T Nation

Just Started HRT, Should I Increase My Adex Dosage?


#1

I've been taking anastrozole since 2007. It improved my morning wood, but not much else. Finally started HRT one week ago and noticed that I feel slightly better, but morning wood is less frequent. The doc put me on 75 mg testosterone daily. I opted for the compounded cream over Androgel because it is much cheaper. Regarding anastrozole, I'm an over responder. I had been taking one drop four times/week. That knocked my estradiol down below range (<5.1).

Now that I am on HRT with the above mentioned symptoms, I'm thinking of proactively increasing my anastrozole dose because I'm assuming that a lot of the increased testosterone is being converted to estradiol.

Here are my most recent numbers:

Estradiol <5.1 7.6-42.6
total test 576 280-800
free test 816 6.8-21.5


#2

I've always had an easy time for the past 8 years with ONE thing:

7.5 to 10 grams of Androgel a day.

End of story.


#3

Good to know, but doesn't really help me. Androgel is almost 10 times more expensive than the compounded cream, so I had to go with the cream. And my experience with anastrozole is that it has definitely helped, just not enough.


#4

The estrodioal reading you are getting is not the proper one and can mislead people according to the range. You want the estrodial sensitive one (3-70) not the 7.6-42.6. I ran these side by side on 2 patients and symptoms corresponded better to the 3-70 range. This7.6-42.6 is more like the ultrasensitive from quest very mis leading..If symptoms would not improve I would advice the patient by examining adrenal with adrenal cortisol saliva test and also looking into dhea-s ,ferritin, ft3, ft4, tsh, tpo, tgab, rt3 for proper thyroid evaluation. I see alot of guys start TRT and there thyroid goes out od wack after being on it for 12 weeks. Some speed up other slow down. Many dr's ignore this fact and do not make the properl adjustments as needed down the road. When starting TRT on needs to look at the pathways which get deplete such as DHEA due to the negative feed back look. Many peoples dhea drops like a rock on TRT.

When are you taking your blood test?
Are you applying the gel then waiting 2 hours or applying it 2 times a day.
You may also want to add HCG to help with testicular volumes at 250 ius every 3 days. I would leave adex where it is then add in hcg to help increase T level to 700-800 and bring up e2.


#5

Thanks hardasnails. My doctor seems pretty cool about treating symptoms, not just lab values. He also spoke to me about adrenal fatigue. Also, I started 30 mg of Armour thyroid daily at about the same time I started HRT. Though not out of range, my thyroid readings were suboptimal.

My next blood test is in about four and half weeks (6 weeks after starting HRT).
I am using a compounded testosterone cream and have been applying it all at once upon waking. I hadn't heard about applying twice per day.
I'm taking a wait-and-see approach to hCG. So far I've experienced no testicular problems.


#6

You might not be able to absorb the cream. That seems to be typical with hypothyroidism. I don't know that thyroid meds change that. And some just do not absorb .

You can test T levels after two weeks with transdermal T. 6 weeks is for injections.

Hardasnails: Please suggest lab timing post application.

T cream is best absorbed on inner arms. Do not apply to chest and shoulders. Also very good on [clipped] scrotum.


#7

Yes applyting to 2 times a day will keep the spike much low
2 hours after applicaton of gel 700-800 trough would be more like 350-400
If you apply it 2 times day the peak may be 600 but trough may be much higher. There will be also be less e2 spike through out the day time as well. Sounds like you have a good dr. I like to see levels about 600-700 2 hours after application then kick in hcg 250 ius ed3day to keep own LH going which is found in all areas of the body as well as the brain. Adding in HCG to many people and personally has given that more sense of well being. One also has to back fill the pathways with dhea as TRT can drop them.


#8

Thanks for the advice, guys. I'll check with my doctor about not waiting 6 weeks for tests. Speaking of which, I'm guessing my follow-up testing needs to include total testosterone, free testosterone, LH, e2, and DHEA?


#9

Lh is not needed since if on TRT.

In 6 weeks
total testosteorne
shbg
e2 sensitive 3-70 not the one you did.
Vitamin D 25 oh is a must.. goal -65-90 range
Dhea -s not dhea if you are supplementing, but not needed 6 weeks down the road.
let the thyroid go because body is adjusting to the increase in testosterone after being on for 3 months then recheck the thyroid as it will give more of a better indicator of true function.