Interview with Dr Ranjith Ramasamy- Author of Estradiol Papers

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Nelson Vergel

Founder, ExcelMale.com
ramasamy md.jpg


I am excited that one of the most published and respected uroogists in the United States has agreed to do a video interview to help me educate men on the role of estradiol in men.

Here are his publications:

Ranjith Ramasamy - Google Scholar Citations

In particular, we will be discussing his review:

The role of estradiol in male reproductive function

Any questions not covered in my article?
Role of Estradiol in Men and Its Management
 
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Defy Medical TRT clinic doctor

KSPhD

Member
It's clear that low esterogen and elevated estrogen both cause serious morbidity and mortality in men. If you plotted this out with estrogen on the x-axis and morbidity and mortality on the y-axis, you would get a U-shaped curve. Where does he believe the "estrogen sweet spot" (the bottom of the U) is for men? What is the best way for men on TRT to hit that sweet spot?
 

Jason Sypolt

Administrator
It looks like a lot of guys try to hit the low 20's no matter what. I think that the optimal point in the curve is not only different for each person, but the curve itself is a function of his testosterone levels at any given time.
 

Nelson Vergel

Founder, ExcelMale.com
I am inviting you to a Facebook Live Lecture tomorrow April 9. 2020 at 3 pm central with Dr. Ramasamy. Go to our FB page and "like" it.

 

DS3

Well-Known Member
@Nelson Vergel

Potential questions to add (if they are no good, toss them):

1. What is the effect of low estradiol on glucose metabolism within skeletal muscle, as well as its impact on insulin resistance? What does this mean for muscle growth?

2. Is there a theoretical cut-off point where elevated estrogen levels in TRT patients can confidently be stated to pose health risks?

For example, if a man feels positive symptom relief while microdosing 200 mg Test per week with the concomitant use of HCG, yet his estrogen remains elevated to ~70 pg/dL with no AI, is this cause for concern? If this level of estrogen, theoretically, poses health risks, should the protocol be to add in a small dose of an AI? Decrease T dosage? Decrease or eliminate HCG? Other?
 
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Nelson Vergel

Founder, ExcelMale.com
Previous interviews:


 

DS3

Well-Known Member
@Nelson Vergel

Two more potential questions after looking through your previous interview:

1. For men on TRT who experience E2 levels above 60 pg/mL yet are unable to use AIs due to joint pain, what are viable long-term alternative treatments? Lower T dosage?

2. In men with lowered bone mineral density and osteoarthritis (either as a result of previous anastrozole use or though other causes), do you use Toremiphene or any second-generation SERM for its beneficial effects on bone mineral density within the skeletal system? Is the use of Toremiphene a viable treatment option in these cases?
 

Fernando Almaguer

Well-Known Member
@Nelson Vergel

Two more potential questions after looking through your previous interview:

1. For men on TRT who experience E2 levels above 60 pg/mL yet are unable to use AIs due to joint pain, what are viable long-term alternative treatments? Lower T dosage?

2. In men with lowered bone mineral density and osteoarthritis (either as a result of previous anastrozole use or though other causes), do you use Toremiphene or any second-generation SERM for its beneficial effects on bone mineral density within the skeletal system? Is the use of Toremiphene a viable treatment option in these cases?
How much AI use would cause osteoporsis?
 

DS3

Well-Known Member
How much AI use would cause osteoporsis?
In the first interview with Nelson, Dr. Ramasamy said that 1 mg ED and potentially 1 mg EOD could contribute to osteoporosis, but that can only be confirmed via a DEXA scan. However, what was continually referred to in the video was that creating an atmosphere in the body where 'negligible' amounts of E2 are maintained by anastrozole (ab)use is what largely contributes to osteoporosis.

However, I hypothesize that this may not be totally correct as I have suffered severely in the past by taking 0.25 mg adex 3 x per week and keeping my E2 at 20 pg/mL (not negligile). During that time my bones and joints hurt so bad I could barely workout, and years later have still not recovered very well. This is part of the reason i place emphasis on the proposed question because I am not the only TRT patient this has happened to, nor will I be the last.

Note that the dosage I had to take to experience profound negative effects on my bones and joints (that 3 years later i still haven't fully recovered from) is far less than the dosage that Dr. Ramasamy said he typically prescribes for high E2 (1 mg weekly or twice weekly).
 

Fernando Almaguer

Well-Known Member
In the first interview with Nelson, Dr. Ramasamy said that 1 mg ED and potentially 1 mg EOD could contribute to osteoporosis, but that can only be confirmed via a DEXA scan. However, what was continually referred to in the video was that creating an atmosphere in the body where 'negligible' amounts of E2 are maintained by anastrozole (ab)use is what largely contributes to osteoporosis.

However, I hypothesize that this may not be totally correct as I have suffered severely in the past by taking 0.25 mg adex 3 x per week and keeping my E2 at 20 pg/mL (not negligile). During that time my bones and joints hurt so bad I could barely workout, and years later have still not recovered very well. This is part of the reason i place emphasis on the proposed question because I am not the only TRT patient this has happened to, nor will I be the last.

Note that the dosage I had to take to experience profound negative effects on my bones and joints (that 3 years later i still haven't fully recovered from) is far less than the dosage that Dr. Ramasamy said he typically prescribes for high E2 (1 mg weekly or twice weekly).
Alarming info. I take .25 every week or everyother week. I just don't see anyother way to get it undercontrol. My left knee sometimes aches. I look foward to more research on this matter. Thanks for sharing your wisdom.
 

Vince

Super Moderator
I just got done listening to the full interview with Dr. Ramasamy. I thought it was great and very interesting. It should be a must for anyone interested or already on trt. I plan on listening to it again tomorrow.

Thanks Nelson.
 

DS3

Well-Known Member
I just got done listening to the full interview with Dr. Ramasamy. I thought it was great and very interesting. It should be a must for anyone interested or already on trt. I plan on listening to it again tomorrow.

Thanks Nelson.
Agreed. I think all 3 videos should be filed under TRT Essentials. Dr. Ramasamy and Nelson provides more valuable information in those three videos than any other source I’ve been exposed to.
 

Vince

Super Moderator
Agreed. I think all 3 videos should be filed under TRT Essentials. Dr. Ramasamy and Nelson provides more valuable information in those three videos than any other source I’ve been exposed to.
You are so right. Too bad there's not more doctors that have the knowledge, that Nelson and Dr Ramasamy have about trt.
 

DorianGray

Active Member
Excellent resource. Looking forward to the additional videos. Interesting info on the use of HCG alone, but noted that it was in younger guys. Standby for report in a few more weeks of its use alone in an old guy. Maybe Vince will be right and it may be minimal effect. We'll see.
 

Vvs1

Active Member
Here is the video. Please post questions here to forward to him. Thanks


Ask him about what he thinks is the cause of persistent side effects of Post Finasteride Syndrome (Accutane,SSRI,Saw Palmetto). Also one guy claims that he has a similar case by taking only an AI. He was super into fitness and training to become a doctor or scientist until he experienced persistent symptoms.

Tons of cases over on Propecia Help where guys take a single pill or less than a week’s worth. Many stories of guys that try AIs w/o TRT and become worse off.
 
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