T Nation

This is My First Post .... Need Advice Asap!!!


Trying to make this as short as possible.. Been going to my regular family doctor and just recently started taking Testosterone Cypionate in July. Started at the docs prescribed 200/every 2 wks. After lots of reading started doing experimenting with up to 300 mg/wk ..still was not feeling the way I should be. I had my T tested and it was 3,300. Way to high for my purpose... So I did more research and started injecting 50mg E3D and just received my most recent blood results:Total testosterone-1150...free test....36.8 and ESTRADIOL 66..
I am just learning... but now realize I should have been tested for E2 long ago... but no doctor did this... only since I requested it after finding out from this site. I think high estrogen was the cause of my extreme lack of energy... frequent urination.. sleepless nights.. sexual issues....etc. I have seen some benefits to the testosterone though.. much improved skin elasticity... much improved recovery... much less aches and pains. Am definitely looking forward to how I am going to feel with getting my E2 under control... But my doctor said... now I need to see an Endocrinologist as my request for Arimidex is beyond him. I went to one before... but that one was totally agains testosterone therapy and told me the horror stories we have all heard due to extreme abuse...so I knew that would not work. How am I going to get my Arimidex? any advice ?




Thanks for the link... I may end up using it...But first I want to try another doctor... it may take a litle time to get an appt. That brings me to my question: how critical is it to get my Estradiol lowered. I would imagine as soon as possible. I mean would another week hurt too much??


another week shouldn't kill you... but don't expect the endo to be open minded about arimidex. You probably should read through the stickies especially the Finding A Doctor one. You need someone well versed in HRT which most endo's don't seem to be.

call around to local compounded pharmacies. Tell them that you have a hormone imbalance of low testosterone and high estrogen and you were wondering if they knew of any good male Hormone Replacement Doctors that they recommend.


If you order it online you're going to wait up to 5 weeks anyway so I wouldn't worry about another week (no choice). If you're wanting it ASAP - what I would do is go doctor fishing while I waited on the AI I mail ordered. The doc is going to be the fastest route if you're aggressive enough and find one that's open.


I would be wary of any drug coming from India that you can get without a doctor's script. Waiting 5 weeks is not realistic either. Many guys on this site have had success with liquid reasearch chemical anastrozole. Googling should provide you with suppliers. Delivery is typically pretty quick.


"How am I going to get my Arimidex?"

From a highly competent doctor.

You started experimenting? Dude, HRT is NOT a matter of self experimentation, and I'm not surprised you had overaromatization secondar to a friggin' T value of 3,300! What do you expect when the CLINICAL DOSAGE for T is anywhere from a measly 50 to 100 mg per week depending on the mode used and the normal range for T is 300 to 1,200 ng/dL. (Human testicles only produce 7 to 10 mg a day, by the way.)

Why not go to a competent doctor, preferably a urologist with a fellowship in ANDROLOGY. An ANDROLOGIST - someone who deals primarily with fertility, hypogonadism, and erectile dysfunction.


Ok... so now that I have my T levels where they should be.... do you think my E will drop some more? How long does it take E to drop when one reduces the dosage? I did not have E2 tested prior to starting my Testosterone... but from what I have read on the symptoms.. I know I have had high E for some time... I would venture to guess it was probably in the high 40's.

I will still try to get a doctor to prescribe the arimidex.
And another thing... my pcp who seemed very enthusiastic.... refused to prescribe arimidex..stating it is VERY Toxic....


And that's one of the reasons you shouldn't be seeing a PCP for hypogonadism.

Yes, estradiol should go down when you lower the dose.

You wrote: "I would venture to guess it was probably in the high 40's." Another reason why we see doctors and don't rely on guessing or experimentation.

Where are you located? Either see an endocrinologist who deals with this, or as I said above, a urologist with a fellowship in andrology under his belt.

www.impotencespecialists.org is a good place to search for competent doctors.


I did not know enough when I first started the testosterone... but was finding out things like inject more often than the docs every 2 wks.... I did not feel anything and at the time did not know E follows T..so I tried a bit higher dosages... using extremely minimal bodybuilding dosage recommendations. Finally after researching more I realized I was making a big mistake and started 50mg E3D. And realized I had to get my E2 tested which I did....and it made me think that it was the E2 all along causing all my problems!! It is amazing to me that most doctors do not test E2... I had been complaining about fatigue and super slow recovery from exercise along with my feeling that I was starting to age very rapidly... all the symptoms I had ....I can say that even though I don't have the E right yet... I feel better... more energetic.. recover much faster.... aches and pains are much, much better.
I am so happy I think I have found what the problem is.... and now I have my work cut out trying to find a doc who will give me what I need. I will try your recomended site for sure.
thanks ..


Read this paper too.



Thanks.... I will be away from a computer for 2 days... but will check back asap. Thanks again!


That paper does not approach the issues of optimal levels and ignores management of serum E2 levels and does not address patient outcomes. It is typical in discussing physiological ranges which means that normal lab numbers are adequate objectives. So this paper does nothing to direct docs towards the proper protocols.

Another paper that fixes lab reports, not people.


Not every paper is going to address each and every individual.

It's not a bad paper just because it doesn't mention treating symptoms, not just lab values.

Where does it not address patient outcomes? The whole point of HRT is a favorable outcome.


No, it doesn't mention estradiol control. Still doesn't make it a bad paper or something to start with before reading other literature.

Anyway, I don't bother to read much, nor should anyone else have to if they have a doctor who knows what s/he's doing.


If E2 management is not addressed and target E2 levels are not discussed, then there will be many man who will have a poor result from any form of TRT. In that regard, the paper fails to provide doctors with proper guidance. The paper thus seems to ignore issues of how men feel aka patient outcomes.


Then don't read or recommend it.


Brick - we get it. You have your point of view, and other people have theirs. You probably cringe when you read some of the advice KSman gives, or HANS gives, or I give - I understand completely because I cringe when I read your advice.

Your advice = Go see a doctor and trust 100% in what they tell you - no need to do your own research - go on faith in the medical system. Go by lab values. Don't worry about symptoms. Use 'papers' that ignore known issues. Don't self treat. If your doctor hasn't heard of it, then it is bogus.

and yes, I am exaggerating.

You are one of the rare lucky people and have found something that works and are at 100% with no other symptoms or side effects. For most of us, the first simple solution isn't enough. If it were, we wouldn't be here.

some may not need to worry about estrogen, but it does seem to be an issue for many - so to recommend people follow a protocol from a paper that ignores known issues seems misleading at best.


You are exaggerating.

Do you think the authors of that paper recommend not working with treating symptoms?

Do you think I'd recommend going to a doctor who doesn't treat symptoms?

Before my current doctor, I went to three fruitcake endocrinologists who said, "It's all in your head. There's nothing wrong," despite the fact that my total T was 240 to 300 consistently and my LH and FSH values were completely abnormal! I was feeling like shit, clinically depressed, totally drained, and impotent for over one year at the age of 22.

So how does this add up with "If your doc didn't hear of it, it's bogus", considering I went to three doctors who didn't know what I was complaining about nor how to treat it?!

Is a training or nutrition article crumby because it doesn't explain EVERY nuance of training or nutrition? Can't a study or article or video, or any other media be decent even though it doesn't mention EVERYTHING that has to do with a topic?

Meanwhile the paper mentions all the intended results of treatment--restore health and all male characteristics. That doesn't fall in line with treating symptoms? Did you people read it in full? Anyway, the paper's target audience is medical professionals, many of whom probably do have to deal with keeping everything in line, and if they are competent DO know how to treat abnormally high estradiol.

I did my own research in the beginning and now don't need to.

And yes, I do cringe when I see people self medicating when there are some competent doctors out there, some professionals whose entire careers and education have been spent studying and treating the male reproductive system. I also cringe when I see people taking medical advice from people on the internet who aren't medical professionals trained in specific areas of medicine (urology/andrology, endocrinology).

And perhaps I am lucky. I've got a competent doctor, one of the best in the northeast. So I encourage others to do the same - find a COMPETENT doctor. I have no need to hunt down obscure sources for medication. When I will need HCG or Clomid, I'll be prescribed it (already used clomid twice as I've said before). No need for AI, but would be prescribed if I needed one.

I don't go by lab values alone. My doc knows I don't FEEL (symptoms related) like myself unless I'm at 700 to 1000. So he keeps me there. That's working with values and symptoms. Besides, everyone I've sent to my doc has been fixed up easily. They get a prescription, go down to Duane Reade and get it filled, take the medicine, and that's it! Perhaps they're lucky too.


Sadly, most need to study these issues and end up knowing more than most docs to become motivated to find a doc who does things right or is open to learning something new. If that fails, it is easy for someone to self medicate and do things better than 99% of the doctors. So do they then self medicate for some components of their TRT needs or simply do nothing and suffer so Brick does not need to cringe. There is nothing difficult about getting your own lab work as needed [for many] and understanding how to make dose changes to achieve target levels.

So Brick, pre TRT your LH/FSH was tanked and now that you are on TRT, your LH is OK and you do not need hCG? What are your LH/FSH numbers now?