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New to TRT, Advice After 6-Week Bloods

Hi there, been lurking for a while and wanted to see if I could get a bit of advice regarding my 6 week bloods. I am 33y/o fit and active, consistent weight of 177, with body fat at 10% prior to starting.

Current Protocol:

Every 3.5 days
100mg test C (#29 0.5ml 0.5" [50iu] insulin syringes filled to the 50iu mark)
500iu HCG (#29 0.5ml 0.5" [50iu] insulin syringes filled to the 50iu mark)
1mg Arimadex

So based on that I am at 200 Test C, 1000 HCG, 2mg Arimadex per week. Initial blood showed my E2 high, and as expected it has increased even further. I am holding at about 191 pounds (14 pound jump) since initial Bloods and beginning protocol. I feel bloated non stop and sluggish due to the added weight.

Estradiol E2 - 58 pg/mL Range 7.6 to 42.6
Free Testo - 7.85 ng/mL Range 4.6 to 22.4
SHBG - 43.3 pg/mL Range 10 to 77
Testo - 447 ng/dL Range 350 to 781
PSA - .4 ng/mL Range <4.1

6 week bloods taken 3.5 days after last injection:
Estradiol E2 - 71 pg/mL Range 7.6 to 42.6
Free Testo - 21.9 ng/mL Range 4.6 to 22.4
SHBG - 33.4 pg/mL Range 10 to 77
Testo - 929 ng/dL Range 350 to 781
PSA - .8 ng/mL Range <4.1

I called the doc to review and get a recommendation on what to adjust and was told to add another 1mg arimadex per week, but it seems like that goes against the normal advice here. I asked about reducing the T dosage since I was at 929 at trough, but was advised to increase arimadex and leave T alone. I need to get this bloat and water weight under control!

Are you certain your E2 test is Sensitive LC-MS/MS method, we see a lot of doctors using the female E2 test for guys and end up overprescribing AI’s when in actuality you E2 is lower. There are some guys who just end up converting too much of their T–>FT–>E2, you could be one of those unlucky few.

I’m not saying your E2 isn’t high, I’m saying make sure your E2 test is the correct one. A guys E2 needs to be 20-30 pg/mL, some guys have higher E2 with no symptoms. Otherwise your other numbers look great. Always take into account how you feel and then numbers can become guideposts.

I spoke with the front desk at the doctors office a moment ago and her reply was “We would not order the female test for any male patients” so, until I hear otherwise directly from the doc I can only assume they are giving me the correct reading. Based on the bloating/weight gain/water retention is seems like I am showing the classic high sides, I’m just not certain which to adjust.

Total Test numbers look good.

It sounds like you already know what your options are. (increase AI or lower test) I don’t think a modest testosterone reduction will give you any tangible results in your e2 though, it being that high.

HCG can cause E2 problem for some people, maybe that is part of your issue? Are you using it to keep fertility? Have read plenty of posts where people have had nothing but issues with HCG, and others have none.

That statement sounds like one of those rehearsed lines, basically what she’s saying is they wouldn’t order the wrong test on purpose, ignorance and mistakes are made all the time. I seriously doubt nurse even bothered to take a look and issued a blanket statement.

My reasoning has to do with I expect an huge obese man to convert large amounts of E2, not a lean guy 177 pounds with 10% body fat.

I agree with all of the above, felt like a generic response to me as well.

Just not sure which direction to go with dosage adjustments. Would like to continue HCG to maintain fertility and keep testes normal size.

When I first started TRT I also felt bloated but this seemed to subside on it’s own. Your body needs time to readjust with these new hormone levels.

However, with E2 in the 70’s, something needs to change. If you are happy with current T levels, try adding another 0.5mg of arimidex to your twice weekly dose. So instead of 1.0mg twice per week, do 1.5mg twice per week. Your other option is to lower your Test dose which will obviously lower TT and FT levels.

I’m no expert but what I’ve seen on this forum is that everyone’s dosing is different and there is no “standard”. I’m also trying to dial in my E2 on 200mg test cyp per week with 1000iu HCG. On 1.0mg of arimidex per week my E2 was 42. I’ve increased the arimidex to 1.5mg per week (0.5mg MWF) and will re-test in 6-8 weeks. You could try doing the same.

@KSman any chance you could add some input?

Thanks for all the replies so far!

@systemlord Do you agree based on the info I have that I should leave T and HCG dosage as is and simply add 1mg additional or arimadex per week?

I’m very worried about it getting out of control, but don’t want to crash it or have to take a unreasonably high dosage if I can adjust elsewhere.

I wouldn’t, not without confirming if it’s the correct E2 test otherwise you could crash your E2. Why don’t you request a copy of your labs results? You’re entitled to them.

@systemlord I have the copy, that is what I posted in my initial post. Lab description simply shows it as “Estradiol E2”

Than it’s the wrong test, if it was sensitive it would say E2 sensitive.

  1. Estradiol E2 Sensitive for males
  2. Estradiol E2 for females
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It’s 100% not the right test. Those are the Labcorp ECLIA ranges for females. Your E2 is probably lower than stated in the test as this test over states E2 dramatically. You can pay out of pocket for the E2 Sensitive test. It’s typically 70 bucks. It will give you an accurate picture before you go changing your protocol and possibly crashing your E2 levels. You will then be in a new kind of hell.

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Thank you guys, I will have this test done and report back. My original concern came from the bloat and rapid weight gain.

Most gain weight in the beginning then lose it later, your body is going through hormonal changes and it could take several months to balance out. I’m still making great progress 9 months later muscle wise, I’m one of those few who haven’t gain or lost a single pound since starting TRT even though I’m showing body comp changes.

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Well I appreciate the input, I’ll report back soon. I purchased the order for E2 sensitive just now from discount labs, only ran $50. My next injection/arimadex was supposed to be tonight but I’ll hold off and get the bloodwork done in the am and inject afterwards. Hopefully they will be quick with results.

Are the Arimidex pills from drug store?
Check that they are 1mg and not 0.5mg.

This seems odd.

  1. Perhaps FT–>E2 has been reduced as expected, but your liver E2 clearance is impaired.
  2. Some have hCG drive high T–>E2 inside the testes and Arimidex as a T competitive drug does not work there.

#2 seems more likely than #1, try reducing hCG by 1/2 as an only change and see how you feel. We have had a few guys who have these E2 issues driven by hCG. Also check that hCG iu/ml is as expected and dosed OK.

SHBG is moving in right direction.

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@KSman I had the e2 sensitive draw last week, still waiting for the lab results. I’ll report back then.

All meds are from pharmacy, confirmed dosages. Regarding the HCG reduction, it feels like my testicles have shrank a bit already, I’d really like to avoid any more shrinkage. They feel smaller and drawn up tighter to my body.

@KSman @systemlord

Thanks for the info so far, I got my lab back.

Labcorp Estridiol Sensitive LC/MS/MS
Result: 33.8pg/ml — Range 8.0 - 35.0

Lab was taken mid morning on day 3.5 since my last injection, so basically right before I injected. E is close to top of the range, but not way overboard like I had feared. What would the recommendation be based on having that correct lab reading to try and get closer to the 22 mark along with my concerns on the post above?

Increase anastrozole by 33.8/22 = ~50%

But if my suspicion about hCG is correct, you could easily be overdosed if testicular T–>E2 is reduced.

So there is uncertainty.

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