T Nation

Injection Frequency and E2 Conversion

i have read a lot of people claiming that they switch to daily injections to lower their E2 by eliminating androgen spikes. I’ve also read others that say they have higher E2 on daily injections than any other protocol, possibly due the body not being able to expel E2 fast enough.
My last blood work was done on daily injections and my E2 was quite high. I’m not symptomatic of E2 sides, but by healthcare provider does not like my levels where they are and is recommending an AI. So far, i have refused and she isn’t forcing the issue.
Has anybody switched and had success in lowering E2 by switching from daily to EOD or E3.5D?

  • as mentioned i do not have E2 symptoms as far as gyno or sensitive nipples goes, but have not had any symptom relief from low libido, brain fog, ED, poor sleep on any protocol i have tried in the past 6 months. so to appease my healthcare provider i would like to lower E2 if possible by switching injection frequency.

Your provider is overcomplicating things, lower the dosage. Your diet an excersise will go a long way to reducing sides on TRT.

It usually works the other way around, sure there are outliers, but most of the time daily injections decreases aromatization the most.

Out of curiosity, what are your levels?

Over the last three months, simply for fun and as an experiement, I’ve dropped from 200mg once a week to 50mg every 2.5 days, roughly 150mg a week. Labs done at trough a week ago revealed no significant change in total testosterone, 955 (usually 880-920) or free test 267 (usually 200-220). SHBG increased from 18 to 25. Interestingly, my E2 was 77 and it is usually 40-50. Plus, hematocrit was higher than it has ever been.

Overall, between the two, I feel no difference at all.

Labs ranges:
Total test 250-1100 ng/dL
Free test 35-155 pg/mL
Estradiol <39 pg/mL
SHBG 22-77 nmol/L

Typically, in my practice, guys going from once to twice weekly do not see much variation in lab results, but report feeling better.

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my last blood work was early January and I had recently switched myself to daily injections for 3-4 weeks at 175mg/wk.
I think i have room to drop my dosage down; i started at 100mg for 8wks, then 140mg for 8wks, neither gave symptom relief. Ran the 140mg for another 5 weeks before switching to 175mg daily.
here are some of my more pertinent results from that protocol (although may not have reached homeostasis at the time of the testing, i have continued that protocol since early January with no change to how i felt). I added my hormone results in conventional units for your convenience to the right, as my tests are in SI unit (because that’s how we roll in Canada); so my free test is quite high at 280 pg/mL.
This is leading me to think I should lower my dosage

and here are some other test results to show where i started pre-trt, then 100mg/wk with weekly injections

If you do not have high e2 symptoms you should only embrace the high e2, it has a lot of health benefits and no proven harm. Just have a box of tamoxifen on the stand by in case you get gyno symptoms.
Your provider seems uneducated on the matter

definitely not my healthcare provider’s speciality but she is light-years better than previous Dr who said my pre-trt test results were fine and that he “wasn’t playing god”.
That’s why i do my own research and come on forums to solicit advice to discuss with my nurse as she is willing to work with me

It controls and fluctuations between peak and trough better. Essentially, you should feel the same everyday. I’ve found it lower E2, but high E2 and high T is what you want.

Here’s the fuck up. Only switched 3-4 weeks. The very minimum is 6 weeks for homeostasis and it really should be 8-12 where you dedicate to a protocol (NO CHANGE).

Exhibit B. Invalid.

I agree. There’s many better providers out there. Your provider is not only wasting your time but they’re just stealing your money and fucking you up without a descent grasp on TRT. I personally would say it’s unethical. I remember going to a pcp for bloodwork (not who I used for TRT) and she went berserk when she saw my Total Testosterone of 1300 in the report. She even called in another female doc that basically said “how dare you advance your testosterone levels? how dare you not accept being a low-t fag. I’m going to refer you to a psychologist.” I simply stood up and left, best decision of my life tbh.

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This is the game

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Seriously? You quoted her. That needs to go into the Stupid Things Doctors Say thread.

I think this is the norms for the thinking of most doctors out there. They just dont speak it out loud.
If I meet a doctor with different way of thinking Im nicely surprised and pleased

I would look into adding DHEA. How is your VitD level? As for testosterone, I think, whatever you try going forward, you should stick with it for a while, probably three months.

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I turned her into a meme in the paraphrase but that was the gist. She literally said 1) I should not boost testosterone as it’ll give me heart issues/some disease. I asked for evidence and she said do more research. I actually found recent studies resulting in no increase [Ref 1, 2, and 3]. 2) She said I should accept my testosterone as it was in range and 3) When I asked about my low energy, she said it’s probably psychological and I should work with a psychologist/therapist. Even me at low t wouldn’t put up with this. Hence, MEMED.

Ref 1: “However, more recent studies show no increase in heart disease in men taking testosterone therapy. Some research even shows a lower risk of death in men receiving testosterone therapy compared with those not receiving therapy. A large 2016 study following more than 1,000 men for three years found that testosterone therapy did not increase the risk of cardiovascular events.”

Ref 2: “Age and prior CV history, not TRT use, were predictors of new-onset CV events in this multi-national, prospective hypogonadism registry.”

Ref 3: "The balance of evidence is that T therapy does not increase CV risk. "

https://www.ecrjournal.com/articles/testosterone-and-heart

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The summary of studies nowadays is very clear: Optimal(not just “in range”) testosterone and estradiol levels reduce the risk of heart disease and all cause mortality. If a doctor thinks otherwise he should really educate himself.

Dr Neil Rouzier probably knows by heart all available studies and he has enough lectures about that

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when i intially started TRT, she also started on i think 15mg of DHEA but discontinued the use of that until getting Test better dialed in. Vit D is low, i am supplementing with 10,000 IUs daily which has brought me to 113 nmol/L (75-250 nmol/L). Winter is slowly coming to an end in Canada, so hopefully can increase that a little more in the coming months.

I would take DHEA, at least 25mg, maybe 50mg. Add more D3.

So, neither of these is totally accurate. Increased frequency will lower you spikes od androgens, both testosterone and estrogen because one follows the other. It will give you a higher trough of both as well. So, testing would indicate elevated levels of both by increasing injection frequency, but that would be misleading. It really just puts you closer to median more of the time. So, is it a slightly jigher constant of one or all of the androgens that make it more effective for some people? Or is it simply that they don’t tolerate the big spikes well? I don’t have a good answer to that question yet.


i will inquire about reinstating DHEA; however in the attached article, it says to avoid the use of DHEA supplementation, especially in conjunction with testosterone

Of course it does. The Mayo Clinic would also say testosterone levels of 400ng/dL are within normal.