T Nation

TRT High E2 and Prolactin Help

Hi guys so ive been on sustanon 250 0.5ml every 5 days with hcg 250iu twice a week as i had low natural testosterone.

My latest bloods
Testosterone 40.1 NMOL/L (10-28.9)
SHBG 36 NMOL/L (14-79)
Prolactin 357 mu/l (30-360)
Oestradiol 231 pmol/l (0-150)

Amylase 53 iu/L 0 -110
Gamma Glutmyl Transferase 26 iu/L 10-75
Albumin 38 g/L 35–50
Alkaline Phosphatase 89 iu/L 30-130
ALT 35 iu/L 10-60
Bilirubin 19 umol/L 0-21
Total protein 68 g/L 60-80
Albumin 38 g/L 35-50
Globulin 30 g/L 18-36
PSA 0.97 ug/L 0-2
Total cholesterol 4.4 mmol/L 2.5-5.0
Triglyceride 2.2 mmol/L 0.4-1.7
HDL 1.15 mmol/L 1.00-1.90
Total/HDL ratio 3.8 2.0-6.0
Sodium 142 mmol/L 133-146
Potassium 4.1 mmol/L 3.5-5.3
Urea 5.4 mmol/L 2.5-7.8
Creatinine 83 umol/L 60-120
Estimated GFR >90 mL/min/1.73m2 60-150
FT4 12.3 pmol/L 7.0-17
thyroid stim hormone 2.20 mu/L 0.20-4.50
Ferritin 11 ug/L 15-200
Haemoglobin 156 g/L 130-180
Total white cell 4.4 109/L 4-11
Platelets 119 10
9/L 150–450
Red blood cell count 5.36 1012/L 4.50-6.50
Haematocrit 0.46 L/L 0.400-0.520
Mean cell volume 85.8 fL 80-100
Mean cell haemoglobin 29.1 pg 27-32
Neutrophil count 2.18 10
9/L 1.70-7.50
Lymphocyte count 1.74 109/L 1-4
Monocyte count 0.49 10
9/L 0.20-0.80
Eosinophil count 0.04 109/L 0.04-0.40
Basophil count 0.01 10
9/L 0-0.10
Nucleated red blood cell count <0.20 10*9/L

I have aromasin on hand and I have held off up to now until i had these results, i had a feeling i had high e2 as my sex drive is gone and bad EQ.

My question is what dose of aromasin should i take to start with? i was thinking 12.5mg (half a tab) twice a week? Should this be taken on the day of injection of test?

Should i retest in 2-4 weeks?

Thanks for your help

Why not anastrozole?

Your target is E2=22pg/ml - 80 pmol/L

Liver health can be a factor with high E2.

Prolactin might be a factor with your low-T.
Did you test LH/FSH before TRT to see if problem is with testes or pituitary?
You tested E2 before TRT?

T levels should be higher for that dose. You may be a fast metabolizer. Please inject T twice a week and always do labs half-way between injections to minimize effects of lab timing.

SHBG is quite decent considering that elevated E2 increases SHBG.

All other bloods look good. Maybe not.
Levels and ranges please: -as available
TSH and other thyroid
fasting cholesterol’
fasting glucose
cortisol with time of day

With your high T dose and high E2, your suggested dose seems low. Pick a dose and keep steady, if working OK for you, you should feel a difference in 7 days. If seems OK, do E2 labs in 2-3 weeks to see where you are. If considering anastrozole, you could try 1mg at time of injections. But start at 0.5mg for a few days to make sure you are not an anastrozole over-responder with crashed E2 - not rare.

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

  • 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.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

Hello, many thanks for the reply. I have edited my post to include all of my blood work I have.

I saw an endo and he said my LH/FSH was within normal range, I was borderline low T.
I have had brain MRIs etc which were normal.
E2 I was told was in normal range although I was not allowed the paperwork.

OK I shall now switch to twice a week injections, I believe this helps reduce E2?

Would you suggest 25mg aromasin on the days of injection then and see how I feel?

Thanks for your help

So its a week since starting 25mg a day with the test injections, ive had two doses so far…

I have really bad ED, i seem to lose it very quickly and takes alot to get an erection. Also takes a very long time to finish. Sorry for the info.

Would you suggest waiting another week or increasing my AI dose, how would i do it?

You should ask for the lab results. Lab ranges are very broad and include levels that are adverse to quality of life. Normal range does not mean normal health or optimal, it is a normal curve, 95th percentile [or worse] that by definition only allows 5% to have any issues.

Borderline low TT or FT?
Borderline with symptoms should always call for action.

E2 normal range can include nasty effects at lower and higher numbers.

Where are you located? All docs there that secretive?

So you are saying that aromasin is causing ED? If so stop for 4 days and resume at 1/2 the dose.

Ok i will ask for results. I had borerline tt and ft with symptoms.

Cheshire UK and yes most dont disclose results.

No sorry, my initial post was that since startiNg TRT and HCG my sex drive has gone and now i have ED. I started aromasin a week ago at 25mg on injection days so twice a week. However it has not helped thus far. Would you suggest waiting another week or should i increase the frequency maybe 25mg 3 x a week?

I had very high E as shown in first post


So after being on the following protocol for a month:
35mls sustanon 250mg/ml Tuesday / Friday
250iu HCG Monday/Wednesday/Friday
25mg Aromasin Tuesday/Friday
12.5mg Aromasin Sunday

My bloods look a little better I think. This was taken Tuesday 9am before my test shot.

SHGB - 53 nmol/l (14-79) ???
Prolactin - 331 mu/l (40-360) ???
Total Testosterone - 42.5 nmol/l (8-29) HIGH
Sodium - 139 mmol/l (133-146)
Potassium - 3.8 mmol/l (3.5-5.3)
Urea - 5 mmol/l (2.5-7.8)
Creatanine - 86 umol/l (60-120)
Protein - 69 g/l (60-80)
Albumin - 40 g/l (35-50)
Globulin - 29 g/l (18 -36)
Alkaline phosphate - 95 (30-130)
ALT - 54 (10-60)
Bilibrubin - 10 (0-21)
Gamma GT - 25 (10-75)
Cholesterol - 4.4 (2.5-5)
Trigylicerides - 0.9 (0.4-1.7)
HDL - 1.2 (1-1.9)
Cholesterol/HDL Ratio - 3.7 (2-6)
PSA -0.77 ug/l (0-2)
Ostradiol - 128 pmol/l (0-150) ???
Ferratin - 11 ug/l (15-200) LOW

My sex drive is still diminished with very bad ED. Struggle to maintain erection at all. Its a bit better than it was thr first time i did bloods with the anti E but still terrible.

What do you think could be the issue, still Estrogen? How would i dose the aromasin to lower it some more? 25mg every other day?

I had both high E2 and prolactin with nearly zero libido and found that taking anastrozole dropped not only my E2 but my prolactin as well. My libido has improved since, and I believe prolactin plays a significant role when you consider that prolactin is what normally kills a man’s libido post-orgasm. Just a point of information for you.

Thanks, what dose were you taking? I know its individual but just asking. I may switch from aromasin to anastrozole

I am thinking of trying 12.5mg ED or 25mg EOD. What do you guys think?

I’m close to having my dose dialed in, currently at 0.225mg/mL. I may end up lowering it to 0.2mg/mL depending on my next blood test results. Your E2 started out much higher than mine, though, and as you say it is different per individual. And you’re taking a different drug. My only recommendation would be to start low and slowly increase, rather than running the risk of taking too much.

Ok il stick on aromasin for now and try 25mg EOD and see how that effects E2 and prolacting in 2 weeks time