Help Dialing in Dosages (3 Lab "Snapshots" over a year)

You can try aromasin in small doses and that might be more compatible with your unique features.

You probably have some mutated enzymes that are mostly not causing any problems. But be concerned that you could have some bad results from other medications some day.

Ok, thanks KSMan.

You have any tips? I can’t seem to quit coffee. I’m gone off cold turkey for a few weeks a couple of times and get insanely tired, depressed, unable to do work; etc. I’m trying to heal adrenal fatigue 'cause that’s what we concluded in my original thread. IDK, a part of me wants to go off of TRT because I feel less like myself and less sexually active than ever before and I feel in a rut of adrenal fatigue that it’s keeping me in because it amps me up and makes me always driven even when I don’t have energy. Wellbutrin seems to improve my mood but no matter what I’m super fatigued. Being 25 I feel like I still might have a chance of getting off of TRT. It definitely makes my adrenal fatigue worse and also sex doesn’t feel that good - makes it very difficult to orgasm.

IDK if going on TRT for adrenal fatigue was the right choice. I feel like no matter what I’ll be stressed in life, which will undermine my T levels. But I’m beginning to think mid-low range T naturally produced is better than TRT.

With adrenal fatigue, you need to stop fT4–>rT3 and to do that you need to take enough T3 to depress TSH so less T4 is made. Only source of time release T3 in USA is compounding pharmacies.

Taking high dose iodine does not work with adrenal fatigue and Armour Thyroid, T4 meds and Nature Thyroid can be blocked.

What if my rt3 labs come back normal (as they have in the past)? Is it something that cannot be easily pinned down in a lab test? A year ago they came back RT3 15.2 (9.2-24.1)

Your sexual issues sound like high E2. In my experience with my own protocol, I have determined my optimum levels are TT-5-700 and E2 15-22. Anything over 22 for E2 and I start getting those sexual symptoms some people don’t get until they get into the 30s or 40’s. I have crashed E2 also and that sucks worse than low T.

This is what I did… I backed off my T dose to 70-80mg week, 2x/wk dose. No AI. This keeps my E2 around 20, and T in midrange. This makes me feel the best. I still have some adrenal fatigue issues, but they are getting better. Add a good B12 liquid supplement or shots, helps alot with energy and brain fog.

Yeah, IDK. I masturbated every day before TRT but it’s only a couple of times a week on TRT although I have some periods where I’m intensely horny for days. So not sure how to get AI under control. Am taking 1/16mg EOD. -_-

As for rt3 IDK what to do about that. Guess I’ll get it tested again

@KSman KSMan,

I am considering swithing to a compunded bioidentical cream with anastrazole in it. My doctor was unwilling to prescribe aromasin since even the smallest amount of anastrazole seems too much. Also a friend seems to like the bioidentical creams as he can take a break from TRT by just not doing it for the day and thus not be amped up, and also that it works similar to how normal testosterone works - high in the morning and low at night. What do you think? I feel like I can figure out anastrazole better with that since I can always add more anastrazole every day if I want. He’s just starting out with .1/day. Do you 100% discourage use of cream? Additionally, is there anything I can take other than HCG (perhaps in pill form) to keep my testes the normal size?

The other thing I am considering is just doing .25mg Anastrazole E6D. I definitely have an issue with an enzyme that breaks down anastrazole, so maybe this is the simplest solution as dosing by drops isn’t working for me…

Anastrozole half-life will not go that distance.
Transdermal anastrozole pointless.

Dissolve anastrozole in vodka and dispense EOD by the drop. Typical is 1mg/ml, some have made thinner, simply count drops per ml and do the math. Drops per ml varies with dropper shape and material, its a surface tension thing. Start small and remember that any dose change takes 5 days to reach final levels in your body. So you can’t be making changes every other day.

Anastrozole cannot be dosed once a week. You can do anastrozole when you inject E3D. Some do both E2D, but maybe that is not for you. Remember that T levels and T dose dictate anastrozole dose.

I got labs injecting 33mg t-cyp 3x/week and .25mg anastrazole along with 250iu HCG 3x/week and my T levels were “very low” as well as my estrogen was “nonexistent”. I would’ve thought that had I even screwed up the anastrazole dose my T levels would be fine, but what gives?

What I’m going to try is 100mg EOD in divided doses .25mg anastrazole/week in divided doses and 250iu HCG EOD in divided doses. I still don’t get how my T levels could’ve been low with injection. Does my body try to force the production of estrogen fighting against the anastrazole or something which drove down the T levels?

We do see some guys who are T hypermetabolizers who typically need ~300mg/week to get where others are at 100/week. Half life is then short and EOD T is needed and labs should always be half way between injections to minimize lab timing artifacts.

Testing FT as well?

Yes, sorry I don’t have the number but FT was low, too.

What about me getting on tamoxifen? Have any ideas for dose/protocol? Also, a doctor suggested taking levothyroxine may help me anyways for energy with the depression. Any input? I am finally treating the adrenal fatigue in every way I can (quit coffee) and my goal is to move away from TRT. Hopefully after 2 years this is possible.

Levothyroxine - Wikipedia
This is T4 and if you have T4–>T3 problems, you need to not take T4 and take T3 medication to reduce TSH and thus reduce T4. You need to lower T4 not increase it.

Hey KSman,

Doctor wouldn’t prescribe the time-release T3 as I did a RT3 lab in January and it was in range RT3 15.2 (9.2-24.1).

Doctor will only let me use cream now since I couldn’t effectively get injections to work. You know of any good doctors in Seattle? I don’t know what else to do, I’m thinking of getting on one of those anti-aging programs where they do blood testing every couple of months as part of the program.

Otherwise, treating adrenal fatigue:

  • I’ve gotten off of coffee
  • I take adrenal cortex supplements
  • Try and destress/reframe etc. all of the lifestyle tips in that book

Any other major ones?

Hey @KSman, what do you think of wilsons temperature syndrome protocol ? I’m attempting a 40-day version of the protocol with AM temperatures right now typically 97.4 or less (my 7:30AM temp today was 96.4! but strangely went up almost a whole degree by 8AM but I was coughing somewhat so maybe that affected it).

@K_11,
I’m no expert here. Just to start a conversation here about your case that I have read through…
#1- It looks like (based on your lab ranges) your doctor is performing the wrong Estradiol testing. Those are Labcorp ECLIA ranges which overstates estradiol levels in men. You need to either request the sensitive estradiol test or get it yourself so you have an accurate picture of your levels. When you were at your highest estradiol levels without AI you may have been pretty close to the acceptable range for men as ECLIA can overstate by 50%. This would explain very clearly why you crash so easily with an AI. At 13 estradiol you were crashed out. That’s why you felt it. Moral of the story is… get the right test and go from there.
#2- Your doctor’s concern and the question about your radically high FT is easily explained by SHBG and it’s method of action. Specifically how SHBG can be affected by exogenous testosterone. You Cypionate is now lowering your SHBG and allowing more FT. Based on the TT and FT I’d say your SHBG is probably below 20 if not in the single digits. There are accounts within these forums where people with low shbg have more success with more frequent injections at lower doses.
-Hopefully I’m not way off in left field but based on everything I see here it seems pretty straight forward. I’m dealing with the same stuff right now. I have an appointment with my endo tomorrow at 2 o’clock to discuss my “ECLIA” results (12.1) which are inaccurate.

There’s a balance between SHBG and FT, too much of one thing is bad. You must find a balance.

Bump for advice on Testosterone creams/gels. Is the Testosterone not in your blood stream 3 hours after application, therefore sweating a lot 3 hours or more after application is not a problem?

I sweat a lot every day - my dogs need a brisk walk every day, weights 3 times per week.

Recommendations to check the effects of sweating? Get blood taken 3 hours after application & after sweating 6 hours after application?

Thanks

I don’t see it as a big deal, I only stay on cream because my e2 levels are great on the concotion of transdermal anastrozole that’s compounded in with the cream, which makes it convenient. I had a hard time with injections because dosing oral anastrozole was VERY tricky for me. Either E2 = 0 or E2 = way too high. If I could convert from the 0.1mg/day of transdermal anastrozole to an oral dose I’d consider switching back to injections. I was also thinking that the HPTA is partially suppressed with cream vs fully suppressed with injections as your T levels get a chance to drop and my doctor was backing up this claim with his patients didn’t get testicle shrinkage and had detectable FSH on their labs. But then I sort-of went back on this idea because I needed a higher dose of cream to feel good. But personally, in my experience, I can go for a run an hour after applying the cream and I’ll feel the same the rest of the day - good.

I’m on a good TRT regimen and previously KSMan said likely that it was adrenal fatigue causing my symptoms. Due to low body temperatures I started taking sustained release T3 and my fatigue improved. I still feel burnt out, though, and I still drink two cups of coffee and 2-3 diet sodas a day. I’m trying to wean myself off, but without SOME caffeine I can’t carry on conversations, I’m completely unproductive at work, and I feel like crap. KSMan says to read Wilsons book on adrenal fatigue. To me the sum of most of the advice is “quit caffeine, eat a low glycemic diet, take some supplements, and lower stress as much as possible”. I MAY need to quit my job and go to something I enjoy more/lower stress, but the caffeine part is the big deal for me. Is it really necessary to quit caffeine ENTIRELY? What about just one cup in the morning? I know I’m at a lot right now but is there a way to quit so it’s not so brutal and I lose productivity at work for several weeks? (I don’t have any vacation hours left). Any tips?

And with sustained release T3. Isn’t that dangerous? Increased RT3 is putting on the metabolic brakes because it needs to slow down and cope. Isn’t suberting that with sustained release T3 a bad thing?

Also I’m 26 and have been on TRT for almost 3 years. I’m wondering if I can treat this if there’s any hope of getting off of TRT.

Thanks for your reply, K11. Do you exfoliate the T cream application area in a hot shower before applying or do anything else?

I’ve not had E2 tested before, but will do soon. I think I’ll get bloods done say 1, 4 & 10 hours after T gel application & see if I’m still producing LH & FSH.

I’d not heard that some natural T production could remain on the creams. I’ve had testes shrinkage, they’re probably 2/3 pre TRT size.

I’ve never used HCG however, I probably will quite soon.

That compounded cream sounds excellent for you.

Dude I hear you on the caffeine! It’s the only psychoactive drug I use. I probably have 300mg a day over 3 strong coffees.

I did quit caffeine for 5 weeks & until a few weeks ago I stopped for another 2 weeks.

I did it cold turkey each time, I tried tapering down slowly, moderately, quickly - lots of ways & I never stuck to a taper. I find caffeine very addictive - given coffee shops are everywhere - I’m not alone haha.

I had the same reservations that I’d be useless at work for weeks - but it wasn’t true - I was fine until day 3 then a bit slow, days 4 & 5 were the hardest fatigue & cravings wise…

Once I’d done 7 days the tiredness left & I had more energy without caffeine. It became clear caffeine was robbing me of a lot of energy.

Why did I go back to coffee?! Because I’ve not got sick & tired enough of it yet + it’s an addictive chemical - addiction is not rational. I think you have to really feel ‘done’ with a chemical to stay stopped - that was my experience with tobacco anyway!