T Nation

Question on Intratesticular Testosterone and AI Ineffectiveness?


KSman I Have seen on a few of Your post that once intratesticular testosterone levels reach a higher level an AI is ineffective, as I'm a little confused? From my findings an AI should reduce aromatase by large percentage( dose depending ), in other words if 1 mg of arimidex isn't reducing aromatase,raise dosage accordingly to a level to effectively lower aromatase at the cell or blood serum estrogen levels.

Please understand that I'm not doubting your words or findings, I'm trying to find an understanding of this as it does have me confused as aromatase is in bound in blood.

I have found on a search a study that was on intratesticular aromatase and prostate cancer, though it doesn't speak of an AI as treatment of effectiveness/ineffectiveness.

Hopefully you can help me get a better understanding on this? Thanks


See my long post about this in the Estradiol stick, dated 01/08/11.

Once you understand the implications of a competitive drug, things will be clear.


personally, I found that AI reduces brain estrogen levels more than blood levels. To get a good blood level of E2, I had to suffer way too many brain fog issues.

hcg can drive high levels of intratesticular testosterone and aromatase. AI reduces periphery aromatase, not intratesticular.

I found support for the concept from another medical site, but can't find the link right now.


It seems there is a lot of disagreement here...

Personally, I am of the opinion that an AI will not do jack shit for your E2 levels past a certain point IF YOU ARE NOT ON TRT...i.e. it can bring you down from 50 to 32, but trying to dial in the sweet spot of E2=22 is an exercise in futility if other hormones are not dialed in...

This is based on an n=1 experiment (myself) and logical reasoning, but I think your body a natural set point for estrogen (based on cortisol and thyroid mainly) and trying to lower it beyond that point will only cause other metabolic processes to change to compensate (i.e. your test will increase a bit to meet the "demands" for current E2)...this can only happen so far before you are forced to start supporting the other metabolic processes, which is what you should have done to begin with...

In summary, I think AI is a good bandaid, but once you have gotten down that path a bit, I wouldn't keep trying to dial it in without fixing what else is broken (which probably cause your high E2 in the first place)...


Bump. I'm sure I'm not the only one who would benefit from this question being answered.


Based on my experience, I believe ultimate control of E2 with or without an AI, or lack thereof is tied to low SHBG.


There has been some talk on here that hCG increases intratesticular testosterone (ITT), and that no AI will reduce aromatization in the testicles. So, since a majority of people on TRT need hCG to promote healthy function of the testes, and hCG increases ITT, AND no aromatase inhibitor will prevent the ITT from aromatasing to E2, how does one effectively combat this?

I haven't been able to find any information that answers this question. Perhaps some are over-responders to hCG, and need less to promote healthy function.

Can you expand on your statement? I had a TT of 626 (205-781), E2 was at 110 (0-47), and SHGB was 5.3 (13.3-89.5).

I know that higher T levels drive down SHGB, AND T->E2. Just started AI this week. Doing another blood test in a month to see where everything is.


Most do not have any problems with T-->E2 in the testes and low dose anastrozole can easily manage serum E2 levels.

For a few, the E2 production is high and a competitive drug cannot work with the high ITT levels. Some need to reduce hCG dose. Some never find a dose that works for them, seems very rare. We do know that high doses of hCG, SERM or a combo can probably create this problem in anyone. So it seems that some guys have testes that are different. High sensitivity to LH and hCG and/or higher aromatase levels; does not matter.


I plan on continuing with my protocol of T/AI/hCG 2x a week until the next blood test to see where the E2 is at. My E2 was at 42 as we have discussed before, then with the addition of hCG, it jumped to 100. 2x/week was the protocol I was on at that time; That is why I will continue in this way until the next blood test.

If E2 remains high, I will cut my hCG dosage by 50 or 100 iu each month with a corresponding blood test so it can be documented here for historical purposes.

I still haven't came across much information on guys being over-responders to hCG. Hopefully I'm not special. I'll keep everyone informed.

KSman, how's that book coming along? We could just copy and paste all of your posts on here and name it "The rants of Kansas Man on hormone replacement", but I think it would be a little better organized if you just wrote the book. Probably have a better name as well. :slightly_smiling:

Thanks again.


I'd buy that book.
Should name it KSistheMAN


Kaynon311: What is the brand of the hCG.

Have to ask; is there any way that you have the concentration or volume wrong?

If mixed to 1000iu/ml, you inject "25" [.25ml] on an insulin syringe?
10,000iu in 10ml BA water?

[I mix to 2000iu/ml and inject "12.5"]


It was manufactured at Eagle Pharmacy in Birmingham, AL.

10,000iu reconstituted in 10ml Bacteriostatic Sodium Chloride

hCG ingredients-Chorionic Gonadotropin, Sodium Chloride, Sodium Phosphate Dried Dibasic, Sodium Phosphate Monobasic, Mannite, Benzyl Alcohol, Sterile Water, Sodium Hydroxide


I have seen some problems when hCG is shipped wet. And no way you have your dose wrong?


It was not shipped reconstituted. I actually watched them reconstitute it.

250iu 2x/week from a 10,000iu vial reconstituted in 10ml is the dosage.

Perhaps I am an over responder. I'll know more after the next blood test at the end of the month.


So you use "25" in an insulin syringe to get 250iu.


1ml .5" insulin syringes. Fill to the 250 (.25ml) mark.


The 50iu [0.5ml] syringes may be cheaper and easier to use accurately.

If one injects T with an insulin syringe, this smaller syringe with its smaller piston, creates higher pressures and reduces injection times. Loading time will not be affected.


Any update on this thread ? I have had a very similar experience with HCG (maybe I am an over responder).

I just started using HCG about three weeks ago.
I inject 100mg T-cyp split into 2 doses per week subQ.
25mg Aromasin split into 3 doses per week.
Was feeling great, and then the shrinking aching balls syndrome hit me.
1-250mg subq of HCG ended it and firmed my boys up proper, but it
also really killed my sex drive and made it near impossible to ejaculate.
It felt like very high E2. I stopped immediately and in a few days my
drive and ability were back.

Fast forward to two days ago, feeling a small ache in the bag so I did 1-100mg shot HCG.
I damn near had to throw my back out to get to climax. My wife loves it, but I definitely think
its the HCG. I am waiting another two weeks and repeat to see if the same thing happens.


Wondering if E2 is been driven high, we have seen that on labs.


I am doing labs in the first week of Jan, and again in Feb. I will wait until a few days prior to the Feb bloods to use HCG again unless I get the aching, in which case I will just use a very small dose, maybe 50mg.
Will be interesting to see the results. Don't know if this correlates to anything, but I am also an over responder to a ADEX.