T Nation

Is It Dumb to Go By Numbers Instead of How I Feel? (in a Good Way)

I take 160mg/week which put me at 887ng/dl and 23-24 free T on NON-FASTED LAB(Does it make a difference for Testosterone level…unlike glucose?)

I see all around that most guys feel the best 900-1100. I want to experience that.

How would I even know if I need more or less NOW…symptom wise?

----On 160mg I feel an energy where I feel I NEED to get it in at least 1-2x per week. Nothing wrong with that but I’d rather WANT to and not NEED to which makes me think I should have it lowered.

----I feel like there’s a slightly unstable energy vs grounded energy. This is important for being efficient and productive daily.

—I also take dexedrine (similar to Adderall for adult ADHD)10mg up to 4x/day so it’s kind of hard to separate some possible symptoms
-I don’t necessarily feel 'confident and assertive vs before TRT. Probably because I didn’t have problem with chicks and was already making lifestyle changes but idk for sure. I think that part is marketing hype same with decrease body fat,etc I’m surprised people don’t notice a placebo on here or maybe it’s cause I’m barely gonna be 26 idk…matter of fact the only real things in my opinion Test will do is increase muscle and your typical androgen effects like faster body hair growth or more,more semen,libido,etc

—I still feel tired sometimes like before TRT but there’s an improvement

—My igf-1 never went up from TRT use vs before TRT. Which is why I also take a peptide. That’s weird because for everyone else it seems to do that.

—I think I might be more irritable on this dose even though estrogen is controlled. I also feel like I need to let everything go so I try my best to keep it within me cause some people tell me to get out of my feelings haha

—I don’t feel euphoric like a lot of people do on TRT(I’m almost a year in)

What will I possibly exoerience if I increase dose to 180-200mg/week to get in that ‘optimal 900-1100’ range? What will I experience if decreasing to 120-140mg/week? The thing is I jumped straight from 100mg,than 1500IU HCG monotherapy, than straight to 160mg/week. Either this dose is too little or high all I know is something don’t feel right.

Hi Emcon, No one can tell you this. You have to find out for yourself. That is what I’ve been doing for the last 4 years. I’ve really enjoyed all the experimenting blood tests and note taking. I have learned so much about myself I would not trade that for the perfect protocol right out of the gate.

You need to feel 1000-1200 and once you get your TT there experiment with your E2. Hold that high TT and see what a 25 E2 feels like and slowly raise it and see what 50 feels like. Some where in that range you will find your sweet spot. The only thing you really need to watch with that high TT is how thick your blood is getting. Do not let your HCT go above 52% and if you donate blood to keep it down start watching your ferritin.

Symptom relief is the name of the game. Take what you need for quality of life and health.

Here is Hrdvln doctor talking about ai. Don’t try to keep a magical level. His doctor doesn’t even suggest it.

I posted a long post a while back summarizing thoughts on the subject. Unfortunately, it was part of a thread where a member became hostile to other members and the entire thread was subsequently deleted.

In essence it all boils down to two words: SYMPTOMS and BALANCE

Symptoms indicate and guide (to an astute and experienced practitioner) the need for any treatment (whether it be TRT in general, AI, thyroid treatment, adrenal support, etc) and balance rules the entire human body, with hormones being no exception.

We know that there is risk with too low and too high of levels for any hormone in a biological entity (is E2 the only exception in the human body?). Where is that line of too high? - no one knows and to complicate further that “line” is likely variable from patient to patient dependent on countless other variables (SHBG, prolactin, DHT, thyroid function and TBG, phyto amd xenoestrogen exposure, alcohol, genetics, receptor regulation, etc, etc).

Anastrozole is a tool in the toolbox. Some patients need it, many don’t. Sometimes it is thought it is needed and subsequently determined it wasn’t. Whereas sometimes it is thought it wasn’t needed and subsequently determined it was. Balancing hormones is a symphony, not a solo, and even the brightest minds in our field are challenged to BALANCE all of the relevant variables and moving parts.

As mentioned in a post above, after participating in the hormone dance for so long, with so many patients, often some intuition begins to develop as well (for all practitioners)…this is the “art” you here spoken of to augment the science.

Also we keep in mind the difference between a medicine and poison is a matter of dosage. Vitamins, supplements, medications, etc can virtually all present toxicities (poison) at high levels and high dosages…thus when ANY medication is used, lowest effective dosage is key (those poor guys taking anastrozole 1mg daily - or similar…).

I’m in agreement Anastrozole is over-prescribed and, worse, often in too high of doses as part of a standing protocol or “cookie-cutter” approach. In fact, even my dearly missed pal Dr John was more aggressive, in many instances, with his anastrozole (0.5mg commonly).

I don’t want to comment in too much depth on that topic, as I am still grieving personally and reconciling the loss of a friend, but everything is not always as it appears on the surface. Dr. Crisler “consulted” with me for his personal hormone treatment and it was my name on his RXs. He did most of his own personal driving, but I ultimately discussed and approved for him while, as noted, “first doing no harm”. Fact is he had been on and off of anastrozole many times in the past, for varying periods of time, only to find himself back on due to various symptoms he would convey (nipples, irritability, excessively emotional, feeling “like a little girl” as he would playfully put it). He would feel better sometimes on, then worse, sometimes better off, then worse…there were many other factors at play (as there are for all of us). The fact he decided to broadcast his most recent anastrozole variations (as opposed to the many occasions of on/off prior) was due to some outside forces (and outside sources of angst) that were troubling him. I don’t want to get any deeper on this topic, but John was troubled by some recent events in his life, which bothers me as well.

Regarding anastrozole/estradiol management - we aim to resolve symptoms, we aim to achieve balance with the hormonal symphony (more challenging in some cases than others), we aim to use our intuition when applicable, and we accept the reality that no one has all of the answers to all of the questions at this time (particularly on this topic). I love all of my patients who need anastrozole just as much as I love those who do not need it.

I will leave this thread be for now as I continue to grieve the loss of my friend and colleague, the great Dr John Crisler