking up hot was just simply my e2 beginning to raise?
A couple of positives after coming off trt,
Lower blood pressure, better erections without cialis or viagra, return of nighttime wood. The only downside has been libido is a little lower but it’s still there. By the way my e2 was 44.2 at the end of November while injecting 20mg cypionate on m/w/f. Range 8-35 and no aromasin.
Would you expect LH and FSH to be where they are now this soon, they were basically zero while on trt.


What time of day for hCG injections? May affect sleep.
You only take aromasin when you hot flash at night?

May be feeling warm at night because of room temperature or too many covers. Your metabolic rate is increasing, getting restored. Try just a sheet and a thin cotton cover.

rT3=20.2 range 9.2-24.1
See the connection?

Take 5,000iu Vit-D3, take 25,000iu for first 5 days

You always need an AI with anything that increases/restores your T levels.
There may be a problem with E2 clearance, liver or some medication.

Anastrozole ~1mg/week is normally preferred VS larger amounts of aromasin.

Read thyroid basics noting:
stress factors
adrenal fatigue
Wilson’s book
AM cortisol


A.M. Injections for HCG. Sometimes with aromasin and sometimes with perceived high e2.

The 6.6 TSH was several years ago. The rt3 was checked the first time last November when TSH was around 1.6.

Based on what you’ve seen you believe I will need to continue with a blocker while taking daily Tamoxifen over the next 30 days?


I will have labs again in 30 days to see where I’m at with levels and request rt3 and rt4. Cortisol and prolactin are normal.


rT4 does not exist

do not assume that normal range means optimal

If E2 gets too low, you can have hot flashes.

Taking an AI the way that you are doing is a bad idea. You need a steady dose. Then E2 labs will tell you how to adjust the known dose. If dose is not well defined, you cannot calculate a new dose from an unknown.

Do not use term “blocker”. That is very imprecise. In your case you are taking an AI [aromatase inhibitor that “reduces” T–>E2. “Blocker” can be confused with SERMs that block/reduce effects of E2 on estrogen receptors.

I hope that you will read those stickies/


Thank you Ksman! I will read the stickies again and have labs you suggested added.
Does HCG alone increase LH or only simulate and trick the body by mimicking LH? I have tried everything to control e2 over the last couple of years. I am definitely an over responder. I have dosed arimidex as low as 1/10mg twice per week and tanked e2. Even injecting small doeses of cypionate 2-3 times per week resulted in +35 e2 levels without AI.


Aromasin is then a good option, or homeopathic doses of anastrozole.

hCG substitutes for LH.
If not on TRT, hCG will lower LH/FSH as/if T and E2 increase.

SERMs cause the hypothalamus and pituitary to release/increase LH/FSH production.

Thinking “trick the body” is not useful. It is simply activating LH receptors with the LH active lobe of the LH peptide hormone or the hCG peptide hormone.

Managing E2 levels with an AI when not on TRT is a completely different game from TRT when there is ample FT for FT–>E2.

With your FT=7, FT–>E2 was very low and any AI could easily be overkill.


So far, not so good on restart.
Free test has dropped from 7 to 4.9
Total test has dropped from 105 to 98
Estradiol increased from 3.4 to 7.5 sensitive
LH increased from 4.5 to 5.8
FSH dropped from 3.4 to 3.0
DHT dropped from 20 to 18
Cortisol a.m has increase from 10 to 20.6
Which may explain the extreme insomnia I’ve had for several weeks.
SHBG increased from22.6 to 27.8

These results are with last injection at the end of December, labs listed are from today and January 26th.
Should I continue with restart attemp or do results prove it to be useless. Have overall felt pretty good except for lack of sleep and almost zero libido for las 3 weeks.


New thyroid results also came today.
TSH up from1.06 to 1.78
Reverse t3 23.4. Range 9.2-24.1
Free t4 1.17 range .82-1.77
Trillodothyronine free 2.8 range 2.0-4.4
T4 8.5 range 4.5-12
T3 uptake 30 range 24-39

Currently taking .088 synthroid and 5mcg cytomel.