HRT - 6 months later with a low t group

So, been doing this for 6 months. After my 6 week bloods they upped my dose of Test Cyp to 200mg a week. everything else stayed the same 1000IU HCG per week and .25mg of Anastrozole per week. After talking to my endo, for my quarterly checkup back in March, about my high Total serum Estrogen (96 and the standard is supposed to be 130 or less) he asked me to up my Anastrozole dose up to .5mg every other day. Well, I did that and here's where I'm at as of 6/8:

TESTS	RESULT	FLAG	UNITS	REFERENCE INTERVAL
Alkaline Phosphatase, S	33	Low	IU/L	39 - 117
Cholesterol, Total	291	High	mg/dL	100 - 199
Triglycerides	239	High	mg/dL	0 - 149
HDL Cholesterol	16	Low	mg/dL	>39
VLDL Cholesterol Cal	48	High	mg/dL	5 - 40
LDL Cholesterol Calc	227	High	mg/dL	0 - 99
Testosterone, Serum	766		ng/dL	348 - 1197
Free Testosterone(Direct)	27.6	High	pg/mL	8.7 - 25.1
Estradiol, Sensitive	11.4		pg/mL	8.0 - 35.0

Could the reason why my cholesterol levels are out of whack be because of upping the Anastrozole? I did start on a Keto diet, could that also be in part responsible? I'm just genuinely concerned because back in March none of my metabolic tests came back high like this. Lastly, while on Clomid alone back in October/November 2014, my main hormone levels were:

TESTS	RESULT	FLAG	UNITS	REFERENCE INTERVAL
Testosterone, Serum	785		ng/dL	348 - 1197
Free Testosterone(Direct)	23.0		pg/mL	8.7 - 25.1
Estradiol, Sensitive	36		pg/mL	3 - 70

What concerns me is that I've had better levels on Clomid alone vs. Test, HCG, and Anastrozole combined. Also, the Estradiol range reference intervals have changed from November to now, from 3-70 to 8.0-35. I almost feel like I was probably better off on clomid and having an AI added in to reduce the Estradiol. I'm just a bit surprised and not sure what to do now. And I'm possibly considering cancelling my membership to the group I use for my low testosterone issues. It comes down to $200/month and not doing as well as I was on Clomid or spending $48/month and using clomid and another $10 for an AI, while saving over $100 in the process. So guys, I'm open to thoughts, opinions, etc... because I'm kind of at a loss again with this.

My Doc has a few patients that metabolize Test at a higher rate then the general population. Regarding HCG, most get buy with 500 to 750 IUs per week. 1,0000 IUs is surely not helping your E2 levels either. I've never heard of lipid levels getting skewed from using Anastrolzole. I'd chalk off the lipids to bad diet and/or genetics. This can be easily reversed for some by taking as little as 5 mgs Crestor 3 times per week & it will also help the HDL (Good Cholesterol) levels. I've been on it for years with no issues, but many here will automatically advise against using it.

There have been studies posted on here that Clomid use is a viable TRT treatment long term. However, it seems many posters claim it doesnt work for them after extended periods.

Personally, I'd try getting the Test Cyp dialed in with the correct amount of Anastrozole needed to maintain healthy E2 levels. You're currently towards the upper range for total and free test looks good (which is what really counts). I've been dialed in using 200 mgs/week for years now with no issues. Many here will automatically bash taking 200 mgs/week outright, but it seems your body is using it. At the end of the day, it's all in the blood work...

PS Six months is not that long BTW. It can take a year or more to get dialed-in properly and feel the benefits...

Thanks APIs! Well my trt doc upped me to 250mg of test Cyp/week today and told me to cut back on the anastrozole and Zinc (I usually take 50mg a day - now they just said 3x a week) bc my Estradiol was at 11 and they want it to be in the 30's at it's lowest. They said that might explain the lipid skewing. I'll try this and see but I'm honestly a bit upset about the whole situation... I think in my mind I was going to just have this incredible response to this therapy and undergo this remarkable transformation. Instead, I feel great - but I want better or more out of it than just where I was at with clomid without the emotional sides, especially when I'm paying $200 a month for the service when I could just figure out another way to get the same pharmaceuticals at a lower price via my insurance or whatever. I don't like throwing good money after bad.

Also, I've actually been eating pretty clean for the past few months. I mean I'm on a Keto diet where most of my food I prepare and cook and I'm not on a bunch of carbs. I think the most I take in is 100g on the days I lift and between 50-75 on my off days. If I refeed with carbs, I stick to veggies and brown rice and maybe oats that day. Most of my carbs on any other day come from veggies or dairy, like yogurt or cottage cheese. Protein sources are usually eggs, maybe bacon, chicken, tuna, steak. If I do use oil in stuff, I use organic refined coconut oil, EVO, or avacado oil. The only thing I can think of is that the last meal I had the night before fasting for the labs was 4 strips of bacon and 6 whole eggs scrambled.

Any other thoughts?

Quote:

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Originally Posted by APIs

My Doc has a few patients that metabolize Test at a higher rate then the general population. Regarding HCG, most get buy with 500 to 750 IUs per week. 1,0000 IUs is surely not helping your E2 levels either. I've never heard of lipid levels getting skewed from using Anastrolzole. I'd chalk off the lipids to bad diet and/or genetics. This can be easily reversed for some by taking as little as 5 mgs Crestor 3 times per week & it will also help the HDL (Good Cholesterol) levels. I've been on it for years with no issues, but many here will automatically advise against using it.

There have been studies posted on here that Clomid use is a viable TRT treatment long term. However, it seems many posters claim it doesnt work for them after extended periods.

Personally, I'd try getting the Test Cyp dialed in with the correct amount of Anastrozole needed to maintain healthy E2 levels. You're currently towards the upper range for total and free test looks good (which is what really counts). I've been dialed in using 200 mgs/week for years now with no issues. Many here will automatically bash taking 200 mgs/week outright, but it seems your body is using it. At the end of the day, it's all in the blood work...

PS Six months is not that long BTW. It can take a year or more to get dialed-in properly and feel the benefits...

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That's a great answer. And why would your doc up your T dose at this point? Seems like he's guessing.....

First Kelkel, I'm not going on Crestor or anything else because of this - I can just stop go back on Clomid cancel my TRT subscription and just go with Clomid and If I decide to, cycle in the future at some point if I'm moved to do so. Like I said before I'm not eating crappy food and the only thing I can think of why everything is off is bc my Estradiol is at 11 and not in the 30's.

What I'm concerned about is how my cholesterol levels bounced out of the normal ranges they were in. Do I think it would be great if 6 months from now I come back to this with bloodwork that has me within all the ranges I need to be in or better? Sure! Is it worth spending another $1200 for? I don't necessarily believe so. I'm feeling like I could've stuck with my endo or found a doc locally and spent less money and had less concerns about how this is going to probably cost me $2400+ a year for the rest of my life if I stick with the group I'm with, instead of the $700 a year I was spending just to be on Clomid and being within this same range. I said at the beginning, when I decided to go with injectable Test for hrt, that my major hurdle with taking the Clomid was that I was just falling in the high mid-range and I wanted to be above that. Yes, I know that a lot of people on this board have said that is not bad and that is fine, but I am right where I was 6 months ago - nearly 800 out of 1200. If my results had come back and I was at 1000-1100 and I felt amazing and even better than I do now, then I'd say this is probably worth it. But honestly wouldn't you feel like you've wasted money if you're paying more money to be right where you were at (with the exception of free test)? I followed the advice of the reliable users on this board 6 months ago and decided to change over to injections. Why do that if I'm at around where I started. You change something and invest more moeny into something because it is a better product and it has a superior efficacy. You don't change over to something just to be exactly where you were before and paying more money to do so.

Sorry for the length but these are the things I've been thinking about this week because when you think about it it's around 1300-1400 I've spent since November in this endeavor and if I could've spent $350 or at least less than $1300 to go through this. If this is all that's in store for me I'll probably go back on clomid and consider cycling at some point or figure out a more cost effective way around going about this.

Your free test is the number that matters much more than tt. You could have 1000 tt but if free is 5 you'd still feel crappy. Ultimately it's how you feel but I know 250/week is a really large trt dose and I don't think it's sustainable. You have to do what you feel is right but it could take a year or more to get your dose dialed in and getting full benefit of trt good luck.

Ok, thanks bigdil