# Importance of AI's in TRT??



## Darkhorse1 (Apr 1, 2014)

First formal post here, guys, so i hope this is the right place for it...
Just got through reading the "estrogen conundrum..." Which is hands down the single best breakdown on estrogen and testosterone I've ever read, but I have a question. 
When I started using AAS's, the use of anti E's and AI's was ONLY for when they were actually NEEDED because it was thought it would decrease the efficacy of the AAS's secondary to binding site competition, so I am essentially BRAND NEW to the idea of using AI's/ AE's as part of therapy or cycles. 
My question is this...
Is it just as important to use an AI during TRT therapy??
I'm really interested in this because my TOTAL T is HIGH NORMAL and I still feel as though I am androgen deficient and I've been wondering if this is the reason why??
The "rub" in this idea though is my prolactin level is DEAD CENTER NORMAL!!
Unfortunately, I do not have all the numerical values and my labs are incomplete because my GP is a FUGGIN MORON and WON'T DO a comprehensive draw for me. 
I'm going to be looking into the "privatemed" labs as I've just learned about that here, too!!

Thanks for any input!!

DH


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## PillarofBalance (Apr 1, 2014)

I think what you're getting at is that your free test is low? Is that what you mean by androgen deficient? If I'm wrong why don't you describe for us what it is that leads you to believe this.

If that's the case, you want to see where your Sex Hormone Binding Globulin (SHBG) is at.  Compounds like winstrol can help that as well as (I think) Drostanalone and proviron.


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## Darkhorse1 (Apr 1, 2014)

Pillar,
Sorry about the lack of description. 
The only values the MD had drawn was total test and that was at the very top end of normal. 
I, however, still FEEL extremely sluggish, low libido and generally listless, as if my test levels are LOW. That is what I had meant by "androgen deficient". 
I'm on 200 mg test cyp Q two weeks. 

DH


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## PillarofBalance (Apr 1, 2014)

Darkhorse1 said:


> Pillar,
> Sorry about the lack of description.
> The only values the MD had drawn was total test and that was at the very top end of normal.
> I, however, still FEEL extremely sluggish, low libido and generally listless, as if my test levels are LOW. That is what I had meant by "androgen deficient".
> ...



Yeah that every two weeks thing is bullshit. You'd do better with 100mg per week. My doc scripted me for 100mg every 5 days.  What was your total t on your last test? And was the test taken the day before your next injection?


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## PillarofBalance (Apr 1, 2014)

Seriously ask your doc why you are taking a medication that has a half life of about 7 days every 14 days. That is retarded. Ask if that's how he scripts other drugs like anti-depressants to his patients and if not then why is he singling you out for inadequate medicine?  If you have low test, that is a legitimate medical condition with very real effects.


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## DocDePanda187123 (Apr 1, 2014)

Darkhorse1 said:


> First formal post here, guys, so i hope this is the right place for it...
> Just got through reading the "estrogen conundrum..." Which is hands down the single best breakdown on estrogen and testosterone I've ever read, but I have a question.
> When I started using AAS's, the use of anti E's and AI's was ONLY for when they were actually NEEDED because it was thought it would decrease the efficacy of the AAS's secondary to binding site competition, so I am essentially BRAND NEW to the idea of using AI's/ AE's as part of therapy or cycles.
> My question is this...
> ...



The goal of TRT is to improve quality of life due and to do so most efficiently, you'd typically use the least amount of compounds and dosages necessary. The goal of TRT should be to not require an AI in the first place whenever possible. There are a few tricks to accomplishing this if you're interested but first we'd need to know some of your hormonal levels and what your TRT protocol is. Can you give anymore details on your therapy, post lab results, stats, etc?


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## DocDePanda187123 (Apr 1, 2014)

Darkhorse1 said:


> Pillar,
> Sorry about the lack of description.
> The only values the MD had drawn was total test and that was at the very top end of normal.
> I, however, still FEEL extremely sluggish, low libido and generally listless, as if my test levels are LOW. That is what I had meant by "androgen deficient".
> ...



Your doc has not sent you for a metabolic panel, CBC panel, E2 panel, free test, etc ??? I'd try to find another doctor if possible. 

What was your PRL levels? Just bc it was normal doesn't meant here isn't an issue with PRL as some are EXTREMELY sensitive to it and ANY elevation could cause issues...even if you're at the lower end of the range.


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## Darkhorse1 (Apr 1, 2014)

Pillar,
Personally, I agree w/ you in that the dose should be higher. I DO split the dose .5 ml (100 mg) Q/ week. 
What the total t was...it was a DOUBLE DIGIT value, so it was sort of an atypical test value, but it was at the very top end of the "normal range". Ill pay better attention and keep a file from now on, though. 
FWIW, I made an appointment to see someone I KNOW, who deals w/ hormones and is also a lifter. Ill feel much more comfortable w/  him. I just recently found out that he was a doc that does the "anti aging/ hormone therapy" in his practice. It'll be out of pocket, but I've been through the RINGER w/ endocrine and GP's in this area. This problem started when I was 25 and has been complicated ever since. I'm now 40, BTW. 
I'm curious about the privatemd route, though.


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## Darkhorse1 (Apr 1, 2014)

Doc,
Thanks for posting up and thanks for the GREAT write ups!
No. The GP, even after suggesting additional labs to him, rejected any additional lab work be done. Like I said, he's a dick and not happy w/ him. 
I have a Hx of ENT issues and see an ENT specialist. Talked to him about the possibility of a prolactinoma. That was how I got the prolactin levels drawn. It was 7.9, I believe. It was drawn later in the day after work and gym and such. 
In considering the idea that there was some E2 related issues, I picked up some Aromasin. I've been doing .25 ml/ q day, but after reading your article, it would seem that is a bit much.


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## Darkhorse1 (Apr 1, 2014)

Sorry..
My stats are
40 y/o
6'2"
225
15% BF (guessing on that)
My appt. w/ the new MD is on the 25th of April, so ill know more, then. 
What started this whole thing was pro hormones when I was 25. VPX had a test/ deca "stack" that I was on for about 3-4 wks and everything went down hill from there, while I was on that. 
Went to GP, urologists and endocrine docs... Nobody wanted to do anything because I was so young. Started self medicating w/ AAS's and have been, since. 
Historically, when I had seen the endocrine guy, he had me off everything for 6 mos. at that time my test was waaaaay low, like 109 and the LH/ FSH was DEAD NORMAL. 
GOD, I'm a ****ed up mess, but I'm trying to get a handle on it. 

Thanks for listening!!


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## DocDePanda187123 (Apr 1, 2014)

Darkhorse1 said:


> Doc,
> Thanks for posting up and thanks for the GREAT write ups!
> No. The GP, even after suggesting additional labs to him, rejected any additional lab work be done. Like I said, he's a dick and not happy w/ him.
> I have a Hx of ENT issues and see an ENT specialist. Talked to him about the possibility of a prolactinoma. That was how I got the prolactin levels drawn. It was 7.9, I believe. It was drawn later in the day after work and gym and such.
> In considering the idea that there was some E2 related issues, I picked up some Aromasin. I've been doing .25 ml/ q day, but after reading your article, it would seem that is a bit much.



Are you primary or secondary? I wouldn't really jump on an AI before knowing my E2 values.


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## DocDePanda187123 (Apr 1, 2014)

Darkhorse1 said:


> Sorry..
> My stats are
> 40 y/o
> 6'2"
> ...



It's tough without more labs brother. Hopefully your new doctor will allow tests done. Also look into HCG as it's a good addition to any TRT regimen. 

If you're interested in the private labs route go to the anabolic forum and up at the top there's a write up about how to go through privatemdlabs. Another brother in here, Assassin32, pointed me out to labsmd which had the same labs but for cheaper (and total test was a sensitive panel).


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## Megatron28 (Apr 1, 2014)

On your injection protocol, there is a very good chance that your TT and E2 are on quite. A roller coaster ride as you go from peak to trough.  You need to even out your levels.  This can be done by splitting your dose and injecting every 3.5 days.  Do that for about a month the and then get blood work.

Are you donating blood every 56 days?  Exogenous test raises hematocrit levels.

You can get your own blood work without the need to go through your doctor.  Go to www.privatemdlabs.com and get the Hormone Panel for Females (for men too).  It costs about $50 and your get the results in about 24 hours usually.  Show the results to your doc and tell him you decided to go there because it is cheaper than using their lab.  Most docs will respect that you don't have unlimited funds to pay for medical bills.


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## Darkhorse1 (Apr 1, 2014)

Docd187123 said:


> Are you primary or secondary? I wouldn't really jump on an AI before knowing my E2 values.



Are you referring to hypognadism?
If so, secondary. 
FWIW, I feel petty good when I'm on high dose test (200-500 mg/ wk)
My source went away about a year ago and figured it was time to get this figured out and tow the line for a while. 
I've felt like shit ever since. Lol.


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## DocDePanda187123 (Apr 1, 2014)

How is it you're secondary but have normal LH/FSH? That would imply either you're primary hypo or took the test at a point when your testes were atrophied and incapable of responding to LH.


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## Megatron28 (Apr 1, 2014)

Docd187123 said:


> How is it you're secondary but have normal LH/FSH? That would imply either you're primary hypo or took the test at a point when your testes were atrophied and incapable of responding to LH.



Low T with low/normal LH and FSH = Secondary Hypogonadism.  
Low T with high LH and FSH = Primary Hypogonadism

If his pituitary isn't "yelling" at the testicles to make more testosterone it is Secondary.


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## Darkhorse1 (Apr 1, 2014)

Gentlemen,
I can NOT thank you guys enough for all the input and great information on this.
I am going to look into the "private" labs route in the interim before the appt next month and will try dosing the HRT more frequently. 
Megatron,
I've never given blood. Would that be a hemochromatosis you're referring to?
This is a great board so far, and I plan on settling in here. 
Ill post the labs when I get em done, either way. 

DH


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## Megatron28 (Apr 1, 2014)

Darkhorse1 said:


> Gentlemen,
> I can NOT thank you guys enough for all the input and great information on this.
> I am going to look into the "private" labs route in the interim before the appt next month and will try dosing the HRT more frequently.
> Megatron,
> ...



Just go to the red cross or similar organization and donate a pint of blood.  When you get your blood work, always check your hematocrit which is part of the CBC panel.  If this isn't included you can look at RBC's or Hemoglobin.  They are just different ways of measuring how "thick" your blood is.


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## Darkhorse1 (Apr 1, 2014)

Docd187123 said:


> Are you primary or secondary? I wouldn't really jump on an AI before knowing my E2 values.





Docd187123 said:


> How is it you're secondary but have normal LH/FSH? That would imply either you're primary hypo or took the test at a point when your testes were atrophied and incapable of responding to LH.



My understanding of it is, secondary means there is an outside source or cause of the issue and primary would be a genetic or congenital trigger.


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## Darkhorse1 (Apr 1, 2014)

Alright. 
I've gotta get up to speed and more responsible it seems.


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## DocDePanda187123 (Apr 1, 2014)

Megatron28 said:


> Low T with low/normal LH and FSH = Secondary Hypogonadism.
> Low T with high LH and FSH = Primary Hypogonadism
> 
> If his pituitary isn't "yelling" at the testicles to make more testosterone it is Secondary.



I see what you're saying. I've seen it normal to high for primary and low to normal for secondary. Assumed it was closer to the high end


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## Megatron28 (Apr 1, 2014)

Darkhorse1 said:


> My understanding of it is, secondary means there is an outside source or cause of the issue and primary would be a genetic or congenital trigger.



No.  That is not right.  

In basic terms, primary means the problem lies with the testicles not working properly.  Secondary means the problem lies with the Pituitary not working properly.  LH and FSH can help determine which type of hypogonadism one has.


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## Darkhorse1 (Apr 1, 2014)

At that time, test was way low and LH/ FSH were dead normal. So no signal happening there. 
That I do remember. 
Thanks for the clarification


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