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I continue to have issues with what appears to be estrogen. Pre TRT my estradiol was 88 nmol/l. Shortly after starting, I had very spicy nipples and general tingling and heat my pecs, anxiety through the roof. My entire chest gets hot and tingly. My clinic started me on 0.25mg anastrozole twice a week. It's been 4 months now and my estradiol levels have gone down to 44 nmol/. I try not to take the Al at all and usually end up taking 0.25mg once a week or sometimes once every 2 weeks (only when the symptoms are over whelming). But I'm curious why even now at 44 nmol/l a level that is half of what it was pre TRT, why do I still get spicy nipples, anxiety and a hot chest with tingling?

AlphaMD's Answer

I'm going to let you in on a little secret in mens health. Its an easy one to remember:Average estradiol levels for men age 18-25 (when we are at our peak health wise) is 18-25 nmol/L. So "ideal" estradiol is 18-25 nmol/L. Many men can tolerate higher levels without symptoms, but it is common for us to see symptoms develop above 40 nmol/L. At 44 nmol/L, I am not surprised you still have symptoms.

It is likely that your levels spike above 44 on the days of injection, and so you would be feeling the change, the spike. It would be ideal to find an AI dose to take consistently rather than off/on like that. It seems like 0.25mg twice weekly would be a good fit for your issues, considering you have such a reaction. Some men are sensitive to Estrogen itself and transference. Some can have much higher levels than you and not care at all. This is probably just how your body is. Alternatively you can aid in the Estrogen reduction by increase injection frequency and switch to Subq if not already.

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