To Anastrozole or not

Nobucks · Aug 27, 2015

Hello to all! I would like to give a summary of my circumstances and hopefully get feedback as to options / recommendations from this much needed and appreciated sight with it's very informed members. Been undergoing TRT approx 5 yrs via Androgel. First blood test total T sub 200. Faithfully been applying Androgel, 4 pumps, 81mg per day which put total T in low 400's, with no improvement in feeling better, no additional energy and it only slightly improved blood lipids and that's why I've continued with TD TRT. In March of this year, read a Dr Crisler article ref applying the gel on forearms. This method put my total T in mid 900's. Felt much better, more energy, libido dramatically improved for a month or two, then it nose dived to nothing. Approx one month ago had the ultra-sensitive Estradiol test per Quest Diagnostics and it came back @ 46. I alerted the Dr prescribing Androgel as to the Estradiol test and he said it's fine and an AI need not be considered. DR said I could cut back the Androgel application and that would lower the Estradiol. I don't have any enthusiasm to lower the Androgel dose. Sure would be nice to feel good all the time like I did when I first applied the gel on my forearms and total T raised significantly. Any recommendations?

CoastWatcher · Aug 28, 2015

Nobucks said:
Hello to all! I would like to give a summary of my circumstances and hopefully get feedback as to options / recommendations from this much needed and appreciated sight with it's very informed members. Been undergoing TRT approx 5 yrs via Androgel. First blood test total T sub 200. Faithfully been applying Androgel, 4 pumps, 81mg per day which put total T in low 400's, with no improvement in feeling better, no additional energy and it only slightly improved blood lipids and that's why I've continued with TD TRT. In March of this year, read a Dr Crisler article ref applying the gel on forearms. This method put my total T in mid 900's. Felt much better, more energy, libido dramatically improved for a month or two, then it nose dived to nothing. Approx one month ago had the ultra-sensitive Estradiol test per Quest Diagnostics and it came back @ 46. I alerted the Dr prescribing Androgel as to the Estradiol test and he said it's fine and an AI need not be considered. DR said I could cut back the Androgel application and that would lower the Estradiol. I don't have any enthusiasm to lower the Androgel dose. Sure would be nice to feel good all the time like I did when I first applied the gel on my forearms and total T raised significantly. Any recommendations?

Welcome to Excelmale. Did you pull testosterone at the same time you pulled the E2 level? I ask because topical testosterone can be inconsistent.

ERO · Aug 28, 2015

According to the testosterone to estrogen ratio, your E2 level is fine if your total T is 900+. 900/46 = 19.5 which puts you within the ideal rage of 14 to 20. The notion that your E2 should never go above 30 is based upon a total T level of 6-700.

Many of us had poor luck with topicals (for all of the reasons you listed) and switched to twice weekly injections. Is your doctor willing to do that?

Vince · Aug 28, 2015

as you probably know E2 is a big subject here, a good place to start is this post https://www.excelmale.com/forum/showthread.php?2309-Role-of-Estradiol-in-Men-and-Its-Management

Nobucks · Aug 28, 2015

I appreciate the information provided. When I had the Estradiol checked, within a day or two I had my total testosterone checked and it came back 963. I'm not familiar with the testosterone estrogen ratio, but plan on reading the provided link. I know the ultra-sensitive test indicated the estradiol amount should be below 29. The overall feeling I got from the higher testosterone amount and it's libido effect was great. Depressing that it went away.

ERO · Aug 29, 2015

Yes, for many of us the experience was similar. Good absorption and good T levels for a while, and then T levels dropped and refused to budge so we switched to injections, typically twice weekly. I would honestly recommend going that route if you can.

Vince Carter · Aug 29, 2015

Rotate every day your application spots for the gel. I don't see 46 as a problem if you're running just short of 1K with your Total T. If you're not bloated, itchy nipples, etc etc I'd look elsewhere for your lingering problems, I suggest a full Thyroid panel and perhaps a 4 tube saliva test for Cortisol.

Nobucks · Aug 29, 2015

As to the thyroid, In March of this year I had the T3, T4 and TSH checked and all were in the normal range. I've never had my cortisol level checked. Can cortisol cause problems consistent with my issues?

Nelson Vergel · Aug 30, 2015

Post your thyroid test results here (TSH, free T3, free T4 at least). More times than not, people have been underdiagnosed.

I doubt that estradiol at 46 pg/mL has any effect on the way you feel.

My biggest concern after working with men for many years is the fact that they expect TRT to be like batteries that should not run out. TRT effects can be dramatically affected by changes in sleep, stress, food allergies, alcohol use, etc. So expecting TRT to always make you feel great no matter what other variables are in your life sets guys for emotional failure.

Even stimulants taken daily do not work well if other aspects of life are not well. We want to blame something, so estradiol becomes that evil hormone that we have told to blame since it represents females going through a period. The fact is that estradiol is an enhancer of testosterone-related mood effects.