TRT Advise With AI

A background - I’m currently 28 and self prescribed medicating due to my country not classing me as low “enough”

I have been taking 120-150mg weekly shot of test (blend) sustanon

10 weeks so far, Not using any AI and i noticed my nipples were feeling heavy and puffy.
I freaked out and got some bloods done and also bought some nolvadex just to be safe with the gyno.
my blood was taken just before the day of my next shot. results below.

( since this was taken I’m now doing 2 shots a week instead of 1 the total will be 150mg per week)

Im now taking 20mg of Nolvadex just because of my paranoia with the gyno.

I hear alot about not taking AI with my TRT is a waste, I would like to gain some advice and knowledge on what and how much I should be using if any at all that is?

I have noticed since the first few weeks my sex drive has lowered a bit the first few weeks i was like a crazed animal lol.

I do have alot of excess stomach fat and from what i researched that can play a role in causing oestradiol to produce more estrogen.

I hate being self medicated because of all this, but my countries health system requires me to be at levels of an 80 year old man to do anything.

Private was an option but it was to expensive for me. ( still is as i have debts to pay)

Looking for help and guidance.

What country? Nice to see were we have guys come from and also affects what diagnostic and treatment options one has.

Your on-TRT T levels are low. While you are near ideal TRT level of E2=80pmol/L, your low T levels are making you estrogen dominant.

SERMs [Clomid, Nolvadex] do not decrease E2 levels, SERMs increase E2 levels but “hide” the E2 from estrogen receptors by interference in a dose dependent manner in only “Selected” tissue, not all.

You are better off managing E2 with anastrozole than masking higher E2 levels.

With your low T levels on sustanon, I worry that it might be fake or you are a T hypermetabolizer who needs much higher T doses.

Always do labs halfway between injections to avoid lab timing artifacts where changes in labs are from timing.

Try 100mg T twice a week.
Take 1/2mg anastrozole at time of T injections.
Judge effects after 6-7 days.
After 2nd dose, stop taking Nolvadex.
If you feel suddenly crashed/depressed, stop anastrozole for 5-6 days and resume at 1/16mg at time of injections and eval after one week.

With labs, target is 80 pmol/L
If you get E2=115 pmol/L, modify anastrozole dose 1/2mg X 115/80

Were labs done while on Nolvadex? How long?
What Nolvadex dose? Often doses are stupid high. [10-20 mg EOD is workable].

Please note that if you double your FT, FT–>E2 is expected to double and then E2 levels do get high and AI dose needs to increase.

  • meaningless!

FT–>Estradiol [E2]

You will be on T+AI. Your FSH/LH will go to zero as expected, testes probably will shrink and may ache. Scrotum then expected to be tight. And fertility at risk. You can use 250iu hCG SC EOD, but can be expensive or unobtainable. Alternatively, 10mg Nolvadex EOD may solve that problem inexpensively. But hCG, a human hormone is preferable.

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys - need more info about you
  • 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.

Thanks for the reply, I’m living in England, UK.

my blood test shown, i took the sample the day before my injection ( 6 days from previous injection)

my total testosterone before starting TRT came in at 12.9 and 13.7
I did not at that time get my free testosterone checked, silly me i guess.

Since im self precribed I do have to get my testosterone elsewhere, but i do try my best to research and inform myself on where is most likely to be genuine.
I’m using TM400 (taylormade test blend 400 - pinning 0.3ml a week) - this was current state as and when i did the bloods.

The results were from last week, and no nolva was in use. I started taking nolva today at 20mg i plan to take it for a couple weeks at 20mg daily just to see if my nipples will calm down the swelling/puffyness.

Thankyou for the advice and information, i didn’t expect this! But Im glad I came here for sure now.

Did you mean 1/2mg anastrozle per injection ( im now as of this week doing 2 injections weekly to help stabilize more so than just 1 a week)
So for a total of 1mg correct?

Just to add before this blood test, I had one more whilst i was on the same stuff and the total came back at total test = 21.5
I believe that was taken closer to the day i injected.although my memory isnt the greatest. at that time i was putting 0.35 in so should of been 140mg ( shot per week)

Lab timing makes a large difference. That in part drives the need to inject twice a week. And yes, asking that you try 1/2mg anastrozole at time of each injection.

We can only cover limited issues in this discussion. You may find other things that apply to you in those stickies that cannot surface otherwise.

Some places do not have FT labs available. Hard to remember what in so many countries.

Many in UK are not using iodized salt and may not be in all of the shops. Dairy is not the source of iodine that it used to be there. See the last paragraph in my post above to evaluate your overall thyroid function. Your overall TRT outcome can easily be affected.


Looking at my blood test prolactin before i started trt it was 128Mu/L

and the one i had last week (on trt) is 240.1 mIU/L

so its doubled im still learning about prolactin but could this be possibly why i feel like my breasts were sore etc?

so i stopped taking the Nolvadex and went on monday with a shot 0.2ml (80mg) + ai as 0.5mg armidex.

I plan to up the next shot to 0.25ml (100mg) and continue like you suggested at 200 a week.

With the AI should i base lowering it next week on how i feel this week,Or should i lower it to 1/4 or even more regardless? I mean when @KSman you said 1/16th so i will need to cut a 1mg up super small ( i ordered a pill cutter incase.