Issues with Elevated Estradiol Levels

[buggsb]

I have been on TRT for about 9 months now and have had very marginal results to date. The protocol (.32ml T-Cyp, .50ml HCG & .25mg Anastrozole - twice per week) has elevated my T levels but my Estradiol levels have tracked proportionally upward.

To date I have had very minimal increases in libido, and basically none of the other positive effects of the increased T levels (mood, strength increases, fat decreases, etc., etc).

We have tried lowering the T-Cyp to .28ml, but at that level libido deceased accordingly to nearly nothing.

After my last 90 day labs we increased the Anastrozole to .5mg/twice weekly. Still waiting to see those labs but physically I feel basically the same as at the lower dose...no noticeable change.

At this point I'm getting a bit frustrated, having spent a lot of $$ but realizing very little benefit.

I'd like to hope that if I could suppress the Estradiol levels appropriately that I would begin to realize more of the benefits of the increased T...thoughts?

Any suggestions from this group on what path to take next?

 

[Gman86]

Have you had labs done recently? Are you sure you haven’t suppressed your E2 too low? What is your SHBG level? Are your currently doing the 0.32ml twice per week, or 0.28ml twice per week of testosterone?

 

[CoastWatcher]

Are you and your doctor measuring estradiol with the sensitive (LC, MS/MS) test? What was your thyroid panel like at the start of therapy? Was your sleep evaluated? Sleep apnea, in North America there an undiagnosed epidemic of apnea sufferers, impedes any TRT protocol.

 

[buggsb]

Hmm, sleep apnea. Interesting. I can see how lack of sleep would counter some of the benefits of TRT but can’t really see a direct correlation between that and elevated E2

 

[YBWV]

I have been on TRT for about 9 months now and have had very marginal results to date. The protocol (.32ml T-Cyp, .50ml HCG & .25mg Anastrozole - twice per week) has elevated my T levels but my Estradiol levels have tracked proportionally upward.

To date I have had very minimal increases in libido, and basically none of the other positive effects of the increased T levels (mood, strength increases, fat decreases, etc., etc).

We have tried lowering the T-Cyp to .28ml, but at that level libido deceased accordingly to nearly nothing.

After my last 90 day labs we increased the Anastrozole to .5mg/twice weekly. Still waiting to see those labs but physically I feel basically the same as at the lower dose...no noticeable change.

At this point I'm getting a bit frustrated, having spent a lot of $$ but realizing very little benefit.

I'd like to hope that if I could suppress the Estradiol levels appropriately that I would begin to realize more of the benefits of the increased T...thoughts?

Any suggestions from this group on what path to take next?

I would suggest that you enquire with your Doctor what is being done to monitor your androgen levels, particularly DHT.

At that dosage of TCyp, if your FT and E2 levels are top of Lab range, or above, and your low mood and libido symptoms persist then check first DHT and then Prolactin.

If your recent Labs don't include DHT - many Doctors don't order on blood panels (with some reason) - then you can get it inexpensively at DiscountedLabs. (Assuming you're in the U.S.).
If your levels of the other sex hormones are high then DHT "should" be too. Often DHT lags behind and sits at mid-range or in the third quartile which is likely inadequate for good function.

Balancing your hormones by increasing DHT, if necessary, is a better prospect for success than chasing E2 up and down by varying the dose of the AI.