Background: Most who have read my posts will know this- I am 57, <15%BF on TRT (100mg/wk test cyp) for 8 months, T alone for 2 months, libido spiked then crashed, added HCG which helped but still felt that something was wrong/crappy, even with TT close to 1000, with strong androgenic and anabolic response.

I inject T IM and HCG 250iu SQ both EOD with insulin needles. (Weekly injections were hell.)

I have been on AI(aromatase inhibitor) for 2.5 months; 1mg/wk of Arimidex. Since then, things have been getting better and better. Best sex of my life, wife (19 years younger) is saying the same thing. Often I feel like I have had major wood all through the night and waking wood as well.

So AI took me from low libido and occasional ED, low energy to my current self. I have to wonder if TRT can ever be good without AI. My E levels were normal mid-high. Obviously one's E does not need to be above 'normal range' to be creating a lot of problems. If you don't feel that TRT without AI is working right for you, get after your doc and don't take 'normal range' for an answer.

You need to be treated for your symptoms, not your lab report. The major on/off observation for me was a fast transition from nocturnal wood only to also getting morning wood with AI. Someone else on T-Nation put that thought into my head and I think that that is a very significant criterion. Higher levels of T on lab work is not the sole objective, it is how you feel. Libido is a tricky balance, more than normal ranges on lab reports. You do not need to have gyno or fat belly to have E interfering with your T receptors.

One lingering thing that I would like to understand is how a SERM* might work compared to AI in this type of situation.

* 07/25/08: A SERM is completely unsuitable for long term use.

Well, KSMan, I hope to be in your shoes sooner than later. Some of us don't know our E2 because our MD didn't test it. I can't wait to see the endo on the 17th. Hopefully, he knows what he's doing and will get me on HCG right away. AND, hopefully, he'll test my E2. Did my 3rd injection this past Friday, and still don't wake up with wood. It seems to me that this is all due to high E2. We'll see what happens. I'm also thinking of changing my syinges and injecting 2x/week, then eventually progressing to EOD.

Mike

You my friend are preaching to the choir.

I have relatively ok test levels(490). Im one lean dude as well at 8% BF. Hell, I have a 4 pack. No gyno, no bloating, etc etc. And Im only 27!

My E is within range, sort of. 47. with a 10 - 50 lab range.

Yea, something is definitely not right. No morning wood. Emotional at times. Libido comes and goes. So yea, i have some of the side effects as well, despite the fact that Im in normal range.

AI therapy along with TRT is a must.

KSman, have you experimented any with the time of day for your injections? Does it make any difference? I'm just wondering if it is better to inject in the afternoon when normal cycles would put test at its lowest.

It seems to me that if you inject in the morning, when natural cycles are at a high, then you're increasing your chances of aromatization. But if exogenous test is shutting down natural production, then would it matter?

I am also not feeling the best on trt without hcg or arimidex. I was using it but switched to a DR. that could get it on my insurance. He didn't want to use any thing but test cyp 200/2weeks. needless to say felt horrible.

I have started with a new DR. that has me on 100/ week. but also I was still missing something. She is consulting a 3rd doctor and we are going to start an hcg/ arimidex protocol also. Hopefully soon.

I was on 5g of Androgel for 90 days with good results. Estrogen level though after 90 days was 37. Dr. added 1/2 mg of Arimedex twice a week. What a difference. Libido is way up and T levels are around 600 from 450 before the Arimdex. My Dr. told me the optimum E level is between 18 and 25ng.

This is a really good thread!

Just had a long chat with my endo about all of this, along with how I'm doing, and he related the following. Most of his guys do just fine on the gels, though most of them wind up at 10 grams/daily dosage. Some of those guys, who like me are non-absorbers, get switched to T-cyp injections starting at 100 mg/weekly and do just fine there.

Some need moderate dosage adjustments. Only a very few need any sort of AI control, and he does treat his patients according to their symptoms/response and not just to the bloodwork. So, as you can see, I really like this guy!

In my case, once I got off the 4 months of gels and went onto weekly 100 mg T-cyp injections I felt fantastic for about 3 months. I literally felt that I could warm up by beating up the Hulk and King Kong at the same time, then proceed with banging each one of those models from the Victoria's Secrets fashion show recently on tv then finish the day by driving railway spikes with my member.

A little over the top perhaps, but I never felt that good before in my life. In time, this feeling faded and I began to do some experiments to try to get it back. Dosing above 140 mg/weekly made things worse, perhaps due to E2 conversion and/or going above the top of the range. Bi-weekly 60 mg shots were somewhat better, but nothing significant. 0.20 mg of liquidex bi-weekly really made things worse for me, as I completely lost my libido and suffered a persistent headache.

What I am left with is 100 mg every 5 days seems to be my happy spot. This keeps my total T in the range of 1100 ng/dl at the peak and the mid 700s at the trough which is "high normal" per the Quest labs range of 280-1100.

My free T runs at 3% of total, and I have no idea where the E2 is at as the endo doesn't test it without any symptoms to indicate it's a problem area. My liquidex experiment indicates that it must be "fine" where it's at without needing to go lower.

So, how do I feel at age 46? Pretty much like I did in my early 20s as far as I can recall. No, I don't have that unbelievable libido I had when I first started the T-cyp, but it is in line with where it was in my early 20s. I chase my wife around the bed every night, young ladies I encounter cause the expected physical reaction and lust filled thoughts, and overall I am a lot more self confident and more aggressive; just like I was in my early 20s.

My endo explained that most of his guys relate the same story about first starting out with an incredible response to testosterone replacement which slowly fades to a "normal" feeling as the body's response to the acceleration in testosterone levels.

Once you hit a steady state you don't feel superhuman anymore, merely "normal". This sounds like so much non-scientific baloney, but it matches my experience. Seemingly the only way to get that feeling back, from what I infer from other steroid message boards, is to go on an anabolic cycle, but even then it's only temporary. Not something I'm considering.

Good luck to all you guys who need to keep tweaking your HRT. I hope everybody reaches their own happy spot as quickly as they can. It's truly amazing how "normal" feels so much better than low-T.

Did the doc prescribe the AI in response to your reports on libido?


No, he prescribed it because my estrogen level was at 37 and he thought it should be less than 30. He also asked if I had any weight gain or nipple sensitivity, which I don't. But he prescibed it anyway.

Hi - I am 2 weeks into tcyp 100/weekly. Decided to get a blood test 2 days after the first shot, which showed no change in numbers. I guess it takes awhile. For the first time, I had them check estrogen level as well. I was told it was 192, which must be from a different scale than what I see here on T-Nation.

Can anyone interpret this number for me ? I was unable to spend much time on the phone getting the doc's take on that number but I assume if it was too high or low, she would have let me know. Thanks - PV

I have been having estrogen issues since adding the androgel. I think it may be the hcg putting me over the top. No morning wood, bloating, nipple swelling, pissy, etc. It seems like everytime I inject the hcg I get an e2 surge then it goes down till the next injection brings it back up again.

I have a blood test on friday so I guess I will find out what my e2 is.

Last blood test was on HCG only 350 iu eod.

Total t 501ng/dl
E2 I think the doctor said it was 29

After that added 5 g androgel a day and lowered hcg to 250iu

Guys on another board have suggested DIM before trying arimidex.

You guys have any ideas.

Thanks

What is your estradoil levels e-loo?

Dead, every 5 days might be a bad, bad idea.

Spikes in test is a major cause for test to estradoil conversion. Spikes in test also cause SHBG to go up as well. Your experiencing a 400mg spike in test weekly!(from 700 - 1100!). I personally wouldn't be comfortable with that. You really should look into EOD.

Busy thread today!

E surging after injecting and when to test for E: I guess that is where EOD injecting comes into play. Things are very level and no issues with when to test for E etc.

HCG and E: The testes do convert some T-->E. So if the testes are working normally, then normally some of that will always be going on. If one takes 250iu EOD SQ, their testicular function should be close to normal and not over stimulated. So this should not be a problem. When I was on T only, I think that I was really feeling E problems. Felt better on T+HCG, but there was still an E problem with that.

Perhaps adding HCG, which will increase T levels will simply increase E by virtue of the TT levels and nothing disproportionate from the HCG. However, the T levels in the testes , when operating normally, are about 100 times greater than serum levels, so there is a lot of fuel if aromatization in the testes is more than expected. But as men age, the aromatization seems to increase. But I feel that having a normal set of balls is needed to go with my vastly improved sex life. And HCG is cheap, even if no insurance or insurance will not pay.

I do not know where all of this HCG-E concerns come from. Perhaps from some of the insanely high doses that have been used in PCT. I am glad to see some speaking out against those practices.