T Nation

E2 Crashing Advice - When to Restart AI?

38 years old
5’ft 11.5 in
191 lbs
Body fat 8%

Been on trt for about 1.5 years. 200mg Tcyp 100mg biweekly IM. For the 12 months I’ve been fighting E2 mostly low and need advice.

1/2017: loss of erections
Labs: E2 20 estro sensitive, test 1400, free 38
Action from doc: reduce to 0.5mg 2x / week from 3x a week. Cialis Daily 7.5mg

2/17 - 8/17: stability. Not in sweet spot but cialis working OK. More premature ejac than ever before in my life.

9/2017: taking dex 0.5mg 2 x / week. loss of erections when standing (weird) wasn’t in tune with what was going on.

10/17/17: no libido, weak erection, loss of penile girth, bat shit crazy emotional, paranoid.
Labs: E2 < 17pg/mL non estrogen sensitive
Total T: 1307, free 36.9, SB 27.3
Action: stopped anastrazole for two weeks, at end of 2 weeks felt slightly better. Took 0.5mg on 10/31 then recheck E2 a day later.

11/01/17 : labs: E2 < 2pg/mL estro sensitive
Total test 1400, weak /no erection, loss of girth, smaller load.
Action: call Doc. Stop AI.

11/10: labs E2 estro sensitive 20pg/mL
Test : total 1300’s, Free 37, SB 26
Actions: switch to SQ test 100mg 2x /week

11/29: sweet spot hit but back acne starting

12/1: no AI for 1 month. Libido thru roof, erections strongest in over a year. Girth markedly bigger, loads bigger, back acne noted.
Labs: E2 40 estro sen, text total 1200
Action from doc: take 0.25 5 days After lab draw then 0.25 q 3 days.
Up cialis to 13mg daily

12/10: loss of erection loss of girth, SMFH I crashed again.
Labs: 24pg non estro sen but I know it’s low.
Action: stop AI. It’s been 7 days today.

Long story short. I’m waiting not so patiently for it to rebound. Upon rebound when should I dose the AI and how much.

Looking at my trends it took 2 weeks for my E to go up 20 points.

I’m considering diluting in a solvent and micro dosing the AI 0.125mg once a week maybe?

I’m desperate for stability and consistent libido /erection strength. Any advice appreciated.

I’m not the expert here, but from my personal experience, if you need that little AI, just back off your testosterone slightly and don’t even use it. You will produce less E and you won’t have to worry about crashing it. Cialis will also drop your E, and that is a large daily dose. I’m really happy with my E2 between 20-30. Lower I get joint pain and weak libido, higher I retain water and have iffy erections.

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I think that is good advice to lower your test a little bit and see if that helps lower it. It wasn’t insane without the AI. Might be able to get it into place with something OTC even.

I totally screwed with my e2 for the first year of my TRT, and I payed for it with joint issues that are just now starting to resolve.

It sucks when you are low because it can have the exact symptoms as being high, and then you end up taking more AI and screwing yourself even more.
Microdosing is an option. Use the alcohol method.

So seems like my options are:

1- drop the test to 160-180mg per week and try no AI or
2- when my E rises again try microdosing the dex .125mg per week.

Decisions decisions…

or DIM or CDG might work if you want to try and avoid using an actual AI. Some people even use zinc, not sure how effectively.

Duplicate posts are really a problem.

Stick to one thread for your case to not create duplication of effort and spreading out your case and responses which looses context and value.

Once members see multiple posts they will lose interest in helping. You are all over the place, you are starting and stopping not allowing yourself to reach any sort of balance. You need to make micro adjustments to your protocol. You don’t seem willing to lower your dose at all, have you ever thought that perhaps your dose is just too damn high? When I was on 200mg my levels bounced around like crazy, lower dose brought about stability in my levels causing the fluctuations to slow down.

Understood. First time poster. The pharma board seemed more active then the trt board.

There is a lot of advice and tribal knowledge there that is arguably very wrong. Try to not drag any of that with you.

I’m considering the lower dose hence my question To microdose AI or lower dose overall. The whole point is to get dialed in and steady.

I’d like to try one intervention at a time in small increments. Either drop the T to 180mg /week or dose the AI 0.125mg once a week. Was hoping for recommendations on which to try first.

I think you need to start out much lower and work your way upwards slowly, this way you will see a slow steady increase in E2 and once this happens you can make small changes. When you start someone out sky high everything becomes more difficult to manage because your levels are all over the place. I started out low and slowly worked my way upwards until I started having symptoms, then I backed down my dose and a day later started feeling good again. I usually alway give my bloods 4-6 weeks to stabilize, then I give it a month or two to see how I feel before making any further changes.