Opinions on E2 management.

[Mike9876]

On TRT for just over 4 years. Lately I've been part of a facebook group that also has a youtube channel:

https://www.youtube.com/c/FoxPowerBasement

They are all things TRT, however a very strong theme of the group is that NOBODY needs an AI. EVER.

So for the past 6 months or so I have not been taking any AI. Prior to this I was taking anastrozole when needed, which was approximately 0.25mg per week.

Since stopping the anastrozole I haven't suffered any major side effects. However, one thing I have noticed is that I have gained a significant amount of belly fat. I have always been lean with almost no belly fat but that has changed. My diet and training have not changed at all. I track macros and calories and I cannot think of any other reason for change.

I'm wondering what everyone here's thoughts are on AI's? I would really like to believe that it's not necessary to take one however I'm unhappy with the change in my body. I'm really temped to start the AI again but would like peoples thoughts?

 

[DaytonaJonah]

On TRT for just over 4 years. Lately I've been part of a facebook group that also has a youtube channel:

https://www.youtube.com/c/FoxPowerBasement

They are all things TRT, however a very strong theme of the group is that NOBODY needs an AI. EVER.

So for the past 6 months or so I have not been taking any AI. Prior to this I was taking anastrozole when needed, which was approximately 0.25mg per week.

Since stopping the anastrozole I haven't suffered any major side effects. However, one thing I have noticed is that I have gained a significant amount of belly fat. I have always been lean with almost no belly fat but that has changed. My diet and training have not changed at all. I track macros and calories and I cannot think of any other reason for change.

I'm wondering what everyone here's thoughts are on AI's? I would really like to believe that it's not necessary to take one however I'm unhappy with the change in my body. I'm really temped to start the AI again but would like peoples thoughts?

I don't think there is anything wrong with taking an AI to manage E sides...but, it has to be done responsibly.

In my current daily dosage protocol, I'm doing 5mg of TC and 3.75mg of TP along with about 500iu of hCG weekly(approx.140iu EOD). My E on this low dosage still climbs up some and thus I need to 'tap the brakes' a bit so I take a micro-dosage of 62.5mcg(1/16th of 1mg.) about every 3-4 days depending on how my body is feeling.

With the above, things are really pretty good in all facets.

 

[Systemlord]

However, one thing I have noticed is that I have gained a significant amount of belly fat.

If your TRT dosage is excessive, meaning your Total T and Free T are through the roof, than I would hardly blame the estrogen for your issues. TRT can cause sodium reabsorption through the kidneys, causing fluid retention that has nothing to do with estrogen.

Most recent labs to share?

 

[Systemlord]

Water Retention While on TRT May Only Occur to Certain Men

ABSTRACT The human body can be viewed simplistically as being composed of fat-free and fat mass. With more sophisticated techniques, body composition can be broken down into fat mass, skeletal muscle mass, nonmuscle lean mass, visceral mass, and bone mineral content. Similarly, it is possible...

www.excelmale.com

 

[Mike9876]

Systemlord, I don't have my labs on hand as I'm at work. But in my most recent labs, my total T was around 800, from memory the range was around 250-1000. I can't remember my Free T but it was within the range. I have not had a blood test since stopping the AI however I did not change my dose, I simply stopped the AI.

Thanks for that link on water retention, I will give that a look.

 

[bixt]

I fail to understand how belly fat = water retention

 

[Phil Goodman]

I know your example is only anectdotal, but one thing I’ve wondered about is how much high body fat leads to more aromatization vs how much high aromatization leads to more body fat. I’m sure it’s probably both, but some seem to think it’s only one or the other.


And while I think AIs should be a last resort, I do think that ignoring E2 will make it harder for some people to reach an optimal state. Not sure what group you’re talking about, but I know of one that takes a similar approach. They’ll advise trying every different frequency and dose protocol you can think of, tell people to add cream to their injections, ask for thyroid labs, talk about vitamin d levels, ask about sleep, stress, alcohol intake, smoking status, and zodiac sign…then when someone asks if symptoms could be due to E2 they freak out and say nothing bad ever happens from E2 and that you can’t even measure it anyway. Seems to me that taking that approach is ignoring a pretty substantial factor. I understand the swing back in the other direction because of how long people were just given AIs like candy for pretty much every protocol, but to me it seems the pendulum is swinging too far in the other direction.




I just got my labs back from my most recent bloodwork and my E2 has climbed quite a bit from the 30’s to 50’s) while everything else stayed about the same as they were in past labs. Well, my DHEA jumped a lot as well but other than that the free and total T levels were the same(barely above the top end of the range). The only difference is that I switched to Pregnyl. If I had to guess, that would be my first bet but I guess I can’t really tell for now. I have noticed a little bit more of a puffy face but nothing too noticeable anywhere else(and I’m pretty strong/lean…6’1” 175). I feel pretty good, but I wonder if I would feel better I dropped my E2 a little. I already have some anastrazole that was prescribed to me but I’ve never used it. I’ve considered adding .125/week and seeing how I feel, but not really ready to try it yet. And even if I did I would probably just use it for 3-4 weeks then stop and compare. For people who have used it with success in the past, how did you incorporate it into your protocol? And ftr I currently use about 100 mg/test divided up MWF and 900 ius of Pregnyl divided up Tues./Thurs./Sat.

 

[Phil Goodman]

If your TRT dosage is excessive, meaning your Total T and Free T are through the roof, than I would hardly blame the estrogen for your issues. TRT can cause sodium reabsorption through the kidneys, causing fluid retention that has nothing to do with estrogen.

Most recent labs to share?

If he stopped the AI wouldn’t that typically mean his total and free test would drop since more would be converting to estrogen?

 

[FunkOdyssey]

I just got my labs back from my most recent bloodwork and my E2 has climbed quite a bit from the 30’s to 50’s) while everything else stayed about the same as they were in past labs. Well, my DHEA jumped a lot as well but other than that the free and total T levels were the same(barely above the top end of the range). The only difference is that I switched to Pregnyl. If I had to guess, that would be my first bet but I guess I can’t really tell for now. I have noticed a little bit more of a puffy face but nothing too noticeable anywhere else(and I’m pretty strong/lean…6’1” 175). I feel pretty good, but I wonder if I would feel better I dropped my E2 a little. I already have some anastrazole that was prescribed to me but I’ve never used it. I’ve considered adding .125/week and seeing how I feel, but not really ready to try it yet. And even if I did I would probably just use it for 3-4 weeks then stop and compare. For people who have used it with success in the past, how did you incorporate it into your protocol? And ftr I currently use about 100 mg/test divided up MWF and 900 ius of Pregnyl divided up Tues./Thurs./Sat.

It sounds like your previous hCG was inert and having no effect on your bloodwork. If E2 is climbing because you introduced an effective form of hCG, is using less hCG an option? Religious feelings about E2 management aside, controlling side effects of one medication by adding additional meds should always be a last resort due to increasing complexity and exposure to even more side effects.

Because the hCG you had was probably bunk, you may need to throw out everything you think you know about how hCG makes you feel and start over. That would mean dose experiments and dialing in from scratch.

 

[Phil Goodman]

It sounds like your previous hCG was inert and having no effect on your bloodwork. If E2 is climbing because you introduced an effective form of hCG, is using less hCG an option? Religious feelings about E2 management aside, controlling side effects of one medication by adding additional meds should always be a last resort due to increasing complexity and exposure to even more side effects.

Because the hCG you had was probably bunk, you may need to throw out everything you think you know about how hCG makes you feel and start over. That would mean dose experiments and dialing in from scratch.

I agree 100% about the advice on avoiding the tendency to add medications to counter effects from other medications. That being said, I know that the HCG I had initially from the compounding pharmacy wasn’t bunk. My ball atrophy was completely reversed, ejaculate volume increased, and orgasm intensity improved. My bloodwork also shows that it was effective(as shown by results below).

Oct 2021 while taking 120 mg/week of test labs were

Total - 1224(264-916)
Free - 26.2(8.7-25.1)
E2 - 38.8(8-35)
DHEA - 259(102-416)


Jan. 2022 taking 100 mg test/week, 1,000 ius of HCG/week, and 25 mg/day of DHEA

Total - 1201
Free - 30.3(so total stayed close and free went up even though I dropped my test by 20 mg/week)
E2 - 36.6(slight drop in E2, which at the time I attributed to going from 2x/week to 3x/week application)
DHEA - 372



July 2022 same protocol except using Pregnyl instead of compounded HCG

Total - 1204(almost identical to Jan.)
Free - 29.5 (very very SLIGHT drop in free)
E2 - 54.3(almost a 20 point jump)
DHEA - 488(over 100 point jump from Jan.)


Only other thing to add is that for most of the summer I’d stopped taking DHEA because I thought it may be the source of acne and pretty sure that was correct. I started taking it again about 2 weeks before my bloodwork, but took the same amount I was taking before(25 mg/day). Not sure if that would throw it off that much, and it doesn’t seem like it would die to being the same dosing as before, but perhaps with it being only 2 weeks in at that point my body was still adjusting?? Also, not sure if that would drive up the E2 like that. Either way it is clear that my prior HCG was working as intended.

But again, I agree with your point about not continuing to pile on medications/substances. So with that input the best advice is probably to drop the DHEA again and avoid the AI. Then see where that puts me. Then I would have a better idea as to whether it’s the DHEA driving those numbers so high(one one hand it could possibly make sense because the 2 that saw that type of jump are DHEA and E2….but on the other hand if so much DHEA was remaining in original form it doesn’t seem that it would have such an impact on downstream hormones).

 

[FunkOdyssey]

My bloodwork also shows that it was effective(as shown by results below).

Oct 2021 while taking 120 mg/week of test labs were

Total - 1224(264-916)
Free - 26.2(8.7-25.1)
E2 - 38.8(8-35)
DHEA - 259(102-416)

Jan. 2022 taking 100 mg test/week, 1,000 ius of HCG/week, and 25 mg/day of DHEA

Total - 1201
Free - 30.3(so total stayed close and free went up even though I dropped my test by 20 mg/week)
E2 - 36.6(slight drop in E2, which at the time I attributed to going from 2x/week to 3x/week application)
DHEA - 372

July 2022 same protocol except using Pregnyl instead of compounded HCG

Total - 1204(almost identical to Jan.)
Free - 29.5 (very very SLIGHT drop in free)
E2 - 54.3(almost a 20 point jump)
DHEA - 488(over 100 point jump from Jan.)

You increased your injection frequency between Oct 2021 and Jan 2022? I think that, and adding DHEA, could account for all of the observed changes in hormone levels without any contribution from hCG.

 

[Phil Goodman]

You increased your injection frequency between Oct 2021 and Jan 2022? I think that, and adding DHEA, could account for all of the observed changes in hormone levels without any contribution from hCG.

Well I don’t think 25 mg/day would make up for taking 20 mg less per week of straight testosterone. But even if you want to attribute it to that, it wouldn’t explain complete reversal of testicular atrophy(and that’s even assuming you want to attribute ejaculate volume increase and orgasm intensity solely to the DHEA).

 

[FunkOdyssey]

Well I don’t think 25 mg/day would make up for taking 20 mg less per week of straight testosterone. But even if you want to attribute it to that, it wouldn’t explain complete reversal of testicular atrophy(and that’s even assuming you want to attribute ejaculate volume increase and orgasm intensity solely to the DHEA).

Not just the DHEA -- your trough values increase on the higher injection frequency because you test closer to your peak. The atrophy and other effects do sound like hCG.

 

[Systemlord]

If he stopped the AI wouldn’t that typically mean his total and free test would drop since more would be converting to estrogen?

I'm sure it does, but I thinks it's by a miniscule amount.

Also reducing estrogen can increase the amount of urine volume, so you hold onto less water.

TRT can cause water retention and the OP might be using the AI as a bandaid and instead should reduce the dosage.

 

[Phil Goodman]

Not just the DHEA -- your trough values increase on the higher injection frequency because you test closer to your peak. The atrophy and other effects do sound like hCG.

Yeah that’s a good point about the frequency. I think my old protocol was Mon. and Thurs. and now I do MWF. I do my labs on Mon. morning though so it’s only a 24 hour difference(Fri to Mon. instead of Thurs. to Mon.)

 

[TorontoTRT]

It’s probably your lifestyle and diet to blame. No one needs an AI. I’ve lost 40 lbs of fat with an e2 ranging from 70-100. Never took an AI, never had 1 drop of water retention. Injecting 180 mg a week EOD.

 

[JimGainz]

The effects of estrogen are highly specific to the individual, much like testosterone ranges. Some guys feel great on a 500 ng/dL total testosterone level while others need it up near 900. I can’t stand those channels that make broad black-and-white decisions on estrogen management and vehemently denounce any use of an aromatase inhibitor. Some men feel better on it and some actually need it. Certainly if you have gynecomastia symptoms you will certainly need one at least for a while. From a personal standpoint I have had my E2 range from the teens all the way up to in the 90s. I never felt good with high E2 and started taking Aromasin to keep it within the 20 to 30 range and feel much better. It’s a subjective benefit but I definitely did experience some symptoms of irritability, itchiness and felt a little bit off when my E2 was unmanaged. Also, if we are trying to keep our hormones in the range of a healthy young male in his mid-20s or so, there are no such men in existence who naturally have their E2 in the 60s or above.

 

[JYD21]

The effects of estrogen are highly specific to the individual, much like testosterone ranges. Some guys feel great on a 500 ng/dL total testosterone level while others need it up near 900. I can’t stand those channels that make broad black-and-white decisions on estrogen management and vehemently denounce any use of an aromatase inhibitor. Some men feel better on it and some actually need it. Certainly if you have gynecomastia symptoms you will certainly need one at least for a while. From a personal standpoint I have had my E2 range from the teens all the way up to in the 90s. I never felt good with high E2 and started taking Aromasin to keep it within the 20 to 30 range and feel much better. It’s a subjective benefit but I definitely did experience some symptoms of irritability, itchiness and felt a little bit off when my E2 was unmanaged. Also, if we are trying to keep our hormones in the range of a healthy young male in his mid-20s or so, there are no such men in existence who naturally have their E2 in the 60s or above.

Good post. Work your e2 range in teens to 90s, was that an ultra sensitive test? Also, do you always take aromasin or what is your protocol for that? Thx.

 

[TorontoTRT]

The effects of estrogen are highly specific to the individual, much like testosterone ranges. Some guys feel great on a 500 ng/dL total testosterone level while others need it up near 900. I can’t stand those channels that make broad black-and-white decisions on estrogen management and vehemently denounce any use of an aromatase inhibitor. Some men feel better on it and some actually need it. Certainly if you have gynecomastia symptoms you will certainly need one at least for a while. From a personal standpoint I have had my E2 range from the teens all the way up to in the 90s. I never felt good with high E2 and started taking Aromasin to keep it within the 20 to 30 range and feel much better. It’s a subjective benefit but I definitely did experience some symptoms of irritability, itchiness and felt a little bit off when my E2 was unmanaged. Also, if we are trying to keep our hormones in the range of a healthy young male in his mid-20s or so, there are no such men in existence who naturally have their E2 in the 60s or above.

Your last part makes no sense. Your e2 levels would and should never be like a natty. Is your test high? Then obv your e2 should be equally high. Estrogen lab ranges are only for guys NOT on trt.

 

[JimGainz]

Your last part makes no sense. Your e2 levels would and should never be like a natty. Is your test high? Then obv your e2 should be equally high. Estrogen lab ranges are only for guys NOT on trt.

I try to keep it within the natural ratio of a young man. A man in his 20s may have an e2 of 20 and a total testosterone of 600 at its peak. So that’s 30 to 1. When I was not managing my E2 and let it creep up to 90, and my total testosterone was 800 that’s less than 10 to 1. That’s a prostate cancer risk in my opinion. Either way I feel way better when my e2 is between 20-30.