T Nation

Finding Sweet Spot with TRT and AI



I am 52 years old and have struggled with finding the sweet spot. I currently injecting .3mg cyp every 3 days and take .25mg AI day after. However, still not losing body fat and libido still low. I’m 6’3 234lbs. Wondering if inup my T and follow suit with AI. Total t was 540, SBHG was 65. Doc didn’t do a E2 test. Free test was 4.5ngm. Any advise is welcomed.

When to Take Arimidex?

Your problem is obvious, your doctor just has no idea what he’s doing and is very common. When SHBG is high, Free T isn’t and a Total T of 540 with an SHBG of 65 just will not do. You need to get Free T to high normal and you will likely need levels in the supraphysiological ranges to ever have enough Free T, sadly you may need to go private as androgen therapy is seriously lacking under most insurance networks to do a lack of doctors specializing in TRT.

A doctor that doesn’t test estrogen is a sign you are working with an incompetent doctor. Defy Medical, a telemedicine anti-aging clinic is a popular option.

What about thyroid testing TSH, Free T4, Free T3, Reverse T3 and antibodies? Thyroid problems share the same symptoms as low testosterone, TRT requires a thyroid that is optimal as the two work together to restore metabolic rates.

If your doctor says thyroid is normal or in range, in range or normal isn’t good enough.

Google “Optimal VS Normal Thyroid Levels for all Lab Tests & Ages”


Thank you. My thyroid levels were all normal. I’m headed back to dr in a couple of weeks to get tested again after arm wrestling with this endro dr. Do you agree with 1mg of AI per 100mg of test as a rule of thumb? I’m new to the site, so thank you. Love TRT when you hit the “sweet” spot. Just seems like a crazy science project to get it right.


Good lord no. How about 0 for 100mg/wk and .25/wk for 150mg/wk but only if your blood tests has your E2 over 50. This is more of the general rule to just start your fine tuning.

Oh and welcome to the forums. It is always nice to have another +50 in the group. We have different needs and requirement then these young fellows.


Let me get this right, your doctor prescribe an AI and never tested for estrogen, you have got to be kidding. Telling us your thyroid is normal isn’t very helpful, low normal would expect to have symptoms and high normal wouldn’t.

It sounds like you need a new doctor because you shouldn’t have to fight with him to get him to do his job which he clearly doesn’t know how to do. This is what happens when you substitute a specialist with an someone who has no idea what they are doing.


Would you take .25 24 or 48 hours after injection?


You are not going to understand this yet I know you are new. I only take a .125mg anastrozole if I can’t stop crying why watching a sad TV show. I take it and it works in as little as 4 hours. I don’t take another unless I start crying again.
This method has served me for over 3 years and I have all the E2 blood test to prove it. I have never crashed my E2 and my E2 has never been over 35. My TRT protocol is 120mg/wk I do two shots. I also do 800iu of HCG/wk divided into two shots. I have .125 anastrozole on hand if needed.
If your protocol right now is 100mg/wk you need to stop taking your AI. I promise you you will know when your E2 gets too high. How do I discribe this? A wave of sadness rolls into your mind. You chokeup for the dumbist of reasons. Think wife or girlfriend on her period. Their E2 is 200-400 on their period. And us men can’t even handle 50-60 without balling like a baby, haha hth


I’ve has this happen (all last week actually), but I’m still dialing in at week 4. That wave of sadness you describe perfectly encompasses how it feels. I’ve never cried, I get the feeling I’m about to, but for some reason I can’t.

Also, never knew you could use AI’s this way, take one and then see how you feel. Do these things go bad? I have .125mg caps and the expiration date is for the end of the year. I have no plans to use them at the moment but I’d rather have them on hand than not.


@jpt365 be really careful if you are only 4 weeks in. I would not do anything unless you think you need to go to the emergency room, Hea it happens there are some real crap protocols out there.

Your body is flipping out right now. All of a sudden your body has lots of T and that T is converting to E. Your pituitary gland is shutting down production of LH and FSH your nuts are shutting down and all these hormones some the docs don’t even know about are in flux and they will overshoot. DON"T try to medicate that. let your body stablize then do blood and deside what to do. You are in no hurry this is a marathon not a sprint.


Sorry, I don’t think I was clear in that post. I’m 4 weeks into a protocol change, not just starting TRT. I’ve never taken an AI and don’t plan on it unless I need to. I was mostly saying that whenever I change protocols my moods swing and I can get into a weird depressive state on and off during the stabilization period. I’ve actually felt pretty good got the past 4 days (knocks on wood).



Got lab results

Total T 351

SHBH 10.3

Free T 114.3

No estrogen results

Still struggling


Hi man glad to see you back. Do you have any ranges for those blood test numbers?

So you got a TT of 350 on .3mg cyp every 3 days?
There’s problems with your numbers when you say .3mg is that where you draw up to on your syringe which would be .3ml? Which would be 60mg if your T cyp concentration is 200mg/mL
I ask because most of us inject 20mg, or 30mg etc never .3mg

We need to get all the ranges and amounts figured out to really offer any good advice. This stuff is a bit confusing at first.

Also can you elaborate on the struggles you are having?


Youre correct. 60mg every 3 days.

Your Value
Standard Range
Total Testosterone-Adult Males
351.5 ng/dL
247.5 - 674.1 ng/dL
Sex Hormone Bind Globulin (Adult Male)
10.30 nmol/L
11.2 - 78.1 nmol/L
Free Testosterone-Adult Male
114.18 pg/mL
47 - 244 pg/mL
% Free Testosterone-Adult Male
3.2 %

Still low energy and low libido.


Looks like your issue is your low shbg.

You should try a protocol of about 20mg EOD and check bloods. Then, you may even want to go to daily shots. Your body is dumping out the test you feed it very fast, hence why you aren’t feeling anything. I would suspect your e2 levels are high as well.

Make sure the check estradiol too. I don’t see it listed.


That is a lot of T but it might not justify .75mg of anastrozole.

If you are feeling tired and your shoulders knees joints hurt or feel dry your E2 could be too low.

When I was doing 150mg/wk I never needed more that .125mg x3 anastrozole sometimes my E2 blood test would be in the low 20’s Without a real blood test we are just guessing. It is way better to guess and recommend less AI than to guess wrong and recommend taking more.

It is better and healthier to run your E2 a little on the high side. If your E2 goes to high the worst that will happen short term is you will get a little too sensitive. The old lump in your throat.
When you get that you now know what high E2 feels like and you can control it with your AI.

So I will recommend you cut your AI back to 1 pill (.25mg) per week. It does not make any difference which day you pick. Give this 2 weeks and see how you are feeling.

I hope that helps? The libido thing can take awhile my libido did not really come back for over a year but when it did holycow it came back too strong. I had to cut my T dose to 120mg/wk so I could stop thinking about sex all the time.


It’s not normal to see SHBG decrease from 65 all the way down to 10, high SHBG to low SHBG guy almost over night.