Dialing In - Haematocrit & Estradiol Management

[madman]

Madman, thanks for the response. We have had this same conversation before. We will continue to disagree on a few things, but that is okay. No harm.
All the answers are in the below thread that I posted back in July. I don't go for new labs for a couple months.

250mg - 2 Yrs Labs Attached

Most men do well having their FT in the 20-30 ng/dL range and others may feel better running levels in the 30-50 ng/dL range but even than not everyone can tolerate running higher levels and may end off feeling worse.

As we know every individual is different but regardless highly doubtful one would need to be running FT levels in the 50--->50+ ng/dL range at trough to benefit from testosterone replacement.

If we are talking trough which is when most should be testing than depending on ones protocol dose/injection frequency.....if one is injecting larger doses of T less frequently as in once weekly or every 3.5 days than there will be a larger difference between the extremes between ones peak/trough.

Adding to all this.....again most are running FT levels much higher than they need in order to benefit from trt simply because they are testing FT levels using the inaccurate direct immunoassay or even using the inaccurate linear law-of-mass action model Vermeulen calculated method which use the model of T:SHBG binding which were developed before the crystal structure for SHBG:T complexes were available.

In most cases FT levels are much higher than one thinks once they use the proper more accurate testing methods for FT such as the gold standard Equilibrium Dialysis or Ultrafiltration or the newer TruT calculated method.

As you know ones SHBG will not only dictate ones dose/injection frequency but most importantly what dose of T is needed in order to have a TT level which will result in a healthy FT level.

Lower SHBG men can get away with running a lower TT in order to achieve a healthy FT and although higher SHBG men will need to run a higher TT in order to achieve a healthy FT as I stated below previously which is of great importance.

* believe it or not even with having higher SHBG although one may need a higher TT in order to achieve a healthy FT.....the higher TT levels needed are not as high as most people would think due to newer research regarding T:SHBG binding.



If we use the newer TruT Free Testosterone Calculator by FPT .....which is on par with results obtained by the gold standard Equilibrium Dialysis than we can see that your FT levels are absurdly high even for the so called mid trough you state.


If we take your TT 1627 ng/dL, SHBG 47 nmol/L and Albumin 4.8 g/dL than your FT is 52.75 ng/dL (well over the top end of the reference range 16-31 ng/dL).

Your peak levels are going to be a lot higher and this is more often than not since you are injecting a whopping dose of T 125 mg every 3.5 days.

I would bet you could easily feel just as well overall regarding energy/mood/libido/erectile function running a lower TT/FT level and your hematocrit levels would come down.

If one truly feels they need to run such high levels 50--->50+ ng/dL to truly reap the beneficial effects of T than I would say that thyroid or adrenals are sub-par!

 

[Gman86]

Don't overwork the numbers on paper. If you feel good and are having no negative side effects than your protocol is working. Just stick with it and don't chase the numbers. For reference, in the beginning I had the same concerns as you.

Protocol: 250mg T cyp split into two doses a week. Daily Tadafil and Deha-S. Same protocol for 4 years now. On paper I have high E2 and high Hemocrit, but feel great. Good libido, morning erections, good energy, etc. I donate blood maybe twice per year and see doc once per year with labs. He is very pleased with all values. I couldn't be happier with my protocol. I do have higher sbhg which effects my T.

What do your labs look like, if u don’t mind me asking. Total T, free T, E2 and SHBG. Always curious to see labs of men when they’re feeling great. Thanks in advance.

 

[madman]

You have new labs coming up in a few months if your SHBH or Albumin levels are lower than what you posted in the previous labs and depending on where your TT levels sit at true trough than your FT levels may very well be higher.

 

[Starplex]

I'll be sure to post those new labs when I go for my blood letting, LoL. Probably be mid August timeframe. As always thanks for the informative post madman. Guess we will see what the trends are looking like considering several years of the same protocol.

 

[jcmaxwell]

- to top it off as you should very well know most on trt are using the piss poor inaccurate direct immunoassay when testing FT and have no idea where their FT levels truly sit when in fact they should be using the gold standard Equilibrium Dialysis or Ultrafiltration or better yet using the newer calculated TruT method.

Madman, you are absolutely correct! FT using direct (analog) immunoassay has been discredited by top researchers for over 30 years. Yet labs continue to offer it, and doctors, even endocrinologists, who should know better, are completely oblivious to the methods used to measure hormones. In the June 2001 edition of The Journal of Clinical Endocrinology and Metabolism, Dr. William Rosner published a commentary entitled An Extraordinarily Inaccurate Assay for Free Testosterone is Still with Us. Since then, researchers have repeatedly demonstrated that direct FT SHOULD NOT be used to diagnose and treat hypogonadism. Even the reference ranges are completely different - Lab Corp FT direct: 6.6-18.1 pg/ml; Lab Corp Equilibrium Ultrafiltration (after doing the unit conversion from ng/dL to pg/mL) 50-210 pg/ml. On a couple of occasions, I have run both tests and found that my free testosterone was twice the upper limit using direct FT but only mid-range using Equilibrium Ultrafiltration. This discrepancy has significant clinical implications, since the assay method has a direct bearing on whether or not an individual patient gets treated!

 

[Cataceous]

Would using the bacteriostatic water that I have to mix with my HCG, act as a suitable solvent for the AI, in the manner that SilverSurfer describes above, using vodka?

I love the ingenuity, but is mixing an AI with vodka, actually safe? Can you feel any alcoholic 'effects'?

Anastrozole does not dissolve well in water. Using vodka is safe and effective. I have done this and had very consistent results. A less accurate alternative is to cut the anastrozole with a powder: Use a mortar and pestle to grind one or more pills to dust and then add a fixed volume of cornstarch or other consumable powder. Mix well and then measure the doses by volume.

 

[mercury]

OK, stupid question. Do you inject the AI/vodka combo or do you take it orally?

 

[Cataceous]

OK, stupid question. Do you inject the AI/vodka combo or do you take it orally?

Take orally only.

 

[edward]

High E2 blocks available testosterone, thus your free test is likely low unless you’re taking megadoses of testosterone. Your Shbg is also a factor

High E2 increases SHBG which in turn reduces free T. That is the relationship here.

 

[DDD]

Not consistently! I thought it would never happen again because it had been nearly 5 years since I’d had one. Yes, I find my libido is more consistent. I started 200 mg Testosterone Cyp with 1 mcg of Anestrozole twice a week. After reading the TOT Bible and listening to multiple TOT docs on Jay Campbell’s vodcast on YouTube (and seeing my estradiol was under 13) I decided no more AI and to take the once a week dose of 200mg and divide it equally into 4 50 mg doses. A little less than the 200 a week. No more Anestrozole!
I rarely see my TRT Doc. Only the first time. We talked, he listened to my heart and approved the treatment. He did no Digital/rectal examine and no testicular exam. His office assistant/nurse runs the whole show! Neither is up to date on the latest protocols! They simply make money! $300 for every visit to get blood work and prescription.

Did you say you were taking 1 mg of anastrozole twice a week? That would be 2mg a week. That's a lot if I understand you correctly. I've heard there is really no need to take more than .5 mg weekly for most men.

 

[mercury]

So i took the advice and mixed a couple of tablets with vodka. Ended up taking 0.2 mg, and within 36 hours I was back to feeling awful with fatigue an lethargy.
Is there a definition of an AI 'over-responder' or any way to get tested for such?

 

[Cataceous]

So i took the advice and mixed a couple of tablets with vodka. Ended up taking 0.2 mg, and within 36 hours I was back to feeling awful with fatigue an lethargy.
Is there a definition of an AI 'over-responder' or any way to get tested for such?

So your dose was 1/10 of your anastrozole solution? The way to tell your responsiveness is to measure serum estradiol before and after with consistent dosing. For me, taking 0.25 mg spread out over each week drops estradiol by around 20 pg/mL.

 

[mercury]

By my calculations it was 0.2 mg Anastrazole that was consumed last week. Yesterday, I reduced it again even further to 0.1 mg (taken 24 hour after T injection), and I’m experiencing none of Gen side effects. That sad, I’m skeptical exactly how much impact 0.1mg per week will have on my E2 levels.

 

[M.J]

Personal experience before starting trt and hcg I had low t, my estradiol 20pg, took ginseng 6000 daily without anything else, it started lowering my E slowly over a period of 40 days, when I reached 15pg I had crazy libido, as soon as I went to 12pg my libido is gone. I stopped it and my e started going up again as I reached 16 I had high libido again then when I hit 20 all gone.

My point here is it seems like there is a level which of you reached in estradiol things can get better.
I know this cuz I took multiple test specially when I felt this high libido. Arimidix may not screen your estradiol as good as this but I have concerns with long term use of ginseng ( I have no idea about it safety)

Now I am on trt just in my third week after 6 week I may try this again to see if it really does make a difference while my T is high now or not.

If so I may use arimidix ? or not to reach there.

 

[M.J]

I did that at one time but i dont manage estrogen anymore.
I have to say it takes only one drop literally just one drop to take my estrogen down, if I do two drops I crash my estrogen.
I used vodka mix, using my 29 gauge needle.