T Nation

Unique TRT Situation


#53

When I was taking too much AI, my FT spiked and E2 crashed. Backne was a problem. Could be too much AI, caused a crash, Acne and loss of morning wood would be a good sign… Your FT was almost double the legal limit in your last test, which is great if you feel good, but keep a close eye on Hemocrit level. If you took too much AI at some point it could have crashed E2 into single digits. I had a lot of issues with symptoms when I took an AI, turned out I really didn’t need it. I finally just reduced my T dose enough to get off the AI, and so all I take now is a lower dose of T. My T>E2 conversion is normal. TT, FT, E2 are all midrange/normal. I’ve never been estrogen dominant, so this works for me. My advice is to reduce your protocol based on how you feel. I don’t feel better with TT and FT above normal, so I reduced mine enough to get off AI entirely.

When I first went on TRT I was terrified of high E2, so I took too much AI and crashed E2 for months. Had all kinds of problems, ance, BO, limp dick, libido, thick blood, etc. Now I keep TT/FT in the normal range and doing great, with no AI and less meds to balance…


#54

Interesting @Jdeck

When my E2 was too high I had three symptoms…low libido (and lack of morning wood), acne, and prostate inflammation. Currently, I have 2 of the 3 symptoms. My prostate is fine. I suppose it’s possible that low E2 is mimicking high E2 minus the prostate problem?

The odd part is, everything was running tip-top at my last labs and at 1.5mg arimidex a week. When things deteriorated I upped the arimidex to 2mg. If I cut back to 1.5 again, I’ll be right back where I started. And I know for sure that 1mg is not enough.

As far as your numbers and what you felt good at, can I ask how old you are? …because my doc told me that guys my age don’t feel any improvement until their FT is at least 200 pg/ml (35-155) (I’m just turning 53).


#55

@KSman

Okay after giving it some thought, here is my working theory…let me know what you guys think.

My first cascade of problems was caused by high E2. Increased adex lowered my E2 and the problems went away. However, knocking back the E2 conversion caused a significant increase in FT, and it is this current high FT level that is causing the current problems (acne, lack of libido).

I guess a good question would be, can high FT cause low libido (having gone from 210 to 333 FT)?


#56

I’m 41 (answering your previous question).

I’m not sure if just high FT alone will cause low libido, but my experiments over the last few years have taught me the lab ranges are important. If you are double the high mark on FT, its likely you will introduce problems long term, such as thick blood (hemocrit) can cause stroke/heart attack, high/immature RBC also. The thick blood can cause blood flow issues to the penis, as well as elevated risk of heart attack and stroke. Your elevated Test causes elevated E2, then too much Adex crashes E2. E2 being high or low causes more sexual problems than T being high/low. To feel optimal, with optimal health you probably want to get your T into range, and you may not need an AI if your T>E2 conversion is working properly. Some people may have had different experience with TRT. Just for your reference I take roughly half your T dose, and no AI. 70-100mg week, I fluctuate a little just for fun. I discovered some fluxuation to be helpful in the bedroom. My TT is normally 7-800 and E2 around 20. FT is usually at the top of norm, and sometimes a couple ticks above range… FT and E2 are the most important numbers to watch.


#57

Thank you Jdeck.

So with your FT at the top of norm, do you feel very positive effects of your TRT?

I ask because My doc said that guys my age (52) don’t feel any improvement until their FT is over 200 pg/ml.

Either way, I suppose I could continue to lower my dose until I get back to 200 FT. My next lab draw date is Jan 4th, so it’s a good time to lock in a revised dosage.

It’s just weird though, because initially my FT was 210, but it was the increase in AI that shot my FT up into the 300 range. So if I simply cut back on the AI I should get back to the 200 range, but then I’ll end up with the original problem of acne caused by too high E2. So I will cut back on both the testosterone and the AI and see where I end up.


#58

Get some research chem liquid AI, its easier to dial in dosage with a dropper than cutting pills. I definitely feel better than I used to(pre-TRT). I’ve had my TT/FT above range for some period of time and didn’t feel any better. I had an issue with overresponding to AI and having low E2. I’ve never had a test come back higher than 21, even without any AI. When I took regular dosing of AI my FT would go above range and E2 would crash quickly down to 10 or 12… The lower E2 caused my sexual problems, and hemocrit above range too. I quit taking an AI regularly about a year ago and haven’t noticed any high E2 symptoms, but again I only take 70-100mg weekly of Cyp. I had a blood test shortly after I quit and E2 was 20. It’s been almost a year since I had labs now. I take a few drops of AI every two weeks or so, and I usually get a short term erection quality boost as E2 falls through the sweep spot. and then comes back up a little. But if I take AI regularly it will crash me E2. Its powerful stuff.

My experience may not reflect everyones. I’d be curious if anyone else would weigh in on that question about feeling better with FT over range…


#59

One other point. E2 slightly on the higher side seems to be less problemsome than low E2(below 20). I’ve seen many guys post on here they do fine with no apparent symptoms with E2 at 30-50. Everybody is different which is why you need to dose based on symptoms and labs, rather than trying to hit that E2=22 mark on the dot.

Also I think everybody has a few months of acne when their body is adjusting to higher T level. I know I did, but its gotten much better and almost gone since I’ve quit messing around with my dosages and got my labs in range.


#60

Thanks again @Jdeck,

I have a pill cutter that is very good and I can cut my pills into 4 pieces if necessary (0.25mg). But in the meantime I’m going to cut my test cyp dosage back a little more and go down to 1mg AI total for the week.

Also, my new syringes arrived today…25G 5/8" 1cc tuberculin needles, so I’m officially in the SQ club now. I’m gonna shoot straight into my love handles like before except just in the fat layer…I hope that fat works as well as upper thigh etc.

So between the lower dose and SQ administration, I’m hoping going back to 1mg AI will be enough. I have labs coming up in 4 weeks, so I’ll be locking in to this routine right now.


#61

I’ve gone sub-Q myself with insulin pins. It works good. I inject in belly fat near belly button twice weekly. Just remember this is so important. Low E2 is a sex killer. If you are going to error, error on the higher side of E2. Too much Adex will kill a boner fast. I have an old thread on here about that very thing if you’re bored you can read up on it.


#62

I shot sub-Q for the first time on Sunday and it was very nice. I was worried that because it’s so shallow, and that I’m using 25G, there might be leakage. But my skin appreciated the 25G so much (in comparison to my 21G) that there was not even a drop of blood. It was tough to find the exact spot to put my alcohol pad on hahaha.

The other worry I had was that I had read somewhere that shooting into fat with very low vascularity has very poor results compared to fat with a higher metabolism. And since I’m shooting into the love handles, that’s probably got to be the slowest metabolized fat on the whole body. Oh well, we’ll see how it works out.

I definitely hear what you’re saying about low E2 being a boner killer. Even though I’ve cut back to 1mg/week of adex, my body hasn’t had time to adjust yet. I guess for me it’s going to be tough. E2 at 32pg/ml was killing my boners, and yet now it’s too low and killing my boners. The sweet spot will be a careful and narrow range for me.

And yes I’d like to read your thread. What is the title or url?

Thanks!


#63

#64

Thanks Jdeck, I just finished reading it.

So guys, tell me what you think of this…for over a week now I’ve been at:

60mg (X2) per week Test cyp (sub-Q).

0.5mg (X2) per week adex.

So everything is cut back. Everything seems fine except the libido. That is still poor. Here’s what I’m thinking…

Since I am pinning twice weekly, and doing sub-Q (both of which apparently reduce conversion to E2), is it possible I don’t need adex anymore? Or maybe I could reduce it by half, to 0.5mg total per week?

If you recall, my E2 was at 32pg/ml back when I was doing 150mg Test cyp per week, injected once, intramuscularly, while taking 1mg adex/week…versus, 21pg/ml when I was doing 70mg test cyp (X2) and 1.5mg adex/week.

Or…

Another possibility. What if I keep the adex at .05mg(X2) but take it a day AFTER injections to let some conversion take place before the adex kicks in and keeps it from going to high?

I still have 27 days until I draw labs, so any slight adjustment right now will still have time to be reflected.


#65

So I’ve done my last 3 injections sub-Q, and I feel like I skipped the last 3 injections. Feeling weak, tired, and deflated. This is gonna be a long 3+ more weeks till labs…


#66

@KSman,

I finally got around to reading your thyroid/iodine sticky. I have to admit, I left that for later because I had read up lots on iodine and it’s relation to thyroid in the past through Dr. David Brownstein (Brownstein…was there ever a better name for an iodine specialist?). But since I hadn’t used or thought about that information in recent years, I hadn’t realized how much I forgot and how important that information is overall.

Thanks for your sticky, and I’ll do what I can to help point members to it when appropriate.


#67

Okay, so I had my appointment today for reading the latest labs, and they are:

Total testosterone: 1282ng/dl (250-1100)

Free testosterone: 234.7 pg/ml (35-155)

PSA total: 0.75ng/ml (0.3-3.8)

Hemoglobin: 17g/dl (13.7-17.5)

Hematocrit: 48.7% (40.1-51)

Estradiol: 21pg/ml (<61)

Vitamin D: 72ng/ml (>30)

So then, the above numbers were obtained while doing 120mg testosterone weekly (divided into two 60mg doses) and 1mg arimidex weekly (divided into two 0.5mg doses).

But right after drawing for those labs, I reduced my dosage to 100mg testosterone a week (divided in two doses), and kept the arimidex the same (so my current testosterone levels are likely a little lower).

I’m happy with these numbers, and especially withe the E2 and vit D. For what it’s worth, I take about 7000iu of vit D a day and have for many years. On occasion I had bumped up my vit D dosages, but I’d end up with a constant headache which was only relieved by reducing my vit D dosages. That’s how I knew I would be too high. It’s nice to have a lab number to confirm my current dose.

That said, I’m still struggling with the libido issue and moreso the terrible acne. I mentioned all this to the doctor and he prescribed a few things…

For acne he suspects too much DHT conversion. So he’s prescribed Proscar (finasteride), 1.25mg a day (or a quarter of a 5mg tablet) every day.

He also wants me to back off slightly on the arimidex. So instead of 1mg per week, it will be .75 mg a week. He said that arimidex itself, aside from it’s anti-aromatase mechanism, has properties than can cause libido problems.

I mentioned that my trial with clomid was a complete disaster and that I’d like to try nolvadex. He said sure, and wrote a script for that too, at half of a 20mg pill, twice weekly. So that’ll be 20mg a week.

What are your opinions on the numbers, his thoughts, the prescriptions, and dosages? Is this the right course of action and if so, are the dosages correct? Will the proscar further complicate things or even make the libido problem worse? Thank you!


#68

Oh and btw, labs were drawn on 3rd day after last injection (@ twice weekly injections)

@KSman


#69

An interesting turn of events.

Before posting the numbers, let me post the regime going into it…

  • 70mg test cyp, twice weekly for a total of 140mg/week

  • 0.7mg adex twice weekly for a total of 1.4mg/week

The results:

Total testosterone 1407 (250-1100)

Free testosterone 229.1 (35-155)

Estradiol 31 (<61)

Hemoglobin 16.9 (13.7-17.5)

Hematocrit 50.9 (40.1-51%)

PSA 0.59 (0.0-3.9)

Now here’s the rub…these numbers are way different than results from an almost identical regime from 7 months ago. The primary difference was, back then I was shooting IM, and for this recent one, I was shooting SQ. Here is the regime and results from 7 months ago (you may also notice I was taking slightly more adex in the older regime):

  • 70mg test cyp, twice weekly for a total of 140mg

  • 0.5mg adex 3 times weekly for a total of 1.5mg/week

Results:

Total testosterone 1601 ng/dl (250-1100)

Free testosterone 333.8 pg/ml (35-155)

Estradiol 21 pg/ml (<61)

Hemoglobin 17 g/dl (13.7-17.5)

Hematocrit 49.8% (40.1-51%)

There is one other caveat that I’d like to throw in and ask if it could have affected things…

Recently I’ve taken a second job. So I’m working 7 days a week. The job also happens to be incredibly physically demanding. Could this greatly increased demand on my body “consume” or otherwise affect my testosterone numbers like this, and would it also explain the rise in E2? Because I don’t see how such a small reduction in adex could explain such a dramatic rise in E2.

The only other difference would be the switching from IM to SQ.

Thank you all in advance…


#70

@Ksman

A while back you had said,

“There is a need to prevent damage to the testes for various reasons. You can use hCG or a SERM. The intent is to not create a lot of T, the injections are most cost effective measure for that. So testicular stimulation should be at a lower level. SERMs are foreign chemicals. hCG is a natural hormone and you were swimming in it for a few months before birth. Less is more.”

I still haven’t been able to get HCG, however I have an open script to nolvadex. You mentioned taking 10mg ED or 20 EOD.

I’ve been conservative and taking 10mg three times a week for a couple months, and have since lowered it to 5mg three times a week. The part that is not conservative is the fact that I’ve been taking it for months. Is there a reason not to be on it long term? I do anticipate being able to get HCG fairly soon, but I want to preserve the testes in the meantime…or is long term a big no-no?


#71

Gtron
How are your prostate issues? Any prostate enlargement?


#72

None. Since being on TRT I’ve come to realize something…

Everyone responds to DHT differently. I’ve always had good hair…to the point that my friends always bust my balls about it (as most of them have lost most their hair by now). TRT didn’t change that. Nor did it affect my prostate.

However, it DID cause deep and painful acne. For which I am now taking finasteride to keep under control. I tried scaling it back recently to try and get off of it, but the acne re-appeared.