T Nation

E2 Management Help


#1

Hey everyone. I’m reaching out for help as I seem to be having some issues controlling E2 and looking for help on an adjustment.

Background:
• On the T-side:
• Testosterone Cypionate every 4 days @ .35 cc
• Lab results at this dosage:
• Total T: 750 [250-1100 (ng/dL) ]
• Free T: 180 [ 46.0-224.0 (pg/mL) ]
• Bioavailable T: 371 [110.0-575.0 (ng/dL) ]
• SHBG: 17 [10-50 (nmol/L) ]
• Albumin: 4.5 [3.6-5.1 (g/dL)]
I know by SHBG is a bit low and one of the reasons I’m having issues. I don’t seem to fit into any of the classic categories for reasons of low SHBG (or at least the drs have not found an issue yet).
Now on the E2 side… Ive been having issues.
I first started on .5mg of Anastrazole EOD. This had my E2 too low (February lab results)…
• Estradiol – 11 pg/ml (reference range < 29)
• Estradiol free - .26 (reference range <.45)
So, we dropped the .5mg between days of the shots and simply went with .5 on the days of the shots.
Current labs:
• Estradiol – 21 (reference range < 29)
• Estradiol, Free - .51 (High) (reference range <.45)
Typically, you would think I would be perfect. However, with the low SHBG I get a lot of free Estradiol and even at this level I have lost the morning wood, feel incredibly cranky and cant sleep worth a darn. My best guess is that my body has a pretty small “window” of around 17-19 that it wants to be at. I felt the window as I was going through it… Wow, what a difference!
Since I shot up so much on just a simple .5 mg decrease… I think I have a few options:

  1. Take a .25 mg dose in between my T shots (.5/.25/.5)
  2. Go to .5mg every third day rather than every 4th day (doing this would get me out of tune with the shots… not sure if this matters or not)
  3. Trying a .25 mg dose every day.
    Any suggestions here? I’m thinking my docs are stumped here as well.

#2

Dissolve anastrozole in vodka 1mg/ml and dispense by volume or by the drop. When you make a dose change it takes a week for the effect to be realized in terms of anastrozole serum levels and E2 levels. So you can’t make short term changes. Do not be handcuffed by 1/2mg or 1/4mg increments.

Guessing 120mg T per week.
Suggest that you take anastrozole only on days of T injections, adjust the dose. Things would be smoother with injections twice a week or E3D. Inject SC over upper legs with #29 1/2" 0.5ml insulin syringes.

You are not the first with problems getting balanced on low SHBG. SHBG can be low from high FT which low SHBG can provide, or from diabetes.

Please report labs with ranges.

E2 levels are inversely and linearly proportional to anastrozole dose.

As for what dose and what E2 and fE2 levels; you need to work that out yourself.

This is your 4th topic. I will repeat standard material below in case you have not seen before.

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

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.
Please report doses in mg’s and iu’s, not volumes.


#3

Thanks KS. Test I am taking 70mg per shot I think.

The thyroid I was a little hypo to start. I think I have that straightend out at this point by taking nascent iodine.

I went back and put the reference ranges in the post above. I really appreciate the tip on the alcohol. Didn’t realize you can do that.


#4

So, after the input… and some math calculations, Ive decided to go the E3D route. I’ve adjusted the Test. C dosage down to .26 CC rather then the .35 CC I was taking every fourth day. I’m keeping the HCG at every fourth day for now, and going to try .5 mg Anastrozole every third day to keep in sync with the testosterone shots.

This should keep my testosterone dosage the same, while backing off a little on the Anastrozole to hit the in between mark I’m aiming for of 17-18 on the total Estrodiol while keeping the free E2 under the high end reference range. We’ll see how it goes in six weeks. :expressionless: