PCP or Specialist for TRT

[Tim1985]

Kelkel, what should I be targeting for my estradiol range? I go back in for a follow up and will get them to run BW again. All my dr mentioned was wanting it back below 40 pg/mL

[Youthful55guy]

Kelkel, what should I be targeting for my estradiol range? I go back in for a follow up and will get them to run BW again. All my dr mentioned was wanting it back below 40 pg/mL

It depends on the laboratory, the exact test method, and their own "normal ranges". For LabCorp, using the LC/MS/MS method (the one I recommend), the normal range is 8-35 pg/mL. I usually shoot for the upper 50% to 75% of the range, which is about 22-28 pg/mL. I adjust my anastrozole dose using the Vodke/Eye Dropper method based on labs. I also use nipple reactivity as a guide. Typically, they become less reactive (lifeless) if I go too far. My last test showed an E of 23.2 pg/mL and nipple reactivity has been somewhat diminished. I retesting next week and will make a decision whether to drop my dose from 0.5mg/week (5 drops per day) to 0.4mg/wk (4 drops per day).

[Tim1985]

Since my last post I have had BW done in mid May and on August 1st.

Before my May BW, I was taking 25mg Clomid daily for 25 days and then 5 days off, along with 0.5 mg arimidex twice a week.

May BW results:-
Total Test: 633.2 (down from 812.7 in Jan)
Free Test: 106.7 (down from 133.9 in Jan)
FAI: 63.1 (down from 79.1 in Jan)
SHBG: 34.8 (down from 35.6 in Jan)
Estradiol: 56.8 (down from 77.5 in Jan)

Going into the appointment, I was feeling about as good as I could ever remember and my lebido was back like it was in high school. After going in for my follow up appointment at the start of June, he swapped me over to injections. Script said 200mg injection once every 2 weeks but I inject 50 mg every 3.5 days. He was happy to see my estrogen come down but still said it was high so increased my arimidex to 1mg twice a week.

He also discovered through some genetic testing that I was homogeneous for the MTHFR gene and heterogeneous for the COM-T gene which long story short was the cause of my depression. Had me start taking a supplement called SAM-E and gradually started to taper me off Prozac.

Mid July, I started to notice I wasn’t feeling as good as I have been the past couple months and thought that maybe I bottomed out my estrogen with the increased dose. I went in for follow up BW August 1st and just got the results.

August BW
Total Test: 687.8 (up from 633.2)
Free Test: 160.1 (up from 106.7)
FAI: 94.6 (up from 63.1)
SHBG: 25.2 (down from 34.8)
Estradiol: 56.2 (down from 56.8)

Needless to say I was shocked that doubling the arimidex dose did almost nothing to my estrogen level. Any chance that would be from the big jump in free test? The Dr wants me to start taking 1 mg arimidex three times a week, which seems really high but gona listen to him. Not sure if the changes I’m noticing are from trying to get off Prozac or my hormones still being out of range. Any thoughts on how my estrogen failed to drop when he doubled my dose? Getting frustrated making adjustments and then having to wait weeks/month for follow up BW, while feeling like shit again.