You guys wont believe this!

[Vic Mackey]

Will you guys please help me?

I had a follow up with my endo today. He read my labs that came back. I had blood drawn on a Tuesday morning WITHOUT fasting. Keep in mind that I get my testosterone shots on Thursdays (125 mg testosterone enanthate weekly).

Here's all he tested:

Total test 970
PRL (does this stand for prolactin?) 12.6
FSH LT.10
LH .10
Estradiol 54.4
DHEA-S 493
HGH .05
Estrone and IGF 1 is pending

He said my testosterone is high, my DHEA-S is normal, my PRL is normal, my LH and FSH are VERY low, and my estradiol is not high but he'd like to see it lower. He didn't comment on my HGH and I forgot to ask him.

I asked him how my estradiol could go from 112 to 54.4 with only lowering the dosage (from 175 mg to 125 mg) in only 1 week. Keep in mind that the first estradiol test that came back 112 was done at Quest. The second test that came back 54.4 was done at my endos own lab at the office. He said the reason for the big drop was because I had a shot of 125 mg instead of 175 mg. That doesn't make sense. I thought it would take a few weeks at the lower dosage to see an affect on my estradiol. He said it would improve within 1 week of taking a lower dosage shot. Than he went on to say that he still wants me to take Arimidex to get my estradiol even lower (around 40). He said to take 1 mg of Arimidex daily. I than showed him Dr. Crislers Arimidex protocol:

My TRT male patients who suffer E2 elevations above the top of normal range are placed on between 0.25 and 0.5mg Arimidex every one to third day, depending upon the specific situation. It is possible to cut the tiny 1mg tabs into quarters, but here a compounded prep, to convenient dosing, makes a lot of sense. A month later I recheck E2, (as subsequently lowered SHBG will affect subjective response as well) and make further adjustment if necessary. Always remember it is important to not lower estrogen too far.

My endo than ASKED ME what dosage we should try!!! He ASKED ME!!! I told him I would try .5 mg every 3 days for 5 weeks. After labs, if it's still high, I will move up to .5 mg EOD for 5 weeks. After labs, if it's still high, I will move up to .5 mg ED. And than will get labs again.

Basically, he told me he has no experience with prescribing Arimidex to his TRT patients. This scares me to death. I'M TELLING HIM WHAT DOSAGE WE SHOULD DO!!! THE ENDO ASKED ME!!!

I than showed him Dr. Crislers Nolvadex protocol for nipple issues (which fortunately I DON'T HAVE right now). He said, "let's cross that bridge IF we come to it. I want to get your estrogen in check so hopefully that won't ever be an issue."

He than said my LH and FSH are low because I'm on TRT. He said that low LH and FSH have NO BEARING on my current ED problems. Fellas, keep in mind I had a pituatary MRI done a few months back and it was 100% NORMAL.

He said this is what he wants:

He will give me 150 mg of testosterone enanthate weekly (thats the middle of the old 175 mg dosage and the new 125 mg dosage I've been getting). He wants me to take the Arimidex as I laid out above (starting with .5 mg every 3 days). He wants me to continue to take 50 mg daily of DHEA (25 mg morning/25 mg night). He wants me to continue to take Levothyroxine 100 mcg daily (he doesn't prescribe Armour or Nature-Throid). He will have me get labs in 5 weeks (fasting night before) to test for Total testosterone, Estradiol, Estrone, FSH, LH, CHEM P (whatever that is), and DHEA-S. He said he will always have me tested AT MY PEAK POINT 3-4 days after the injection.

He also has me scheduled to see a Urologist on January 12 for my ED to see if it could be something OTHER than high estrogen.

One thing I want to make clear above all: even though I can't get strong erections, my sex drive is THROUGH THE ROOF (which makes the situation even worse)!

A few things:

1. How do you guys explain my estradiol dropping from 112 to 54.4 in one week?

2. What do you guys think of my plan with the Arimidex (first trying .5 mg every 3 days for 5 weeks, than trying .5 mg EOD for 5 weeks, and than trying .5 mg ED for 5 weeks ONLY incresing the dosage if my labs keep showing my estradiol is high)?

3. Would the low FSH and LH be causing ED problems?

4. Can a Urologist do tests to see if something is causing my ED problems?

5. How did the rest of my labs look?

6. Is the fact that my endo will only do labs AT MY PEAK POINT going to cause any problems? I get my shots on Thursdays and he wants my labs drawn on Mondays.

7. How do you guys explain the fact that I can't get a strong erection but my sex drive is THROUGH THE ROOF?

8. For my next labs, should I have my doc test for SHBG?

Can you guys please help me?

[LowT]

Your low LH and FSH are normal for someone on TRT. They are signaling hormones and would not be causing your problems.

Since it seems your endo is open-minded I would talk to him about starting hCG. Dr. Crisler has a sticky on this board about it. This will help some with libido and also keep your testicles from atrophying. At this point though I would wait until your T and E2 are dialed in though since hCG will just cause more confusion.

Your E2 is most likely still too high so it's good he's willing to work with you to lower it.

[Vic Mackey]

My endo told me that he's open to ideas and he likes the fact that I'm educating myself about TRT and that he prefers a knowledgeable patient over a clueless patient any day of the week.

LowT, what did you think of my Arimidex plan? What about my other questions?

[Vic Mackey]

Originally Posted by LowT

...I would talk to him about starting hCG...At this point though I would wait until your T and E2 are dialed in though since hCG will just cause more confusion...

He said if I ever want to have a kid, while trying to have a kid I WILL HAVE TO include HCG in my regimen. He said it's also good if I don't like having my somewhat atrophied nuts. I told him that was the least of my concerns right now. He said he wants to hold off on HCG now anyway until I get my testosterone/estrogen ratio in check.

[r3drang3r]

Originally Posted by Vic Mackey

Will you guys please help me?

I had a follow up with my endo today. He read my labs that came back. I had blood drawn on a Tuesday morning WITHOUT fasting. Keep in mind that I get my testosterone shots on Thursdays (125 mg testosterone enanthate weekly).

Here's all he tested:

Total test 970
PRL (does this stand for prolactin?) 12.6
FSH LT.10
LH .10
Estradiol 54.4
DHEA-S 493
HGH .05
Estrone and IGF 1 is pending

He said my testosterone is high, my DHEA-S is normal, my PRL is normal, my LH and FSH are VERY low, and my estradiol is not high but he'd like to see it lower. He didn't comment on my HGH and I forgot to ask him.

I asked him how my estradiol could go from 112 to 54.4 with only lowering the dosage (from 175 mg to 125 mg) in only 1 week. He said because I had a shot of 125 mg instead of 175 mg. That doesn't make sense. I thought it would take a few weeks at the lower dosage to see an affect on my estradiol. He said it would improve within 1 week of taking a lower dosage shot. Than he went on to say that he still wants me to take Arimidex to get my estradiol even lower (around 40). He said to take 1 mg of Arimidex daily. I than showed him Dr. Crislers Arimidex protocol:

My TRT male patients who suffer E2 elevations above the top of normal range are placed on between 0.25 and 0.5mg Arimidex every one to third day, depending upon the specific situation. It is possible to cut the tiny 1mg tabs into quarters, but here a compounded prep, to convenient dosing, makes a lot of sense. A month later I recheck E2, (as subsequently lowered SHBG will affect subjective response as well) and make further adjustment if necessary. Always remember it is important to not lower estrogen too far.

My endo than ASKED ME what dosage we should try!!! He ASKED ME!!! I told him I would try .5 mg every 3 days for 5 weeks. After labs, if it's still high, I will move up to .5 mg EOD for 5 weeks. After labs, if it's still high, I will move up to .5 mg ED. And than will get labs again.

Basically, he told me he has no experience with prescribing Arimidex to his TRT patients. This scares me to death. I'M TELLING HIM WHAT DOSAGE WE SHOULD DO!!! THE ENDO ASKED ME!!!

He than said my LH and FSH are low because I'm on TRT. He said that low LH and FSH have NO BEARING on my current ED problems. Fellas, keep in mind I had a pituatary MRI done a few months back and it was 100% NORMAL.

He said this is what he wants:

He will give me 150 mg of testosterone enanthate weekly (thats the middle of the old 175 mg dosage and the new 125 mg dosage I've been getting). He wants me to take the Arimidex as I laid out above (starting with .5 mg every 3 days). He wants me to continue to take 50 mg daily of DHEA (25 mg morning/25 mg night). He wants me to continue to take Levothyroxine 100 mcg daily (he doesn't prescribe Armour or Nature-Throid). He will have me get labs in 5 weeks (fasting night before) to test for Total testosterone, Estradiol, Estrone, FSH, LH, CHEM P (whatever that is), and DHEA-S. He said he will always have me tested AT MY PEAK POINT 3-4 days after the injection.

He also has me scheduled to see a Urologist on January 12 for my ED to see if it could be something OTHER than high estrogen.

A few things:

1. How do you guys explain my estradiol dropping from 112 to 54.4 in one week?

2. What do you guys think of my plan with the Arimidex (first trying .5 mg every 3 days for 5 weeks, than trying .5 mg EOD for 5 weeks, and than trying .5 mg ED for 5 weeks ONLY incresing the dosage if my labs keep showing my estradiol is high)?

3. Would the low FSH and LH be causing ED problems?

4. Can a Urologist do tests to see if something is causing my ED problems?

5. How did the rest of my labs look?

6. Is the fact that my endo will only do labs AT MY PEAK POINT going to cause any problems? I get my shots on Thursdays and he wants my labs drawn on Mondays.

Can you guys please help me?

My own personal experience with Arimidex:

I find it works very quickly and effectively. I went from 93 to 16 "E" on just three doses of .5 Arimidex taken over a period of one and a half weeks (three doses). Now I maintain my "E" by taking .25mg every M,W.F. Even this small a dose keeps my E at a level in the high teens which is probably a little on the low side.

[Vic Mackey]

r3drang3r, how does this plan look?:

I will try .5 mg every 3 days for 5 weeks. After labs, if it's still high, I will move up to .5 mg EOD for 5 weeks. After labs, if it's still high, I will move up to .5 mg ED. And than will get labs again.

[Bulldog]

In Bold.

Originally Posted by Vic Mackey

Will you guys please help me?

I had a follow up with my endo today. He read my labs that came back. I had blood drawn on a Tuesday morning WITHOUT fasting. Keep in mind that I get my testosterone shots on Thursdays (125 mg testosterone enanthate weekly).

Here's all he tested:

Total test 970
PRL (does this stand for prolactin?) 12.6
FSH LT.10
LH .10
Estradiol 54.4
DHEA-S 493
HGH .05
Estrone and IGF 1 is pending

He said my testosterone is high, my DHEA-S is normal, my PRL is normal, my LH and FSH are VERY low, and my estradiol is not high but he'd like to see it lower. He didn't comment on my HGH and I forgot to ask him.

I asked him how my estradiol could go from 112 to 54.4 with only lowering the dosage (from 175 mg to 125 mg) in only 1 week. He said because I had a shot of 125 mg instead of 175 mg. That doesn't make sense. I thought it would take a few weeks at the lower dosage to see an affect on my estradiol. He said it would improve within 1 week of taking a lower dosage shot. Than he went on to say that he still wants me to take Arimidex to get my estradiol even lower (around 40). He said to take 1 mg of Arimidex daily. I than showed him Dr. Crislers Arimidex protocol:

My TRT male patients who suffer E2 elevations above the top of normal range are placed on between 0.25 and 0.5mg Arimidex every one to third day, depending upon the specific situation. It is possible to cut the tiny 1mg tabs into quarters, but here a compounded prep, to convenient dosing, makes a lot of sense. A month later I recheck E2, (as subsequently lowered SHBG will affect subjective response as well) and make further adjustment if necessary. Always remember it is important to not lower estrogen too far.

My endo than ASKED ME what dosage we should try!!! He ASKED ME!!! I told him I would try .5 mg every 3 days for 5 weeks. After labs, if it's still high, I will move up to .5 mg EOD for 5 weeks. After labs, if it's still high, I will move up to .5 mg ED. And than will get labs again.

Basically, he told me he has no experience with prescribing Arimidex to his TRT patients. This scares me to death. I'M TELLING HIM WHAT DOSAGE WE SHOULD DO!!! THE ENDO ASKED ME!!!

He than said my LH and FSH are low because I'm on TRT. He said that low LH and FSH have NO BEARING on my current ED problems. Fellas, keep in mind I had a pituatary MRI done a few months back and it was 100% NORMAL.

He said this is what he wants:

He will give me 150 mg of testosterone enanthate weekly (thats the middle of the old 175 mg dosage and the new 125 mg dosage I've been getting). He wants me to take the Arimidex as I laid out above (starting with .5 mg every 3 days). He wants me to continue to take 50 mg daily of DHEA (25 mg morning/25 mg night). He wants me to continue to take Levothyroxine 100 mcg daily (he doesn't prescribe Armour or Nature-Throid). He will have me get labs in 5 weeks (fasting night before) to test for Total testosterone, Estradiol, Estrone, FSH, LH, CHEM P (whatever that is), and DHEA-S. He said he will always have me tested AT MY PEAK POINT 3-4 days after the injection.

He also has me scheduled to see a Urologist on January 12 for my ED to see if it could be something OTHER than high estrogen.

A few things:

1. How do you guys explain my estradiol dropping from 112 to 54.4 in one week?

Not sure. It is possible your last E2 lab was bogus. Also, is this a sensitive test? If not then you could be getting random numbers for results.


2. What do you guys think of my plan with the Arimidex (first trying .5 mg every 3 days for 5 weeks, than trying .5 mg EOD for 5 weeks, and than trying .5 mg ED for 5 weeks ONLY incresing the dosage if my labs keep showing my estradiol is high)?

I think it sounds OK as long as you know your E2 test is valid.


3. Would the low FSH and LH be causing ED problems?

Nope. As a matter of fact you are wasting money testing LH and FSH now that your HPTA is suppressed.


4. Can a Urologist do tests to see if something is causing my ED problems?

Not sure.


5. How did the rest of my labs look?

It's hard to tell without knowing which lab did the test and what the ranges are. Please post all lab info including the name and location of the lab as well as all lab results WITH ranges.


6. Is the fact that my endo will only do labs AT MY PEAK POINT going to cause any problems? I get my shots on Thursdays and he wants my labs drawn on Mondays.

Four days after a Testosterone Enanthate shot is probably not at the peak. The peak is probably at least a day, maybe two earlier than that.

Can you guys please help me?

[Vic Mackey]

By the way fellas, my insurance covered the Arimidex. I only had to pay a $15 dollar co-pay. He wrote me a script for (15) 1 mg tabs with no refills.

[medgerton]

Originally Posted by Vic Mackey

My endo than ASKED ME what dosage we should try!!! He ASKED ME!!! I told him I would try .5 mg every 3 days for 5 weeks. After labs, if it's still high, I will move up to .5 mg EOD for 5 weeks. After labs, if it's still high, I will move up to .5 mg ED. And than will get labs again.

Basically, he told me he has no experience with prescribing Arimidex to his TRT patients. This scares me to death. I'M TELLING HIM WHAT DOSAGE WE SHOULD DO!!! THE ENDO ASKED ME!!!

Same thing happened to me with my initial Internist who prescribed T gel for me. I told him to double the dose after starting at 5 g Testim and 2 week labs and clinical symptoms showed I was too low. He wasn't sure what to do. So he welcomed my suggestion.

You need to change your thinking of the relationship between you and your doctor. He doesn't have the experience to tell you exactly what to do. So the usual doctor patient relationship where the Doctor dispenses information and prescriptions and you just listen does not exist here.

The good point is that he is willing to listen to you and work with you. So you have learned some stuff from this Forum and others. Go ahead and put it to use. Your Arimidex plan sounds OK. 0.5 mg every 3rd day then retest at a month and adjust. I am no medical professional but from my own experience and what I read here that dose and retest and adjust sounds OK.

Bottom line for me was that I didn't want to be the expert in my relationship with my Doctor so I made an appointment with an expert, Dr. Crisler. Now, I don't worry about figuring this stuff out on my own.

But your way can work. It is higher risk and takes longer. You can think of yourself as a medical school instructor filling in a few gaps in your Doctor's knowledge.

[may19th2001]

It really does sound like the Dr is going to help you.
I think it sounds like a quite acceptable treatement plan, so it sounds like you are going to get somewhere with this Dr and you already have.
It really sounds like the Dr wants to help you.

Originally Posted by Vic Mackey

He said if I ever want to have a kid, while trying to have a kid I WILL HAVE TO include HCG in my regimen. He said it's also good if I don't like having my somewhat atrophied nuts. I told him that was the least of my concerns right now. He said he wants to hold off on HCG now anyway until I get my testosterone/estrogen ratio in check.