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  #161  
Old 18 January 2019, 17:51
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Originally Posted by Sigi View Post
Another update:

Testosterone, serum: 911 (264-916 range) - was 787
Free testosterone: 28.7 (6.8-21.5 range) - too high, backed me off to 8 ML (4 Mon - 4 Thurs) in lieu of 10 ML per week.
Prostrate-Specific Ag, Serum: 1.1 (0.0-4.0 range) - was .6
Estradiol, Sensitive: 17.8 (8.0-35.0 range) - was 64.1

So I am on Cypionate 200MG @ .8 ml per week, and continuing 1 Anastrozole 1MG tablet per week.
How do you FEEL though?
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  #162  
Old 18 January 2019, 18:16
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How do you FEEL though?
Awesome. My workouts are more focused. My joint problems (ankles, shoulders, hips) are gone because I move more. My heat rate is down 20+ because of my activity, I sleep like a champ, and I just feel less like a 50 yr old.

No more blue pill either. If my wife was up for it we'd have sex 5 times a week. I was lacking in libido prior to treatments, which I never thought would happen. That's not the reason I started - I was low T, had stupid pain, and my energy sucked. The sex drive is a ++ though. Wow!

And my cramps are gone - those painful ones at the top of the inner calf, hamstring, and belly. Ugh, those were horrible. My productivity is up, I have a healthy "zest" I guess I'd say.
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  #163  
Old 19 January 2019, 11:39
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Sounds good. Personally, I would have never reduced my dose just because my Free T was a little over range - Free T is actually the stuff that is doing all the good stuff. That's all an interaction between Total T and SHBG, and diet can influence SHBG.

There are some new thoughts on managing Estrogen, and even Dr. Crisler (who was an admitted hold-out) was going to change his protocol based on the work of Dr. Neal Rouzier: The use of Aromatase Inhibitors (especially Anastrozole) was going to be ceased. Instead, Estrogen was going to be "controlled" by smaller, but more frequent injections. Dr. Rob Kaminiarek, who has a DEXA scanner in his office, was seeing Osteoporosis occurring in his 40 year old clients due to "controlling Estrogen" with Anastrozole - not good. Anastrozole also raises LDL a bit. Estrogen is essential for health, and is responsible for things like Lipid Control, Joint Lubrication, Muscle Gain, Libido, and Preventing Bone Mineral Loss Old women who break hips, do so because they ceased producing Estrogen.

I have changed my protocol (I was literally scheduling my 6mnth bi-annual with Dr. Crisler online, when I found out he died) to 52mg of Testosterone Cypionate Every Other Day, and have stopped the AI. 26mg Per Day would be even better, but not even *I* want to inject daily, LOL! (HCG is easy with a 31G though, I do that daily).

Sigi - what is the mg/ml of your Testosterone? 0.8ml of 200mg/ml is 160mg - yet you say you are on 200mg/week?
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  #164  
Old 19 January 2019, 12:51
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Originally Posted by Polypro View Post

Sigi - what is the mg/ml of your Testosterone? 0.8ml of 200mg/ml is 160mg - yet you say you are on 200mg/week?
My Cypionate is 200mg. The dose was .10ml, but she wants me at .9 but it's kinda tough to pull 4.5ml so we settled at .8ml, which is .4 twice a week.

I asked the pharmacist about 100mg vs 200mg and his response was "some of the smaller towns across the country prescribe 100mg but it's always been 200mg in Las Vegas." Not sure what that means but it's working for me.

If I take .8ml of 200mg it isn't 200mg it's 160mg? Is that what you're saying?
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  #165  
Old 19 January 2019, 14:40
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Originally Posted by Sigi View Post
If I take .8ml of 200mg it isn't 200mg it's 160mg? Is that what you're saying?
Correct. 200mg if you take one injection of 1ml (1.0) *or 2 of 0.5ml, 4 of 0.25, etc...*

Each tiny line on a 1ml syringe is 2mg, the longer 1/2 line is 10mg, and each numbered (0.1, 0.2, etc...) is 20mg - so 0.8 = 160mg.
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  #166  
Old 19 January 2019, 21:24
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So the doc has me on Anastrozole, he said 1MG every other day, but I break that in half. I'm uncertain whether I should be on it at all. Poly, do you know anything about DIM?
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  #167  
Old 20 January 2019, 10:13
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Originally Posted by Purple36 View Post
So the doc has me on Anastrozole, he said 1MG every other day, but I break that in half. I'm uncertain whether I should be on it at all. Poly, do you know anything about DIM?
Well, not being a Doctor, and definitely not being female (so I don't research you gals as much), the only thing I an say is:

Unless you are at risk/have Breast Cancer or *maybe* PCOS, I can see no reason at all for a normal, healthy woman to be taking an Aromatase Inhibitor???

Pre/Peri/Post Menopausal women go ON Estrogen, because the ovaries stop producing it. The aromatazation of Estrogen from Testosterone should/would be minuscule in females. 1mg EOD absolutely crushes Estrogen in a Man (who have way more Testosterone to aromatise), I can only imagine what your E2 levels are (What are they from your last bloodwork?) as a woman on 1mg EOD?

To be more clear:

Quote:
Anastrozole

From Wikipedia, the free encyclopedia

Anastrozole, sold under the brand name Arimidex among others, is a medication used in addition to other treatments for breast cancer.[1] Specifically it is used for hormone receptor-positive breast cancer.[1] It has also been used to prevent breast cancer in those at high risk.[1] It is taken by mouth.[1]

Common side effects include hot flushes, altered mood, joint pain, and nausea.[1] Severe side effects include an increased risk of heart disease and osteoporosis.[1] Use during pregnancy is known to harm the baby.[1] Anastrozole is in the aromatase-inhibiting family of medications.[1] It works by blocking the creation of estrogen.[1]

Anastrozole was patented in 1987 and approved for medical use in 1995.[4] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[5] Anastrozole is available as a generic medication.[1] The wholesale cost in the developing world is about US$1.92–30.60 a month.[6] In the United States the wholesale cost is about $3.81 per month.[7]
Mechanism

Anastrozole works by reversibly binding to the aromatase enzyme, and through competitive inhibition blocks the conversion of androgens to estrogens in peripheral (extragonadal) tissues.[8]
Quote:

Before menopause, estradiol levels are widely variable throughout the menstrual cycle:

Mid-follicular phase: 27-123 pg/mL

Periovulatory: 96-436 pg/mL

Mid-luteal phase: 49-294 pg/mL

Postmenopausal: 0-40 pg/mL

Following menopause: Under 10 pg/mL
I would ask for very detailed reasons on why you are on 1mg of Anastrozole EOD. If it's in combination with Estrogen/Progesterone Hormone replacement - why not just dial in the Estrogen (cream/pellet?) correctly?


DIM (and Indole3Carbinol - the body converts 1 to the other) comes from Cruciferous Vegetables (Broccoli/Cauliflower, etc...). It has been shown to have a postive impact on the types of Estrogen produced by the body - NOT the overall amount. There are actually many different types of Estrogen, some good, some bad. Estrodiol (E2) is just used as a surrogate marker on bloodwork. The other major ones are Estrone (E1), and Estriol (E3). And I think if you follow the conversion chart downward from Cholesterol, there are ~30 other sub-types.

So eating Broccoli/taking DIM/IC3 is good, won't hurt.

Again not a Doctor.
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  #168  
Old 20 January 2019, 10:24
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Quote:
Originally Posted by Polypro View Post

1mg EOD absolutely crushes Estrogen in a Man (who have way more Testosterone to aromatise
Spot on. My estradiol, sensitive reading went from 64.1 to 17.8 after 10 weeks on 1 mg Anastrozole tablet per week.
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  #169  
Old 20 January 2019, 23:47
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Originally Posted by Polypro View Post

There are some new thoughts on managing Estrogen, and even Dr. Crisler (who was an admitted hold-out) was going to change his protocol based on the work of Dr. Neal Rouzier: The use of Aromatase Inhibitors (especially Anastrozole) was going to be ceased. Instead, Estrogen was going to be "controlled" by smaller, but more frequent injections.

I have changed my protocol (I was literally scheduling my 6mnth bi-annual with Dr. Crisler online, when I found out he died) to 52mg of Testosterone Cypionate Every Other Day, and have stopped the AI.
Good to hear you have gone this route. I tried to avoid taking any AI from the start. I was prescribed 100mg of test a week. Decided to split it up into 2 injections. In that protocol my Estradiol in May was at 34.8 on the sensitive scale, right at the normal limit. I switched to 3 day a week injections and had it down to 17.9 by September.

My Hematocrit is still border line high, but I have been battling with my Dr. on what to do. All the rest of my blood numbers (RBC, WBC, Platelets count) are in the normal range, and from what I have read and researched, a little elevated HCT is not a problem it once was thought.

I lift 5 days a week and run about 30 miles a week. Eat a very clean diet with my occasional cheat day. All of the issues i had prior to TRT have subsided. I feel good, energy is up, and sleep is better. It's working for me.
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  #170  
Old 21 January 2019, 10:47
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Good to hear you have gone this route. I tried to avoid taking any AI from the start. I was prescribed 100mg of test a week. Decided to split it up into 2 injections. In that protocol my Estradiol in May was at 34.8 on the sensitive scale, right at the normal limit. I switched to 3 day a week injections and had it down to 17.9 by September.

My Hematocrit is still border line high, but I have been battling with my Dr. on what to do. All the rest of my blood numbers (RBC, WBC, Platelets count) are in the normal range, and from what I have read and researched, a little elevated HCT is not a problem it once was thought.

I lift 5 days a week and run about 30 miles a week. Eat a very clean diet with my occasional cheat day. All of the issues i had prior to TRT have subsided. I feel good, energy is up, and sleep is better. It's working for me.

That's awesome, glad to hear it bud. The leaner you are, the less Aromatase Enzyme there is anyway - it's produced mostly in adipose tissue. Hematocrit: Lot's of old people in Denver All Hematocrit is, is a ratio of RBC to blood volume - simply being a little dehydrated can artificially increase it. And since your RBC # is good.... Piss clear before your next blood draw, and see what it comes back at.
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  #171  
Old 21 January 2019, 21:39
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Thanks Poly, although you are not a doctor you probably are more read up on this than most docs I deal with. I'm on an Estradiol patch and a daily progesterone pill for this hell known as Menopause. I'm on my 2nd T. pellet for crushed libido, but so far I'm not seeing any improvement and this is month 4. At least with the shots, I got about a week's worth of Mojo back before it faded..haven't seen any improvements with the pellet. The doc who does the pellet is the one who recommends the AI...so, what I am going to do, is to keep taking a 1/2 pill every other day and see what my blood work shows in a few weeks. I've only been on AI for 2 weeks. I will ask him why precisely he recommends this.
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  #172  
Old 22 January 2019, 07:45
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Thanks Poly, although you are not a doctor you probably are more read up on this than most docs I deal with. I'm on an Estradiol patch and a daily progesterone pill for this hell known as Menopause. I'm on my 2nd T. pellet for crushed libido, but so far I'm not seeing any improvement and this is month 4. At least with the shots, I got about a week's worth of Mojo back before it faded..haven't seen any improvements with the pellet. The doc who does the pellet is the one who recommends the AI...so, what I am going to do, is to keep taking a 1/2 pill every other day and see what my blood work shows in a few weeks. I've only been on AI for 2 weeks. I will ask him why precisely he recommends this.
Yeah, it seems weird to me - you're female, healthy 20-somethings are 120-440 (looks like Labcorp's max is 300) depending on time of month, why in the heck try to control E2 in a woman, who is trying to get back to young lady levels? Trying to control what little would aromatize from the tiny amount of Test with an AI, seems a bit extreme - why not just let it ride and use the patch dosage to adjust?

Especially in the face of the current data on Men, and getting rid of the AI altogether by moving to smaller, but more frequent T injections.

A 2014 study on T in women, showed a daily application of 5mg of a 1% T-Gel/Cream, did the trick - they didn't use an AI. Not a fan of pellets for T.

Guess the bloodwork will tell - but have you ever had E2 measured while on Estrogen, Progesterone, and Testosterone, but NOT with the AI? If not, it seems that would be step 1. Then if E2 is too high, go from there - but decreasing the patch dose would be my step 2, not an AI - you're lean and probably have very little aromatization (of what little Testosterone you're on) occurring. That's *all* an AI is good for - Aromatase enzyme Inhibition of Testosterone conversion to Estrogen.
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  #173  
Old 23 January 2019, 09:06
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^Who took over the practice after Dr. C died? Are you going to the same place? I live in Ohio and was thinking about making the trip.

Went into the VA a couple weeks ago and had my blood drawn for T and total Est. I was at 379ng/dl for T (300-900)and 96pg/ml (40-115) for total estrogen so within range for both. I've been feeling like shit for a long time now, no major low T side effects other than low libido and general feeling of crappiness.

I read about Clomiphene as a way to get back in range. Has anybody know any doctors that are willing to go that route for someone not looking for TRT?
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  #174  
Old 23 January 2019, 11:42
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Went into the VA a couple weeks ago and had my blood drawn for T and total Est. I was at 379ng/dl for T (300-900) so within range for both.
Did the VA say that was within range or someone else? The reason I ask is that the VA here says anything over 170 is within range and mine is at 178. I would think the standards would be the same across the entire VA????
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  #175  
Old 23 January 2019, 11:42
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Poly I filled out the new patient thing for the guy in OH but no contact so far.
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  #176  
Old 23 January 2019, 12:58
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Did the VA say that was within range or someone else? The reason I ask is that the VA here says anything over 170 is within range and mine is at 178. I would think the standards would be the same across the entire VA????
The VA in NC told me that 300 and above was in the normal range...
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  #177  
Old 23 January 2019, 13:32
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^No Sharky, that is not in range. I have the estrogen results on labcorp's website also because apparently they farmed the lab out to them.

From Myhealthevet:


Test Name Result------------Units-------------------Reference Range---------Test Details
TOTAL TESTOSTERONE------379 ng/dL ------------241-827-------------------Details
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  #178  
Old 23 January 2019, 16:42
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Originally Posted by Polypro View Post
Well, not being a Doctor, and definitely not being female (so I don't research you gals as much), the only thing I an say is:

Unless you are at risk/have Breast Cancer or *maybe* PCOS, I can see no reason at all for a normal, healthy woman to be taking an Aromatase Inhibitor???

Pre/Peri/Post Menopausal women go ON Estrogen, because the ovaries stop producing it. The aromatazation of Estrogen from Testosterone should/would be minuscule in females. 1mg EOD absolutely crushes Estrogen in a Man (who have way more Testosterone to aromatise), I can only imagine what your E2 levels are (What are they from your last bloodwork?) as a woman on 1mg EOD?

To be more clear:





I would ask for very detailed reasons on why you are on 1mg of Anastrozole EOD. If it's in combination with Estrogen/Progesterone Hormone replacement - why not just dial in the Estrogen (cream/pellet?) correctly?


DIM (and Indole3Carbinol - the body converts 1 to the other) comes from Cruciferous Vegetables (Broccoli/Cauliflower, etc...). It has been shown to have a postive impact on the types of Estrogen produced by the body - NOT the overall amount. There are actually many different types of Estrogen, some good, some bad. Estrodiol (E2) is just used as a surrogate marker on bloodwork. The other major ones are Estrone (E1), and Estriol (E3). And I think if you follow the conversion chart downward from Cholesterol, there are ~30 other sub-types.

So eating Broccoli/taking DIM/IC3 is good, won't hurt.

Again not a Doctor.

Pulled labs I took four months ago, pre AI, but while on a pellet for T and Estradiol/Progesterone.


Testosterone: 175 ng/dl
Estradiol: 34.3 pg/ml
Estrogen: 160 Pg/ml
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  #179  
Old 23 January 2019, 16:44
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Did the VA say that was within range or someone else? The reason I ask is that the VA here says anything over 170 is within range and mine is at 178. I would think the standards would be the same across the entire VA????
Docs that donít treat it regularly always give that same answer. In my experience.

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Poly I filled out the new patient thing for the guy in OH but no contact so far.
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  #180  
Old 23 January 2019, 22:03
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Originally Posted by Polypro View Post
Yeah, it seems weird to me - you're female, healthy 20-somethings are 120-440 (looks like Labcorp's max is 300) depending on time of month, why in the heck try to control E2 in a woman, who is trying to get back to young lady levels? Trying to control what little would aromatize from the tiny amount of Test with an AI, seems a bit extreme - why not just let it ride and use the patch dosage to adjust?

Especially in the face of the current data on Men, and getting rid of the AI altogether by moving to smaller, but more frequent T injections.

A 2014 study on T in women, showed a daily application of 5mg of a 1% T-Gel/Cream, did the trick - they didn't use an AI. Not a fan of pellets for T.

Guess the bloodwork will tell - but have you ever had E2 measured while on Estrogen, Progesterone, and Testosterone, but NOT with the AI? If not, it seems that would be step 1. Then if E2 is too high, go from there - but decreasing the patch dose would be my step 2, not an AI - you're lean and probably have very little aromatization (of what little Testosterone you're on) occurring. That's *all* an AI is good for - Aromatase enzyme Inhibition of Testosterone conversion to Estrogen.

Can you point me to some of the studies and readings you are looking at..I'm not finding anything beneficial.
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