New to HRT, please help!!

[Jdoch]

It's a bit of a read, but thanks in advance for any help you can offer.

I'll start by saying this. I am well aware that I don't know what I'm doing. I found a local Dr who does HRT and figured that all I would need to know is how to inject. Aparently I was wrong.

I'm a 38 year old male who had "relatively normal" levels for my age before HRT. I had noticed a little muscle loss, and my libido was a little less than it was a year prior. Did some reading, found a Dr, and thought why not?

Intial prescription:
DHEA - 10mg daily
Anastrozole (arimidex , right?) - 50mg weekly
Delatestryl (200mg/mL) - 0.3mL 2x a week

Blood Tests:
(pre HRT -> First follow up, range)
TSH -------------------1.49 -> 1.11, 0.20-4.00
DHEAS ----------------11.5 -> 9.3, <14.0
Estradiol --------------52 -> 162, <200
Ferritin ---------------179 ->107, 12-300
Free T3 ---------------5.0 -> 5.6, 3.5-6.5
Free T4 ---------------14.0 ->17.4, 9.0-23.0
Free Testosterone ---299.9 -> 329.6, 175-700
Cortisol 413 -> n/a, 120-620

When I started the first few injections, I didn't notice much benefit... in fact within a week or a week and a half, I was super stressed, irritable, and depressed... border line wanted to die. I broke up with my GF because she was just straight up pissing me off (not an issue before, at all). After the break up, I started to think that maybe it was the hormones. It was a long weekend, Dr was unavailable, so I did some reading and found that some people have had depressed reaction to arimidex and/or DHEA... so I stopped both. Felt better within a few days, although still sad as I had dumped a girl that I really liked... but anyways.

Over the next couple months, I'd say that my mood ws roughly the same as pre HRT. I put on about 10lbs of muscle, and made some strength gains in the gym. Libido was maybe a margin higher, and function (erection strength, recovery time, etc) were about the same as before. That said, kind of tough to gauge that as I no longer had a GF to play with regularly.

First follow up appopintment with the Dr yeilded the results above. Was told that I had to try the arimidex, or stop the HRT. DHEA was not a big deal in their minds. Within a week, I'm depressed, snapping at my daugher over everything, and can't focus on anything.... feel zoned out. Finally have a chance to hook up with this girl I've been chasing for a while... and I lose my wood. Damnit. Try again a half hour later, and have a half success. Not fully hard, not a good perforance, but technically did it. The next day, I call her for redemption... same thing. Almost exactly.

I'm not sure what my levels are at right now, since starting the Arimidex again, but something has changed... for the worse. As you can see, Estridiol tripled. Free testosterone only went from 299 to 329. I thought the Dr said that we wanted about 500-600.... yet they haven't adjusted the dose.

Has anybody else had issues with depression, temper, focus, and/or libido due to arimidex? Is there an alternative?


Thanks a bunch!!

[IncreaseMyT]

Well you were below 200 so you were in range right? Yes your symptoms, most guys get headaches and joint pain, seem like they are from suppressing E too much.

Your dose is obviously a little cautious in our opinion With 2x per week TD injections levels will not swing much.

A study in Canada showed like a 150 point swing I believe with 2x per week sub c dosing.

Hope this helps.

[Jdoch]

I'm a little confused by your reply.

TD is transdermal.... aka creams, right?

I'm injecting subcutaneously 2x a week. 60mg each injection.

Is intramuscular the way to go?

[IncreaseMyT]

Either way is fine. Whatever is comfortable for you as far as injecting, it all goes to the same place at roughly the same speed.

Sorry I use TD for testosterone depot.

I thought that is the kind of testosterone you have, or what I mean is that is the label I see sometimes for those brands.

Based on your labs 3x per week dosing or an increase to 1/2 ml will most likely put your TT in the upper range.

[macmathews]

Either way is fine. Whatever is comfortable for you as far as injecting, it all goes to the same place at roughly the same speed.

Sorry I use TD for testosterone depot.

I thought that is the kind of testosterone you have, or what I mean is that is the label I see sometimes for those brands.

Based on your labs 3x per week dosing or an increase to 1/2 ml will most likely put your TT in the upper range.

Have you seen where some people do better on less not more ?

Mac

[Jdoch]

Ah... gotcha. I'm not sure the brand. I'm up in Canada. Vial JUST went out with the trash, and my other is back home.

Any opinion on the loss of libido, and depression... is it a reaction to arimidex specifically, or more likely just too high of a dose and my Estridiol dropped too low?

Thanks a bunch BTW!!

[IncreaseMyT]

Have you seen where some people do better on less not more ?

Mac

Yes it really all depends on symptoms. The problem everyone has is they are so worried about lab work they drive themselves crazy. What is the point of adjusting to a number on lab work if it does not alleviate symptoms?

Besides he said his doctor was aiming for 5-600 and he is not there yet. The adjustment will get him there.

Most of the time physical aspects, history and symptoms are far more telling than lab work. If my number is 600 and I feel like crap thats not going to work for me.

For depression symptoms, irritability or cognition impairment 100mg is usually enough.

For men with sexual symptoms, trouble sleeping, excess android fat.....its going to take more than that to alleviate symptoms.

Hope this helps.

[IncreaseMyT]

Ah... gotcha. I'm not sure the brand. I'm up in Canada. Vial JUST went out with the trash, and my other is back home.

Any opinion on the loss of libido, and depression... is it a reaction to arimidex specifically, or more likely just too high of a dose and my Estridiol dropped too low?

Thanks a bunch BTW!!

Yes sounds like common symptoms of lowering E2 too much. Or rather impairing the T/E ratio too much. We need E2 for lots of things like BMD, brain function, fat loss and even libido.

So yes thats what it sounds like. Up to you and your doctor but we would adjust and see if symptoms were alleviated, if so test to get positive lab results. These are important because they give you something to aim for in the future.

Others will say test again. But you just did. And unless I am not interpreting your lab work correctly your E2 was fine.

Hope this helps.

[Jdoch]

E2 tripled, which was their concern. "You will definitely grow boobs if we don't lower you Estrogen" were her exact words! Hahaha!

Now... I haven't had the E2 tested since starting to take the Arimidex again... but the more I read, and the more you say, I'm going to try .25 mg with every injection for a bit. If I'm still feeling blah, I'll drop it to .25mg every other injection and then see where the levels settle at in 6 weeks. My Dr is away until Monday, but I'll also be requesting a dosage increase for the Testosterone . I'd just up it myself, but I won't have enough to get me through until me next appointment. Likely better that I communicate with the Dr as much as possible too.

Is there anything else that I should be trying to get tested for? Or prescribed? HCG ? My semen production and testicle size are both down significantly.... not a huge deal... but the ego is a little bruised. Ha!

[IncreaseMyT]

With increased dosage a tad on anastrozole may be useful. Definitely run it by her.

Most men that have been around a while, we have some 20 year TRT clients, will tell you HCG is the best hormone for men since testosterone . Suppression affects us in many more ways than is talked about, HCG is a no brainer IMHO, unless your primary of course. It helps in many more ways than just fertility. Progesterone production for one.

[Jdoch]

Great! Thanks so much for the info and advice.

Much appreciated. I'm sure I'll post more as I know more.

[hammerheart]

It's a bit of a read, but thanks in advance for any help you can offer.

I'll start by saying this. I am well aware that I don't know what I'm doing. I found a local Dr who does HRT and figured that all I would need to know is how to inject. Aparently I was wrong.

I'm a 38 year old male who had "relatively normal" levels for my age before HRT. I had noticed a little muscle loss, and my libido was a little less than it was a year prior. Did some reading, found a Dr, and thought why not?

Intial prescription:
DHEA - 10mg daily
Anastrozole (arimidex , right?) - 50mg weekly
Delatestryl (200mg/mL) - 0.3mL 2x a week

Blood Tests:
(pre HRT -> First follow up, range)
TSH -------------------1.49 -> 1.11, 0.20-4.00
DHEAS ----------------11.5 -> 9.3, <14.0
Estradiol --------------52 -> 162, <200
Ferritin ---------------179 ->107, 12-300
Free T3 ---------------5.0 -> 5.6, 3.5-6.5
Free T4 ---------------14.0 ->17.4, 9.0-23.0
Free Testosterone ---299.9 -> 329.6, 175-700
Cortisol 413 -> n/a, 120-620

When I started the first few injections, I didn't notice much benefit... in fact within a week or a week and a half, I was super stressed, irritable, and depressed... border line wanted to die. I broke up with my GF because she was just straight up pissing me off (not an issue before, at all). After the break up, I started to think that maybe it was the hormones. It was a long weekend, Dr was unavailable, so I did some reading and found that some people have had depressed reaction to arimidex and/or DHEA... so I stopped both. Felt better within a few days, although still sad as I had dumped a girl that I really liked... but anyways.

Over the next couple months, I'd say that my mood ws roughly the same as pre HRT. I put on about 10lbs of muscle, and made some strength gains in the gym. Libido was maybe a margin higher, and function (erection strength, recovery time, etc) were about the same as before. That said, kind of tough to gauge that as I no longer had a GF to play with regularly.

First follow up appopintment with the Dr yeilded the results above. Was told that I had to try the arimidex, or stop the HRT. DHEA was not a big deal in their minds. Within a week, I'm depressed, snapping at my daugher over everything, and can't focus on anything.... feel zoned out. Finally have a chance to hook up with this girl I've been chasing for a while... and I lose my wood. Damnit. Try again a half hour later, and have a half success. Not fully hard, not a good perforance, but technically did it. The next day, I call her for redemption... same thing. Almost exactly.

I'm not sure what my levels are at right now, since starting the Arimidex again, but something has changed... for the worse. As you can see, Estridiol tripled. Free testosterone only went from 299 to 329. I thought the Dr said that we wanted about 500-600.... yet they haven't adjusted the dose.

Has anybody else had issues with depression, temper, focus, and/or libido due to arimidex? Is there an alternative?


Thanks a bunch!!

That estradiol is just perfect. Unless it's the sensitive assay the standard one will overestimate levels a bit, so you were in the ideal range there.

If you continue stay on that dose, you should drop anastrozole. Crushing your E2 will make you feel like a zombie. ED also is a common feature of low estradiol.


It's nice to see how TRT also provided a nice boost in free thyroid hormones, thanks for sharing.


Have you ever done a CBC? The lowered ferritin (and index of your Iron stores) could be due to testosterone pushing red blood production. Be sure to get enough Iron from the diet.

[Jdoch]

That estradiol is just perfect. Unless it's the sensitive assay the standard one will overestimate levels a bit, so you were in the ideal range there.

If you continue stay on that dose, you should drop anastrozole. Crushing your E2 will make you feel like a zombie. ED also is a common feature of low estradiol.


It's nice to see how TRT also provided a nice boost in free thyroid hormones, thanks for sharing.


Have you ever done a CBC? The lowered ferritin (and index of your Iron stores) could be due to testosterone pushing red blood production. Be sure to get enough Iron from the diet.

CBC was done before the TRT, but not since. All levels were within range. If I remember correctly, they plan to do it again at the second follow up in a couple months to make sure all is good.

SO... you don't think that E2 jumping up to 162 is a problem? Even for long term HRT?

On second look at my test results it looks like the E2 dropped down to 30 after one .5mg dose of the Anastrozol. Not sure how I missed that at first. Who knows how low it went after the second dose.

[hammerheart]

CBC was done before the TRT, but not since. All levels were within range. If I remember correctly, they plan to do it again at the second follow up in a couple months to make sure all is good.

SO... you don't think that E2 jumping up to 162 is a problem? Even for long term HRT?

On second look at my test results it looks like the E2 dropped down to 30 after one .5mg dose of the Anastrozol. Not sure how I missed that at first. Who knows how low it went after the second dose.

Nope, it's great. What you sure don't want is long term low oestradiol. That will wreck your bones.

Remember that readings are overestimated.

[FONZY007]

I'm a little confused by your reply.

TD is transdermal.... aka creams, right?

I'm injecting subcutaneously 2x a week. 60mg each injection.

Is intramuscular the way to go?

Could be an elevated or to low of E2. Your not using that much of test, maybe to much Ai