T Nation

Taking AI During TRT Question


I am new here
I have a question

I have been on trt for about 6 months
my estradiol is double what it should be,. like 220 pmol… it should be around 100

my question is this:
If taking an AI like arimidex to help lower the estradiol, will this also increase my test levels as well? or will it only lower the estradiol and the test / free test numbers stay the same?

thank you


come on anyone??

i know if you are not on TRT and you take an anti e, it will raise your test but is the same true for guys on TRT???


When not on TRT, your LH/FSH levels depend on negative feedback effects of T and E2, E2 the dominant player. Then reducing E2 can increase LH/FSH and T levels.

When on TRT, LH/FSH–>zero and reducing E2 can not do anything as above.

In both cases more E2 increases SHBG produced by the liver which scavenges sex hormones from the blood. More SHBG means more SHBG+T which means less FT. SHBG+T is tightly bound and not bio-available. So while more SHBG+T means higher TT, the higher TT number is more SHBG+T junk and you gave less T benefits with more TT. Reducing E2 will cause SHBG to slowly drop, increasing FT which is good. E2 also interferes with T at T receptors, so there is a benefit there with less E2. E2 also drive gene expression that is opposite to what we want T to do. All of this needs to be tempered by a view point that understands that there is a optimal E2 level near 22pg/ml - 80 pmol/L that works great for almost all guys, some thrive better with more E2.

When you add AI, E2 will drop, SHBG should reduce and FT increase. TT may change a bit. All of this depends on your SHBG levels and how that responds. Some just have high SHBG and some simply low. And some have extremes driven by medical problems or starvation diets.

Post labs with ranges and more info about you.
Did you test LH/FSH or prolactin before starting TRT?

Please read the stickies found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.


thank you for your reply

i have done labwork before starting trt but i dont have them available… i was JUST out of limits in total and free… that along with lost of muscle and increase fat and other symptoms like hot flashes and anxiety,… i decided to get on TRT and doc allowed it. The doc did some stupid stuff tho in the beginning,. 1ml of test Cyp ONCE a MONTH? wtf? then twice a month, then once every 10 days and now im at 1ml every week. I divide it into .5ml tues eve and .5ml sat morn

the doc stated he was worried i was going to get addicted so i believe this is why he started me off so slow.

i have my most recent blood work

total, free test, lh , fsh, estradiol. liv enzymes and CBC were only taken, no shbg or cortisol which i think should have been tested.

LH < 1 range is 2-9 iu/l
FSH <1 range is 2-12 iu/L
testosterone 17.9 range 7.6 - 31.4
estradiol 219 range < 159 pmol/L
free test 540 range 196-636 pmol/L

as you can see my estradiol is more than double what it should be… so im being referred to an endocronologist to hopefully get some arimidex…

heres the thing… even tho my free test is almost in the upper range… when i work out i am not making any gains and my strength is shot… before i use to be able to build muscle so easily and have super strength … i dont know wtf happened… im hoping once the estradiol is reduced to like 80 or so, my strength and gains will come back…

im also trying to increase my dose from 100mg to 200mg a week. but i dont know if the doc will allow that… i already have my previous muscular physique from years ago buried under a lot of body fat but i still pass for the bodybuilder type so this works against me when i ask the docs for AIs or higher dose or shorter duration… they stereotype me and deny my requests.

also i wanted to ask… IM vs subQ. what is really the preferred method?


SQ is preferred as it prevents decades of muscle needle damage and SQ is slower release with steadier hormone levels.

Body fat is greatly influenced by thyroid function. I posted above how you need to sefl-eval that. Thyroid function is poor if you have not been using iodized salt and/or vitamins that list iodine+selenium.

What other labs? - need more than hormones?

Do not test LH/FSH as these -->zero on TRT, doc should know better.

Your TT and FT suggest very low SHBG and that can be from diabetes, but some guys simply have low SHBG. Need more info about you, see the advice for new guys sticky.


i have a big problem with body temp regulation… actually its only heat,. im always HOT even in winter… i get so so hot , even my glasses will fog up from the heat from my face… i dont know if its from anxiety or as u have mentioned thyroid or possibly even hot flashes from high e2?

i will request thyroid bloodwork as well as the SHBG.

When im done my box of 25g 1 inch needles i will switch to the SQ method.

i will take a read over the new guys sticky


Your body temperature measurements when you wake up AND mid-afternoon will be helpful. Your sensation of feeling warm may not mean that you are.

Self-inject T twice a week
and take anastrozole at time of T injections.