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Weekly IM - High E2 - New Plan Feedback

I am a 44 year old male. Been on TRT for a long time. After limited success with pellets, gels, creams, decided to go with IM testo cypionate. Doc started me on 100mg weekly IM injections about 2 months ago. After 7 weeks, I had labs done 72 hours after my last injection. Total T was 1330. Free T was 37.9. Hemoglobin and hematocrit where on the high side, but still within range. I noticed about 4 weeks ago some shortness of breath, weight gain, fatigue, lack of morning wood. Wondered if it was high estradiol, so I had sensitive estradiol test from Discounted Labs. Got results last week. Sure enough, estradiol at 53.3. Went to doctor to discuss yesterday. He wanted to keep same t.cyp dose but increase to E10D.

I told him that I actually was hoping to go E3.5 days (twice per week) and split the dose. He was hesitant, but agreed to it, but wants to cut my dose by 20%. So the plan now is 40mg twice per week. He believes that bringing the testosterone down a little will lower the estradiol. He also suggested I skip my last weekly injection before starting twice per week. He believes that will let estradiol come back down. So, the plan is that I begin 40mg E3.5D two weeks after my last 100mg weekly injection.

We are going to pull labs again in about 6 weeks. I am trying to avoid an AI if possible. I also need to lose about 40 pounds. My doctor is not very progressive with TRT, but he is willing to try things based on my suggestions from research, these forums, etc. Does this seem like a good plan? Or would folks recommend starting an AI right away? Any concerns with the doctor dropping my dosage by 20%?

Those are a little high for three days after a 100mg injection.

One week after last injection makes more sense, unless the thinking is that skipping a week will bring the E2 down quite a bit and that is the priority.

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He wants the extra week to bring the E2 down. He also wants to drop overall weekly does 20% because he feels that the dosage is too high. Will see how it goes.

I do weekly injections, but from what I understand a lot of guys can reduce the overall dose with more frequent injections. Sounds reasonable.

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But he may not realize that.

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Sounds like your doctor is a gud un, willing to work with you off T nation forum, can’t get much better than that lol.

Everything is spot on to me. Going to every 3.5 days and lowering the dose, then rechecking bloods in 6 weeks. That will/should lower hemo, hema and the E2.

I’d love a doctor like that on board, one willing to take outside knowledge from his usual book of commandments

Work on the weight lose, will make a big difference to your TRT


SHBG needs to be tested, low SHBG men tend to do better on more frequent dosing. If Free T is labcorps ranges, then it’s likely SHBG is low. Sadly I couldn’t continue with daily dosing. In my experience, the larger the dosage of T, the higher the estrogen.

I work myself down to daily dosing (7-10mg) and estrogen had never been lower on any protocol, finally was able to ditch the arimidex and feel normal. You must determine what’s worst, high estrogen or daily dosing.

I’m high body fat so estrogen is a problem until the weight is lost, visceral fat contains aromatase enzymes which converts testosterone over to estrogen.

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My SBGH was tested back in July. It was 31. This was when I was still attempting to use compounded cream. Should I re-test? Or does SBGH stay pretty steady regardless of method of TRT?

Yes. My doc is pretty good. A little hesitant, but willing to try stuff. I appreciate all the feedback. Thanks.

How do you time labs to get peaks and troughs on E3.5D?

Trough would be day of injection BEFORE you inject.

Sounds like your doctor has at least some idea what he is doing.

Couple things.

  1. Don’t take an AI.

  2. Increasing your frequency actually increases your dose, so going down 20% is not a terrible idea, especially with your e2.

  3. Skipping a dose and letting the e2 come down before resuming is probably a good idea.