DragonBits
Well-Known Member
btw, I have seen 1197 top range from posters.
1500 is as high as the typical assay test can measure, if you are higher than that and want to know, you need the expensive LC test.
TRT without the use of Aromatase Inhibitors
- Thread starter Dr. John Crisler
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btw, I have seen 1197 top range from posters.
1500 is as high as the typical assay test can measure, if you are higher than that and want to know, you need the expensive LC test.
Another case of needing E2 around where your SHBG is. It’s not an exact science, but I think it’s a pretty damn good rule of thumb, in my opinion.
Improvement in body composition will be part of hormone optimization specially if diet and exercise are spot on. And of course that can bring a sense of well being by itself. And to be clear i have nothing against someone that wants to push testosterone levels higher to improve that even further but from my experience if you stay close to supraphysiological ranges the benefit of increasing testosterone dosage in body composition is small and you might end up having to deal with more side effects (elevated HCT as a classic one where i see people complaining about it and fighting against it but not willing to decrease their dosage). My point is that you can actually feel better and have the same benefits in improved body composition by using a lower testosterone dosage. And you will have less or no side effects hence no need for ancillary drugs (or just the need for very lower dosages). And i am not talking about micro dosing testosterone and neither talking about having your FT mid range. I am talking about FT close to the top end of the range at trough (which means above range at peak). Indeed modern men have lower testosterone than out ancestors so having a peak moderately above range shouldn’t be a problem. But many men on TRT have FT at 30-35+ at trough and at peak that can be 10 points + higher. In that case in the presence of side effects like high estradiol i think it makes sense to reduce testosterone dosage first, bring FT levels closer to 20-25 at trough and see if that negates the need for an AI for example. And all that without any detriment to how you feel.
However further reductions might not make sense because that will start to negatively affect how you feel. Then a small AI dosage can handle estradiol issues if present.
My take. Try a lower dosage and see how you feel. Give it time (your body takes time to adapt to changes in protocol). That approach can save you from all common side effects associated with TRT.
However further reductions might not make sense because that will start to negatively affect how you feel. Then a small AI dosage can handle estradiol issues if present.
My take. Try a lower dosage and see how you feel. Give it time (your body takes time to adapt to changes in protocol). That approach can save you from all common side effects associated with TRT.
If every TRT doctor thought the way you do, and had the same opinions on how to administer TRT as you do, it would put forums like this out of business, due to 99% of guys on TRT walking around feeling amazing and having no issues to complain about. Sometimes you can just tell when someone has the perfect mind set when it comes to optimizing hormones, for example, and you sir just get it. I literally don’t think I could of said it any better than you just did. You’re an amazing asset to this forum, hopefully you stick around for a long time. Awesome post Healthman.
I almost want you to make a whole thread, starting with what you just wrote, just so it can be referenced back to at any time. Maybe the thread can be called “How to avoid the ups and downs of TRT” or “How to minimize side effects on TRT” or something along those lines. Makes me kind of sad that what you wrote is going to end up getting lost in the mix after a day or two. I think it could help a ton of guys out by just following the plan that you laid out.
Rouzier's never been on the Roundtable, to my knowledge. I think those numbers were thrown out there by Dr. Nichols, Jay's new business partner.
Dr. John Crisler
Physician
That is only if you run the invalid immunoassay test, which greatly overestimates the actual serum concentration.
In all my years of looking at mens' labs, I have never seen a valid E2 level that high in any man who was not in liver failure.
I want to add that I think the world of my old friend Dr. Neal Rouzier. Not only is he brilliant, and a great teacher, he is also one of the funniest, and nicest, fellows you could ever meet.
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Dr. John Crisler
Physician
So I am clear about this, it's probably time I say there may indeed be no negative consequences whatsoever from inducing very high levels of T, E and DHT. We just don't know yet.
This is why I am listening very carefully to what proponents of these types of therapies are saying.
This is why I am listening very carefully to what proponents of these types of therapies are saying.
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Spoken like a true intelligent individual. One of the ways I judge intelligence is not by a person being able to explain all the things they know, but being intelligent enough to be cognicent of the things they don’t know, and be comfortable enough with their intelligence to admit when they don’t know things. A person that can’t admit when they don’t entirely know certain things, or can’t admit when they were wrong in the past, I view as very insecure with their intelligence, which makes me believe that they are not very intelligent at all. Otherwise, why would they be self conscious about it? A true intelligent person is confident in their intellect, and therefore doesn’t care about how people will view them after admitting that they were wrong, or admitting that they are still learning and don’t entirely have certain concepts nailed down completely. So you my friend, I view as a very intelligent man, and appreciate the honesty.
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Jeromefrance
Member
I have had E2 : 117pg/ml range : 10-50pg/ml ) on a roche ecl ria test. I was feeling like shit. Anxiety , sometimes hot flashes , letgargy... no drive. Adding a very small dose of arimidex is absolutely changing my life. And my protocol is 15mg test/ day...
Are they actually business partners? Where'd you see that?
Of course, this just begs the question as to why Dr. Rouzier refers to such "invalid testing in the first place". Has anyone ever asked him directly about this?
Is the immunoassay consistent at all by how much it overestimates actual serum concentration? In other words, does it overestimate by a fairly consistent percent whereby one could factor this in to arrive at a more accurate serum concentration?
Thanks for posting here, Dr. Crisler.
I think the question to be answered is. Are there any benefits (other than body composition) in getting someone’s testosterone levels way over supraphysiological levels? I find hard to believe any reason to justify putting someone’s FT at 50+ other than performance enhancement purposes. Is it safe? Difficult to know. Maybe we can get some insight by looking at the bodybuilding community. I think if side effects are under control and bloodwork shows normality across many health indicators i guess it might be ok (although you never know what might be going on in the background that might only manifest itself decades down the road).
I think there is a reason why hormone levels in a healthy population is within a certain range give it or take (and i am not saying current lab ranges are representative of that population). Mother nature is wise and finds balance. Side effects are the first sign things are being pushed too far and balance is being compromised. Of course we can use other drugs to counter-interact these side effects and keep the hormone levels very high. But what’s the point? I rather aim for optimizing hormone levels until balance is found and the subject feels great subjectively. And balance might require some AI or another ancillary drug in modest dosages. But that should the exception not the rule.
Having a men estradiol levels way above range and leave it there on purpose doesn’t really make sense to me. Men in nature don’t have these high estradiol levels. There is gotta be a reason for that. Even if there wasn’t. What are the benefits of letting someone’s estradiol levels go that high? Then the debate is. What is safer? Add an AI to lower estradiol or let estradiol levels alone untreated? I would say neither. Lower someone’s testosterone dosage is the best option. If that is not enough add anastrozole would be the second option.
All speculation given that are no studies proving one point or the other.
I think there is a reason why hormone levels in a healthy population is within a certain range give it or take (and i am not saying current lab ranges are representative of that population). Mother nature is wise and finds balance. Side effects are the first sign things are being pushed too far and balance is being compromised. Of course we can use other drugs to counter-interact these side effects and keep the hormone levels very high. But what’s the point? I rather aim for optimizing hormone levels until balance is found and the subject feels great subjectively. And balance might require some AI or another ancillary drug in modest dosages. But that should the exception not the rule.
Having a men estradiol levels way above range and leave it there on purpose doesn’t really make sense to me. Men in nature don’t have these high estradiol levels. There is gotta be a reason for that. Even if there wasn’t. What are the benefits of letting someone’s estradiol levels go that high? Then the debate is. What is safer? Add an AI to lower estradiol or let estradiol levels alone untreated? I would say neither. Lower someone’s testosterone dosage is the best option. If that is not enough add anastrozole would be the second option.
All speculation given that are no studies proving one point or the other.
Nashtide
Member
My lab ranges for FT go up to 155.
Using labcorp as a reference
I’m far more interested to hear your take on Jay and Dr Rouzier’s latest podcast where Dr Rouzier essential debunks the theory that lowering E2 has any health benefits and in fact can only lead to poorer health.
I was especially interested when he brought up the study that I hear about on this site every time there is a conversation about having high E2. The study goes something like this, people at the lowest and highest levels of E2 have the highest rates of mortality. What is never mentioned on this site is that the people with the highest E2 already had metabolic conditions and that was the reason for the high E2. His claim seems pretty logical that the reason they had a higher mortality was the metabolic condition and not the E2. He went through study after study pointing out the same flaws in the E2 argument.
Jay just put up an interview with Dr. Rouzier and near the end of it Dr. Rouzier says that some doctors are even experimenting(On themselves, not patients as far as I can tell from that convo) with ADDING estrogen with testosterone therapy to bring E2 in the 200+ range which according to him only has benefits and they aren't suffering any symptoms of high E2, in fact the opposite.
I'm not going to start taking extra E2 but I've recently switched over to a once daily test injection with a higher dose and won't be using an AI and see how it goes, don't have much to loose at this point, I've tried everything else so will be interesting to see what happens.
For anyone interested here's the link, pretty interesting presentation:
I'm not going to start taking extra E2 but I've recently switched over to a once daily test injection with a higher dose and won't be using an AI and see how it goes, don't have much to loose at this point, I've tried everything else so will be interesting to see what happens.
For anyone interested here's the link, pretty interesting presentation:
Very interesting, though not entirely surprising considering their rapport, apparent mutual respect, and Jay's business mind. I wonder how well they'll do. Obviously the podcast provides a ton of valuable information, and I for one love it. But both guys have naysayers, given Nichols' polarizing approach and Jay's aggressive personality.
Man I want to support Dr. Rouzier so bad, just because he seems very intelligent, insightful, really passionate about hormone optimization, and in it for all the right reasons, but I just don’t understand how he can say that young men are walking around with E2 levels around 75-90. How can such an intelligent man, and one that is so deep in the hormone optimization world, quote such figures? I obviously am not out there testing young men’s E2, but I can pretty much guarantee that no young males are walking around with E2 numbers even close to this. Can anyone explain how someone as smart as Dr. Rouzier can get this so wrong? Anyone? Dr. Crisler? I’m legitamately baffled and dying to know the answer.
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