On TRT and still struggling - Estrogen issues?

[mrgeeky]

I came across this in another forum and thought this was worth sharing as it might help some one else.
It has some signifigance for myself as my last blood test shows - Estradiol - 50 pnmol / L which is in the extreme end of the normal range. Or whats consider normal for older people. But who wants to feel old right?
So it looks like  Im going to have to look at some sort of A.I (Aromatise Inhibitor) which was something I really wanted to avoid..
Im quite over weight so am going all out to strip off some fat to see if or how much of a difference that makes to my estrogen levels before taking any A.I.
Funny enough, I feel fine but according to the read below, I could feel a lot better if I got my estrogen levels down a lot.
I'll post results after next blood tests..
52 years old.
Im currently just over 5" 11 and weight 114kg.
Goal weight, low 90Kg's.
Currently on 40mg x 5 per day of Andriol testocaps!
Recommended dose is 40mg to 160mg per day.

 

"Estradiol is an estrogen. It is known on blood tests as E2. Many people (even doctors) simply call it estrogen.

Why it Matters

There are basically two reasons we care about estradiol.

The first is that E2 is a powerful testosterone receptor antagonist. What this means is that estradiol binds to androgen receptors and renders them useless. When testosterone binds to an androgen receptor, it activates the receptor and you get the effect you're looking for. When estradiol binds to that receptor, it blocks testosterone from binding, yet it does not active the receptor, so nothing happens.

This means that if your estradiol is high, no matter how much testosterone you have, it isn't helping you as it should because too many of your androgen receptors are blocked by estradiol and your free testosterone has no where to go. Testosterone can't do you any good if it doesn't have receptors available to activate.

It can even get worse... because high levels of estradiol can cause the downregulation of androgen receptors. This means that your body may respond to higher levels of estradiol by creating fewer androgen receptors as cells are replaced in normal regeneration. In other words, not only does estradiol block the available androgen receptors, it causes your body to produce fewer of them in the future! This is one reason why raising testosterone levels may not have any immediate effect. It may be that your receptors have downregulated and so you'll need to lower estradiol and increase testosterone in order to get your body to upregulate again and this takes time.

The second reason we care about estradiol is that you also have estrogen receptors and estradiol binds to them and causes them to activate. This is fine if you want to grow man boobs, store fat on your belly, and have an enlarged prostate, but not so good if you want to look and feel like a man.

Where It Comes From

Brushing aside the highly controversial subject of environmental estrogens, the primary pathway for estradiol production is via the conversion of testosterone by aromatase. This means that the aromatase enzyme binds to testosterone and chemically converts it to estradiol. Think about that for a minute. Realize that this conversion is a double whammy. In one process you're losing T and gaining E. Obviously this is not good.

This is where aromatase inhibitors (AI) like anastrozole (brand name Arimidex - aka "adex" etc.) come into the picture. They bind to the aromatase enzyme and prevent it from converting your testosterone to estradiol. They do not work directly on estradiol nor on estrogen receptors. It is SERM's like Clomid and Nolvadex that bind to estrogen receptors. SERM's and AI's are different animals, so don't get them confused.

So an AI gives you the double whammy in reverse. It prevents the loss of testosterone to conversion and consequently lowers your estradiol which helps keep your androgen receptors available for testosterone.

E Follows T

Here's where doctors f*ck up. They forget that E follows T. As your T levels go up, so will your E levels. If you're not doing something to control your E (like taking an AI) then you aren't really going to get anywhere with higher T levels because your higher E levels are just going to cancel out any beneficial effect from the T. Like I said, your T can't do you any good if all your androgen receptors are bound with estradiol.

For those of us with "age related" low T, this is a serious issue because our bodies are naturally trying to keep T low and E high by pumping out aromatase.

If you're younger and have low T for some other reason, aromatase may not be as much of an issue, but it still matters.

Fat

Fat produces estrogen and aromatase; even in men. If you're carrying extra fat, one of the best things you can do to help your hormone balance is to lose the fat.

In Range does not equal Normal

One of the problems you're likely to face is the problem of doctors believing that any blood test value that is "in range" is "normal" and therefor fine. I wish it was that simple.

Let's look at testosterone values. The range for Quest is 241-847 ng/dL. But those values are derived simply by looking at the values of everyone who has a blood test for testosterone. What's normal for a younger man is to be in the higher end of the range. What's normal for an older man is to be in the lower end of the range. Well low T might be "normal" but that doesn't mean it's good! I may be an older guy, but why should I be happy with low T simply because it's normal? ALL men of all ages should be in the higher end of the range if they want to feel good and perform athletically and sexually as men.

The same holds true for estradiol. The range is 13-54 pg/mL but "normal" young men are at the low end of the range and that's where you want to be as well.

Trust me, if your T is 250 and your E is 50, you may be "in range" for both values, but you aren't going to feel good or have anywhere near the athletic and sexual performance that would have if your T was 800 and your E was 15.

Natural Variation

All populations exhibit variation. The average height for men might be 5' 10" but we all know guys who are much taller and much shorter. This same variation applies to T levels, E levels, and reactions to various therapies. In other words, while the principals I've outlined hold true in general, how they specifically apply to you will vary. Be smart and deal with it.

Ok, that's enough from me for now. This is just a basic primer; there's a lot more to this subject so use this as a springboard to do more research on your own"

[Dinahlady]

Firt off I dont really know about what other drugs you are taking, - test but how much? by TRT i suspect you mean testo replactement therapy and this is medically legitimised from having low testosterone levels? 

I think this article has Okay information in it -but if you look at the way its written it seems more than a bit biased. 

He makes out that higher levels of estradiol in a man can seemingly "irreversibly" block the function of testosterone - that is definitely not the case. Some of the science in this seems quite unspecific and incomplete and im not sure if accurately classified. he calls estradiol and antagonist (which would mean it competes with an agonist - testosterone but creates no effect instead of gene transcription) but then also describes that when it binds no effect at all from testo can happen at all, irreversibly - which definitely wouldnt happen - that method would never be induced by a drug. 

Also if it is spending all its time doing this it cant be off transcribing more estrogen genes at ER receptors ASWELL. 

Also - having just had 3 pharmacology lectures on androgen an ER there is no obvious info on the effect of anything estro on andro receptors, or from a quick search online - so if there is an effect it wont be a riduclously large on or a very very common one at all. Maybe its something come through in research and hes read things on pubmed -  but its not one of its most glaring qualities. 

In the mecahnism it is normal for an increase in estradiol if you have been taking TRT. 

I think the main points about estradiol from the websites I've read is that it is converted from testosterone and that in particular - fat cells are precursors to this transformation. 

If you ask me you would probably get a lowered likelihood of this happening if you did lose some body fat - as that seems to be the only real thing you can do about this other that tlking to your doctor or taking AI. 

If you take AI you then what you are doing is inhibiting that mechanism of conversion to estradiol and pushing your ratio of test to estrogen up which is not "normal" and is getting into a blurred lines about whether this is more like enhancing (up to you)

If levels are within physiological normal I wouldn't worry about any of the scaremongering in the article, im sure the effects he mentioned are minimal at doses you are on (if they are medically legitimised) - but if you did want to have a better test/estro ratio that will definitely affect your physique.

I'm pretty sure the increased testosterone if given a medical amount will be much more effecting to the body more than the small changes in cell receptors. But bring it up with your doctor - they will be able to tell you what is normal for TRT and what the long term process is for dealing with "down regulation of testosterone receptors"

I'm pretty sure there isn't even a big effect of this - especially not within physiological normal 

Have you been experiencing any estrogen related side effects since starting taking the TRT?

loss in strength, body hair loss, weight gain? 

 

Thats as much as I know. 

[Murhf]

Letro kicks my arse. Tappered up 2mgs, just felt like I.d been hit by a truck. Balls shrunk, sex drive crashed, weak, tired and felt like the flu sweating, urine stunk like pioson, couldn.t sleep, and thats just what I remember off hand. Felt depressed as hell, couldn.t stay on that dose for more than 2 days. Seems the more I read about TRT, estrogen-test balance the more I dn.t understand. And believe me I.ve read alot this year. The bottom line is everyone is different, body fat is different, age related health problems, blood pressure, it all adds up to a confusing topic. But one which I will perservere with.

[mrgeeky]

DinahLady -   Im currently on 40mg x 5 oral caps of Andriol per day. I have a fair bit of weight to loose so will go down that track first and will post what happens to my estrogen levels after i drop body fat.

thank you Dinahlady, an interesting read..

[nate225]

Letro kicks my arse. Tappered up 2mgs, just felt like I.d been hit by a truck. Balls shrunk, sex drive crashed, weak, tired and felt like the flu sweating, urine stunk like pioson, couldn.t sleep, and thats just what I remember off hand. Felt depressed as hell, couldn.t stay on that dose for more than 2 days. Seems the more I read about TRT, estrogen-test balance the more I dn.t understand. And believe me I.ve read alot this year. The bottom line is everyone is different, body fat is different, age related health problems, blood pressure, it all adds up to a confusing topic. But one which I will perservere with.

 

mrgeeky how are you getting on with TRT, did you end up doing a low dose? Have you had any problems and how do you feel. I.ve just come off 300mg test pw, went off early at 8 weeks. Had some problems tho, first I got the flu wk 1-3 then stuffed my bicep wk 4, took time off till week 7 then got gyno. Letro and nolva..into week 3 from the last dose.

Ummmmmm that aint TRT.......

TRT aims to replace normal range levels (often at a younger age group than your age Murhf). Normal range doesn't equate to 300mg/week, in fact many young guys get effective gains on lesser doseages (e.g 250mg/week) even if their T is in norm reference.

As I said earlier Dorian manages with 200mg/10 days and he's looking great at 50ish, can't see you needing more than him as TRT for some reason! I know guys using 100mg/week as TRT and they believe it to work effectively (some, again near 50 years old, have more muscle mass than me as a competitive bodybuilder in my 30's). 

Worth considering as always more mg = more sides. Use the minimum you can get away with to feel youthful & virile Murhf! *i-m_so_happy*

 

 

[Dinahlady]

DinahLady -   Im currently on 40mg x 5 oral caps of Andriol per day. I have a fair bit of weight to loose so will go down that track first and will post what happens to my estrogen levels after i drop body fat.

thank you Dinahlady, an interesting read..

I re-thought and edited my post so re-read if u like! srry... 

[Murhf]

Thanks Nate for your wise wisdom, I understand letro has little to do with trt. To date I have been trying to find the magical amount of test I can use without to many sides. I dn.t need trt, but I can use the added sex drive and confidence/strenght I felt with a dose of 300mgs p/w. That was my first cycle and I thought I.d researched and learnt as much as I could. Personally it was the best I.ve felt since I was in my teens. I doubt many would want to return to return to normallity after that experience.

[mrgeeky]

Can anyone work out what this means? I been arguing with my doc over dosage as he tried to drop me to 80mg per day..  I read on the data sheet this:

==============================================

""Dosage and Administration

Adults including elderly

In general, dosage should be adjusted according to the response of the individual patient. Usually, an

initial dosage of 120-160mg daily for 2-3 weeks is adequate, followed by a maintenance dosage of

40-120mg daily based on the clinical effect obtained during the first weeks of therapy.""

==========================================================

But it also says on the data sheet under the heading Parmacokinetics this:

=====================================================

""Pharmacokinetics

Linearity:

Dose-linearity has been demonstrated for a dose range of 40-240 mg/day.""

==============================================================

Do I read that right?  240mg a day is ok as a dose? What is meant by Linearity???? Can I send this to my doc as proof that 6 caps per day are ok???

[mrgeeky]

Thanks Nate for your wise wisdom, I understand letro has little to do with trt. To date I have been trying to find the magical amount of test I can use without to many sides. I dn.t need trt, but I can use the added sex drive and confidence/strenght I felt with a dose of 300mgs p/w. That was my first cycle and I thought I.d researched and learnt as much as I could. Personally it was the best I.ve felt since I was in my teens. I doubt many would want to return to return to normallity after that experience.

so you're saying you think you need to be on TRT???

[mrgeeky]

 

DinahLady -   Im currently on 40mg x 5 oral caps of Andriol per day. I have a fair bit of weight to loose so will go down that track first and will post what happens to my estrogen levels after i drop body fat.

thank you Dinahlady, an interesting read..

I re-thought and edited my post so re-read if u like! srry...   any loss in strength, body hair loss, weight gain? 

no sides, everything is feeling ok.... Only problem I see is that my estrogen levels were at 50 pmol / L which is quite high. According to that article I would be feeling a lot better if that was lower..  That was my only concern.. According to that article, thats a level an old man would have.  I suppose I should mention Im 52

 

 

[Dinahlady]

I'm not sure but i think dose-linearity means that if you increase the dose then it will increase the concentration of it in your blood/affect by the same amount - linearly. im not sure if it implies that after 240 it either wont have any more effect or that there is side effects etc and it's not shown to be helpful for your diagnosis. And that doesnt explain why they recommend a drop (that could be estro/sides related in itself. 

 

[mrgeeky]

I'm not sure but i think dose-linearity means that if you increase the dose then it will increase the concentration of it in your blood/affect by the same amount - linearly. im not sure if it implies that after 240 it either wont have any more effect or that there is side effects etc and it's not shown to be helpful for your diagnosis. And that doesnt explain why they recommend a drop (that could be estro/sides related in itself. 

 

I changed doctors and he insisted that i took the lower recommended dose of 2 x 40mg's .. Thats why the drop.. But it never happend.

I refused to drop down that low. 

 

The doc that originally prescribed it was fine with the higher dose so I went back to him...

 

I took 7 x 40 mg's for over a year with out any issues..  Only self regulated back to 5 x 40mgs'  as I couldnt help wonder if there could be any long term affects from the larger dose. I'm thinking of dropping that back to 40mg's x 4 perday..  Just hoping dieting will sort out the high estrogen or Im going to look at taking A.I.

 

[Dinahlady]

If your doctor seems cool maybe you should just ask what he thinks? 

He's spent 10 years in education to learn about physiology, pharmacology and also patient care and wellbeing, plus years of experience.

If hes a dece guy, and you say you're interested in losing some bf and gaining some muscle aswell, even,  and maybe he recognises he's not 100% on the topic and you actually give two stuffs about it all he might even look up/interpret some research studies etc for you? Mention the estradiol and AI and the things you've read and just have a chat to him? 

He's not gonna stop your meds, you're still someone who needs treatment, he might even be more sensitive to your needs if you explain some other stuff to him. 

I'm not saying to tell him you want to take heaps of it and get massive but just bring up your concerns. 

 

 

 

[mrgeeky]

Hi DinaLady, yes of course I'll bring it up with the doctor.. But I want to learn a bit about this stuff. Its one of the reasons I read, post and debate this stuff.. Also every one seems to have a different opinion.. I have a doctor I'm fairly happy with and he does seem knowledagable.. But he lets me take what I want, another doctor insists thats bad and I should stay on the low recommended dose.  Im trying to find out why.. Thats one example..  And Im sure Im going to get a lot of this stuff wrong, befor I get it right but I want to learn.. Also if I find stuff I think maybe helpful for others, worth posting it in here Im sure.. Also its great to have a variety of opinions although it does get rather confusing at times lol

[Kalidane]

Maybe keep it simple.

 

From your OP:

"Funny enough, I feel fine but according to the read below, I could feel a lot better if I got my estrogen levels down a lot."

 

I don't think that is the implication of the reading at all.  In isolation, I'm not sure the reading has any particular meaning.

 

How does your test/est ratio look?  I'm guessing your test levels are at or near supra-physiological levels (normalised for age) so you can expect a higher than typical e2 reading.  If your prostate is happy, I don't know why you'd care about the absolute level of e2.

 

The whole article you pasted is pretty sketchy dude.  I think it best to forget you read that.

 

The most sensible way to have a lower, but healthy, E2 level is to stop reading about endocrinology and walk the dog.

 

PS: You may recall conversations on this forums where people on-cycle had E2 readings >3x your levels.  Is it your belief that very little of their test was able to successfully bind to androgen receptors because it was competing with E2 (which magically has preference)?  That would make it harder to build muscle wouldn't it?  Steroids sounds pretty silly then huh - you're more anabolic without them

[mrgeeky]

cheers Kalidane, Im trying to learn about this stuff.. The more I post on it or talk about it, the more I see there are many differing opinions on the same topics. Makes it really hard to get a grasp on the reality of it all.. I have been going in to a forum where a guy on TRT claims most doctors and endo's are full of shit and know stuff all about TRT.

He claims to have studied it in depth and gives his views on it all..
Although it is hard to figure out how much if it is bullshit and how much makes sense as I am not knowledgable myself, some of the stuff he says makes perfect sense..
As one example, the majority I talk to say just take your test and shut up.

Where as this guy equates taking test with out HCG to chemical castration.. Which makes sense as we all know taking test with out HCG could cause permanent shut down of some ones ability to ever produce sprogs.

So as much as I dont know how much of what  he says is true, I do know some of his main points do make sense.. As above. 

Just trying to weed my way through it all..

And regarding this, "PS: You may recall conversations on this forums where people on-cycle had E2 readings >3x your levels.  Is it your belief that very little of their test was able to successfully bind to androgen receptors because it was competing with E2 (which magically has preference)?  That would make it harder to build muscle wouldn't it?  Steroids sounds pretty silly then huh - you're more anabolic without them"

Cheers mate, that does make sense and I have taken it on board.

[mrgeeky]

 

 

  If your prostate is happy, I don't know why you'd care about the absolute level of e2.

 

Can I ask, what is the cause of prostate enlagement?  I know the test levels Im on are probably much higher than normal..  would this possibly be a cause?  Or is it as you appear to suggest above, high levels of e2?  Hmmm, off to google I think lol 

You are right though, Im probably better off walking the dog instead, the more of this stuff I try to learn the more I confuse myself lol

[mrgeeky]

Oh, this is somethign I hadnt counted on.. I thought being on TRT was a walk in the park.. Seems it has its risks too.. :-(

"Most men have continued prostate growth throughout life. In many men, this continued growth enlarges the prostate enough to cause urinary symptoms or to significantly block urine flow. Doctors aren't sure exactly what causes the prostate to enlarge. It may be due to changes in the balance of sex hormones as men grow older."

[Kalidane]

Mmmm sure but in many, many, many men this enlargement is not sufficient to cause urinary symptoms or significantly block urine flow.

 

20,000 men is many, but out of the male population of New Zealand, isn't a high proportion.  [numbers entirely made up.]

 

Every course of medical treatment has risks (and all drugs have side effects - whether you feel them or not).  The GP/specialist has to determine if the benefits outweigh those risks.

 

I don't really know anything about the prostate - haven't had reason to look in to it yet.

 

Remember you don't have to be Dr House in order to start or continue a course of treatment!

 

"Where as this guy equates taking test with out HCG to chemical castration.. Which makes sense as we all know taking test with out HCG could cause permanent shut down of some ones ability to ever produce sprogs."

Yeah so I'm really not a fan of this guy at all.  People have had kids after a cycle and even during a cycle, with no HCG usage.  Have a look around here for some informed opinions on the use of HCG during a cycle.  And frankly, no I don't know that taking test without HCG could cause permanent shut down of ones ability to ever produce sprogs.  Sure I've heard it said.  I haven't looked in to it and I simply don't know enough about it.

 

Long-term high-dosage steroid usage will have far greater consequences than what you are doing.  The 'fact' that there is a certain outcome at the very far end of the bell curve does not imply the same outcome for the entirety of the bellcurve.

 

Improved hormone health will come from trimming the jiggly bits and that is within your control.  I would focus on things that are within your control.  Successfully becoming a self-taught endocrinologist sounds unlikely for the vast majority of us eh

[mrgeeky]

I think any one on TRT really needs to have some knowledge to some degree.

I was living in a small town and sought out many diffrent doctors about getting on trt. None of them knew anything about it, and the only one that claimed any knowledge put me on 1 40mg cap per day. Imagine what I felt like on that?

 If I were to shift back to that town the chances are if I couldnt supply a doc with the knowledge he needs to know how to treat me, I would have to start sourcing underground gear because all the doctors there were clueless..

Gee, its hard enough here in Auckland finding a doctor with the knowledge. My current doctor hasnt a clue and tried to drop me back to two caps per day. When I mentioned I should possibly keep some arimidex on hand, he said, no way, and didnt really even want to discuss it..I cant help but wonder what would happen if I went to him and said my nipples were getting puffy and itchy he would probably tell me to stop taking any test for a while.

Thats the reason I think we need some knowledge.  I am lucky at the moment I do have a good doctor I can go to. The thought of ever losing that doc for some reason is a bit of a worry.. ie: if he ever shifts towns of if I do.

There are places like The Mens Clinic but they charge for your regular doses of Test and its quite expensive when you consider you are on it long term and when you consider its normally free under the health system.

So yeah, I think the more knowledge we can arm our selves with the better.