When to Test E2 after Starting AI

I started Anostrazole a little over a month ago. Started feeling a lot better within a week. E2 was in the 50’s. I am starting to feel like I was before I started. I don’t have any sore joints though and it may just be a bad spell. How fast can a AI bottom E2 out and how soon should one check E2 after starting an AI?

I’m not sure why I am feeling bad the last several days. With all the crap I have been through and being on HRT it makes me a little gun shy. I am noticing this morning my forearms hurt from my elbows down to my hands. Like when I used to race MX and my arms hurt the next day. I woke with good morning wood and libido is fair. I know I need to check E2 along with everything else and I am not scheduled for labs for another 2 months. But since I just started the Anostrazole a month ago I though it might be wise to check now just in case I need to adjust the dose.

Anastrozole starts working very quickly, but the estradiol takes a little time to clear the liver. Liver issues can slow the process.

Just a thought, but what are the chances that you were experiencing wishful thinking placebo effect? Objectively think about this. Were you feeling better because you thought YOU WOULD feel better?

I’ve experienced this before myself. I was sold that something would work, and it worked…for a few days. The takeaway here is maybe you have something else going on that isn’t related to E2.

Or perhaps you are an over-responder, but libido could be gone if E2 was bottomed out. Not everyone is the same.

You can test in two weeks after starting or changing T or AI dose.

Try stopping for 5 days and restart at 1/4th the normal recommended dose.

If you post your protocol, you can get better answers.

Been on 200mg Test Cyp every 3 weeks broken down to SQ EOD for the last year. I know it doesn’t sound like much but it keeps TT in the 800-900 range, and FT always good. Started 250iu HCG EOD about 6 months ago. 75mg Synthroid every day, 5mg Cialas Daily, and started .25mg Anastazole EOD one month ago. I am seeing a new Anti Aging Doc and things are good with him. Last labs were perfect, everything FT3, FT4, TSH, TT, FT, ect. other then E2 was 52 which was at top of range. So I started the Anastrazole and felt great with in a week up until a few days ago and started having severe mood swings, mainly bad depression like when I was on the chemo for hep C.
I was due for my next dose yesterday but stopped and had labs drawn today. That should still give good results? Just having TT, FT, and E2 done on this lab.

I was like you, took the same dose of Arimidex (I/8 mg/day, compounded) and 21 days later I stopped because I was getting sore joints all over the place, especially elbows and knees. I guess I would be labeled an “over responder”, but that Arimidex is strong shit, and shouldn’t be screwed with.

My numbers changed very quickly from about 50 to 15 in 18 days. I went off the stuff March 21, and it took about 2 weeks for the soreness to disappear, and my left elbow is still not right. Basically the stuff obviously works, but it drys out your joints, big time. The last couple weeks my estradiol came up again to about 35-40 and I started taking 1/8 mg just 4 days ago and took another today. So I’m every 4 days with 1/8 mg. Like I said I’m obviously an over responder, but the message is BE CAREFULL!

[quote]Ontarioguy wrote:
I was like you, took the same dose of Arimidex (I/8 mg/day, compounded) and 21 days later I stopped because I was getting sore joints all over the place, especially elbows and knees. I guess I would be labeled an “over responder”, but that Arimidex is strong shit, and shouldn’t be screwed with.

My numbers changed very quickly from about 50 to 15 in 18 days. I went off the stuff March 21, and it took about 2 weeks for the soreness to disappear, and my left elbow is still not right. Basically the stuff obviously works, but it drys out your joints, big time. The last couple weeks my estradiol came up again to about 35-40 and I started taking 1/8 mg just 4 days ago and took another today. So I’m every 4 days with 1/8 mg. Like I said I’m obviously an over responder, but the message is BE CAREFULL![/quote]

Yeah thanks! I am still waiting on labs drawn Thursday. Like I said I’m not sure what it is I have been cutting down on Methadone slowly and I think it causes some of my problems. It is some nasty stuff to get off of.
A lot of my problems last week were severe mood swings, mainly depression. Did you experience anything like that when you bottomed out? I haven’t taken any Anastrazole since last Tuesday. I want to see where my E2 is at. The last few days I am feeling better mood wise. Sometimes I feel like there is no light at the end of the tunnel!

It’s good that you stopped on Tuesday and are waiting for blood test results. As mentioned, with me, Estradiol can move quickly, in the space of a couple of weeks.

If I’m out of the preferred zone, I do get more moody, probably to the depressed side. It’s not dramatic, but it is there. Additionally I’m frustrated, that if I’m out of that narrow preferred zone, then I really can’t get it up very well, if at all. Last night the old lady was feeling amorous, and I was left trying to shoot pool with a rope instead of a cue. It really takes a lot of time and patience to get this all dialed in.

Next week I’ll be starting HCG, which will probably screw up my numbers yet again. I’ve been on test 5 months, with sporadic results. I’m betting that it’ll be at least 9 months before I get this all balanced, if in fact I do. When it works it’s great, but when it doesn’t . . .

[quote]Ontarioguy wrote:
It’s good that you stopped on Tuesday and are waiting for blood test results. As mentioned, with me, Estradiol can move quickly, in the space of a couple of weeks.

If I’m out of the preferred zone, I do get more moody, probably to the depressed side. It’s not dramatic, but it is there. Additionally I’m frustrated, that if I’m out of that narrow preferred zone, then I really can’t get it up very well, if at all. Last night the old lady was feeling amorous, and I was left trying to shoot pool with a rope instead of a cue. It really takes a lot of time and patience to get this all dialed in.

Next week I’ll be starting HCG, which will probably screw up my numbers yet again. I’ve been on test 5 months, with sporadic results. I’m betting that it’ll be at least 9 months before I get this all balanced, if in fact I do. When it works it’s great, but when it doesn’t . . .[/quote]
Have you tried any ED drugs. Cialas daily is great stuff. just enough to help out, and helps with BPH as well.

I have tried the ED drugs; all three of them, Viagra, Levitra and Cialis. Before I started the TRT (been on it 5 months now) they had a limited effect, but as time went on the low T issue became more obvious. Initially I had hoped that the TRT would do the trick without the ED drugs (they are expensive . . .). In the beginning the TRT seemed to be doing quite well (probably as a result of still having some natural test in addition to the synthetic) and before the Estradiol got too high. But then the E got out of whack, and results have been sporadic. When my E is too high, or too low, even Levitra (my favourite) doesn’t help much. I can get it up, but I can’t get it off. It’s an erection, but it’s numbed, somehow without much feeling. I’m in the saddle and after 20 minutes my back’s killing me and I call it quits; not great obviously. When it comes to TRT, a lot of men seem to think that if you can get it up, then all’s well. But I find you need a balance between effective libido, ability to get an erection, and ability to eventually ejaculate. I haven’t found that balance yet, and I’m finding it a much bigger challenge than what the TV commercials advertise: "think you might have low T? Talk to your doctor . . . " Yeah, right.

The Cialis that I tried was supposed to be effective for a weekend. Do they have a “Cialis daily” pill?

Yes they have a 5mg daily pill. My insurance only covers 8 ED pills of any kind per month so it won’t cover the Cialas daily. So I get 8 of the 20 mg Cialas and quarter them up into 5mg or close to it. They are kind of egg shaped so it is hard to do. It really does work good once you get it in your system and is also approved for BPH. But insurance only covers the daily Cialas for BPH once you have tried everything else used to treat BPH and it isn’t effective.

The thing I like about the Cialas every day it doesn’t have the side effects like Viagra and Levitra. They make me feel like crap.
Also my Docs say the Cialas is safer then the others and has the added benefit of controlling BPH if it is, or becomes a issue. I would give it a try for a month and see what you think. I actually find my self getting wood at different time like when I was young.

As far as not being able to climax I have that issue sometimes as well. It is do to the Methadone though. I try to make sure my dose is earlier in the day so it doesn’t effect me. Are you on SSRI’s or anything else that could be causing that problem? There are a lot of drugs that interfere with the ability to achieve orgasm.

I got my lab back today and E2 is 42 after a month on .25mg of Anatrazole. It was 52 a month ago. I was so worried about bottoming out my E2 and I haven’t even got it down to where it probaly needs to be. It seems 22 is a average of where guys need to be. I don’t have a base line when I was naturally healthy to go off of. So I will need to pay close attenrion to how I am feeling so I can dial it in.
I will quit trying to lower my Methadone dose until I get things figured out. I believe the withdraw side effects from it is causing me to think it is HRT related. I will work on getting off of it later. The thing is it’s a catch 22, because the Methadone is working against what I am trying to do.
I wonder how I should adjust my dose? Any input?

Any advise on how to adjust my AI dose?

The basic formula for a ballpark figure on dosage is:

new dose= old dose x (current e2/optimal e2)

I think you are at .25mg EOD. so you are doing roughly .875mg every week (4 one week, 3 the next)

.875mg x (42/22) = 1.67mg/week= .477mg EOD

Based on this above, you should be almost doubled up. Obviously this formula isn’t exact but at the very least you have a rough idea of where to be- a little less than .5mg EOD. Hard to split your pills into that so a liquid form would be best. Of course, not everyone is perfect at an E2 of 22 so you could try it, see how you feel, get labs after ~2 weeks of the higher AI dose and re-evaluate

I adjusted my dose of Anastrozole to .5 mg EOD 2 weeks ago. I already feel a difference. My mood is pretty good, no lows, depression, more interest in things I enjoy other then sex. I don’t know if it is to early to jump to conclusions but I have zero libido and erections are week including morning wood when I do have it. I will give it more time I need to see how it effects my E2 on the higher dose.

I was wondering what are common side effects are for men taking doses of Anastrozole recommended for TRT. I’m not talking about being a over responder or severe side effects but more common ones. There is not much listed online because of it being mainly a drug for women.

I believe it is a drug with mostly no side effects. Honestly, even if there are, the benefit to getting it honed in outweighs any potential ones that I’ve never heard of anyway!

I would suggest you get another estradiol level done to see how it looks. 2ish weeks is enough time for the blood levels to be effected by an AI. The formula I provided above is just a ball park.

At any point did you have days where you were getting good morning wood? That would be a good gauge of whether you went over or are still under-dosed. If you did get it, then back off for a few days until wood returns and cut back on the dosage. If you didn’t, bump it up a little bit more. Or again, get a blood test to see where you are at. It takes a while to get honed in and not everyone needs a 22ng/dL level so it may take a little bit to get on point

[quote]coolnatedawg wrote:
I believe it is a drug with mostly no side effects. Honestly, even if there are, the benefit to getting it honed in outweighs any potential ones that I’ve never heard of anyway!

I would suggest you get another estradiol level done to see how it looks. 2ish weeks is enough time for the blood levels to be effected by an AI. The formula I provided above is just a ball park.

At any point did you have days where you were getting good morning wood? That would be a good gauge of whether you went over or are still under-dosed. If you did get it, then back off for a few days until wood returns and cut back on the dosage. If you didn’t, bump it up a little bit more. Or again, get a blood test to see where you are at. It takes a while to get honed in and not everyone needs a 22ng/dL level so it may take a little bit to get on point[/quote]

I here you. Because I had know base line I don’t know what is a good number for me. The morning wood is hit and miss. I will be 53 in June and maybe I am just expecting to much for my age. It’s not like I’m ever going to feel like when I was 16 again. lol

Over all since I have started this journey things are a lot better, and I need to remember that on some of the not so good days. I mean what is normal for a 53 year old with Hep C, taking Methadone for pain, (weaning off slowly) and the hormone problems?

Looking back I was really in a lot worse condition then I am now. Thank God for HRT!
I will play around with the Anastrozole. I don’t think Insurance will pay for lab after 2 weeks so I will go off of how I am feeling and wait until I can get new lab. Thanks for the input!

Look into other lab sources. LEF.org, directlabs, and there are countless other ones. You purchase the tests you want, print out the requisition form, and take it to a facility that supports them (like Quest or LabCorp). There is no insurance involved and everything is paid for up front and typically pretty cheap.

You definitely need the lab to help establish a base line but you can go based on feel. Erections are the simplest and fastest of these observational approaches. I can’t really comment on the feeling young again thing but I know lots of guys do feel MUCH younger. I’m only 27 so I don’t have the same outlook but I am trying to feel like I am an 18year old since I kind of hopped over the high testosterone years with my personal hormonal struggles.