When To Take An AI?

binkskii said:

Hey guys,

I’ve been on 100mg of Testosterone Cypionate weekly, broken up into 4 subcutaneous injections in the stomach/love handle area. It has been 7 weeks since I started. I am also taking 750ius of HCG split into 3 injections.

I have been getting acne, and sensitive nipples. More recently, I’ve been retaining water and my hands, fingers, face and feet have been swelling.

The doctor offered an AI but I’d like to use it as a last resort. The sides weren’t horrible until things started swelling pretty bad.

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FunkOdyssey said:

Go straight to lab, do not pass go, do not collect $200. Then come back and we'll chat.

You're doing multiple things that can ramp up E2, between the hCG and the subq injections, but let's see the results of your bloodwork before you change anything.

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binkskii said:

This is from October 19th.

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binkskii said:

Thanks for the response.

The doc ended up prescribing me Arimidex. The dose was 0.5mg three times a week. I’m starting at 0.25mg a week.

I’m just trying to get rid of the swelling in my face and hands then I’m going to adjust my protocol.

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Systemlord said:

Testosterone effects the kidneys absorption of sodium and this can lead to fluid retention.

The acne is DHT related.

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FunkOdyssey said:

There are independent contributions to water retention from both testosterone and estradiol. The rhetoric that only one or the other is responsible is false. Reducing E2 is a legitimate and effective way to reduce at least some of the water retention. This is blatantly obvious to anyone that has used an AI before.

Acne and oily skin in men on TRT (important distinction here) is often driven more by E2 than DHT. It seems counterintuitive, because the conventional understanding of acne and production of sebum focuses almost exclusively on androgens. This is another instance where the literature diverges from reality. But again, it's something you'll learn by direct experience with the use of AIs.

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Fernando Almaguer said:

what is it in your experience or opinion that makes e2 drive acne?

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Systemlord said:

Testosterone effects the kidneys absorption of sodium and this can lead to fluid retention.

The acne is DHT related.

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FunkOdyssey said:

I have no idea. Studies report estradiol suppresses sebum production by countering androgenic activity in sebaceous glands. On paper, it should prevent acne.

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Fernando Almaguer said:

e2 suppresses sebum, then higher e2 would lead to less acne, right?

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