I emailed a clinic here in Singapore this morning, thinking I am going to pay a bit extra and just get estradiol tested now so I know if I should stop Arimidex or not. Does Arimidex cause rebound estrogen?
The LC/MS/MS estradiol assay is expensive and even in the U.S. only performed at specialized labs. A search for availability of this test in the far east yielded no result. I can't imagine trying to stabilize a complex case like yours in any protocol which employs a powerful AI like Arimidex in the absence of tight monitoring. Given the purported propensity of hCG to raise E2, you and your doc might want to re-think how appropriate it is for you. If it were me in your shoes, in the absence of the monthly or bimonthly testing that is indicated early in the protocol, I'd be looking to find the lowest dose of hCG that yielded a positive result on a few of the symptoms. I would not entertain expectations that hCG mono w/ or w/o AI is the answer.
I suggested trying EOD because you reported slumps in your trough byond day two. Given all you've disclosed including the lack of good insurance coverage you might want to consider limiting hCG to under 250 IU per dose for now. Since I am neither a doctor nor an expert consider this number to be completely arbitrary yet possibly wise for patients with above average aromatization. Gene suggests you look elsewhere for solutions. I agree although not for reason he gave. The high T club is known for its strong armed bouncers. Not all get admitted. A serum goal much lower than 700-1200 ng/dL total T might be the ideal for certain patients. Bioavailable and other markers could easily be more useful. Keep reporting your experience and progress here.