T Nation

TRT: Femara/Arimidex instead of Test

I got my test results back yesterday. Total T was 351 or something (check the thread I started yesterday I don’t have results in front of me), however FREE T was higher than average and the total percent of free to total was 5.5% or something.

Estridial was 35 (out of 0-52 or somethign scale).

The doctor wants to put me on androgel. However, I don’t know how this would work as wouldn’t my body just shut down a corresponding endogenous production of T, leaving me in the same place overall?

Anyway, I read that taking an AI ALONE could raise T. Obviously, I’d have to be careful not to lower it too much.

I ask because I don’t think I can get a test other than androgel. Even if I did, it would be IM injections, and I don’t feel like waiting 2 hours in the waiting room every 10 days for an injection. He wasn’t familiar with SubQ and didn’t seem open to the idea of me injecting myself anyway. So I think that’s out.

Or maybe my free T means I don’t need T?

I do have a greasy face, an abundance of body hair (yay me) and relatively muscular. I’m also pretty fat (6’1" 245) and have low libido/energy.

I don’t think I could get T legally and don’t want to break the law. AI are available and are less illegal I believe.

You can see my response to your other post about losing weight helping TT.
With that said, yes you can use arimidex to raise your T and lower your E; but you need to ensure you are monitoring your bloodwork like with any TRT. There are multiple studies where they use Arimidex alone for hypogonadism (as long as your testicles and pituitary are working).

Arimidex will increase both your LH and FSH, as long as everything is in working order.
I still believe losing weight should be your first priority, and if you start using arimidex, your goal should be to lose the weight and get off (which has to be done carefully to avoid a rebound of E2).
Obviously, all of this should be done under the supervision of a doctor and using legal prescriptions.

Get copies of all of your lab work and retain.

Post numbers and ranges.

Please… no more “or something”

FT is released in pulses and has a short half life. The lab may have caught a peak level. With injected TRT, FT levels do not swing by the hour. For transdermals, FT changes a lot. TT can be a better measure of T status than FT for ‘natural’ guys.

All effective TRT shuts down the HPTA. So you need to replace your existing production then more to increase above the baseline.

It would be worth trying anastrozole, you can always start TRT later if needed. That may or may not work.

Part of the problem could be caused by OTC or Rx drugs.

What was your fasting serum glucose?
Cholesterol numbers?

Thyroid: Do you ever feel cold when it does not make sense? Ever check your body temp when you wake, before you get out of bed?

Thanks for replies. KS man here are my other results.

glucose 83
chol 258
trigly 351
hdl 42
vldl 70
ldl 146
ldl/hdl 3.5
test serum 321 (241-827)
test free 16.76 (5.00-21.00)
% free 5.22 (1.5-4.2)
lh 4.1 (1.5-9.3)
fsh 2.9 (1.4-18.1)
igf-bp3 6.0 (3.3-6.6)
tsh 1.66 (.45 - 4.5)
tyroxine (t4) free, direct 1.03 (.93-1.71)
igf-1 187 (101-267)
estradiol 35 (0-53)
dehydroepiandrosterone sulfate 109 (95-530)
prolactin 5.6 (2.1-17.7)

Doc wants me to start on androgel. I asked him about suppression, ie wouldn’t androgel just cancel out my own test leaving me in exactly the same place? He said no, “we want to raise TT to the 500s”. He may not have understood what I was saying, but that would be odd, suppression is pretty basic.

regarding your question, no, I never feel cold, more the opposite, I tolerate cold too well, it’s heat I don’t like.

I’m going to be contrary and say take care of business before beginning a lifetime of TRT obligations.

Judging from your high triglycerides I’d say your diet needs cleaning up. High TG is mostly from too much fat in your diet. Junk food junkie, perhaps?

More physical activity and especially heavy lifting might have a salubrious effect on your cholesterol numbers. Your HDL is too low and your LDL is too high, plus your total chol should be under 200. You might be able to fix that at the dinner table and at the gym. If not, statin drugs will do it. But I wonder sometimes if driving the total chol too low contributes to low test. Anyway, a lot of people are on statins and there is no question that they improve cardiovascular risk.

Your glucose control is great. Be thankful, and loose some body fat so that you can retain that insulin sensitivity as you age. How old are you?

Your total test is low (about like mine was) but your free test is mid-range or higher, and it is the free test fraction that does the biological work. KSman would say to lower your estradiol to low 20’s. I suspect that is good advice, based on my own experience, but no one really knows for sure. For sure, androgel will raise your estradiol due to aromatization of test to estradiol in the skin and subcu.

So I’m thinking that losing body fat (down to the low teens at least) through better diet, heavy lifting, and better sleep might do much for your energy and libido. After you take care of the basics, then consider TRT. TRT is not a panacea and is, in fact, a lifetime commitment. You might be disappointed if you don’t take care of the basics first.

Lowering serum E2 to the lower 20’s [pg/ml] may be a critical factor for weight loss. We have seen that 0.5mg/week of anastrozole can be a good starting dose for guys not on TRT. B vitamins can increase HDL. Exercise reduces triglycerides. Both T4 and TSH are lowish. When this is seen, one can wonder if low LH and TSH have a common cause.

We have to ask about blows to the head and loss of some peripheral vision.

OTC/Rx drugs?

Androgel is not a good option if you sweat and shower a lot. Most are self injecting T. That is least cost which brings up the subject of insurance. If you are having a thyroid problem, then you might not be able to absorb transdermals.

[quote]KSman wrote:
Lowering serum E2 to the lower 20’s [pg/ml] may be a critical factor for weight loss. We have seen that 0.5mg/week of anastrozole can be a good starting dose for guys not on TRT. B vitamins can increase HDL. Exercise reduces triglycerides. Both T4 and TSH are lowish. When this is seen, one can wonder if low LH and TSH have a common cause.

We have to ask about blows to the head and loss of some peripheral vision.

OTC/Rx drugs?

Androgel is not a good option if you sweat and shower a lot. Most are self injecting T. That is least cost which brings up the subject of insurance. If you are having a thyroid problem, then you might not be able to absorb transdermals.[/quote]

Hmm…blows to the head. I suppose I’ve had my share over a lifetime, nothing too spectacular, but I’ve had a concussion or two. Loss of peripheral vision…not that I know of. Do blows to the head frequently result in thyroid and LH problems?

Not sure I have thyroid problems. It would explain the steady weight gain over the past 10 years, but that’s true with a lot of 40 year olds. I don’t have the sign of being cold etc.

I’ve heard femara can inhibit AI in the fat stores better than arimidex…not sure about dosage. Seems pretty cheap as supposedly you only need a mg a week or so.

I would be willing to go on an subQ T + hcg + AI regimen and am also getting back into lifting (had surgery for a torn tendon a few months ago)…but I don’t know that I can get T prescribed let alone prescribed for self injection. Seems like I’d be going on a wild goose chase as most doctors just don’t know/care or whatever.

Thanks for help.

[quote]brianb wrote:
KSman wrote:
Lowering serum E2 to the lower 20’s [pg/ml] may be a critical factor for weight loss. We have seen that 0.5mg/week of anastrozole can be a good starting dose for guys not on TRT. B vitamins can increase HDL. Exercise reduces triglycerides. Both T4 and TSH are lowish. When this is seen, one can wonder if low LH and TSH have a common cause.

We have to ask about blows to the head and loss of some peripheral vision.

OTC/Rx drugs?

Androgel is not a good option if you sweat and shower a lot. Most are self injecting T. That is least cost which brings up the subject of insurance. If you are having a thyroid problem, then you might not be able to absorb transdermals.

Hmm…blows to the head. I suppose I’ve had my share over a lifetime, nothing too spectacular, but I’ve had a concussion or two. Loss of peripheral vision…not that I know of. Do blows to the head frequently result in thyroid and LH problems?

Not sure I have thyroid problems. It would explain the steady weight gain over the past 10 years, but that’s true with a lot of 40 year olds. I don’t have the sign of being cold etc.

I’ve heard femara can inhibit AI in the fat stores better than arimidex…not sure about dosage. Seems pretty cheap as supposedly you only need a mg a week or so.

I would be willing to go on an subQ T + hcg + AI regimen and am also getting back into lifting (had surgery for a torn tendon a few months ago)…but I don’t know that I can get T prescribed let alone prescribed for self injection. Seems like I’d be going on a wild goose chase as most doctors just don’t know/care or whatever.

Thanks for help.

[/quote]

As drugs for breast cancer, I do not expect that you will find any head to head studies on weight loss in males.

If the pituitary gland is injured, more than one hormone system can be affected. Low T can drag down TSH and visa versa. These two hormones are coupled to some extent, to the point that low T3/T4 with high TSH can drag up LH levels in women, leading to PCOS and excess hair growth from increased T, increased sex drive as well.

thanks for reply. Not sure how I’d tell if my pituitary gland is injured…or maybe I just have low T, or maybe both.

Any rec on how much femara to take? I can get that online, but the liquidex I am not sure where to go. Research chemicals, I know, but there are a lot of sites and I’m not sure which are legitimate.

Have you ever heard of someone just using an AI as TRT? IE no testosterone just AI?

Just curious as to how it would work. I’d have to be careful not to lowoer estrogen too much, of course.

It doesn’t work well. Been there tried that. What will happen is you lower E2 into the ground to get T to raise. Ir doesn’t work like you think it would. You can’t lower E2 a little and raise T a little. In my experience with it you’ll run E2 into the ground, feel like shit, and then the day before your next Adex dose pass through a sweet spot. If you’re going to run something as stand alone Proviron is it.

[quote]brianb wrote:
Have you ever heard of someone just using an AI as TRT? IE no testosterone just AI?

Just curious as to how it would work. I’d have to be careful not to lowoer estrogen too much, of course.[/quote]

I am sure you have gotten your diet straightened out, but consider looking at how carbs impact your triglycerides. Personally, if I don’t watch carb intake my triglycerdies have been up to 2,700 (pure sludge). At the recommendation of a holistic doc before Atkins was big, i went lo-carb and as long as I stay away from simple carbs and too many others, i can maintain healthy Triglycerides even when eating loads of fat (not saying I advocate fast food!)