Anastrozole Cognitive Impairment

[optimizely]

Does anyone feel like anatrozole affects their memory recall and cognitive abilities? I have been on daily shots with .25mg of adex daily for a few months now and am having ED, issues learning things, and articulating myself. Not sure if I just bottomed out my E or if it might be a side effect to the adex. I have low SHBG so I do believe I operate better with lower estrogen. Prior to this I was taking .25mg EOD and increased my dose to .25 Ed after my LC/MS came back at 19 (SHBG 15.9). Not sure what to do.

 

[Systemlord]

Personally I don't like the estrogen rebound after stopping anastrozole, I would just reduce the dosage since your estrogen isn't super low or crashed for that matter. You may look into getting anastrozole compounded into .125 from Empower. I think that would solve your problem.

Did you ever test estrogen when on .25mg EOD?

 

[optimizely]

Yeah it was 19 pg/ML on EOD. I haven’t tested it on .25mg ED after I increased. I just feel way more off than before and not sure how I should proceed.

 

[fifty]

You increased to .25 ED after your e2 came back 19???

 

[optimizely]

Ya, my SHBG is 15.9. So I figured .25 Ed should get my E2 close.

 

[Moogie]

My SHBG is 8 and .25 AI ED put my E2 at 9. I felt pretty good with no ED/Libido issues. But my SHBG is terribly low so I can run lean on E2.

 

[Deleted member 16042]

Am I missing something?

I realize low SHBG guys may have lower E2 LC/MS/MS thresholds, but E2 sensitive of 9-19 seems like no reason to be taking anastrozole.

0.25 daily anastrozole is a hefty dose. I suspect you did indeed bottom out your E2, sounds like a blood draw is in order. I believe Vince Carter would advise you to get free Estrogen tested.

 

[Moogie]

You are correct, you missed it. Pre-trt E2 was 38 and first 6 weeks E2 bloods was 45. I felt like death. I was diagnosed with General Anxiety Disorder 4 years ago. They misdiagnosed me - it was because I was overweight with low T and high E2 with SHBG of 8. Imagine with me what my Free E looked like with those numbers. Yeah - no wonder I was high anxiety - my hormones were out of whack.

I did not understand what I do now. In terms of anxiety - it is virtually gone - no more Ativan nor Lexapro needed.

If a guy has low SHBG - he virtually has no mechanism to rid themselves of bioavailabile Free E! We must use AI. Guys with higher SHBG automatically get a pass because the E2 can be bound and made ineffective by SHBG. Both types of people probably will not understand each other’s plight. I don’t expect you to understand what a SHBG of 8 feels like - nor vise versa.

When you say “bottom out” what does that even mean to a person that can’t process E2 effectively? Your E2 of 25 with SHBG of 25 may be identical to my E2 of 9 with a SHBG of 8.

 

[Vince Carter]

You're pretty correct by my low SHBG experience, run that Estradiol, Free test along with LC/MS/MS if it's affordable. You correctly note that we can piss out that Test pretty quickly but cannot likewise get rid of the Free E we have at the same rate.
I am doing my best to this point with my LC/MS/MS in the single digits, A LOT of my issues have resolved...I have fewer nights of being hot/sweaty/overly warm in bed at nite, and my body acne has cleared to great extent and no longer have to scrub my body with a bristle brush twice per day.
Resolving erections and erection quality is still challenging though. Libido is very high.

 

[Vince Carter]

Does anyone feel like anatrozole affects their memory recall and cognitive abilities? I have been on daily shots with .25mg of adex daily for a few months now and am having ED, issues learning things, and articulating myself. Not sure if I just bottomed out my E or if it might be a side effect to the adex. I have low SHBG so I do believe I operate better with lower estrogen. Prior to this I was taking .25mg EOD and increased my dose to .25 Ed after my LC/MS came back at 19 (SHBG 15.9). Not sure what to do.

You do need some tests would be interested in the low SHBG context how that and your are responding. Though I'm not sure E is the thing youre after with your post though. Note here that you don't say how much Cyp youre using and as stated you have basically no labs. It's extremely tough to have any sort of worthwhile conversation when you don't get detailed.

 

[optimizely]

You are correct, you missed it. Pre-trt E2 was 38 and first 6 weeks E2 bloods was 45. I felt like death. I was diagnosed with General Anxiety Disorder 4 years ago. They misdiagnosed me - it was because I was overweight with low T and high E2 with SHBG of 8. Imagine with me what my Free E looked like with those numbers. Yeah - no wonder I was high anxiety - my hormones were out of whack.

I did not understand what I do now. In terms of anxiety - it is virtually gone - no more Ativan nor Lexapro needed.

If a guy has low SHBG - he virtually has no mechanism to rid themselves of bioavailabile Free E! We must use AI. Guys with higher SHBG automatically get a pass because the E2 can be bound and made ineffective by SHBG. Both types of people probably will not understand each other’s plight. I don’t expect you to understand what a SHBG of 8 feels like - nor vise versa.

When you say “bottom out” what does that even mean to a person that can’t process E2 effectively? Your E2 of 25 with SHBG of 25 may be identical to my E2 of 9 with a SHBG of 8.

By bottom out, I meant dropping my E2 drastically lower than my SHBG which is 15.9. I upped my adex dosage in hopes of feeling better and getting my estradiol closer to my SHBG. On my last set of labs 6 weeks in I was on 16mg test daily and .25mg of adex EOD. Below are my 6 week labs:

TT: 912.3
FT: 30.1
SHBG: 15.9
E2 Sensitive: 19.8

I upped my arimidex to .25mg ed and lowered my daily test dosage to 13.75 daily based on my sensitive E2 and FT numbers.

I’m now 12 weeks in and feel worse than when I was 6 weeks in. I feel cognitively slower, issues with forming sentences and carry conversation, lack of libido, and ED. I was hoping my adjusts (lowering daily cyp dose and increasing adex dose) based on my blood work would have made me dialed-in. It feels like the opposite. I’m wondering if anastrozole the drug itself and taking it everyday may cause cognitive impairment (as I’ve read numerous studies on it causing cognitive impairment in women cancer patients taking at least 1mg per day for 3 months) or if I simply drove my E2 too low which is causing these side effects. Stuck on how I should proceed. I do agree a blood test is in order. But, in the meantime should I continue with the AI or hold off.

 

[optimizely]

You do need some tests would be interested in the low SHBG context how that and your are responding. Though I'm not sure E is the thing youre after with your post though. Note here that you don't say how much Cyp youre using and as stated you have basically no labs. It's extremely tough to have any sort of worthwhile conversation when you don't get detailed.

Vince, sorry for not giving you the complete picture. I am 12 weeks into a new test cyp daily protocol.

Below are my 6 week labs on 16mg test cyp
daily and .25mg adex EOD

TT: 912.3
FT: 30.1
SHBG: 15.9
E2 Sensitive: 19.8

Based on those 6 week labs I upped my adex from .25mg EOD to .25mg ED based on my sensitive E2 being 19.8 and my SHBG being 15.9. I also lowered my test cyp from 16mg to 13.75mg daily based on my free T of 30.1.
I’m now 12 weeks in and feel worse than when I was 6 weeks in. I feel cognitively slower, issues with forming sentences and carry conversation, lack of libido, and ED. I was hoping my adjusts (lowering daily cyp dose and increasing adex dose) based on my blood work would have made me dialed-in. It feels like the opposite. I’m wondering if anastrozole the drug itself and taking it everyday may cause cognitive impairment (as I’ve read numerous studies on it causing cognitive impairment in women cancer patients taking at least 1mg per day for 3 months) or if I simply drove my E2 too low which is causing these side effects. Stuck on how I should proceed. I do agree a blood test is in order. But, in the meantime should I continue with the AI or hold off?

 

[Gman86]

You definitely dropped your E2 too low. It might of been fine if you switched from anastrozole EOD to ED while staying on 16mg/ day instead of dropping it to 13.75mg/ day. Anastrozole doesn’t cause the symptoms you are reporting, or the symptoms breast cancer patients experience. It’s the low E2 that is causing the symptoms.

So either go back to 16mg/ day of testosterone and stay on 0.25mg/ day of anastozole, or stay on 13.75mg/ day of test and go back to EOD with the anastrozole.

Whichever route you choose, I would stop the anastrozole temporarily to let your E2 come up a little. I would just stop it for a week or two, or until you notice some improvement in your symptoms, then resume taking it.

 

[Vince Carter]

.25mg/D is a lot by most TRT standards though it's necessary for me and you.

So how long have you used .25mg/D? You can just go back to EOD AI dosing and see what, if anything, resolves to your benefit.

16mg/D of Cyp seems to be where most of us reasonably end up based on Free T.

 

[optimizely]

Thank you for helping me think rationally. I agree, I probably dropped it too low by decreasing my test dose and increasing my adex dose to ed. I’ll likely just stop the adex for 2 weeks and continue taking it eod after.

 

[optimizely]

.25mg/D is a lot by most TRT standards though it's necessary for me and you.

So how long have you used .25mg/D? You can just go back to EOD AI dosing and see what, if anything, resolves to your benefit.

16mg/D of Cyp seems to be where most of us reasonably end up based on Free T.

I have been on .25mg adex ed for 6 weeks now. Vince, do you think my free T was too high or would 30.1 pg/ml have been ok?

 

[Vince Carter]

Ive worked my 16mg/D dose down to having my Free T trough at the lab range or just a little above. Too much Free T has a reasonable translation to just as much Free E so that's what I've limited...having Free T too high or over the lab range.

I wouldn't stop the AI and restart in two weeks just start right back @ EOD, no reason to stop.

 

[optimizely]

Ok, I will try that. What daily cyp dose are you on again? And what’s your SHBG.

 

[Systemlord]

Vince, sorry for not giving you the complete picture. I am 12 weeks into a new test cyp daily protocol.

Below are my 6 week labs on 16mg test cyp
daily and .25mg adex EOD

TT: 912.3
FT: 30.1
SHBG: 15.9
E2 Sensitive: 19.8

Based on those 6 week labs I upped my adex from .25mg EOD to .25mg ED based on my sensitive E2 being 19.8 and my SHBG being 15.9. I also lowered my test cyp from 16mg to 13.75mg daily based on my free T of 30.1.
I’m now 12 weeks in and feel worse than when I was 6 weeks in. I feel cognitively slower, issues with forming sentences and carry conversation, lack of libido, and ED. I was hoping my adjusts (lowering daily cyp dose and increasing adex dose) based on my blood work would have made me dialed-in. It feels like the opposite. I’m wondering if anastrozole the drug itself and taking it everyday may cause cognitive impairment (as I’ve read numerous studies on it causing cognitive impairment in women cancer patients taking at least 1mg per day for 3 months) or if I simply drove my E2 too low which is causing these side effects. Stuck on how I should proceed. I do agree a blood test is in order. But, in the meantime should I continue with the AI or hold off?

I think you levels are just too high, a lot of guys just aim to high and those guys seem to be having trouble. Your SHBG isn't holding to most of it anyways, but the estrogen lingers around requiring you to overcompensate with AI's.

How could you feel any sort of balance?