Gyno on TRT need advice

[Rickyticky]

Aloha from Hawaii,

Sorry for the long post here but I’m in some serious need of advice.

I’m a 35 yr old male 6ft 195lbs and started TRT at 200mg/week Once a week And Adex .5mg/week. This was 14 weeks ago after getting labs that showed Low T (121 NG/DL Total and 23 pg/ml free). I ran two cycles in my 20s and has some mild Gyno symptoms at the time that resolved after cycle.

After starting TRT I gained some good weight, increased strength and libido, but still had low energy, and by week 7 of TRT I had tenderness and a pea size lump under my right nipple. Doc sent me to get labs done again but somehow the lab didn’t include the estradiol test. At week 7 of TRT my total and free test levels had shot up dramatically to (1158total and 264 Free). This was 6 days post my last injection, so levels were almost certainly higher than this. Doc apologizes for leaving off the estradiol test by mistake but said based on symptoms of Gyno starting, some water weight and low energy he could tell my Estrogen was too high and test was a little too high also. Told me to increase Adex to 1mg M/W/F. And drop Test dose to 180mg rather than 200. Within 3 weeks the lump was half the size and sensitivity had decreased. I went again to test my estradiol and it was at 12 pg/ml. I felt like shit, more tired And little libido. I voiced my concerns that low E can be a bad thing too and my doc didn’t seem to know/ be conceded about this at all but told me I could reduce the Adex dose if I wanted.

I backed off the Adex to .5mg M/W/F and split my injections to 100mg On Monday and 80mg Friday. after just one week I felt better, but my nipple mass has grown some and is very tender! It’s about the diameter of a marble, but if you cut it in half through the middle ( half as thick) if that makes sense. It’s not visible just tender and I can feel it when I press down. I called the doc again and told him I want Nolva, he prescribed it but didn’t seem to really understand what it’s for. At this point I am pretty sure my doc doesn’t know what the hell he is doing and I plan to just use him for prescriptions and do my own research to get dialed in.

Seems like I have to keep my E2 levels so low to avoid Gyno that I experience the shitty sides from low estrogen. But if I let it rise some Gyno becomes a problem.

Planning to run nolva at 10-20 mg a day for 30-60 days while I get things in check. Need some advice from the experienced users as to what is going on/ what I should do. Pics of discussed labs attached.

[JaneDoe]

Take 40mg of Nolvadex a day until the lump shrinks, IMHO: Your mistake was using an AI, you could have very well fought gynecomastia with 40mg of Novaldex a day from the beginning. That for 4 to 6 weeks total.

[Ephemeral]

You still have room to reduce your dose and / or increase injection frequency. I didn't see where you mentioned if this is Test E, C or P, but with twice weekly I am going to assume E or C. At any rate, you could try both, reduce your dose and increase frequency, so say you could do 50mg 3 times per week for 150mg per week total. You could also likely do those doses sub-q if you wanted.

This strategy has the dual purpose of reducing overall levels and leveling out the peaks and valleys, both of which should decrease the opportunity for aromatization. I don't think getting rid of the AI entirely right now is a good plan, but you should be able to TRT without it eventually.

Nolvadex is a good plan at 20mg to start, then 10mg after the first couple of weeks or so. Once the gyno is resolved, it might just become part of your normal TRT at 5 - 10mg per day.

There are a number of gyno reversal protocols that are more significant, but since yours seems to be relatively minor, I would only look at them if the nolvadex doesn't improve the situation.

BTW, do you have other numbers like DHT, SHBG, etc?

Why do you think that increased frequency reduces aromatization?

[ShredBundy]

Hey Ricky welcome to the Forum! Lots of good advice in here already. If you haven't already, read the sticky in the HRT forum here

It seems as though your doctor is shooting from the hip as the initial 200mg/week is VERY high for TRT. This is more along what bodybuilders use to "cruise" on between cycles. Also a single 1mg dose of Arimidex is enough to reduce estrogen by 80%, but you already came to that conclusion on your own and have reduced the dosage. 0.5mg 3x/week is still VERY high but im surprised the lump has returned even at that dose, however I wouldn't go any higher and after a few weeks (probably no longer than a month) it should disappear and you can stop taking the ADex. I had the same problem last year and this protocol worked well for me (0.75mg/week until the lump was gone, also crashed my E2).

AIs are harsh, and I completely agree with Cylon that you should be able to get off them entirely with TRT as they are unhealthy to take long term and you shouldn't need them with the proper TRT protocol and dosing schedule. 120mg of test per week split into 3 injections should keep your levels in check, is a commonly prescribed dose, and should negate the use of AI altogether. YOU MIGHT BE TEST SENSITIVE, consider further reducing your T dosage. But if you can get things managed at your current dose I think the above advice is good. Run Nolva, and keep the arimidex in place until the lump disappears, it might take a few weeks but let us know if it gets worse. Again I think your T dose is still a little high given your blood work. Keep us posted

[The Deadlifting Dog]

Agree with above...

I would add...

I would drop the test down to 100mg per week and do 2 injections per week of 50mg.
I would start with Nolva at 20mg a day for a week and then 10mg for 3 weeks.

At the end of the month I would evaluate the changes.

At that point you may be able to bump up the test to 120mg/week.

The idea of TRT is to take as little as possible.
If you are taking so much test that you need AI and Nolva then you are doing too much test.

[Rickyticky]

Thanks so much for the solid advice everyone. I have split my dose and lowered a bit. Now shooting 80mg of test Cyp 2X/week (reduced from 200 once per week). Keeping Adex at .5 mg M/W/F for now and added nolva at 20 mg per day. Lump now has almost no tenderness and has shrunk some. Not completely gone but if it could stay like this it wouldn’t bother me. I’m just afraid it will worsen when I stop the nolva/AI. Will get labs again in a few weeks to see where I’m at.

[Rickyticky]

So gents, here is the latest. I went and did a sensitive E2 test in my own and levele came back at 6.1 pg/ml. In a weird way I was happy to see them this low because I have felt like shit lately, super tired and no motivation/ drive almost feel depressed. I hope these low E2 levels are the reason and now I can just back off the A dex until I find the right balance of AI to Test where I don’t have any Gyno issues.