Nipple Pain Despite Normal E Levels

[Boscobarbell]

Hoping for a little help here. I've been on TRT for about a year and a half now (test cyp, thyroid, hcg). Almost immediately had nipple pain, and a subsequent blood test showed elevating E levels. I went on arimidex almost immediately. The nipple pain diminished but remained on one side (I have pre-existing gyno from prior andro use...small, maybe pea-sized).

Fast forward to today: the nipple pain remains, and I've noticed that the gyno appears to be just a bit bigger of late. My TRT provider is reticent to up my arimidex dosage, as my E levels are just fine (floating between 12 to 16 on most blood tests...it had risen as high as as the high 40's before starting the arimidex).

I'm looking for suggestions here, as I'm otherwise feeling great and would hate to stop TRT. But I'd also hate to get full-blown gyno and face surgery. Some quick questions:

1) I'm assuming that too-low E levels entail cardiovascular risks. But how depressed must it get to face those dangers?

2) Are there any SERMs that one can safely use long-term to combat such localized aromatization?

3) Are there any other meds/supplements that have proven successful (I'm already using DIM, with no discernible difference)?

Thanks for any help you can provide....

 

[1cc]

Nolvadex 20mg per day for 6-8weeks should help this. Once you stop Nolva, you will need to make sure your E2 does not go high again. What dosage of HCG are you doing? HCG can elevate progesterone which can also cause gyno.

 

[Boscobarbell]

Nolvadex 20mg per day for 6-8weeks should help this. Once you stop Nolva, you will need to make sure your E2 does not go high again. What dosage of HCG are you doing? HCG can elevate progesterone which can also cause gyno.

Thanks for the response. I'm on 500iu of HCG three times per week. Is there a way to combat the progesterone, if that's the culprit?

And re the Nolvadex, is this a short-term solution. In other words, am I likely to jump right back into aromatization once the 6-8 weeks is up?

Thanks again for your help....

 

[1cc]

Thanks for the response. I'm on 500iu of HCG three times per week. Is there a way to combat the progesterone, if that's the culprit?

And re the Nolvadex, is this a short-term solution. In other words, am I likely to jump right back into aromatization once the 6-8 weeks is up?

Thanks again for your help....

Your HCG dosage is way too high. Best way to reduce progesterone is to reduce HCG dosage. What is your TRT regimen currently? Nolvadex should resolve the problem, but unless the progesterone is addressed, it will return once you stop nolva.

 

[Boscobarbell]

Your HCG dosage is way too high. Best way to reduce progesterone is to reduce HCG dosage. What is your TRT regimen currently? Nolvadex should resolve the problem, but unless the progesterone is addressed, it will return once you stop nolva.

I'm on 100 mg of Test Cyp 2x/week along with the 500iu of HCG 3X/week. Also daily arimidex and thyroid.

Been doing some research re the progesterone issue you raise. I'm guessing that most would recommend both cutting the Test to 100 every 5-6 days, and then HCG @ 250 2X/week? I've got some reticence in cutting the Test, since I've been feeling so great at the current dose, but my blood work is coming in at the very top of the "average" scale, so I suppose I have some margin of error there.

Anyway, thanks to your comments and my research, I'm considering asking my TRT provider to start an immediate 6-8 week course of nolvadex, and concurrently dropping the doses as outlined above.

Sound like a plan, or am I missing something here?

p.s. BTW, I'm wondering if alcohol plays a noticible role in rising E levels while on TRT. I'm no booze-head, but I do have a couple of glasses of red wine every night. Something to worry about?

 

[taser]

hcg should be 250 iu 2x per week on the 2 days prior to your next T injection. did i read your post correctly,you are using 100mgs of test cyp 2x per week; 200mgs total per week? thats too high. 100 mgs is plenty with the hcg. that is a bodybuilding dosage and possitive effects will diminish over time with 200 mgs.

 

[Boscobarbell]

hcg should be 250 iu 2x per week on the 2 days prior to your next T injection. did i read your post correctly,you are using 100mgs of test cyp 2x per week; 200mgs total per week? thats too high. 100 mgs is plenty with the hcg. that is a bodybuilding dosage and possitive effects will diminish over time with 200 mgs.

You read it correctly. It never struck me as being particularly high since the bodybuilders I've trained with all use 500-1000mg/wk minimum. But after reading up more on this site and the allthingsmale site I see now that my dosage appears to be awfully high for TRT purposes.

So...does my plan to rectify things seem sound??

 

[1cc]

I'm on 100 mg of Test Cyp 2x/week along with the 500iu of HCG 3X/week. Also daily arimidex and thyroid.

Been doing some research re the progesterone issue you raise. I'm guessing that most would recommend both cutting the Test to 100 every 5-6 days, and then HCG @ 250 2X/week? I've got some reticence in cutting the Test, since I've been feeling so great at the current dose, but my blood work is coming in at the very top of the "average" scale, so I suppose I have some margin of error there.

Anyway, thanks to your comments and my research, I'm considering asking my TRT provider to start an immediate 6-8 week course of nolvadex, and concurrently dropping the doses as outlined above.

Sound like a plan, or am I missing something here?

p.s. BTW, I'm wondering if alcohol plays a noticible role in rising E levels while on TRT. I'm no booze-head, but I do have a couple of glasses of red wine every night. Something to worry about?

200mg per week is too much for TRT, and in itself will cause E problems.

Here are a few scenaros:

1. 100mg IM once a week 250iu HCG on 2 days before shot in the morning
2. 43mg IM Every 3 days 250iu HCG day before next T Cyp shot.
3. 43mg SubQ every 3 days and you may not need HCG

Labs to be taken day before next T Cyp shot and 2-3 hours after HCG shot

Alchohol will increase aromatization. I experienced this particularly when doing shots (nipple sensitivity after drinking a little).

 

[Boscobarbell]

200mg per week is too much for TRT, and in itself will cause E problems.

Here are a few scenaros:

1. 100mg IM once a week 250iu HCG on 2 days before shot in the morning
2. 43mg IM Every 3 days 250iu HCG day before next T Cyp shot.
3. 43mg SubQ every 3 days and you may not need HCG

Labs to be taken day before next T Cyp shot and 2-3 hours after HCG shot

Alchohol will increase aromatization. I experienced this particularly when doing shots (nipple sensitivity after drinking a little).

Looks good! Off to contact my TRT provider. Thanks for all the advice!

 

[Boscobarbell]

I'm bumping this after a couple of telcons with my HRT provider.

First, it's apparent that I need to find a better service, as they were completely ignorant regarding the use of nolvadex for gyno, and even of the difference between it and anastrozole. They were also reticent to get me prescription until I got more blood work done and scheduled an appointment with my doc...not what you wanna hear when you've been complaining about nipple pain/swelling for a number of weeks already!

Anyway, I've been doing further research and am certain that I need to get on more moderate doses of both hcg and test. My provider also doesn't wanna hear that, as he says my blood levels are "textbook."

Anyway, two questions:

1) Do I just immediately diminish the doses back to more suitable levels, or do I need to perform some type of taper? And do I need to add in clomid or anything else while dropping down?

2) Anyone know of a good TRT provider in New England? I live in RI, but would be willing to drive into CT or MA (which I currently do) in order to find someone a bit better at this?

Thanks for all the help....

 

[MacDonnell]

BTW, I'm wondering if alcohol plays a noticible role in rising E levels while on TRT. I'm no booze-head, but I do have a couple of glasses of red wine every night. Something to worry about?

Bosco,

I also have a couple of glasses of wine or cocktails every night before/with dinner. My E2 is fine. So, although drinking is not recommended with TRT therapy, I think if you're conservative, you should probably be okay. Ideally, a no alcohol policy is best....but that is DEFINITELY NOT an option for me! Also, I'm sure it's very individual-specific. As someone who is already having gyno probs, you may want to think about temporarily cutting back on your alcohol consumption until your problems are corrected. Think of it as an early lenten sacrifice.

Mac

 

[Boscobarbell]

Bosco,

I also have a couple of glasses of wine or cocktails every night before/with dinner. My E2 is fine. So, although drinking is not recommended with TRT therapy, I think if you're conservative, you should probably be okay. Ideally, a no alcohol policy is best....but that is DEFINITELY NOT an option for me! Also, I'm sure it's very individual-specific. As someone who is already having gyno probs, you may want to think about temporarily cutting back on your alcohol consumption until your problems are corrected. Think of it as an early lenten sacrifice.

Mac

Not a bad idea. I'll just have to find some other vices to tide me over.....

 

[1cc]

1) Do I just immediately diminish the doses back to more suitable levels, or do I need to perform some type of taper? And do I need to add in clomid or anything else while dropping down?

2) Anyone know of a good TRT provider in New England? I live in RI, but would be willing to drive into CT or MA (which I currently do) in order to find someone a bit better at this?

I think it would be best to take Nolva until your gyno symptoms go away. I think it would be a good idea to stop TRT for 14 days until your body has gotten rid of all the excess T. You can then resume at 43mg every 3 days, which works out to 100mg per week. Even this dose may be too much, which you can check with labs. I believe DR. John uses as much as 40mg Nolva for gyno, but this must depend on severity. You may want to consider consulting with him at www.allthingsmale.com.

Here is a post by Swale on treating gyno:
https://thinksteroids.com/community/threads/134240469

Here is a study on treating gyno with Tamoxifen:
https://thinksteroids.com/community/posts/453014

 

[lou123]

I'm bumping this after a couple of telcons with my HRT provider.

First, it's apparent that I need to find a better service, as they were completely ignorant regarding the use of nolvadex for gyno, and even of the difference between it and anastrozole. They were also reticent to get me prescription until I got more blood work done and scheduled an appointment with my doc...not what you wanna hear when you've been complaining about nipple pain/swelling for a number of weeks already!

Anyway, I've been doing further research and am certain that I need to get on more moderate doses of both hcg and test. My provider also doesn't wanna hear that, as he says my blood levels are "textbook."

Anyway, two questions:

1) Do I just immediately diminish the doses back to more suitable levels, or do I need to perform some type of taper? And do I need to add in clomid or anything else while dropping down?

2) Anyone know of a good TRT provider in New England? I live in RI, but would be willing to drive into CT or MA (which I currently do) in order to find someone a bit better at this?

Thanks for all the help....

Dr Ilja Hulisky in Easton, CT specializes in HypoG 203-374-4490. I would just cut your cyp dose to 100 mg/week and your HCG to 250 per shot.

 

[Boscobarbell]

Thanks again for the help, guys!

 

[supwiz]

200mg per week is too much for TRT, and in itself will cause E problems.

Here are a few scenaros:

1. 100mg IM once a week 250iu HCG on 2 days before shot in the morning
2. 43mg IM Every 3 days 250iu HCG day before next T Cyp shot.
3. 43mg SubQ every 3 days and you may not need HCG

Labs to be taken day before next T Cyp shot and 2-3 hours after HCG shot

Alchohol will increase aromatization. I experienced this particularly when doing shots (nipple sensitivity after drinking a little).

What has been your experience with doing the tes injection subq? would you inject it in the belly area like a hgh shot? Does it seem to work as well as the im injection? I havn't seen much on this but it sounds interesting.

 

[1cc]

What has been your experience with doing the tes injection subq? would you inject it in the belly area like a hgh shot? Does it seem to work as well as the im injection? I havn't seen much on this but it sounds interesting.

I personally have not done T Cyp shots Subq. Dr. Shippen does all his T Cyp shots SubQ. He claims that it leads to more stable T levels and less aromatization. This is similar to the way pellets work, namely a slow release from the SubQ area.

Here is one of a few threads on this subject:
https://thinksteroids.com/community/threads/134237662

 

[Boscobarbell]

Okay...the good news just keeps rolling in!

Saw my GP doc yesterday (not my TRT provider) because I'm getting treated for HBP (which pre-dated my TRT regimen) I just finally smartened up and got it looked at. Anyway, the general blood work came back and...for the first time in my life...I have high cholesterol! I was always relatively low (low to mid 100's), but the latest test came back at 220.

It's important to note that I eat like a monk: mostly whey protein, egg whites, lean meat, lots of fish, lots of greens, fish oil, virtually zero "junk".

I'm suspecting that my high TRT dosages might be the culprit. Does this make sense?

 

[Boscobarbell]

Okay...the good news just keeps rolling in!

Saw my GP doc yesterday (not my TRT provider) because I'm getting treated for HBP (which pre-dated my TRT regimen) I just finally smartened up and got it looked at. Anyway, the general blood work came back and...for the first time in my life...I have high cholesterol! I was always relatively low (low to mid 100's), but the latest test came back at 220.

It's important to note that I eat like a monk: mostly whey protein, egg whites, lean meat, lots of fish, lots of greens, fish oil, virtually zero "junk".

I'm suspecting that my high TRT dosages might be the culprit. Does this make sense?

Hey, guys. Just wanted a quick bump on the above question, along with a couple of other questions if ya'll have the time:

a) I've just started nolva--yup, my provider finally got it through his head that I needed it--and was wondering if you guys recommended going off or perhaps lessening the dose of my anastrozole while on the SERM.

b) Either I had a helluva couple of workouts, or I'm getting some joint pain from the nolva?

Once again, thanks guys....

 

[keaster]

Hey, guys. Just wanted a quick bump on the above question, along with a couple of other questions if ya'll have the time:

a) I've just started nolva--yup, my provider finally got it through his head that I needed it--and was wondering if you guys recommended going off or perhaps lessening the dose of my anastrozole while on the SERM.

b) Either I had a helluva couple of workouts, or I'm getting some joint pain from the nolva?

Once again, thanks guys....

Drop the anastrozole. Used in concjuction with a SERM lowers the effectiveness of both, if I am not mistaken.