Anastrozole side effects and is it really necessary to add HCG to standard TRT?

[alexenvalencia]

31 years old - went on TRT after having low libido and energy for 3 or 4 years - probably due to a year of high stress at work and resultant use of SSRI for 3 years. My free Test was evaluated borderline low so Urologist decided to trial TEST CYP IM at 50mg. On reading and researching myself the Crisler protocol, decided to add some HCG and anastrozole.

Current regime:
50mg TEXT CYP E3D
250IU HCG E3D
0.25mg ANASTROZOLE E3D

Started TRT beginning of April, End of June added HCG and End of July added ANASTROZOLE.



First few months up to end of July, improvement in libido and energy no doubt. Then over August (IMO coinciding with adding the ANASTRAZOLE, initially at 0.25 E2D) start to feel weak and muscle/joint achy on getting up in the morning, some muscle weakness during the day, reduced libido.

I reduced the ANASTRAZOLE to 0.25 E3D a month ago and did a blood test. E2 had risen from my pre TRT baseline to 31 pg/ml which I think may be a little above the ideal. Also the TT level is about 200 too high (800 would be good) with resultant acne issues on my back and arms.

Could the muscle weakness and aches be a side effect of the anastrazole or even of too low/ too high E2?

Is HCG really a necessary addition to a simple TRT of 50mg TEST CYP E3D? My thinking is that I remove the HCG, test levels drop into the 700-800 range and thus I can try removing the Anastrazole due to lower aromatisation. Instead of 3 meds, I would be on 1 as the urologist originally intended. Any opinions?

[sirupate]

Good "report"...like the way you displayed the lab results. I don't know on your question. Guess you could drop the anastrazole and see how you feel in a month or two. Taking the anastrazole doesn't seem to be driving your estradiol too low. Dropping the HCG could lower your testosterone levels, but your testes may suffer. Some guys don't much care...others do.

[APIs]

Nice write up. TRT is very individual and should be based on how you are feeling and less on actual lab numbers. That is how my Doctor administers TRT.

Having said that, @ 50 mg Test Cyp E3D you are on the low end of the dosing schedule. But even at this dosing level, your testes will eventually most likely shut down which necessitates the addition of HCG. Remember that your testes produce other hormones that are vital to male well being. Some will argue that they do not see a difference being on HCG or don't care about shrunken testes. I would have to disagree with this thought process.

As for the AI, this is very individual also. I do not feel as well with E2 at 30 or even 25. You need to find your own "optimal level" and dose the AI based on this value. It seems you havent been on TRT long enough to determine "your" optimal E2 value/number.

If you are happy with how you feel & perform at your current Test levels than keep the dosing as-is. However, I would suggest you need more time with follow-up Blood Work to establish the best HCG & AI dosing that works best for you. Just my thoughts...

[steroid.com 1]

This is a very nicely done post from a new member; good job.

Some initial thoughts:

1. I would also suspect some adrenal fatigue as your cortisol is at the lower range of the assay. Symptoms seem to suggest as well.
2. Do you drink? Taking any other meds? Liver enzymes are high.
3. Thyroid seems fine but converting T4 to T3 is not optimal...most likely age related.
4. Your high on all three Test assay fronts but nothing to freak out about. Your averaging 125 mg of Test per week and averaging 625 iu of hCG per week. Both in the "normal" protocol range. My guess is that you are still producing and the hCG is creating more natural test. Either way, you could lower both to get your levels down to optimal normal range. But as I said, I wouldn't worry to much as all three panels look good to me.
5. E2 is slightly elevated but not greatly. You present sides of high E2 but from a serum perspective it's a little surprising. You could be E2 sensitive. If you lower Test injections this should come down.
6. I really like your E3D protocol; mimics a more natural state and keep all levels smooth and consistent.
7. Here's why you need hCG: http://forums.steroid.com/showthread...ow.&highlight=
8. You need your AI...no mistake about it. You're already a bit high E2. Lower your test amount and it should come down.

Overall, you look pretty healthy. Just need to do some fine tuning and you should be set.

[meathead320]

I don't think HCG is an obsolute must, and I don't use it.

There are lots of healthy men who are on TRT, because due to injury, or cancer lost thier testes.

I didn't lose mine altogether, but lost a lot of the function after an injury. So Primary hypogonadism.

HCG is pretty much pointless, IMHO for primary cases.

Keep in mind that there are a LOT of guys who lost their testes and simply inject 100mg EW, sometimes less, I've heard as low as 60mg 1x EW and feel fine, and have good sex drives.

Keep in mind that your protocol has your Free T at 28.6 on a 5.7 to 17.8 range.

And your Total and Bioavailable T are also higher than the top of the range.

HCG may help keep you fertile if you want to have kids in the future.

I do wonder if you would need the AI at all if you were just in the upper 1/3rd of the range however, not over it.

Such as a FreeT of 12-14 on that range, and TT of 600-700, I'd figure you would feel fine and not be having Estradiol issues at all, or at the least could cut back the AI use even further.

Might also be a good idea to have your LDL and HDL levels looked at too, as back in Dec1 your HDL was a bit low and your LDL a bit high. Always good to keep track of those, and try to have your HDL higher and your LDL lower. Nobody wants plaque in the pipes.

[bass]

yea good work on the write up Alex! and yes Anastrozole will give you the problems you've described. mine is muscle ache especially lower back!

[alexenvalencia]

As meathead points out, I feel if I can get my TT levels down to the 600 to 800 range then I would not need to use the ANASTROZOLE.

The HCG I would like to keep for fertility reasons and also to make a possible future restart easier.

Certainly regarding the muscle weakness and aches, I read on this forum:

"These sides are what women get on higher doses of Arimidex men only need about .25mgs every 3 days if you get sore joints and mucles and have ED your to low on E2."

My plan would be to:

REDUCE TCYP 40mg E3D
REDUCE HCG 200IU
ELIMINATE ANASTROZOLE.

How does this sound to get those TT levels down and not need the AI?

[bass]

it seems you are naturally low on E2, so based on these doses you may be able to get away with not using AI, but because of hCG will probably need to add AI once after every test injection, maybe 1/4 mg!

[alexenvalencia]

How often do most people here dose their TCYP?

E3D?
E2D?

I am being recommended to increase my dosing frequency as smaller amounts injected more often will result in lower conversion to E2.

[bigboy67]

How often do most people here dose their TCYP?

E3D?
E2D?

I am being recommended to increase my dosing frequency as smaller amounts injected more often will result in lower conversion to E2.

I do my Test C injections IM and E3.5D. I did notice that when I increased from E2W to EW to E3.5D I felt a lot less puffy and swollen

[bass]

well for me i was doing it ew, but i took GDevine's advice and split my dose to twice a week, also reduced my AI intake to once after each injection. will see how it works. BTW, my dose is 50 mgs test twice ew and 1/2 mg anastrozole after each injection.

[steroid.com 1]

How often do most people here dose their TCYP?

E3D?
E2D?

I am being recommended to increase my dosing frequency as smaller amounts injected more often will result in lower conversion to E2.

This is correct.