T Nation

Next Adjustment

Former poster a year or so back. Took time off Trt as I was all over the place, on multiple meds and felt like I was going crazy.
Back on TRT. After dropping the hcg due to uncontrollable E2 we are currently doing .3ml E3D
.25mg anastrozole E3D for past 5 weeks.
Results 1 day after dosing.
TT 535 E2>5 was at 32 with Hcg and same AI dose, shbg 15
I was also told my iron and DHEA levels were low but have no values.
I was told to completely drop the anastrozole take 25mg DHEA daily and after a stool test possibly start iron supplements.
The negative symptoms I have are constant fatigue which I know the low E2 has a lot to do with (hopefully goes up now after dropping ai) and I definitely feel the worst the day before next shot.
I’m looking at these possible options to discuss with the dr. 1. Up dose slightly and continue 2x/wk
2. Keep dose the same and increase injection frequency. I’m leaning towards option 2 due to low shbg.
What’s worked better for others?

With 0.3ml 200mg/ml E3D you are getting .7ml/week x 200mg/ml = 140mg/week

We then normally expect that 1.4mg anastrozole/week would be needed.
You have been taking 0.583mg/week

I assume that you mean E2<5pg/ml

You are an anastrozole over-responder, then I would expect that .35mg would work. But you may be more responsive than that. You would need to make a solution in vodka then dispense by the drop and experiment. We had one guy here who needed 1/8th the expected dosing.

What was your hCG dosing?

Iron levels vary a lot day to day and you can end up chasing your tail. CBC and ferritin are more useful guides to iron status. If a male truely has low iron, there is blood loss and an occult blood test should be done. Doc wants that stool test!

What is your thyroid status now?
Oral body temperatures?
Feel cold easily?
Outer eyebrows sparse?
Using iodized salt?

Yes E2 <5pg/ml
Beginning hcg dosing all done with .3ml Test 2x/wk was 500ius MWF no AI very fatigued E2 was at 39.
Next we dropped to 250ius MWF no AI same symptoms no change E2 was 32.
Next we moved to 250ius 2x/wk with shot E2 stayed at 32. Here we added the anastrozole at .25mg 2x/wk. Kept hcg dose as is and my E2 didn’t budge. Fortunately we had our baby and are no longer worried about fertility. We dropped the hcg and move onto our current protocol. Which has tanked my E2. But now looks like dropping the AI I may bounce into the preferred range!

I don’t have any current thyroid test but when I started with this Dr we discussed previous experience and we checked before 1st protocol and after and everything seemed decent. So we focused on the TRT. Now I go back august for blood work again to see what dropping the AI has done. Upon those results if my TT is low 500s 1 day after my shot. Would it be more beneficial for me to talk to him about either upping the dose a little still E3D or keep the dose the same (.3ml) and just up the frequency of shots and what should that frequency be? Seems that with low shbg this may be the best option.
Who knows maybe getting my e2 up some a may feel much better just want to be prepared for the next consult after labs.
Thanks KSman

We have had a few guys who create a lot of testicular T–>E2 with hCG. Something different going on. Perhaps a smaller dose would be OK for you. When you stopped T and E2 stayed up with hCG+AI, that really nails the problem. Anastrozole cannot prevent T–E2 inside the testes this points to hCG as the problem.

You will need to experiment and see what works for you. Maybe you can get high T levels that will make you feel great, using a small amount of hCG to moderate E2. At least you now know what you were dealing with and how you can approach this. You can explain the issue to your doc.

Anastrozole as a competitive drug cannot compete with high intratesticular testosterone levels inside the testes and is ineffective there.