First Round Labs In

So I’m 40, 8 weeks into TRT at 80mg twice per week. Feeling really good. Had about 2 weeks in. The middle where I felt like I reverted and then went back up to feeling like I did 10 years ago again. Went into this with TT 460 and SHBG at 67. No HCG, no AI. Prior to this, I was on Clomid monotherapy for 8 years and slowly started to work less and less as my SHBG crept up. Cal with Defy this afternoon. I’m a little wary about jumping to an AI as on Clomid 0.1mg per 1.5 Anastrozole per 1.5 weeks put my E2 at 22. I respond strongly.

Overall, my cholesterol, glucose, and IGF numbers really improved. It’s the E2 that probably needs to be discussed, but perhaps I can move to more frequent injections as my SHBG has come down as I do feel peaks and valleys between shots. Also, any concern about my Hematocrit? It’s gone from 47.3 pre TRT to 48.6. I’ve read many stories about this and worried this will be a limiting factor for me. As always, thanks!

If you’re feeling good/great I wouldn’t worry about the estradiol number. Treat symptoms not numbers as they say. On the other hand if you are symptomatic or if you think you might feel better and want to try something I think the prevailing wisdom is to use tamoxifen rather than an AI. Go ahead and let the test convert so you reap iestrogen’s protective effects but block enough of its action to prevent the unwanted side effects.

You might just want to wait it out a bit to see if things continue to stabilize.

Absent any high E2 symptoms, I would be happy with your E2 status, especially given your lipids.

Your hematocrit is fine.

Thanks. Morning wood came in strong and then wavered a bit. No nipple sensitivity. Did have a migraine for the first time since puberty 2 weeks ago.

Knowledgeable doctors usually don’t take action until hematocrit reaches 54% at which time a blood donation or dosage reduction is done.

Don’t overly focus on the numbers, focus on symptoms because symptoms are the reason why you sought treatment in the first place.

My morning wood went away, mostly. Little bit of water retention. Otherwise I feel good. I spoke with defy today and I told them that I don’t want to go to an AI. So we landed on moving me to three days per week from twice per week at the same total weekly dosage to see if that brings E2 down a bit on its own.