T Nation

On TRT, E2 is High, Doctor is No Help


#1

57 y.o. man on testosterone cypionate 100 mg IM every week for the past 15 months. A recent total testosterone level (LabCorp) drawn on day five was 903 ng/dL. My estradiol level was high at 49 pg/mL and therein lies the problem. My prescribing physician is a board certified endocrinologist about my age, well regarded but conservative.

I had to sweet talk him into writing for the testosterone in the first place and he is not interested in prescribing an aromatase inhibitor. He threw up his hands at the suggestion of adding hCG. He rightly points out that there are no long term outcome studies regarding this protocol, only anecdotal reports. I want to keep on good terms with him so I am not pressing him on the AI and hCG issues. He is, after all, writing for the testosterone which is a schedule three drug.

I am considering ordering some Liquidex on the web and trying my luck. I have scouted out some other doctors to write for Arimidex but none seem interested, except for the life extension guys who want an arm and a leg on a monthly basis to join their panel of patients. A pox on them.

My question then is this. What has been the experience of those who have bought generic Arimidex (Liquidex) over the internet? I would like some recommendations as to sources. I know that this will not be guaranteed safe pharmaceutical grade drug but maybe that is the best I can do under the circumstances. I would like to think that what I buy is safer than Chinese toothpaste.

Once I get my E2 level under control I will tackle the hCG issue.

Let me state that I appreciate KSman's postings and respect his opinions. I have tried biweekly injections I but noticed no subjective differences from weekly. There is a little drug wastage in each syringe used and I decided I was getting more total drug with one weekly injection as opposed to two. I have not tried subcutaneous injections but I have had no issues whatsoever injecting into alternating glutes with a 27 gauge 1.5 inch needle attached to a 1 ml. syringe.

This is my maiden post after reading for a few years. I welcome all replies.

Turt


#2

[quote]Turtello wrote:
57 y.o. man on testosterone cypionate 100 mg IM every week for the past 15 months. A recent total testosterone level (LabCorp) drawn on day five was 903 ng/dL. My estradiol level was high at 49 pg/mL and therein lies the problem. My prescribing physician is a board certified endocrinologist about my age, well regarded but conservative.

I had to sweet talk him into writing for the testosterone in the first place and he is not interested in prescribing an aromatase inhibitor. He threw up his hands at the suggestion of adding hCG. He rightly points out that there are no long term outcome studies regarding this protocol, only anecdotal reports. I want to keep on good terms with him so I am not pressing him on the AI and hCG issues. He is, after all, writing for the testosterone which is a schedule three drug.

I am considering ordering some Liquidex on the web and trying my luck. I have scouted out some other doctors to write for Arimidex but none seem interested, except for the life extension guys who want an arm and a leg on a monthly basis to join their panel of patients. A pox on them.

My question then is this. What has been the experience of those who have bought generic Arimidex (Liquidex) over the internet? I would like some recommendations as to sources. I know that this will not be guaranteed safe pharmaceutical grade drug but maybe that is the best I can do under the circumstances. I would like to think that what I buy is safer than Chinese toothpaste.

Once I get my E2 level under control I will tackle the hCG issue.

Let me state that I appreciate KSman’s postings and respect his opinions. I have tried biweekly injections I but noticed no subjective differences from weekly. There is a little drug wastage in each syringe used and I decided I was getting more total drug with one weekly injection as opposed to two. I have not tried subcutaneous injections but I have had no issues whatsoever injecting into alternating glutes with a 27 gauge 1.5 inch needle attached to a 1 ml. syringe.

This is my maiden post after reading for a few years. I welcome all replies.

Turt [/quote]

If you are in the northeastern USA Pm me I know of a good and competent dr. There may be other factors involved in the cascade that also need to be addressed as well .


#3

Hey Turt,
Liquidex is usually properly dosed per the label on the bottle. There are many of here that use it due to both cost and availability. The quality of the powder used is research chemicals is very high, and I have never heard of anybody getting sick from drinking a few drops of liquid adex everyday. (unless they are an over responder)

In theory, 1mg a week of liquidex should take you from an E2 of 49 to an E2 of 25 or so, so If it was me, I would start there and see how I felt in a month or so.
For me, the difference between an E2 of 40 plus and an E2 of 22 or so was actually life changing…
PM if curious.


#4

Turt, you can feel the differences in injection frequency because the E2 is messing everything up.


#5

I have been reading through the various TRT threads trying to learn what I can. I have come across the fear, expressed more than once, that TRT will cause permanent shutdown of the pituitary/testes axis, and perhaps permanent atrophy of the testes. I, too, was concerned that taking exogenous testosterone might cause permanent atrophy of my testes.

This isn’t a problem according to my endocrinologist. The boys will come right back if one stops injecting testosterone. The pituitary will again make LH and FSH and the testes will respond. However, if you are taking testosterone because your testes are not up to par anymore, why would you stop? You would only get back to your previous low level of testicular function. But it is nice to know that option remains available.

(This is a distinctly different situation than with the pituitary/adrenal axis. Exogenous corticosteroids (like prednisone) can eventually cause complete adrenal atrophy and permanent loss of adrenal function. This is called iatrogenic Addison’s Disease. President Kennedy is thought to have suffered from this, possibly from youthful overuse of the then new prednisone miracle drug. Sudden cessation of prednisone can be fatal in this instance.)


#6

[quote]Turtello wrote:
I have been reading through the various TRT threads trying to learn what I can. I have come across the fear, expressed more than once, that TRT will cause permanent shutdown of the pituitary/testes axis, and perhaps permanent atrophy of the testes. I, too, was concerned that taking exogenous testosterone might cause permanent atrophy of my testes.

This isn’t a problem according to my endocrinologist. The boys will come right back if one stops injecting testosterone. The pituitary will again make LH and FSH and the testes will respond. However, if you are taking testosterone because your testes are not up to par anymore, why would you stop? You would only get back to your previous low level of testicular function. But it is nice to know that option remains available.

(This is a distinctly different situation than with the pituitary/adrenal axis. Exogenous corticosteroids (like prednisone) can eventually cause complete adrenal atrophy and permanent loss of adrenal function. This is called iatrogenic Addison’s Disease. President Kennedy is thought to have suffered from this, possibly from youthful overuse of the then new prednisone miracle drug. Sudden cessation of prednisone can be fatal in this instance.) [/quote]

When adrenals are properly supported with lifestyle, nutrition, adrenal supplements and some times cortef there is no adrenal suppression on <20-30 mgs of cortef which is barely 5 mgs of predisone. SOme time taking care of the thyroid will help to lower e2 because it helps to speed up e2 clearance. Again there are other factors such as zinc deficeincy, altered omega 3:6 ratio, dietary imbalances as well as environmental exposures.


#7

I just left my fiancee’s endo, and what a bone head! He says ALL MEN WILL DEVELOP PROSTATE CANCER IF THEY LIVE LONG ENOUGH. I’m like WTF? He was willing to admit it’s an ESTROGEN ISSUE, but he says Arimidex is not STANDARD CARE, and if a man on TRT has estrogen problems, the way to fix it is to lower the amount of T injected each week. Holy crap!, he also says adrenal fatigue doesn’t exist. He is of course 100 plus pounds overweight, and when questioned about anything, becomes combatively defensive.
Thank God he’s not my doctor…


#8

The lifetime incidence of prostate cancer is about one in six men. Of men with a brother or father with prostate cancer, the incidence doubles to about one in three. That’s me, one in three. Pretty high. That’s why I have looked into this more closely and talked to about six urologists, formally and informally.

Prostate cancer research is lagging compared to other fields. Many basic things about the disease remain unknown. It may not be a single disease, for example. Some men can live with the disease for years without trouble, and other men develop aggressive disease that kills them.

Estrogen’s role in prostate cancer is not well understood. Testosterone causes prostate cancer to grow. Some men choose to have bilateral orchiectomies (castration) to reduce testosterone levels, usually men with advanced disease. Testosterone is not thought to cause normal prostate tissue to turn cancerous. (We all hope!)

Armidex is not standard treatment in TRT. Studies remain to be done. What some of us are doing is acting as our own test subjects, and that always should be kept in mind.