Need Help With AI Dose Since Doctor Can't Help

[swain66]

Hey guys, Ive been on trt for about 1 1/2 years and currnetly ive gotten my level to a good range but my estrogen is still a bit high. i have the 1mg anastrozole tabs but im not sure how much to take without lowering my E too much,last time i tried it I think it dropped too low and i felt like shit. My Doc is pretty new to trt and isnt much help with AI dosages. I had my labs done 2 weeks ago. I inject 40mg twice a week(80mg total a week).

testosterone total-774
test free-18.5
estradiol-45.1
DHEA-124
hemocrit-53

the AI pills I have arent scored and are a bitch to cut and get a reliable dose without crushing them even with a pill cutter. any help would be appreciated. thanks!!

 

[Vince]

If that's your level with the sensitive estradiol test for men. I would stay away form an AI, low E2 levels only causes issues.

 

[Vince Carter]

Most certainly the wrong test, Dr has no much a clue what he doing, is using a pretty miniscule amount of test per week, 80mg, is prescribing AI with no clue how to use it, if it's even needed.

So much is wrong here.

 

[CoastWatcher]

Hey guys, Ive been on trt for about 1 1/2 years and currnetly ive gotten my level to a good range but my estrogen is still a bit high. i have the 1mg anastrozole tabs but im not sure how much to take without lowering my E too much,last time i tried it I think it dropped too low and i felt like shit. My Doc is pretty new to trt and isnt much help with AI dosages. I had my labs done 2 weeks ago. I inject 40mg twice a week(80mg total a week).

testosterone total-774
test free-18.5
estradiol-45.1
DHEA-124
hemocrit-53

the AI pills I have arent scored and are a bitch to cut and get a reliable dose without crushing them even with a pill cutter. any help would be appreciated. thanks!!

As Vince noted, it's critically important that the correct estradiol test, the sensitive, LC, MS/MS, was run. If you are uncertain, please post the reference ranges for your labs (it's always important to post reference ranges) and we can determine which e2 test you had run.

What symptoms are you presenting that may be associated with elevated estradiol? Finally, what is your doctor's reaction to your climbing hematocrit?

 

[TheDude]

If that's your level with the sensitive estradiol test for men. I would stay away form an AI, low E2 levels only causes issues.

At what level would you be concerned?

 

[Matt Leiser]

At what level would you be concerned?

it is not so much the level, but how you are feeling and if you are presenting symptoms of high E2. It is different for everyone.

 

[Vince]

At what level would you be concerned?

As testosterone increases your E2 will follow, I wouldn't think about AI until levels of estradiol are over 60.

 

[TheDude]

it is not so much the level, but how you are feeling and if you are presenting symptoms of high E2. It is different for everyone.

I understand that. I started out with low E2 when I began. During the middle of my protocol, I experienced what I would call good libido and erection quality. That lasted about a week. In my latest labs, E2 reached 60. I'm going to try an AI because I think the week when libido was great, that was when my E2 was climbing and it hit a sweet spot. Then it kept rising and got me out of that spot to where I am today.

The reason I asked that is because I've never seen Vince recommend using an AI. Just curious if there was ever a point in which he would.

 

[FeelingLost]

I don't know why the who saids on this forum never ask about prolactin lvls in this situation when E2 is high and sex drive has been lost.

A quick google on high prolactin in men and the web is full of info:

"Studies have found that high prolactin levels in men are linked to low sexual desire and erectile dysfunction, and men suffering from such conditions are sometimes tested for high prolactin levels."

To me, one who has had both High E2 and High prolactin diagnosed with hyperprolactinemia high prolactin is far worse with more noticable sides.

swain, did you have your prolactin checked on your last bloods?

 

[swain66]

As Vince noted, it's critically important that the correct estradiol test, the sensitive, LC, MS/MS, was run. If you are uncertain, please post the reference ranges for your labs (it's always important to post reference ranges) and we can determine which e2 test you had run.

What symptoms are you presenting that may be associated with elevated estradiol? Finally, what is your doctor's reaction to your climbing hematocrit?

My reference for my E labs are 7.6-42.6 pg/ml Im not feeling that bad as of now,i havent had morning wood and have had a couple mild erection probs in the sack but other than that not much. as far as my hemocrit my Doc just told me to donate blood.

 

[swain66]

My reference for my E labs are 7.6-42.6 pg/ml Im not feeling that bad as of now,i havent had morning wood and have had a couple mild erection probs in the sack but other than that not much. as far as my hemocrit my Doc just told me to donate blood.

 

[swain66]

I originally started with 150 a week and my E levels went through the roof so my doc prescibed the AI and we started lowering my dose of T slowly to this point.I havent used the AI in a few months. I was just tested and thats when i got the results I posted.I just wanted opinions on if that E level was high enough to be taking a small dose of an AI. My Doc is pretty new to T and admits to not knowing a ton.

 

[CoastWatcher]

My reference for my E labs are 7.6-42.6 pg/ml Im not feeling that bad as of now,i havent had morning wood and have had a couple mild erection probs in the sack but other than that not much. as far as my hemocrit my Doc just told me to donate blood.

You ran the incorrect estradiol test. Your LabCorp reference range is a dead giveaway. Men need to have estradiol evaluated with the sensitive test - LabCorp test number 140244. The test you had is inaccurate and typically (though not always) over-reports the actual level of estradiol in a man's blood.

 

[swain66]

I'll get that sensitive test ASAP.thanks!! whats a good range to be in on the sensitive test?

 

[Saul]

I'll get that sensitive test ASAP.thanks!! whats a good range to be in on the sensitive test?

I am on a very similar protocol. My T levels are a bit lower. My E2 (sensitive test) was previously 40 and others on this site and my dr. were not concerned. Like others have said, some of it depends on how you feel.
1. Get the sensitive test - see Coastwatcher's post.
2. Test the morning of and before your shot.

You are on the right track. Depending on the test, you might not need any ai.

 

[OMI100]

CostWatcher is correct. When I run the sensitive my results show up as:
Estradiol, Sensitive - ##- (8.0-35.0)

I ran BOTH the standard and sensitive last time I did blood work (both draws were done within a minute apart), Standard first and sensitive second:
Estradiol - 32.1 - (7.6-42.6)
Estradiol, Sensitive - 25.4 - (8.0-35.0)
If you are using the STANDARD you run the risk of overcorrecting and ending up with E2 lower than you want, but thinking you are within rage based on the wrong test.
FeelingLost makes a good point on the Prolactin also. Wont hurt to get that tested also.

 

[Pringle]

One thing that is hard for many of us is chasing the number vs how do you feel. Me personally I have high E2 symptoms with sensitive nipples, cystic acne, and bloat when I get over a sensitive test range of 45. I hesitantly started my AI regimen at a compounded dose of .125mg twice weekly on injection day. E2 is now mid 20’s which feels great for me, with all symptoms gone. Many on here feel great with higher E2....I don’t. We are all different!

 

[Vince]

One thing that is hard for many of us is chasing the number vs how do you feel. Me personally I have high E2 symptoms with sensitive nipples, cystic acne, and bloat when I get over a sensitive test range of 45. I hesitantly started my AI regimen at a compounded dose of .125mg twice weekly on injection day. E2 is now mid 20's which feels great for me, with all symptoms gone. Many on here feel great with higher E2....I don't. We are all different!

That is a nice dose .125, so many men start with too high of an AI and crash their estradiol levels. I blame their TRT doctors.

 

[Pringle]

That’s the value of this site. The doc actually wanted to start me a little higher in dosage, but through all the examples here, I convinced them to start at the smaller compounded dosage.....you can always add if needed and I had a phobia of crashing E2 to start with.

 

[TheDude]

One thing that is hard for many of us is chasing the number vs how do you feel. Me personally I have high E2 symptoms with sensitive nipples, cystic acne, and bloat when I get over a sensitive test range of 45. I hesitantly started my AI regimen at a compounded dose of .125mg twice weekly on injection day. E2 is now mid 20’s which feels great for me, with all symptoms gone. Many on here feel great with higher E2....I don’t. We are all different!

You sound very similar to me. Mine was at 60. Just started a .125mg twice weekly protocol. Hopefully it has the same impact as yours did.