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Pagan_grappler TRT Log

Edit: Ok so it’s official. My current provider is capping my dose at 140mg a week (a level that I’ve been at before and have had no libido return).

They’ve rejected my request to try a higher dose temporarily because I have a low shgb of 20, and I am a “high aromatizer”. The nurse practitioner I spoke to also stated that I’d have the e2 of a woman if I raised my dose.

I’m looking into rejuvenation care that swoops recommended, but I’d rather not pay more up front fees. Initially I’m going to try to convince my current provider to raise my dose.

I’m really happy with my clinic, Rejuvenation Care Clinic in FL. Telemed, very fast responses, flexible, and $99-150/mo all included.

Will look into them, thank you!

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Updated the post. @highpull, i’ve seen that you comment that you haven’t seen a strong correlation to shgb and symptom resolution at different doses. Should I be concerned my provider is so focused on shgb and e2, despite my libido not returning?

@dbossa, unfortunately I’m having trouble with the search function. Off the top of your head do you know prominent trt doctors that have changed their minds on controlling high e2? I’m familiar with Dr. Jordan Grant who you’ve done some videos with. I’m going to try to convince my provider to let me raise my dose before going through the hoops of finding a new provider.

I think so. Without seeing lab results, assuming nothing outrageous there, I would be much more focused on your libido than lab values.

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You did not ask me (I don’t think Danny is around any longer), but you might refer him to Worldlink Medical and Dr. Neal Rouzier’s work, especially relative to E2. He has changed the minds of a lot of TRT practitioners.

Glad you answered that specific question, I didn’t double check my wording! I meant to ask both, but had to tag dbossa somewhere and got lost in his videos for a moment. On re-read it was definitely a solo question

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I’m currently dealing with roughly a dozen different physicians, all whom prescribed aromatase inhibitors almost religiously at one point and then did a complete reversal once they were caught up with the literature. None of them use it anymore with any of their patients. I know of one single physician currently using it with a single patient who’s sensitive E2 was in the several hundreds (a true, clinical over aromatiser). Men are so stuck with their confirmation bias on this subject that it sometimes takes a lot of arguing but they eventually get it as do many guys in this forum. Anytime anyone says they ‘need it’, it’s virtually always the same issues with their protocol which are often easily rectified. Suddenly their symptoms disappear yet their E2 is either at the same level or even higher than before.

Take a look at the “How I fixed my gynecomastia” video I did on the TRT and Hormone Optimization YouTube channel.

For your physician, have him watch this. If this doesn’t change your opinion on estradiol, nothing will.

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That’s my thought too.

Nothing outrageous in my labs. The following is from labs at 154mg weekly, no A.I. (last summer for 3 months, highest dose they let me try before throwing in the a.i.)

  • My SHGB is typically steady at the lower range (20 nmol/L - range: 16.5-55.9), dose independent
  • My free t is typically steady at closer to the top of range (26.9 pg/ml - range: 8.7-25.1), dose independent
  • My e2 fluctuates, but is typically on the higher end. In this particular lab it was 69.6pg/ml (range: 8-35)
  • My Total T was 943 ng dl at this dose. (range: 264-916)

This is awesome, thank you dbossa

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@highpull @dbossa @dextermorgan

Hey guys, just looking for a sanity check. I dropped the A.I. and raised my dose to 200mg a week. It’s been 1 month (started a bit earlier than the doctor prescription with some left over test) and I’m experience the side effects that typically scare me away from this type of dose. I plan on riding it out for 3 more months to see if anything changes.

Primarily, lower libido/arousal (although I have rock hard morning wood), feeling what I’d call hot flashes starting, acne beginning, and my temper flaring up a bit.

Just wanted to ask if these will subside, especially the temper? Also, if I should be concerned about something, what should I be looking for?

You changed two variables at the same time. Why?

How much a week were you taking previously?

What were free T labs before dose change?

How many times a week are you injecting?

Those symptoms are fairly normal. If you aren’t already I’d start doing a twice a week split (100mg every 3.5 days). Expect another month or two of not feeling amazing before things start getting really good. If you’re able to push through and get there it’ll all have been worth it.

Problem is, what if his free T is in the stratosphere at that dose? You know me, I like high free T. However, I’ve seen guys hit over 100 ng/dL on 200mg a week and they were curious why they had so many issues. What if he recently doubled his dose? What if he’s injecting once every two weeks and doing the equivalent of 200mg a week? We’re missing a lot of key information here.

Then after a few months he’ll know and he can check that protocol off the list and move to another. He’s already committed to it (which is more than most folks are able to do).

That is what I would do.

Typically, yes. Also, be careful what you look for, you often find it. I saw too many guys, back in the day, taking 400-800mg testosterone a week, on top of synthetic anabolic steroids, who were just fine without the “roid rage” many talked about. It wasn’t even a thing for a long time. I also saw guys claim they lost their shit ten minutes after an injection.

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I would have used a different approach… But our end goal is the same. Had he been on 150mg a week, for example, and had a free T of 50ng/dL, and then said he was going to go to 200mg a week, I would have talked him out of it. Now he’s asking questions about his current dose but we have zero information to provide any kind of assessment other than ‘give it 6-8 weeks and then you’ll know’. With a bit of background info, we may have been able to save him some time getting dialed in.

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Yeah, this is what happens when Test and E2 begins rising. Every time I increased my TRT dose by 20mg, so from 140mg to 160mg, and again to 180mg, I could feel it. Blood pressure will go up a bit, too, and I would get a ton of facial flushing, especially in the first few sets in the gym. Scale weight will generally go up as well as you start holding on to more water. Although I have never experienced any kind of temperament issue.

This is all reversed in about 6-12 hours after taking AI, and I’ll usually get up to urinate all night the day I take it,

Anyway, these symptoms would usually self-resolve within a few weeks once my body adapted. I’m blasting 500mg weekly right now and high E2 symptoms and their management has become extremely obvious. I pin every other day at this dose and it helps a ton - you might try that as well if you’re still not tolerating it well in a couple weeks.

Also, it seems different for everybody, but I can tell whether a dose or dosing schedule is going to work for me in about a week - it’s never taken me months and months.

I don’t know. I’m passed the point of anyone making any sense of T labs unless they test when things are good so they know where that is. I did the whole start low and go up thing but it turned out had I just stayed on the initial dose and wiped the sand out of my vagina I would have saved myself a year. 200mg won’t kill him and it’ll likely make most things better than 100mg. There’s enough folks pushing the low dose route here that he can get it from one of them.

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Apologies for the lack of clarity. I did technically change 2 variables at once, but it was not A.I… It was switching from T-Cream applied to scrotum to 200mg E with no a.i. Brief history of treatment to follow:

In the past I’ve done from 140 to 200mg Test E with 3x a week A.I. down to 22pg/ml. Felt like crap on all.

When I came off A.I. I was convinced e2 was the killer so I’ve done between 70mg -165mg weekly without A.I… I had no symptom resolution through 165mg Test E weekly.

I did 175mg weekly test e with no a.i. for 3 weeks, and the second I felt a “hot flash” I dropped the dose back down due to fear of e2 side effects. That was back in febuary.

That’s when I decided to switch to the T-Cream in march-july which wasn’t helpful, cost too much, and was annoying to apply.

When I jumped back onto test E i wanted to start higher than 165mg/weekly, so I figured why not and just started at 200mg/weeky.


For reference on my labs my highest blood lab without a.i. was 154mg/week. Doctor did not order labs at 165mg and had me titrate directly to 175mg (which I gave it up in 3 weeks).

SHGB --> (20 nmol/L - range: 16.5-55.9), seems steady here despite dose or a.i.
Free T --> (26.9 pg/ml - range: 8.7-25.1), seems steady here despite dose or a.i.
E2 --> 69.6pg/ml (range: 8-35)
Total T --?> 943 ng/dl (range: 264-916)

I am currently injecting EOD in the mornings as i can stay more consistent with it than I can with 2x weekly (missing the nightly shot occasionally).


Also I indeed was pulled down the low dose path for a year. Not fun and felt like I wasn’t on anything.


Anyhow good to here that these symptoms are ok for the time being, and I will ride the wave out and see what happens. I will keep an eye out for my free t when I get my next lab in two or so months.