T Nation

E2 Level Control

40 y/o M - 200mg Cyp x 1 pin per week - 12 weeks in. Was doing .25mg Anastrozole once per week. Based on the bloods below am considering .5mg twice a week. Intention is to maintain the T dose constantly.

So far I have experienced

  • Possible breast changes - could be paranoid though
  • Balls have not shrunk at all
  • Really bad back acne
  • Libido exceptionally high
  • Morning wood is daily and strong

Had bloods back. E2 is elevated. Should I lower dose of T, have a better AI protocol, split the dose? Any advice would be appreciated. Is there a sweet spot I should aim at for the E2 number?


Red Blood Cells

HAEMOGLOBIN (G/L) *173 g/L 130.00 - 170.00

HCT 0.491 L/L 0.38 - 0.50

RED CELL COUNT 5.16 x10^12/L 4.40 - 5.80

MCV 95 fl 81.00 - 98.00

MCH *33.6 pg 27.00 - 33.00

MCHC (G/L) *353 g/L 300.00 - 350.00

RDW *10.0 % 11.50 - 14.40

White Blood Cells

WHITE CELL COUNT 6.0 x10^9/L 3.00 - 10.00

NEUTROPHILS 3.04 x10^9/L 2.00 - 7.50

LYMPHOCYTES 2.08 x10^9/L 1.20 - 3.65

MONOCYTES 0.61 x10^9/L 0.20 - 1.00

EOSINOPHILS 0.14 x10^9/L 0.00 - 0.40

BASOPHILS *0.15 x10^9/L 0.00 - 0.10

Clotting Status

PLATELET COUNT 234 x10^9/L 150.00 - 400.00

MPV 9.5 fl 7.00 - 13.00


Kidney Function

SODIUM 139.3 mmol/L 135.00 - 145.00

UREA 3.3 mmol/L 2.76 - 8.07

CREATININE 69 umol/L 62.00 - 106.00

ESTIMATED GFR 117.7 60.00 - 250.00

Normal range: >60

Afro-caribbean ethnicity: Multiply result above by 1.21

Liver Function


ALANINE TRANSFERASE 23.6 IU/L 0.00 - 50.00

CK 86 IU/L 39.00 - 308.00

GAMMA GT 20 IU/L 10.00 - 71.00


TOTAL PROTEIN 71.6 g/L 66.00 - 87.00

ALBUMIN 40.2 g/L 35.00 - 50.00

GLOBULIN 31.4 g/L 19.00 - 35.00

Iron Status

FERRITIN 172 ug/L 30.00 - 400.00

Cholesterol Status

TRIGLYCERIDES 1.72 mmol/L 0.00 - 2.30

CHOLESTEROL 3.13 mmol/L 0.00 - 4.99

HDL CHOLESTEROL *0.92 mmol/L 1.00 - 1.50

LDL CHOLESTEROL 1.43 mmol/L 0.00 - 3.00

NON-HDL CHOLESTEROL 2.21 mmol/L 0.00 - 4.00

Heart Disease Risk

HDL % OF TOTAL 29.39 % 20.00 - 100.0

Thyroid Function


FREE THYROXINE 14.800 pmol/L 12.00 - 22.00

FREE T3 5.39 pmol/L 3.10 - 6.80


TESTOSTERONE *72.1 nmol/L 8.64 - 29.00


17-BETA OESTRADIOL *170 pmol/L 41.00 - 159.00

SEX HORMONE BINDING GLOB 26.3 nmol/L 18.30 - 54.10

PROLACTIN 251 mIU/L 86.00 - 324.00


PROSTATE SPECIFIC AG(TOTAL) 0.806 ug/L 0.00 - 1.39

The acne is a sign of higher estrogen. But you seem to not have really any other negative symptoms. YET.

I presume your shbg will lower a bit over time. This may affect things.

You could try lowering your dose to 175mg a week and see if you maintain your libido and acne clears

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Why are you using such a high amount of T? That’s over 2,000ng/dl people normally aim to be around 800 on TRT. You will run into issues in the long term at that dosage, I would be running around half that dosage. Also consider increasing injection frequency to at least E3D that will help keep levels more stable and e2. The key to effective long term TRT is to not need an AI by finding the right dosage and frequency (unless you’re someone that is super prone)


I take your points on board. I shall think about reducing the dose and see how I feel / symptoms / bloods do.

Am on the dose to build mass over a longer period, not a competitor. Don’t fancy the blast and cruise method, would rather have a steady cycle and figure the controls out.

High total testosterone usually means high DHT for some guys which equals acne problems. You injected massive T doses and am not at all surprised at the results.

You need lower doses twice weekly to keep levels consistent throughout the week. As for your E2 sweat spot, you will have to figure that out on your own as everyone is biochemically unique.

I agree with others… lower your dose of T. Your HDL is already low and arimadex tends to lower HDL and increase LDL. You could solve the problem by simply lowering test. I prefer to find a spot where no AI is needed. It took me two years to figure it out but I did and I feel better than ever with no AI. My cholesterol improved dramatically too.

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I am vegan so cholesterol is not a major concern for me.

I shall half my dose and take it from there. No AI would be good.

Should E2 be in ‘normal’ range even with T?

Second everyone saying to lower dose slightly. Its better than messing with your e2, which always seems to bring issues.

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Hormones are derived from cholesterol, so without it you have no hormones. Nobody knows the normal range for estrogen as it’s not well studied, the current ranges are a best guess based on limited information.

You are ignoring free estrogen, like free testosterone it’s bioavailable. We assume high free testosterone likely means high free estrogen, the difference is going to be how well you liver removes estrogen from the body.

This may be why some men can get away with higher estrogen and not have any symptoms, if you don’t excrete estrogen well, you may need estrogen on the lower end

That’s 2072ng/dL! I take 200mg/week, it’s not a massive dose. When were those labs pulled, relative to your last injection? I get less than half those numbers at trough.

When my doc first put me on TRT I was given 150mg/wk T cyp split M/W/F on week 8 I had what I would call extreme libido issues and did a mini blood test. it came back >1500ng/dL. It was the cheap test I know now to ask for the full range TT.

Hard to pick a trough when you inject 3 times a week. So I picked Monday 8am before shot.
My ShGB was 24 at the time. I can see 200 giving one a +2000 even in trough.

You might not have to cut it in half. But if you continue with the 200 sooner or later your blood would thicken and you would have to start donating blood to keep it thin but you can only do that a short while before your ferritin would crash. We all would love to be able to run 200-300mg/wk but our bodies just won’t allow it. 2000ng/dL is not healthy it just allows you to build big muscles and pound nails with your stiffy. haha

That’s interesting. I have to think that is unusual though. Mine is 900/220. SHBG also 24. I know a few guys also taking 200mg. I’ll have to ask them. Wonder what my test would have been when I was competing and taking 800?

It might depend on frequency of injections. Once a week is going to have a deeper trough than EOD. To keep my Free T in range and my HCT in check without donating I can’t run more than 120/wk. That does not stop me from blasting every now and then, Haha.

Do you feel bad when your Hct gets high? At what point do you start to notice symptoms?

Thanks for all of the input.

I have changed to 100mg of Sus, 1 X pin / week.

So far, so good. Wood is good, feeling focused and great. Training progressing well still. Back is starting to clear. Will do bloods between Xmas and new year and update the thread.

Sorry highpull, This forum never tells me when someone copies a comment I posted. I just saw this thread.
When my HCT hit ~52 my blood pressure goes up 10 points on the top and bottom. I don’t really notice much but as soon as my BP goes up I either donate blood or drop my T cyp dose to below 100/wk. Either fixes the HCT and BP issues.
Now a days I just find it easier to cruise at 70-90mg/wk (no AI or donations needed) and blast at ~400 twice a year. That seems to let me build and keep muscle. While blasting I do use anastrozole to keep the E2 and prolactin low as well as doxazosin and cialas to keep the BP in check.

No problem, that is interesting. This may explain why some feel better immediately after donating. It’s happened to me a couple of times.


A couple of weeks into 100mg sust pinned 1 X week. Having .25mg of Anastrozole with the injection.

Back acne actually getting much worse. Libido good. Training good. Mentally feel a bit low, tho may be junk food Xmas comedown.

Ordered bloods today. Will be curious as to the outcome. Shall update next week when test results come back.

Determined to find a long term sweet spot.

Did you start to use the AI and your back acne got worse? Why did you introduce the AI? 100mg of test a week should not require an AI unless you are obese.