T Nation

New TRT Patient - AI Needed or Not?

Hello Nation,

I am 41 years old and was recently (and finally) diagnosed with low T. My total T is 220. Free test is 9. Estradiol is 30.

My protocol that was just prescribed is:
200mg of test C (2 injections of 100mg weekly)
1mg of ana (0.5 mg twice weekly)
1mg of HCG (0.5mg twice weekly)

My question and concern is regarding the AI. A lot of different opinions that I have found recommend it and others say not to take it. I will begin trt next week. Should i follow what the doctor says and let them dial me in during this first 8 weeks or not take the AI and see how my labs look? Any advice or opinions are welcome and appreciated.


With very few exceptions, trt that requires an AI is an indication that the dose is too high. Starting out at 200 is unfortunately very typical. It’s where most of us started before we knew what we were doing.

Your protocol is similar to the one a lot of men start out with. Hell, it’s exactly what I was on at the beginning. You should follow it as prescribed and then get blood work as scheduled. If you feel like shit for the first eight weeks I imagine it won’t be all that different from how you feel with low t now. Get an idea of what the doctor’s protocol does for you and then you can assess from there. Knowing what I know now I would have followed zero of my doctor’s guidelines when I started. But I only learned that through trial and error. Others may disagree.

You should be asking your doctor these questions:

  1. What are the pros and cons of using anastrozole?
  2. Why do I need anastrozole?
  3. Would it be OK to start without it and consider it later?
  4. Why do I need hCG?
  5. Would it be OK to start without it and consider it later?

If your doctor’s rationale makes sense to you, then go with it.

I would not take anything without a proven need for it. You didn’t ask, but guys with lower levels typically do fine with lower dosing. Regarding hCG, unless actively trying to conceive, I would hold off on that as well.

Of course, most want to help and they naturally assume whatever works for them, or whatever they think works for them, will work for you and everyone else.

Thank you highpull! I will certainly ask those questions. I am completely new at all of this and screwing with hormones scares me a little I guess.

Thank you iron_yuppie!! That is exactly my plan. As far as following what my doctor says. I guess watching and reading about so many that say AI’s are not necessary in 99% of people had me worried.

You are advised to start TRT in isolation with as few variables as possible.