Some help with Blood test results and breast pain

[ztm88]

I follow-up again with him Friday to get new labs. His impression was that he would only be treating me for a few months because once my E2 levels were lowered back into normal range, I would be just fine and could cease taking the arimidex. I will ask him Friday about long term E-2 management. He originally prescribed me arimidex for two months so I have quite a bit left.

 

[ztm88]

Doesn't anyone have advice

 

[ztm88]

I am planning on staying on the arimidex this week until I go see my doctor on Friday. I've had a great response to the AI but imagine I will be coming off of it soon. Does anybody have any advice for long term E2 management? How can I avoid my E2 rising too high when I come off of the arimidex and how can I keep my T:E ratio high?

 

[Nelson Vergel]

Ztm88

Have your doctor check your DHT also. Men with low DHT can experience gynecomastia also.

I think keeping you total testosterone above 500 ng/dL should keep you from developing gynecomastia. You may have to stay on a low dose anastrozole regimen.

 

[ztm88]

I had my appointment with a new endocrinologist today. I was away during an internship when I saw the previous endo. Now that I am back home, I saw a new endo. I told the new endocrinologist about what had been going on and that I was taking anastrozole for gynocemastia and high estradiol. I brought a copy of my labs and let him take a look. Essentially he told me he wants me to stop taking the anastrozole because it is not benefiting me according to him. He took some new labs, and told me he would take a look at those and see me back in a couple of weeks. He said when he looked at my new labs he could determine if I have hypogandism or hemacritosis. So I am not sure what to do at this point. I think I am going to have to see a new endocrinologist. I believe that the arimidex twice a week is working and just want a endo who can formulate a plan with me for long-term E2 and Free test management. I wanted to get your guy's advice on this. I really appreciate all your help in this, I was originally very stressed about the situation but you guys have made me feel much more calm knowing I have a wealth of knowledge to refer to on this issue.

 

[CoastWatcher]

I had my appointment with a new endocrinologist today. I was away during an internship when I saw the previous endo. Now that I am back home, I saw a new endo. I told the new endocrinologist about what had been going on and that I was taking anastrozole for gynocemastia and high estradiol. I brought a copy of my labs and let him take a look. Essentially he told me he wants me to stop taking the anastrozole because it is not benefiting me according to him. He took some new labs, and told me he would take a look at those and see me back in a couple of weeks. He said when he looked at my new labs he could determine if I have hypogandism or hemacritosis. So I am not sure what to do at this point. I think I am going to have to see a new endocrinologist. I believe that the arimidex twice a week is working and just want a endo who can formulate a plan with me for long-term E2 and Free test management. I wanted to get your guy's advice on this. I really appreciate all your help in this, I was originally very stressed about the situation but you guys have made me feel much more calm knowing I have a wealth of knowledge to refer to on this issue.

What reason did he offer for the opinion that Anastrozole was not working? He couldn't take a moment, review your labwork, and photographs, and draw some conclusions? If your gut is telling you to get another doctor (most of us have been through multiple doctors), get one. You owe it to yourself.

 

[ztm88]

Hey everybody, I did find a new endo that I am happy with. He has me continuing on the arimidex, which seems to be working well. We have a follow-up in three months to take new labs and discuss me coming off of the arimidex. I have been taking .25 MG twice a week. My current question as I am always looking to learn more, is how does the SHGB play a role in your E2 and Free Testosterone management?

 

[ERO]

Almost everybody knows that having SHBG be too high is a problem because you can have a high total level but due to high SHBG a very low free T level, basically causing you to have low T symptoms even though you have a high total T number. Low SHBG is also a problem, and IMHO a worse problem than high SHBG because it is fairly easy to lower a high SHBG level, but next to impossible to raise a low SHBG level. Guys with low SHBG (like me) often look great on paper with a nice high total T, high free T and a good E2 number and yet not really feel like they are on TRT at all. This is basically me for the last 5 years that I have been on TRT.

 

[craig weston]

I took Dianabol orals and injectables way back in late 80`s. Put on 4 stone and gyno was a big problem that still effects me to this day. Im losing weight and that helps

 

[Vince Carter]

I dispute the low SHBG as being a problem. I work with it and around it and view it that way, it requires a different approach to TRT in dosing and frequency, and that's it as far as I'm concerned. I got off Anastrozole completely, too.

In Dr Crisler's latest book he identifies a correlation between high free T and high free estrogens in low SHBG guys. Trickiest part of the low SBHG is dealing with E2. My experience was wildly up and down E2 from day-to-day and injection-to-injection, very difficult to medicate it so I strive to get off Anastrozole entirely. I adopted the T:E ratio theory and got on EOD T injections. It's changed my life, quite honestly, from my low T days.

 

[craig weston]

Vince, What approach would you suggest for my low SHBG and T ?