I'm on doc prescribed TRT at 175 mg of test cyp weekly and my estradiol is 112

Vic Mackey · #1 12-07-2009

Dr. Crisler, I need your help.

I'm on doc prescribed TRT (at 29 years old) at 175 mg injections of test cyp weekly. I just got some bloodwork back (I get my shots every Thurs afternoon, this draw was taken Thursday morning BEFORE my shot) and my test came out to be 949 ng/dL and my estradiol is 112 pg/mL (should be <=54 pg/mL). I'm also taking DHEA 50 mg daily (25 mg morning/25 mg evening) and NatureThroid 1/12 grain daily.

Over the last 9 months my doc (a wellness doctor) has slowly been upping my test dosage (from weekly injections of 125 mg to 150 mg to 175 mg). And as my test ng/dL has been rising so has my estradiol pg/mL. He had me taking Indole Forte for a couple months. That didn't work and my estradiol raised. Than he had me taking Calcium D-Glucorate for a couple of months. That didn't work and my estradiol raised.

Now this is my problem:

Over the last 6 weeks I noticed something: my erections ARE WEAK AS HELL. I'm talking very small. I can't understand it because my sex drive is through the roof. And plus my testosterone is very high so I'm baffled. My doc says even though my test is high, my estrogen is also very high and that is what is keeping my erections from being real hard and stiff. He said my estradiol should be 40 pg/mL. I also asked if the DHEA (which I know can convert to test and ESPECIALLY estrogen in men) could be causing this. He said no way would DHEA be causing your estrogen to sky rocket like this.

My solution was to add Arimidex to the mix (which I've been suggesting to him for months). His response: I do not prescribe that because of all the side effects. I will never prescribe you any anti estrogen other than Indole Forte, Calcium D-Glucorate, or Progesterone Creme. So I asked what do we do next? He said he will lower my test from 175 mg weekly to 125 mg weekly. I asked if that didn't work what do we do. He said we could than try a progesterone creme.

He also mentioned maybe my ED problems are something more and I should maybe see a Urologist for some tests. I don't think that's the case because a couple months ago I was getting rock solid.

I'm confused more than ever.

A few questions:

1. Even though my test is high, would my high estrogen be causing ED?

2. Even though I'm taking no anti estrogens right now, would him lowering my test dosage from 175 mg to 125 mg weekly lower my estrogen to normal levels? How long will it take? Should I even have him go lower and only give me 100 mg of test a week?

3. If all else fails, and I start taking the progesterone creme...would that work? Is progesterone creme an effective anti estrogen? How long will it take to work?

4. How do you explain that my sex drive is through the roof but I can't get it up?

5. I have a meeting with an endocrinologist Tuesday. I'm going to get a second opinion. Do endocrinologists presrcibe arimidex to men with my situation or am I wasting my time?

6. Last but not least, if I were to have my doc fax my bloodwork over to you, would you be able to fax me a script for Arimidex Dr. Crisler? You could even speak with him on the phone if you wanted. Sir, I want to apologize in advance if it's against board rules to ask you this kind of thing. But please believe me when I say I need help and my doctor is slamming a door in my face.

A couple points:

*Last year before I got on TRT my test was real low (206 ng/dL) and because of that I had ED. Since I got on TRT (until a couple months ago) I had NO ED PROBLEMS WHAT SO EVER.

*For those of you who will suggest I go see another doctor, there is no other TRT doctor anywhere near where I live. He is the only one. And he vehemently will not prescribe Arimidex. I'm stuck with him.

*I refuse to go black market to get AI's. That's not even an option.

*My doc is not a primary doc, endocrinologist, or urologist. He is a progressive medicine/wellness doc who specializes in TRT.

Dr. Crisler (or anyone) please help me make sense of this.

josh · #2 12-07-2009

Quote:

Originally Posted by Vic Mackey

Dr. Crisler, I need your help.

My solution was to add Arimidex to the mix (which I've been suggesting to him for months). His response: I do not prescribe that because of all the side effects.

There are no side effects to Arimidex. The only side effect you may notice is if you lower your E2 too far, but that's not a "side effect", that's a "dosage issue".

Quote:

Originally Posted by Vic Mackey

1. Even though my test is high, would my high estrogen be causing ED?

Yes. High Estrogen can negate positive effects of high testosterone, trust me on this one I know!!

Quote:

Originally Posted by Vic Mackey

*For those of you who will suggest I go see another doctor, there is no other TRT doctor anywhere near where I live. He is the only one. And he vehemently will not prescribe Arimidex. I'm stuck with him.

Seems like we need to get him to change his mind on the Arimidex...

Vic Mackey · #3 12-07-2009

Quote:

Originally Posted by josh

...Seems like we need to get him to change his mind on the Arimidex...

Let me make this as clear as day...HE IN NO WAY SHAPE OR FORM WILL EVER EVER EVER PRESCRIBE ME ARIMIDEX. EVER.

I have asked, pleaded, begged, even just about cried in his office. He won't do it.

What do I do now?

LowT · #4 12-07-2009

Quote:

I just got some bloodwork back (I get my shots every Thurs afternoon, this draw was taken Thursday morning BEFORE my shot) and my test came out to be 949 ng/dL and my estradiol is 112 pg/mL (should be <=54 pg/mL).

Your T is presumably at its lowest right before your next shot. A result of 949 is fairly high and indicates you are probably spiking at well over 1,000 (probably quite a bit) during mid week. This is going to spur a lot of aromitization and increase E2. Most guys would peak at that 900 level. Your T and E2 are probably too high. You haven't provided enough labs to say so though so we're guessing quite a bit.

Taking huge T doses and trying to offset that with an AI is a recipe for disaster.

At first glance, (without any other info provided) your dosing is probably too high and too infrequent. A solution would be smaller doses more frequently.

Best would be to find a doc that will allow you to self-inject on a more frequent schedule as a first step.

If more frequent lower dosing fails then a small dose of an AI is certainly an option. Your care is a two way street...your doc will have to agree or you have to change docs. You need to consult a doctor about these changes.

No one here can do much about either.

Vic Mackey · #5 12-07-2009

Quote:

Originally Posted by LowT

...Best would be to find a doc that will allow you to self-inject on a more frequent schedule as a first step.

If more frequent lower dosing fails then a small dose of an AI is certainly an option. Your care is a two way street...your doc will have to agree or you have to change docs. You need to consult a doctor about these changes...

As I said before:

Quote:

Originally Posted by Vic Mackey

...*For those of you who will suggest I go see another doctor, there is no other TRT doctor anywhere near where I live. He is the only one...I'm stuck with him...

LowT · #6 12-07-2009

Quote:

*For those of you who will suggest I go see another doctor, there is no other TRT doctor anywhere near where I live. He is the only one...I'm stuck with him...

Then it sounds like you're asking a rhetorical question.

Most of the people on this board travel hundreds of miles to see doctors like Dr. Crisler and others...distance doesn't have much weight around here. My two docs are both a few hundred miles from me.

More to the point...the solution I gave would be to talk to your doctor about more frequent dosing of smaller amounts to try and get a better baseline without spiking. Spikes cause more E2 as your body tries to neutralize the excess T.

Teegunn · #7 12-07-2009

You need a new doc. This one doesn't understand the balance of hormones well enough. Others gave advice of possibly lowering T dose and splitting it up into 2 injects per week, which I agree with and do myself. Self injecting isn't bad once you are used to it. Also, I need Adex. I take a small dose twice a week to help combat any possible esto sides. You may also consider HCG - this could possibly help with the ED problems, however I personally would probably wait and give the lower T, twice weekly shots and adex time to work before tweaking anything else in your protocol. This is just my 2 cents from my own personal experience. I have a doc who listens to my needs. He knows I do my research, but also seems to have a good basis on the subject of male hormone replacement. First thing you need to do is find a good doc who knows what he/she is doing. Good luck.

Vic Mackey · #8 12-07-2009

Is there a search engine of some sorts where I can find a doc who can help me?

Vic Mackey · #9 12-07-2009

If I were to get 100 mg weekly of test, would that get my test and estrogen to normal levels?

Keep in mind, I would than go from getting 175 mg of test a week to 100 mg test a week. That's a pretty big decrease.

josh · #10 12-07-2009

Quote:

Originally Posted by Vic Mackey

Is there a search engine of some sorts where I can find a doc who can help me?

What is your rough location?