New to TRT...questions about Arimidex

[jdwhiskey13]

I have just started TRT this week and had my first injection of Testosterone Cypionate 100mg on Tuesday. My doctor has prescribed 3mg of Arimidex per week (1mg 3x week) and everything I have read so far seems to suggest that might be too high of a dose. I will post my labs below from Quest Diagnostics and any feedback is appreciated.

26 YOA
Test total [369] range [250-827]
Bio-available [247] goal [450-500]
IGF I [90] range [63-373]
Estrogen [221.5 H] range [60-190 pg/mL]
Vitamin D [9] goal [60-80]

Additionally I am dealing with some blood pressure and cholesterol issues from neglecting my body and I have been put on medication and supplements for that. I'm certainly not trying to go against doctors orders but a couple of friends also on TRT had some concern about the dosing for Arimidex. I can post additional information if necessary.

[kelkel]

Welcome jd!

How's your current body fat level?
What was the causative factor in your low T at such a young age?

To your question, yes, that's a ridiculously high dose for your estrogen level and TRT dose. It will quickly crash your E2 and cause more issues. To put things more in perspective for you the average adex dose for a 500 mg per week testosterone cycle is .25 mgs every other day. Do the math on that. No doubt your doc means well but doesn't understand how effective adex really is.

Also know that the proper test for men is called an E2 Sensitive Assay. Standard estradiol is geared to women and can be quite erroneous when used for men. It tends to read higher than it actually is. Often times, very much so.

Give us more detail on the protocol your doc is putting you on. Frequency of T dose? HCG ?

[jdwhiskey13]

Welcome jd!

How's your current body fat level?
What was the causative factor in your low T at such a young age?

To your question, yes, that's a ridiculously high dose for your estrogen level and TRT dose. It will quickly crash your E2 and cause more issues. To put things more in perspective for you the average adex dose for a 500 mg per week testosterone cycle is .25 mgs every other day. Do the math on that. No doubt your doc means well but doesn't understand how effective adex really is.

Also know that the proper test for men is called an E2 Sensitive Assay. Standard estradiol is geared to women and can be quite erroneous when used for men. It tends to read higher than it actually is. Often times, very much so.

Give us more detail on the protocol your doc is putting you on. Frequency of T dose? HCG?

Thank you for your response! I'm currently at approximately 23% body fat. Frequency of the T dose at this time is once per week. I don't really recall him stating a particular reason for my low T levels but I'd imagine it has a lot to do with my lifestyle. My primary care doctor blamed my low T in the past on sleep apnea primarily but I've got that under control now and my T is still an issue. I don't recall what my levels were several years ago other than they were "a little low for my age". What would be your recommendations on the Arimidex ?

[Simon1972]

I think taking trt as well as statins is too much too soon.
I take arimidex at half a tablet, twice a week.
Also split your trt dosage into two separate doses each week.
Your test will convert to estrogen at a higher rate at a weekly dose compared to split/twice/week

I'd start off with trt and 5000iu of vitamin d3 daily. Get bloods drawn and then see how your cholesterol moves. I'm not a fan of statins in any case. What else are you taking?

[kelkel]

I'd start low at .25 maybe two times per week and pull BW for E2 Sensitive in 4 weeks and adjust.
Do you have BW from just before implementing TRT? Love to see it.

[jdwhiskey13]

I think taking trt as well as statins is too much too soon.
I take arimidex at half a tablet, twice a week.
Also split your trt dosage into two separate doses each week.
Your test will convert to estrogen at a higher rate at a weekly dose compared to split/twice/week

I'd start off with trt and 5000iu of vitamin d3 daily. Get bloods drawn and then see how your cholesterol moves. I'm not a fan of statins in any case. What else are you taking?

Thank you for your response. I was looking at splitting up the doses of Testosterone already, guess I'll go ahead and do that next week. I'm also taking the following per the doctor:

Vitamin D3 5000iu daily, 2x daily for the next month
N-Acetyl Cysteine 600mg 2x daily
Milk Thistle 500mg 2x daily
Coq-10 200mg daily
Losartan HCTZ 50/12.5 1x daily
Testosterone Cypionate 100mg/week

[jdwhiskey13]

I'd start low at .25 maybe two times per week and pull BW for E2 Sensitive in 4 weeks and adjust.
Do you have BW from just before implementing TRT? Love to see it.

That sounds like a plan so far. All the numbers I've posted are from BW that was drawn 1/25/2016. Are there any specific numbers you would like to see? I can't figure out how to PM on here or I don't have access to it yet...

[kelkel]

You can't pm until you get 50 posts. It prevents people from trying to instantly scam people, etc.
LH & FSH would be the main ones to help determine whether the issue is primary or secondary.
Did the doc say what the actual issue was? Or just that your T was low?

[jdwhiskey13]

You can't pm until you get 50 posts. It prevents people from trying to instantly scam people, etc.
LH & FSH would be the main ones to help determine whether the issue is primary or secondary.
Did the doc say what the actual issue was? Or just that your T was low?

Ah ok I understand about the PM. I am not seeing LH and FSH on my blood work. He didn't say what the actual issue was just said my T was really low for my age. He seemed more concerned about my BP and cholesterol. Do I need to ask for a different blood test next time or find a new doctor altogether?

[kelkel]

Well, without LH and FSH your doc would have no clue what the root cause of your low T is. They're indicators of pituitary function. LH & FSH both signal your testicals to produce testosterone (LH) and sperm (FSH.) So, if your LH/FSH levels are low then your T is low which is considered secondary hypogonadism. Many things can cause this such as hypothyroidism, cortisol, prolactin issues, trauma, etc. If your LH/FSH levels are elevated and your T is low then the issue lies with your testicals not responding properly (primary hypogonadism.) There can also be combination of both.

All the above being said, many doc's simply don't know hormones as they are not trained in them in med school. It sounds as if he's just putting a band aid on the issue with testosterone being the "quick fix." Know that initiating TRT shuts down what production you currently have, it does not add to it. In most cases a competent doctor should be able to determine where the issue lies and attempt to address it. And you should want to know this, especially at your age as it's very doubtful it's idiopathic. I would hate to be on TRT at your age due to an improper diagnosis.

With what you've mentioned so far I don't think I'd accept another injection and I'd find a more knowledgeable doctor asap. Just the fact that he did not test LH and FSH send up major red flags. Plus the ridiculous amount of adex doesn't help his case. Take a look in the Finding A Doc sticky thread at the top of this forum and try to use the first set of BW there. You can pare down some of the items recently pulled without worries.

Watch this entire video. It's a great explanation of how our HPTA works:

https://www.youtube.com/watch?v=_xrU7HREfcU

[jdwhiskey13]

Well, without LH and FSH your doc would have no clue what the root cause of your low T is. They're indicators of pituitary function. LH & FSH both signal your testicals to produce testosterone (LH) and sperm (FSH.) So, if your LH/FSH levels are low then your T is low which is considered secondary hypogonadism. Many things can cause this such as hypothyroidism, cortisol, prolactin issues, trauma, etc. If your LH/FSH levels are elevated and your T is low then the issue lies with your testicals not responding properly (primary hypogonadism.) There can also be combination of both.

All the above being said, many doc's simply don't know hormones as they are not trained in them in med school. It sounds as if he's just putting a band aid on the issue with testosterone being the "quick fix." Know that initiating TRT shuts down what production you currently have, it does not add to it. In most cases a competent doctor should be able to determine where the issue lies and attempt to address it. And you should want to know this, especially at your age as it's very doubtful it's idiopathic. I would hate to be on TRT at your age due to an improper diagnosis.

With what you've mentioned so far I don't think I'd accept another injection and I'd find a more knowledgeable doctor asap. Just the fact that he did not test LH and FSH send up major red flags. Plus the ridiculous amount of adex doesn't help his case. Take a look in the Finding A Doc sticky thread at the top of this forum and try to use the first set of BW there. You can pare down some of the items recently pulled without worries.

Watch this entire video. It's a great explanation of how our HPTA works:

https://www.youtube.com/watch?v=_xrU7HREfcU

I'm gonna go ahead and stop injections at this time. I actually just got my package from the pharmacy. I thought I was doing pretty good finding this doctor as he was listed on the A4M website and several people referred him.

Unfortunately there's not a lot of choices in my my area so it's gonna be a hassle. I called lowt.com about a month ago and still haven't heard back. I really appreciate your help and thank you for your honesty.

[kelkel]

JD did you get to watch the video? Hopefully that's helps you understand how easily testosterone production can be impacted. I wanted you to see that as I really think you need to find the cause of your low T, not just cover it up with TRT. You're too young to be injecting yourself for the next 60 years without knowing if the initial issue is fixable. If he's listed on the A4M Doc list I'd think he'd be a bit more up to date, especially with his adex dosage.

When it comes to estrogen, simply initiating a low dose of adex will elevate your T level. Some people tend to aromatize more than others. The aromatase enzyme lives in the skin with a particular affinity for belly fat. The more you have the more T can turn to E. Make sense?

Have you considered talking to him some more about trying to find the root cause and being uncomfortable starting TRT at your age? Know that when you start TRT it eventually stops your bodies own production of testosterone. It's not "in addition" to your own production. There's also been no mention of your doc talking to you about HCG to maintain testicular function and fertility.

Maybe write down a list of questions and talk to him.

[jdwhiskey13]

JD did you get to watch the video? Hopefully that's helps you understand how easily testosterone production can be impacted. I wanted you to see that as I really think you need to find the cause of your low T, not just cover it up with TRT. You're too young to be injecting yourself for the next 60 years without knowing if the initial issue is fixable. If he's listed on the A4M Doc list I'd think he'd be a bit more up to date, especially with his adex dosage.

When it comes to estrogen, simply initiating a low dose of adex will elevate your T level. Some people tend to aromatize more than others. The aromatase enzyme lives in the skin with a particular affinity for belly fat. The more you have the more T can turn to E. Make sense?

Have you considered talking to him some more about trying to find the root cause and being uncomfortable starting TRT at your age? Know that when you start TRT it eventually stops your bodies own production of testosterone. It's not "in addition" to your own production. There's also been no mention of your doc talking to you about HCG to maintain testicular function and fertility.

Maybe write down a list of questions and talk to him.

I just finished watching the video. Thank you for posting that it was very informative. I will schedule a follow up appointment within the next couple of weeks to go over things again before I move along any further. Once again I appreciate your help!