Controlling E2 Whilst on TRT

[Klippe]

Hi All. Trust everyone is well?

I would like some advice please....

I am on TRT at the moment, the following:

1) Monday morning, Wednesday afternoon, Friday evening, 0.2ml Test Cyp @ 250mgs/ml (equals 150mg Test Cyp week for approx 108 mgs test without the ester) injected with a 29G needle in the delts (alternating)

6 weeks ago, I dropped HCG 250IU's at the time of the T injections, in an attempt to reduce E2 levels. (I had understood that HCG causes rises in E2)

I have just received my labs back. The test was done 24 hrs after last injection.

The results are:

E2: 139 pmol/L - 40 - 161
TT: 30.2 nmol/L - > 12
SHBG: 14.10 nmol/L - 11.1 - 78.1
FT: 992 pmol/L - 180 - 739

So, basically everything is high...My T is not too far over the range, but I would like to get E2 down to 90 - 100.

I would prefer not to make use of an AI if I can help it.

Yes, I do carry to much BF so my aromatase activity is on the high end.

If I change the injection site to the belly (into the fatty area), will that make a change in the peaks and troughs of the T (and also E2)? Bringing it lower due to the slower release rates?

If I reduce the T dosage by 25%, would, all things being equal, that result in a 25% decrease in E2 levels (i.e. are they linear?)

Help and guidance would be really appreciated.

[KSman]

That hCG dose typically would not contribute much to E2 levels.
Please show before and after E2.

E2=80 pmol/L would be a good target.

Reducing T dose by 25% would not get you there.

Aversion to anastrozole is because doctors will nor prescribe it there?

[Klippe]

Hi KSman, thanks for your kind reply.

You are correct, my E2 did not change markedly after dropping the HCG (1 or 2 points only)

What is odd to me though is that my SHBG is so low given the relatively high E2....

TBH, my aversion to anastrozole has more to do with that I have been led to believe that using it to control E2 is a bit of a hit-n-miss affair giving rise to nightmarish fluctuations that are difficult to pin down. Also, that it is harsh on the lipids. (Seeing as I am on TRT for life, I reckon the less the better iro exogenous chemicals)...sooooooo.....But I can get hold of anastrozole with no hassles and in fact I have on hand at the moment.

What would you be suggesting in this case? Keep my T dose stable, injection site the same and to introduce anastrozole at your recommended dose of +- 1mg/week at injection time and retest after 4 weeks to get a baseline and adjust from there?

[KSman]

With steady T levels you should not get E2 swings at all. That can occur when guys make ill-considered dose changes. There are a few guys that have a hard time getting balanced, but you should not let that steer your ship.

Yes, SHBG is low. Some guys are like that. But there can be medical reasons.

Sex hormone-binding globulin | Conditions associated with high or low levels

[Klippe]

Thanks for the info.

I won't bother the SHBG.

You are saying, keep all things equal and introduce the anastrozole and retest?

[KSman]

Yes.

You know that some guys are anastrozole over-responders who need 1/4th the expected dosing? No way to know in advance.

You could restart hCG as well.

[Klippe]

Thanks, will start dosing AI with next T injection tomorrow evening.

One question if I may...the standard here on this forum is to use arimidex / anastrozole as an AI, with 1 mg/week as point of departure. Have you ever considered using Aromasin / emexstane? It is supposedly "gentler" and easier to dial in? I have no idea, hence the question....

[KSman]

Anastrozole is well behaved with a known dose-response. The AI that is not predicable is Letro.

You can use 1mg anastrozole per week or use multiple 25mg doses of Aromasin. Anastrozole is more effective, less drugs in your body and less cost.

[Klippe]

Thanks, I am assuming that cost is the prohibiting factor in any event...

will keep you up to date with progress once new labs come in.