T Nation

Need Help Managing Anastrozole (Again)


Hello Gentlemen

I have been on TRT going on four years, and I have continually had a problem managing AI dosing. With that in mind, once again I thought I would bring my problem to the experts.

In an effort to better understand, AI dosing and more specifically Anastrozole (Ana) during the month of September I upped my dose frequency a little, to see what my experience would be, in an effort to try and find the right dose, and frequency.

On 9/10/15 I took .25 Ana which was a good call

9/15/15 .25 Ana took me to low, after a 5 day waite

9/22/15 .25 Ana problem took me to low after 7 day waite

Now this might seem like too much to fast but, I though since I was taking HCG 400IU EOD that I would need a little more Ana.

I decided to leave things alone and wait to feel better, you know looking for better erections libido etc. By the way sides for going to low for me are, very soft dick, Viagra no help, joint pain, dry lips, dark circles under the eyes, depression, crying, sleeping a lot, but not feeling rested, urinating often to name a few.

Maybe this will help someone regarding their to low sides.

Then on 10/9/15 I noticed that my prostate was uncomfortable and urinating was difficult. I thought for sure that I was high on E2 so I took a lower dose of Ana .15 and over night my prostate and urinating symptoms greatly improved.

However, getting and maintaining an erection got worse like I was to low still in the dumper and Viagra not working, but yet I lowered the E2 enough to help the prostate and I only took .15 mg Ana after a 17 day waite.

Here is where the wheels come off the cart for me. I'm loading up on Ana for about .75mg over 12 days and the last .25 Ana is on 9/22/15 and considering half life I have Ana in my system until 9/28/15 or so. Plus I believe I must have knocked my E2 level down with the previous .75 I had taken and then on 10/9/16, 17 days later I go to high based on the prostate discomfort and difficulty urinating add .15 Ana and feel better.

10/11/15 function improving, ED fading and this morning I take my regular .17ml T injection EOD and all that good recovery feeling is gone about 45 minutes after injecting. Got soft and small nothing going on. So did the .17 T kick up my E2?

One hand it looks like that .15 Ana was right on the money since it helped the prostate and urinating, but on the other hand it looks like it was to much since I had noteworthy ED. during the same few days.

I know it's a mess. But if you have any suggestions to take an AI and adjust dosing.

Lastly lab results for E2 sensitive are no help, when your trying to learn how to dose yourself. Considering the time you feel bad and the time you make an adjustment and the time it takes to get to the lab and the turn around time the lab number is irrelevant since it's like 2 weeks old.

I never feel good and I've been bouncing around since I got on this therapy almost 4 years ago. Defy isn't much help so I guess I need to find someone different.

So as always I appreciate your thoughts!


TT 1419 Range: 348-1197
FT 33.7 flagged as High 7.2-24.0
TSH 1.2 .450-4.50
PSA 1.2 0.0-4.0
DHEA-S 161.7 48.9-344.2
E2 27.1 8.0-35


Why not take anastrozole at the time of each EOD injection to get smoother levels?

Looks like you are splitting anastrozole pills. Dosing with a liquid would allow for smaller increments.

You could be an anastrozole over-responder.

Can't tell what the situation is by your description.

Half life of anastrozole means that it take around 6 days to get steady state levels after a dose change. If you increase dose, your serum levels of anastrozole keep increasing. So you cannot make short term evaluations and dose changes.

A few do manage things better with aromasin.

Get on a steady method and routine, then do labs and know how they relate. Your labs are not helpful for me as I have no idea what your protocol and duration were.


Hey KS Man thanks for the input!

Why not take Ana EOD w/ injection. Because I know that once a week is to much so 3 times a week would be too. But I understand your point, if I can get Ana at doses .10 then I'd try 1x weekly on T inject days and get lab work, then 2,3 what ever fits. Does it matter if it's T day or HCG day?

Half life I get your point of being stable my point was at 6 days it's about gone from system.

My explanation, I know all over the place, sorry about that but I really did try to make it clear.

I guess I was trying to say that the .15 Ana helped the prostate problem (High E2), but simultaneously hurt sexual function, this is contradictory to me. It seemed to me that if it helps the prostate, than it would help sexual function, there on the same side of the equation.

Today is the same kind of situation. I have a little Ana in my system remaining from 10/9/15 .15 dose. I feel low on E2 based on symptoms, then I inject .17 T and I feel a rapid move down hill regarding sexual function. This tells me I got an E2 spike, so I should take .10 Ana to offset, but I got worse,the sexual dysfunctional sides got exacerbated. So what's that about?
How can I feel low, spike and get worse by adding Ana low dose .10?

Are there other reasons I would feel something like an E2 spike, after an injection, because if it was an E2 spike then after taking the .10 Ana I should feel better not worse.


It makes sense:

High E2 hurts sexual function and prostate.
Low E2 hurts sexual function, but not usually the prostate.

Sex depends on many things and needs sufficient E2 to happen. Whether your prostate is swollen or not is for the most part separate from sexual function.


Two things come to mind. First, some guys don't feel good when TT at 1400. Have you ever considered lowering your T dose?

Secondly, just to clarify, you're injecting T EOD but only taking adex once per week? If that's the case, you'll never find stable estrogen levels.

I also found it slightly interesting that its been four years and you seem at a loss yet disregarded KSmans suggestion of dosing adex the same day as injection.

This reminds me of a popular definition of insanity.



I would like to thank you for your interesting "help".

Regarding your input of TT, a reasonable thought, but as I understand things it really isn't about TT but more about FT which is a bit high, but not a determent. I believe it's good where it is. You seem to be guessing, although thoughtful, not a lot of help.

Obviously I'm not as knowledgeable as you apparently desire to be, but I understand dosing to be a function of amount and frequency. If you had read the entire post you would see that the post contained far more information than you apparently could comprehend. Perhaps reading everything, slower would help you next time.

Regarding my personal struggle for four years, I would like to thank your understanding, insight and compassion since we can all see that you truly are a champion of the ill.

Oh, and Speaking of popular definitions one does come to mind, but I will just suggest that when you see my post in the future, please walk on by....

Please know that most of us come here to get help, advice and understanding for the illness we have. I don't claim to know the reason, but the medical community seems to know little or nothing on how to actually treat us. So we come here and hope for a small bit of information, support to maybe feel better. If you want to help great but, you need to know presently your not helping.

Final point regarding KS man's advice. I don't know this gentleman, but I do know something about him, he cares. If you would take the time and go through this sight I don't believe you would see one posting more than KS man.

Over the time I have been coming here he has never missed offering me a helpful opinion, and 9 out of 10 times I benefited from his time and knowledge.

Maybe you would like to have others who have earned respect here if so I suggest next time when you want to help ...help.

Regarding that definition I opted not mention it goes something like this, "If your not part of the solution, your part of the........

Best of luck.


I read your entire post which was poorly constructed and missing much needed information. You seem to draw conclusions that aren't possible without lab work. You seem to believe you know when your e2 is high or low but you're only speculating because this has never been confirmed with lab work. You cannot dose Adex once a week and inject T Eod and expect steady e2 levels or expect to be able to draw conclusions on your Adex dosing and timing, aside that it's ineffective. Aromatization and clearance rates of estrogen do not work that way. I believe your arrogance is the impeding factor for your lack of progress. I was and am trying to help you, by the way. I'm sorry that I got your panties in a bunch.


Your sir are, as previously are ill informed. Please avoid all future posts to my T Nation Name "Thomtst" since you offer nothing in the way of insight, or value. Please do this as I have requested, so I don't have to make this a formal request.

Please stay away!


Your total and free T are elevated above the top of the range.

That is the source of your difficulties with E2 management. It may also cause other long term problems, such as high hematocrit, that can cause cardiovascular problems. Elevated androgen levels can also cause low SHBG, which is associated with metabolic syndrome.

Elevated T tends to cause erection and libido problems in many guys no matter what their E2 levels are.

You should reduce your T dose if you would like to manage your ED (and other aspects of your health) better.

Your muscles will be the same at 800 as they are at 1400 (water retention aside).


seekonk: " Elevated androgen levels can also cause low SHBG, which is associated with metabolic syndrome. "

It is the low SHBG of diabetes, associated with metabolic syndrome that is the problem; not the SHBG modulating effect of testosterone.

Thomst: I provided my best advice. Let me know if I can help later. If you then ping me at the KSman is here thread, I will get an email notice.


Hey KS Man and Seekonk

Thanks for the advice, I think it's worth following. I was at 15ml Test (30mg) EOD and I got bumped to .17ml (34mg). Once that happened I started having higher hematocrit levels, and blood pressure moved up. Presently I'm 149/98 pulse,72. I also got "red face" suddenly after the bump up in Test. I'm do for my 90 day phlebotomy, so that might have to do with the high BP.

I'm 180lbs waist 38 age 59, non smoker one cocktail per day.

I'm assuming that dropping my Test injection amount won't change anything like libido etc. Also, are there any supplements that support TRT, to "enhance" libido? Most of I've read about are about increasing Test and we know that horse left eh barn..:slightly_smiling:

I think I'll get the SHBG blood test, and see what's going on there. Since I'm going should I get anything else done?

KS Man, thank you for the thread to contact you. I "searched "Ks man is here" and saw several threads does it matter which one I use. I never used the email threads before.

Thank you both for your assistance I'm grateful.



My first post indicated lowering your T dose. Arrogance strikes again. No formal request needed jackass.


In the KSman is here thread: https://tnation.T-Nation.com/free_online_forum/sports_training_performance_bodybuilding_trt/ksman_is_here

which is typically on the first or second page of this forum, simply make a post and it is very helpful when you put a link to your post in the text of your post.

Whats mission critical for libido? Good TT, FT, DHT and favorable E2. Good thyroid function. Good health and the rest is up to your brain and nerves. Some drugs mess things up, SSRI's and others. Research all of your meds on Wikipedia.

Sleep i This is what I do:
- trazodone, $40/year, 150mg/tablet, start at 50 and expect to need more over time as your body adjusts
- melatonin - must be time release, 5-6mg
- magnesium supplement, if you get muscle cramps, you are deficient
- vitamin C also seems helpful

Look at the foods that you eat, and vitamins. Eliminate any that are iron added/fortified. The only time that males typically need iron is when there is blood loss, which as a GI bleed might not be obvious unless an occult blood test is done.

I did not see hematocrit or other related items in your lab data!


Hey KS Man

Sorry I haven't responded sooner. But that work thing seems to get in the way of my personal interests.

Regarding your most recent comments.
Thanks for the high point where libido is concerned good to know.

Except for TRT meds I don't take anything pharma.
I sleep great with any form of sleep aids.
Regarding supplements I take several, Multi, 4,000 Vit C, Magnesium 800, Probiotics, Glutamine, selenium 200mg, omega 3 5000, B-12 B Complex, zinc copper.
My diet is mostly natural and organic foods, and alcohol is limited to 2.0 ounces per day.
Hematocrit s always over 50, and every 90 days I get a phlebotomy. I did try lowering my EOD T dose from .17 ml to .15 ML and I went right into the tank within 48 hours. The fact is that I didn't have a Hematocrit problem until I bumped the T to .17ml but it seems that where I need to be which is only 127,5mg or 63.750ml per week.

Ok, I'm going to also post this on the link you provided and see if I can understand this thread business, but I thought I would put it here so I was sure at some point you would see it.


If you are stable and change T dose, the same change to anastrozole will tend to maintain the same serum E2 level.

We do not have a full set of labs or info requested in the advice for new guys sticky.

Pissing a lot and circles under the eyes begs for CBC, AST/ALT, urinalysis, fasting glucose and cholesterol, A1C

4,000 mg Vit-C might be causing some mineral absorption issues.

It take a week of a steady anastrozole dose to reach steady state serum anastrozole levels - effect of half-life. If you get steady and feel reasonable after 10-14 days, do E2 lab work then and see what the number it.