Estradiol: Why You Should Care

[quote]KSman wrote:
You need to use the non-age adjusted range for FT to get the youthful range.[/quote]

I was planning to illustrate the question in detail. I just billed my client 77 hours for last week and am trying to make it up to my daughter and get some sleep before tomorrows all-niter.

The rub with the FREE-T number is that there is clearly 2 systems going on yet they report with the same measure/volume so I cannot decipher why my 48 is similar to GEOBOBs ‘300’.

Something is amiss beyond age-adjusted ranges wouldn’t you agree ?

Thanks - The learning is a fantastic voyage. .75 anastrozole per day now to get E2 under control

Using .25 does thrice daily. Cut T down from 300 per week to 200.

Gentlemen,

I’ve been off the boards for a long while but would like to update my (fantastic) progression and observations. This board truly saved my life and it’s time to give back.

Where do I post?

Start your own post in the T-Replacement forum, and not in this topic specific sticky. -thanks

first time poster,was wandering where to post my blood tests and symptoms,thanx …great thread

Read the post above yours.

The original post on this thread makes perfect sense to me and I have zero medical training. Why is it that Doctors know so little about this? Is there more to the story that takes more to explain or is it really just a lack of knowledge.

I have faxed Ksman’s “protocol for injections” post and this one to my doctor that originally prescribed my T. I hope he reads them and at least looks into the possibility that he has been misinformed on TRT therapy.

Sorry this did not belown in a sticky as I understand our protocal

No morning wood at all for last 2 days. I tried 1.5mg/week of Arimidex just to see what would happen. I know now that at .75mg/week I felt great, and at 1mg/week started to draw down some. At 1.5mg/week…feel really lethargic and libido is zilch…whatever my levels were. I’m sticking with .75mg/week regardless of E lab number once I get it.
Im still dosing 100mg/week Tcyp E3D and 250iu’s HcG EOD.
Labs aren’t for another 3 weeks.

One of the things that has changed is the soreness in my back. I fractured my T1-T4 sp. process last year and have had ongoing pains from it. I felt 100% better when I was first starting HRT, this morning the pain is back. Low E definitely causes joint pain.
I’m an example of what Low T can really do. 38yo healthy male doesn’t fracture spine without something serious going on. Low T is not just about “wood” or “libido” it can cause more that has a greater affect on QOL.

Your E2 labs will tell a story about what your Arimidex dose should be. Are you breaking the dose into EOD units or E3D?

The 1.5mg/week dose was .75mg E3D.

The .75mg/week was .25mg EOD

I never said this but I’m a 6’1" 185lb skinny guy. I was tested a few years back and had like 4.8% body fat. I don’t think I may need the normal 1mg arimidex dose. I was on so many meds when I went through my gallbladder and back fractures. I wonder sometimes if it affected me more than I realize.

recent labs…
TT 907
FT 277
E2 32
Currently taking 125mg test enanthate divided 3X per week, .25mg anastrozale EOD and 30IU of HCG EOD, wondering why the estrogen is 32 with a full mg of arimidex…suggestions would be great, thanks all. On a side note I inject M W F and wait out the weekend then resume on Mon. The labs were taken on the monday following a friday injection before I injected mondays meds.

30iu hCG is what? Are you confusing your insulin needle volume dose with IU’s? You mean 300iu? Not everyone mixes hCG to 1000iu/ml

Your calculated anastrozole correction is 0.25mg EOD * 32/22 = ~.37mg EOD or 1.27mg/week

You were taking .875mg/week and with 125mg T ester per week should have been taking 1.25mg/week. Note how close the 1.27 is to the 1.25

You should have followed the recommendation of 1mg anastrozole per 100mg injected T ester as your first try.

Dosing 3/8ths of an Arimidex pill will not work well. This is where a liquid is more suitable.

FT without range is sort of useless. You cannot compare FT across different labs, it should not be that way.

With that one dose change, you will have great numbers. You should feel a nice change with E2=32–>22

I go through a clinic that uses a compound pharmacy. They send me the adex in .25mg capsules. How should I go about increasing the dose if they wont change the amount in the capsules or if they wont provide a liquid option? They may but in case they don’t I’m just wondering how to go about increasing the dose and achieving stable levels, or if that’s even possible…With the HCG a 5000IU bottle lasts one month and I shoot at the 30 mark of an insulin needle EOD

hCG, the missing information is the iu:ml. Assuming that your 5000ml had 5ml, that would be 1000iu/ml or 300iu for “30” on your syringe. Again, you should know and talk hCG IU’s, not insulin IU’s.

Ask to have your compounded prescription changed to 37mg. If so, you can use up the old ones if you can cut some in half and take 1 & 1/2.

Anyone having any issues switching from brand Arimidex to generic anastrozole? I was switched to generic back in August. I’ve been working out more and still gaining weight around the midsection since then. My diet is good. I’ll have bloodwork done in 10 days.

Lets wait for the lab results. If a generic is true to dose, there is no reason to expect any differences. Differences in a situation like this can be swamped by result variations that arise from changes in lab timing relative to prior dose of T and anastrozole. Introduction of hCG is also a game changer.

We do not want to let this issue grow beyond the purpose of this sticky.

Contradictions between TRT anastrozole dosing needs and high anastrozole effects in normal younger men:

We know that many guys on TRT do very well on 1.0mg anastrozole per week. We also are aware of studies where younger normal males were given 1mg or 2mg of anastrozole per day and their E2 levels averaged around 17mg/ml. [There were no significant differences between the two doses.] The result is that T levels have a strong increase, LH/FSH goes up and E2 does not drop too low levels. While technically interesting, the costs would have been extremely high.

That much anastrozole would take take E2 way too low for TRT guys and can lead to loss of libido, depression, loss of energy, ED and joint aches.

So how do we reconcile this apparent contradiction? Thankfully the needed data to resolve this is mostly already in this forum. The high dose anastrozole issue has been discussed here before, but is appropriately not in the stickies. We do have guys who find the high dose anastrozole data and they think that that is a clinical recommendation. A research paper is rarely a clinical recommendation. We have seen where doctors who go in that direction in a TRT context which is stupid and harms the patient. [Clinical research papers often are useful for determining treatment.]

We know that higher hCG doses lead to elevated or high E2 levels that do not respond very well to anastrozole. In this context, higher TRT doses of anastrozole have often been seen to be ineffective in approaching levels near E2=22pg/ml. The high doses of hCG over stimulate the testes. The concentration of T inside the testes can be up to 80 times higher than serum levels in young virile males. High hCG doses may be increasing this concentration level even higher and some males will respond more than others. In the context of TRT, for older guys we can expect the testes of many to be blunted by age. So this effect could be expected to be stronger for younger males who have secondary hypogonadism. Because anastrozole is a competitive drug that competes with T at the aromatase enzymes, the ratio of anastrozole to free testosterone determines the outcome. A serum level of anastrozole that does a good job of managing peripheral aromatization of T–>E2 is mostly ineffective inside the testes where the T concentration levels are so much higher than serum levels. From this, you can easily see that higher doses of hCG drive intratesticular T–>E2 aromatization that cannot be managed with sane or affordable amounts anastrozole. If you drive T–>E2 down to close to zero in peripheral tissues, we can expect that there may be adverse effects in the brain and elsewhere.

We know that SERMs increase T and E2. LH levels can go high. From this we can expect that there can be effects that are similar to high doses of hCG. [We also see a few take a SERM and hCG at the same time, totally wrong.] SERMs can easily lead to high rates of T–>E2 inside the testes and we would expect E2 levels to be unmanageable. We have seen a few hints of this effect in the forum [and in PMs sent to me].

In one of the studies of high dose anastrozole in normal younger males, the following was postulated: The serum E2 levels do not drop as one might expect because higher T levels are creating more E2. Well we would also expect that, no brainer. But we know that peripheral T–>E2 in this context must be very very low. The only conclusion is that the testes alone are creating enough E2 to support healthy serum levels of E2. In this context, we get the same effect as a SERM and LH/FSH levels are increased, driving up intratesticular FT concentrations. [Why FT, because SHBG is only found in the blood and not in peripheral tissues; the T cannot be SHBG bound. We should expect that some would be weakly bound to other proteins, very little is known about that to my knowledge.] In light of this, these ideas really enforce the points presented in (2) above.

Summary: Low dose anastrozole works well in the TRT context of weaker or little testicular T generation. SERMs and high dose hCG can create high levels of LH/FSH that create high T levels driving high levels of T–>E inside the testes. High dose anastrozole can create the same effects as high dose SERMs or hCG, with the exception that peripheral T–>E2 is then very very low and the resulting serum E2 levels are not pathologically low, but can be healthy as a result of the testes producing enough E2 to support decent serum levels. But note that there could easily be adverse effects from blocking T–>E2 in the body where E2 is created for local utilization. The discrepancy is resolved and understood.

A danger: We know that high doses of hCG can over stimulate and down regulate the LH receptors inside the testes. Testicular LH insensitivity would be classified as testicular failure aka primary hypogonadism. I think that there is enough evidence to suspect that high levels of LH induced by SERMs or high dose anastrozole can over stimulate the testicular LH receptors and lead to the same LH receptor downregulation that one risks with higher doses of hCG. When older men with age degraded testes use higher amounts of hCG, SERMs [or high dose anastrozole] as a TRT treatment , they are at risk of damaging their testes that support those TRT methods.

What does sticky refer to?,
im new on here and have posted on a couple of other threads.
Keep up the good contributions, is there any docs/specialists on this T replacement forum, seems alot of very knowledgable guys on the whole TRT subject, are any professionals?
Cheers

Do not post crap like this in the stickies.
At the top of the forums, you will see topics that have yellow icons. These are ‘stuck’ to the top of the list and are called ‘stickies’. Read these. Do not post into stickies with your personal concerns, they are not meant to address personal particulars. Look as the ‘protocol for injections’ and you can see how that got messed up.

There are a few docs who float in and out from time to time. But most here simply have learned a lot because they have had to know more than their docs, and that really is not hard to do.

Didnt realise there were rules, dont understand what stickies are, kind of figured that posters on here are just knowledgable and clued up and most are not professionals just learning from research and experience and each other, and i hear you about docs not being to bright and clued up on TRT as im in the UK and docs/specialists are not so good at TRT here.