I’ll try to keep the post as short as possible to avoid annoying you.
Basically, I’ve been diagnosed with post finasteride syndrome 1 year ago, after 6 years of taking the medication. The main symptoms were an early awakening insomnia, extreme fatigue and difficulty focusing, plus low libido and ED. The lab tests were showing low T, high prolactin and SHBG, normal estradiol (20ish).
In terms of lifestyle, I’ve always been muscular since I started weight lifting when I was 17, and I never stopped since now that I’m 30. I’m 85 kg with a 13% BF, never smoked or drunk.
So that’s what I tried in order across last year:
Functional medicine, that helped me find the problem, but after lots of money and tests done, didn’t provide any solution to my problem.
Tried few months with natural supplements: pine pollen, tongkat ali, mucuna pruriens, vitamins etc. Nothing changed.
Contacted a famous endocrinologist in London, who decided to put on Clomid + Anastrazole, stacked with Cabergoline twice a week to lower prolactin. After 3 months of tweaking doses of both, I ended up having not bad lab tests (1100 Total T, 50ish Estradiol, still high SHBG), but still feeling awful with no libido, like most of the men on Clomid. And most of all, my sleep quality was still bad.
After 3 months I decided to quit any medication, except for Cabergoline, waited 1 month, and tried to do a blood test. I was shocked with the results: I went back to the starting point, like I didn’t ever do any treatment. Low total T, extremely low free T, high SHBG, normal Estradiol.
We tried, on my suggestion, to do an AI mono-therapy treatment, first with Aromasin, then with Arimidex. Not a good idea, as my Estradiol was 32 and I ended up crashing it even with a low dose AI. My Total T did get better, around 500, but I was feeling destroyed, due to the low Estradiol.
Moved country in the meanwhile, I tried with another doctor here that doesn’t really have a clue on TRT, but has the rare virtue of listening to his patients. We tried first to fix my slightly hypothyroid with Eutirox, to see if it was boosting my hormones. I’ve thrown it in the trash bin after 2 weeks, as I was feeling even worse.
So after a bit of hesitation, I managed to convince him to put me on 100mg of Testosterone Enanthate per week, divided in 2 injections weekly (Wednesday and Saturday). I started feeling way better in 1 week, my libido was restored by the second week and my sleep improved a bit, even if it wasn’t still good.
On week 3 the effects started to fade, libido was getting low again and I was feeling a bit more tired, even if not even close to the exhaustion I was experiencing before. The only side effect was a bit of nervousness overall.
So I waited week 4 to do a blood test and that’s the result:
Total T = 1107 ng/dL
Free T = 29.80 pg/mL
Estradiol = 43.1 pg/mL
I blamed the surge of Estradiol for the lack of results with TRT and I decided to add 0.5mg of Arimidex twice a week, the day before the injection, to lower a bit the Estradiol, but it seems that I’m really sensible to AIs and I got a really bad insomnia and anxiety, like when I was on AI mono-therapy. I can’t fall asleep and I roll in the bed for hours, while before I didn’t have any problem falling asleep. My problem was with staying asleep rather than falling asleep.
So now, I wanted to ask you your suggestions to keep Estradiol on track without taking any AIs, that my body doesn’t tolerate. Should I lower the dose of each injection to 40mgs? Should I try to add a natural anti-aromatase supplement? What do you reckon?
I don’t really trust my doctor, because he’s not experienced on TRT, and here in Cyprus where I’m living now, I couldn’t find any doctor with some knowledge on the matter. That’s why I’m asking you.