You guys wont believe this!

[legbuh]

You're lucky to have an open minded doc. He's helping you and learning so he'll also help others in the future.

I had no such luck with my doc. With TRT or anything else I've seen him for.

[00slotiv]

Originally Posted by 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.

Arimidex is very potent, believe me. .5 mg EOD or ED I bet would trash your E2. Knowing what I do now I would ask for 0.2 or 0.25 mg compounded Anastrozole (same thing) EOD or E3 and check in a month.

Higher amount of testosterone than usual if you are new to it, but hey, you may really like it. I know I would.

Bob

[TryingToFix]

Originally Posted by Vic Mackey

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 thought for the arimidex is you are starting in the middle of the range with respect to what Dr. C mentions using in his paper. Why not start at one end (smaller) as it is mentioned that it is a potent medication and work your way up in a controlled study fashion? Plus with those two test results it is a big range to know what is reality.

You are missing SHBG, very important to know if and how much your body is binding T. Comprehensive Metabolic Panel includes albumin and CBC Panel contains your hemoglobin and hematocrit to make sure your blood is not getting too thick.

E2 being at either of these levels can cause ED, may need to get some of these values in check to see if ED remains.

If E2 is truly at this high of a level taking arimidex will stop the aromatase conversion and thus make T go up.

JanSz had a link to a detail study on Thyroid with respect to T4 and T3 vs just T4.

The only other comment is that you are change several variables at once. In a controlled study that is great if you can hit the results the first time, but usually hard to do.

[Dr. John Crisler]

I have to tell you I think your Endo is pretty sharp. I concur.

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!!!

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.

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?

[canthavetoomanytoys]

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.

I would not dismiss the importance of HCG for preserving the nuts, libido, and other aspects. Although against recent practice here, adding the HCG before dialing in everything may be helpful and will avoid a new "dial-up" in the future. I believe that I read the Dr C now adds HCG at the start.

[buck]

A Dr. that can say I don't know. Is open minded and willing to listen and learn. Sounds like a keeper to me. I have had a couple that were at the other end of the spectrum.

[Vic Mackey]

I've added two questions to my list:

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?

[agoraphobe]

hey vic i'd just like to say you should consider yourself very very fortunate that your dr is allowing you to take charge of your own protocol and educate yourself and him where possible.

before you said it scares you to be telling him what you want to do with arimidex, i was thinking to myself "wow that's pretty cool his doctor is allowing this".

there's only a handful of doctors in our country who know how to or are willing to engage in attempts at hormone optimization... you should have the expectation that any doctor you talk to will have no clue about using arimidex on men but would probably would be against it on principle.

you got a guy who knows enough to help but is kind enough to allow you to help yourself as well.. outside of an ACTUAL specialist like dr crisler this is as good as it gets.

mind telling us who this endo is and the city he works out of?

[chilln]

Originally Posted by 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.

I recommend discussing with your medical professional adviser to avoid 0.5mg, no matter what schedule you're one.

Better to opt for 0.25mg at most, on any day. There are very very few males who do well on 0.5 mg dosing.

If you're converting T into E2 so quickly, then better to drop total T to lower, where T will convert into E2 less quickly.

T converts into E2 more quickly when T levels start rising higher than your body's genetic optimum for T.

T converts into E2 super fast when T levels are very much higher than your body's genetic optimum for T.

T converts into E2 nice and slowly when T levels are close to your body's genetic optimum for T.

###

While many of us have bodies whose genetic optimum for T is too low for optimal health, and as a result we're stuck on arimidex dosing for life, we also know that managing E2 via arimidex is actually quite tricky, and it's easier the less arimdiex we need, and it's more difficult the higher the arimidex dosing is.

.

[cpeil2]

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!!!

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?

THe arimidex is too high. Dr. C's maxim is to '"Start low, go slow" for the greatest possibility of a successful outcome. Start with .25 2x/week. If not enough, go to 3x/week. If not enough go to .5 for one dose out of the three ,etc. Do it that way and there is less of a possibility that you will overshoot your sweet spot.