Did estrogen crash cause me permanent symptoms of low dopamine?

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simeoni

Member
Long story short: Last fall I had my first "proper" estrogen crash with arimidex. The following months were a struggle for me when I tried to re-adjust my adex dose. Now I have to state that before that I had period of months were arimidex seemed to work just fine and I felt good. I did lose about 11 pounds after that so I guess that meant that I was aromatizing less.

Rewind to year 2017: Ive experienced 5-6 crashed during the past 7 months. According to my lab work, my E2 usually comes back in 7-10 days.

That said, the biggest thing that has been bothering me is the fact that since last november I have been experiencing strong apathy which is greatly hindering my every day life. There have been few weeks where I felt better, butt at the moment im feeling pretty horrible.

I feel that my symptoms are mainly realated to dopamine. They are:

- low libido - sometimes non existant
- cant really enjoy the things that I used to like
- I have a really low "drive" at the moment
- social interactions feel difficult
- Feel that my working memory is not the same anymore
- at worst I feel agitated
- I cant really handle stress

Overall my symptoms seem to resemble the early non-motor symptoms of parkinson's disease. Last november I made a thread here about a study that showed how an estrogen deprivation of 10-30 days lead to a 30% loss of dopamine producing neurons - in the substantia nigra. Now of course this was an animal study and a brief estrogen therapy (2 days) did restore the neurons in the animals that were deprived for 10 days. Here's the thread I mentioned: https://www.excelmale.com/forum/sho...-lethargy-by-destroying-your-dopamine-neurons

I guess my fear is that my current symptoms are permanent. Now I did have somewhat high e2 readings with my current protocol (54pg/ml on the non sensitive and 50 pg/ml on the sensitive). Because of that I did use an AI up until the 4th of july. After that I did however decide to ditch the AI completely and now Ive been "clean" for 4 weeks. Suprisingly on the latest non sensitive test I did not have a high reading - it was 38 pg/ml. Im still planning to go without an AI. Im hoping that the recovery time of 6-8 week's applies also for me.

Here are my latest labs and protocol.

Protocol: 0,15ml(37,5mg) TE E4D. I also take 5-7mg of testosterone gel on the scrotum ED or EOD.

Labs:

Androgens (2days after an injection):
TT: 840 ng/dl
SHBG: 25 nmol/l
FT:493 pmol/l (200-650 pmol/l)
E2: 38 pg/ml (non sensitive)

thyroid

TSH: 0,78 (0.3-4.5)
T4: 17 pmol/l (10-21)
T3: 5.1 pmol/l (3.2-6.5)

Iron status

Ferritin: 82 mq/l ( 20-250 )

Other labs

CRP: 1
Cortisol: 521 pmol/l (250-650 pmol/l)

So that's my current situation. Im wondering if there are any people here who have had similar experiences and eventually recovered - after a long period of having symptoms?

I know that my approach during last fall was stupid. I should have stopped adex after the first crash and waited for the usual 6-8 weeks. I took a long time to get it in my thick skull, that the only situations where you should introduce an AI should be after a high sensitive reading and persisting symptoms. Here's hoping it's not too late.

Also I want to keep this thread as a log on my road to recovery. I dont want to go forward alone. every advice is appriciated!
 
Defy Medical TRT clinic doctor
Your problem as far as I see it is total mismanagement of Estrogen, you're not going to have any success at all doing ^ what you're doing here. There's no way that you can dose things one day to the next and then state you have 5-6 "crashes" in 7 months and then not divulge how much, dose/frequency of the AI you're using. It's a curiosity that you're trying to find answers like Dopamine and even Parkinsons while you're doing this to yourself, why you're even using an AI to begin with unless you've fallen victim to unfounded Estro-Phobia

Get off the AI totally for at least 6 weeks and test using the proper LC/MS/MS testing and reevaluate.
 

simeoni

Member
Thanks for the response vince!

Like I stated, I haven't taken an AI during the past 4 weeks and im planning to go without it for 8 weeks and then I will test E2 - LC/MS/MS.

With my current test dose the protocol for the AI was 0,25mg of adex taken E4D.

One of the most confusing things has been the fact that I do seem to experience a lot of the symptoms of high E2 a day or two after the injection - feeling hot, moody. These symptoms used to be a clear sign of high e2 in the past. When I was using Nebido (aveed), and I had those symptoms, 0,25mgof adex always made me feel better. It took me a while to realise that I simply cannot use those symptoms to justify the use of an AI.

Before switching to test E, I used 1ml of Nebido every 2,5 weeks. With that I also took 0,25mg of arimidex EOD. This protocol worked well for 4 months.

Your problem as far as I see it is total mismanagement of Estrogen, you're not going to have any success at all doing ^ what you're doing here. There's no way that you can dose things one day to the next and then state you have 5-6 "crashes" in 7 months and then not divulge how much, dose/frequency of the AI you're using. It's a curiosity that you're trying to find answers like Dopamine and even Parkinsons while you're doing this to yourself, why you're even using an AI to begin with unless you've fallen victim to unfounded Estro-Phobia

Get off the AI totally for at least 6 weeks and test using the proper LC/MS/MS testing and reevaluate.
 

CoastWatcher

Moderator
Thanks for the response vince!

Like I stated, I haven't taken an AI during the past 4 weeks and im planning to go without it for 8 weeks and then I will test E2 - LC/MS/MS.

With my current test dose the protocol for the AI was 0,25mg of adex taken E4D.

One of the most confusing things has been the fact that I do seem to experience a lot of the symptoms of high E2 a day or two after the injection - feeling hot, moody. These symptoms used to be a clear sign of high e2 in the past. When I was using Nebido (aveed), and I had those symptoms, 0,25mgof adex always made me feel better. It took me a while to realise that I simply cannot use those symptoms to justify the use of an AI.

Before switching to test E, I used 1ml of Nebido every 2,5 weeks. With that I also took 0,25mg of arimidex EOD. This protocol worked well for 4 months.
If you did, indeed, crash your estradiol, recovery can take quite a while. Depending on all that happened - how long you were suppressed, whether, as you may have, crashed and then begun a recovery only to resume anastrozole and crash again, your age, your dose of testosterone, your SHBG - it can take a number of months.
 
ever heard of testosterone flu? - feeling hot, moody.
happens to many when they first start testosterone.. you may feel tired but unable to sleep, headache, dry cough, chills/heat and moody you should stick with it and give it some time it will go away and you will feel different.. taking AI during this time may remove the symptoms but you will never get the full benefits of T that you would get after "testosterone flu" time.. Vince wrote about this too when he started trt he felt like sick then after some time it went away and he felt good. doesn't mean your estrogen is high it's body
acclimatization to higher levels of hormones
its not like a real flu but the some symptoms match flu and it happens to many after introduction to testosterone so thats why testosterone flu :)
 

simeoni

Member
I do not know about "testosterone flu", but I did have a period of adaption when I first started TRT. It went pretty much the way you described.

Im sure there is a somewhat similar need for adaptation when you are recovering from an estrogen crash.

I will give it time and report back!
 

simeoni

Member
I would like to give an update in a sence that I feel that im somewhat improving. I seem to be having bettter days now; more motivation, able to enjoy things again, anxiety is not as strong anymore.

Overall I feel that im not as apathetic as I used to be. Libido could definitively be better.

Now that said I doo feel occasionally that after the injection im getting the old symptoms of high estrogen: moody, feeling hot in the face etc, feeling somewhat wired, etct. Im not doing anything without labs. Tomorrow will mark my 6 weeks without an AI. I will take the regular and sensitive E2 test in the beginning of september.
 

keigwin

Member
I know you're not focusing on dopamine anymore, but I did want to post for anyone who finds this thread later and share my thoughts about how dopamine plays in all this. I had high E2 (40+ pg/mL) for about two years. I couldn't convince either my PCP or an endocrinologist that it was an issue that needed addressing. I had typical symptoms: low energy, low libido, weight gain, depression, etc.

This last spring, I had some symptoms that I suspected were due to taking the antidepressant bupropion. I'd been on it for about two years and recently had started experiencing tremors, especially in the hands and neck. After reviewing my meds, this seemed like a likely culprit so I cut my dosage. My symptoms improved. Then I decided (foolishly) that maybe I didn't need the bupropion at all and I just quit taking it. It's an NDRI, which means it keeps dopamine in your system longer, resulting in higher dopamine levels. One month after stopping it, I had ZERO libido and ZERO energy, was sleeping way too much, and couldn't get myself off the couch all day. Dopamine crash?

This was the point I decided to hell with the doctors and got my hormones retested on my own. I had not only high E2, but high prolactin 21.5 ng/mL (4.0-15.2). It turns out that dopamine plays an important role in regulating prolactin production. I went back on the bupropion and my prolactin came down a bit to 18.9 ng/mL after 4 weeks. It seemed the bupropion was helping my energy levels, but my libido was still ZERO. It was then I started anastrozole. My prolactin continued to come down, as did my E2. At the same time, my energy level improved dramatically and my libido returned. My most recent test had me at E2 17 pg/mL and prolactin 10.9 ng/mL. (Yes, I'm cutting back my anastrozole dosage).

I know it's a bit hard to separate things out since I started taking anastrozole only 4 weeks after restarting bupropion, but I strongly suspect a dopamine crash was involved and that going back on the antidepressant has played a significant role in bringing my hormones back in line.

Hope someone finds this helpful!
 

simeoni

Member
Thanks for sharing your experience!

Your first symptoms probably were due to the bupropion withdrawal. Im assuming that your dopamine receptors got used to the higher levels of dopamine in the synapse and after you stopped it took a while your brain found a new homeostasis with the lower levels of dopamine.

Its interesting though that your libido returned only after you lowered your estrogen. You said it was high at 40+. Can you give the exact reading? was the E2 test that you took the sensitive one - LC/MS/MS?

I might be having a somewhat of an high E2 at the moment myself. The reason I think this is the fact that in february I had this same protocol, and with it my sensitive E2 reading was around 50. Also, at the moment I have been taking a small dose of test cream ED/EOD. With that, its possible that my total testosterone might be a bit too high.

Altough I have improved, im still also experiencing some symptoms that were not present in the past. These are:

- Sleep problems: I seem to wake up a bit too early
- Feeling hot during the day and in the evening: this is when others around me feel chilly
- anxiety: my stress tolerance is not that good at the moment.
- Libido: its not non-existant but I would not call it normal in no ways.
- Cant "feel" testosterone: This is a bit hard to put in to words but I havent been getting that "manly" feeling in a while which used to be present in the past. With this I mean the fact that with injections you actually feel that you are putting testosterone in to your body.

Since I do not want to take an AI without labs, im considering of splitting my dose and taking it EOD - instead of E4D. My test dose is quite small, but that does seem to bring my keep my levels in a good range.

My current injection protocol is:
0,15ml of test E E4D
+ 5-7mg of test cream 3 times during that 4 day injection period.
Overall this bring my weekly testosterone dose to 85mg.

My changed protocol would be:
0,075ml of TE EOD
+ 5-7mg of test cream day before the injection.

Since the dose is that small, Ill probably inject it into my delts using an insuling syringe - instead of the glutes. The weekly amount of injected test will remain pretty much the same. Im just hoping that with the lowered peaks there's less chance of excess aromatization. Ill be sticking with this protocol and take labs on the 3rd of september.

at the moment the set of labs would include:

TT
SHBG
cFT
E2(sensitive)
E2(regular)
---
I have also a few option tests that I might take. These are:

DHT
Cortisol
Ferritin

My thyroid number have looked good for so long that I dont think that testing them is necessary.




I know you're not focusing on dopamine anymore, but I did want to post for anyone who finds this thread later and share my thoughts about how dopamine plays in all this. I had high E2 (40+ pg/mL) for about two years. I couldn't convince either my PCP or an endocrinologist that it was an issue that needed addressing. I had typical symptoms: low energy, low libido, weight gain, depression, etc.

This last spring, I had some symptoms that I suspected were due to taking the antidepressant bupropion. I'd been on it for about two years and recently had started experiencing tremors, especially in the hands and neck. After reviewing my meds, this seemed like a likely culprit so I cut my dosage. My symptoms improved. Then I decided (foolishly) that maybe I didn't need the bupropion at all and I just quit taking it. It's an NDRI, which means it keeps dopamine in your system longer, resulting in higher dopamine levels. One month after stopping it, I had ZERO libido and ZERO energy, was sleeping way too much, and couldn't get myself off the couch all day. Dopamine crash?

This was the point I decided to hell with the doctors and got my hormones retested on my own. I had not only high E2, but high prolactin 21.5 ng/mL (4.0-15.2). It turns out that dopamine plays an important role in regulating prolactin production. I went back on the bupropion and my prolactin came down a bit to 18.9 ng/mL after 4 weeks. It seemed the bupropion was helping my energy levels, but my libido was still ZERO. It was then I started anastrozole. My prolactin continued to come down, as did my E2. At the same time, my energy level improved dramatically and my libido returned. My most recent test had me at E2 17 pg/mL and prolactin 10.9 ng/mL. (Yes, I'm cutting back my anastrozole dosage).

I know it's a bit hard to separate things out since I started taking anastrozole only 4 weeks after restarting bupropion, but I strongly suspect a dopamine crash was involved and that going back on the antidepressant has played a significant role in bringing my hormones back in line.

Hope someone finds this helpful!
 
Last edited:

keigwin

Member
Your first symptoms probably were due to the bupropion withdrawal. Im assuming that your dopamine receptors got used to the higher levels of dopamine in the synapse and after you stopped it took a while your brain found a new homeostasis with the lower levels of dopamine.

I don't think I ever did adjust to the lower dopamine levels, because after seeing my labs from 5/17/17 I went back on bupropion SR, albeit at a smaller dosage (was 150mg/day, then zero, then 75 mg/day). By 6/14/17 my prolactin had lowered nearly 10%. After 7/2/17 when I started the AI it's hard to say whether the continued lowering of prolactin was due to increased dopamine or lower estrogen, but I know it takes time for a dopamine reuptake inhibitor to fully take effect so certainly it must have been playing a role. Restoring 'homeostasis' as you say.

Its interesting though that your libido returned only after you lowered your estrogen. You said it was high at 40+. Can you give the exact reading? was the E2 test that you took the sensitive one - LC/MS/MS?

Again, it's hard to disentangle the effect of lower prolactin vs. lower E2 on my libido, but I can say that before the dopamine incident I still had a libido, though not a strong one. This points to prolactin as the ultimate libido-killer, which makes sense when you consider its role in killing post-orgasm libido in men.

To answer your question, my E2 readings were and 43 pg/mL (<= 39) on 2/17/15 and 41.5 pg/mL (7.6-42.6) on 5/17/17, using the non-sensitive test. Those are my only pre-AI references. I've been testing about every 4 weeks since starting anastrozole, trying to home in on the ideal dosage for me. I definitely wouldn't recommend playing with an AI without frequent testing, as it seems pretty easy to go from feeling bad (high E2) to good to bad again (low E2).

I wish I could say something helpful about your situation, but since I'm not on testosterone at the moment I have no experience to draw upon. I do wish you the best, though!
 

simeoni

Member
Now that I finally have all my bloodwork, Ill give you guys an update on my situation. These labs were taken on the 4th of september which marked my 8th week without an AI.

My protocol with these labs was 0,075ml of TE EOD and 5-7mg of test cream EOD. My weekly testosterone dosage was about 85mg.

These labs were taken at the day of my injection. Test cream was taken the day before. These labs should indicate my lowest point.

TT: 840 ng/dl
SHBG: 26 nmol/l
FT(calculated): 497 pmol/l (200-650 pmol/l)
E2 (regular): 33 pg/ml
E2 (LC-MS/MS): 28 pg/ml
DHT: 47 ng/dl
Ferritin: 62.2 mcg/l (28-300 mcg/l)


Few toughts on those values: This was the third time I pulled bot of the E2 test's and again those readings seem to fall in the 5-10 pg/ml range. In my case they seem to always be pretty close - at least when im in the "normal" range.

As strange as it seems, I think that I can lower my T dose a bit. At the moment im taking 0,05ml of TE EOD. Which - with my test cream - amounts to 65mg of testosterone in a week.

Now with my symptoms, heres what has changed. Ill take the list from my last post.

- Sleep problems: Im sleeping a bit better at the moment. Im not anymore waking up 2-3 hours before my alarm.
- Feeling hot during the day and in the evening: This symptoms has pretty much subsided.
- anxiety: Im not having nearly as much anxiety. Its still there in certain work related situations but I can function much better now.
- Libido: It has also improved even though its not really back to the level where it was before my crash.
- Cant "feel" testosterone: Well I guess this has slightly improved. I do feel more of a man now - at least from the point of my subjective experience. That said; I still do not get that old "high" which occured always the day after my injection. This however is a minor problem and it doesnt really matter that much.

Overall I feel that I have made a lot of clear improvements. Id say that I have regained about 60% of my subjective well being. I still seem to have bad days and I also have symptoms that resemble some sort of problem in my dopaminergic functioning. This for me means that there still is a lacking in my drive and the ability to enjoy the things I liked. During my bad days everything fleets flat. On the good days im horny and can enjoy life again!

Im hoping that things continue to improve. Ive read few anecdotals where people reported that it took them months to fully feel normal again.

Ill update this thread in a month or two.

I would also like to thank everyone who commented in this thread!
 

nurselyfe

Member
Now that I finally have all my bloodwork, Ill give you guys an update on my situation. These labs were taken on the 4th of september which marked my 8th week without an AI.

My protocol with these labs was 0,075ml of TE EOD and 5-7mg of test cream EOD. My weekly testosterone dosage was about 85mg.

These labs were taken at the day of my injection. Test cream was taken the day before. These labs should indicate my lowest point.

TT: 840 ng/dl
SHBG: 26 nmol/l
FT(calculated): 497 pmol/l (200-650 pmol/l)
E2 (regular): 33 pg/ml
E2 (LC-MS/MS): 28 pg/ml
DHT: 47 ng/dl
Ferritin: 62.2 mcg/l (28-300 mcg/l)


Few toughts on those values: This was the third time I pulled bot of the E2 test's and again those readings seem to fall in the 5-10 pg/ml range. In my case they seem to always be pretty close - at least when im in the "normal" range.

As strange as it seems, I think that I can lower my T dose a bit. At the moment im taking 0,05ml of TE EOD. Which - with my test cream - amounts to 65mg of testosterone in a week.

Now with my symptoms, heres what has changed. Ill take the list from my last post.

- Sleep problems: Im sleeping a bit better at the moment. Im not anymore waking up 2-3 hours before my alarm.
- Feeling hot during the day and in the evening: This symptoms has pretty much subsided.
- anxiety: Im not having nearly as much anxiety. Its still there in certain work related situations but I can function much better now.
- Libido: It has also improved even though its not really back to the level where it was before my crash.
- Cant "feel" testosterone: Well I guess this has slightly improved. I do feel more of a man now - at least from the point of my subjective experience. That said; I still do not get that old "high" which occured always the day after my injection. This however is a minor problem and it doesnt really matter that much.

Overall I feel that I have made a lot of clear improvements. Id say that I have regained about 60% of my subjective well being. I still seem to have bad days and I also have symptoms that resemble some sort of problem in my dopaminergic functioning. This for me means that there still is a lacking in my drive and the ability to enjoy the things I liked. During my bad days everything fleets flat. On the good days im horny and can enjoy life again!

Im hoping that things continue to improve. Ive read few anecdotals where people reported that it took them months to fully feel normal again.

Ill update this thread in a month or two.

I would also like to thank everyone who commented in this thread!

Thanks for the update. Glad to see you are doing a bit better. I have a couple questions for you if you don't mind sharing.

Do you have labs of your E2 where you were crashed? If so, can you post them with the ranges?

Do you have any other symptoms like hair loss, fluid retention, weak pumps in the gym, dry skin, harder to gain muscle? If so, do they seem to be getting better?
 

simeoni

Member
I dont have any lab work at a point when it was crashed near to zero. I have few readings from the day that I took my AI. For example, last may I had a non sensitive reading of 13 pg/ml. Still believing that I needed to take an AI, I took 0,25mg of adex on that day. Felt horrible after that for few weeks. That was even though my E2 came back within a week - to 32 pg/ml.

All my non sensitive E2 readings are originally in the nmol/l range and the reference range in them only states that E2 should be <15 nmol/l.

I am not experiencing any of the symptoms that you mentioned. The main ones for me seem to be related to dopamine.
 

at15

Active Member
you seem to be on the road back stay patient. Personally i overdid the ai's a bit in the past it might take a while but things do go back to homeostasis. Im doing 200mg 1x per week for greater aromatization (no ai) and im feeling good. E2 still within range.

Got caught up in that internet dogma about needing to run an aromatase inhibtor. Even when i ran 600mg per week of testosterone, 0.25 adex eod crashed me. In medical studies, healthy young men ran 25,50,125,300,600 per week of testosterone with NO AI. zero adverse effects and between the 125,300,600 no significant difference in sexual activity or sexual desire. (obviously the 25,50 groups went down)
 

madman

Super Moderator
you seem to be on the road back stay patient. Personally i overdid the ai's a bit in the past it might take a while but things do go back to homeostasis. Im doing 200mg 1x per week for greater aromatization (no ai) and im feeling good. E2 still within range.

Got caught up in that internet dogma about needing to run an aromatase inhibtor. Even when i ran 600mg per week of testosterone, 0.25 adex eod crashed me. In medical studies, healthy young men ran 25,50,125,300,600 per week of testosterone with NO AI. zero adverse effects and between the 125,300,600 no significant difference in sexual activity or sexual desire. (obviously the 25,50 groups went down)

Monitoring estradiol levels with the sensitive assay test is critical as too low/too high e2 can be detrimental but my belief is that as long as ones total t is fairly high a slightly higher e2 is beneficial too many regarding overall health/sexual function. To many worry about lowering e2 as overuse of aromatase inhibitors is rampant and people end up driving their e2 into the ground or can never find that sweet spot. I would rather have slightly elevated e2 with a higher t level than a lower e2.
 

simeoni

Member
Overall im definitively seeing improvement in my low dopamine symptoms. That said I still feel that things are not fully back to normal with this. My "pleasure response" still seems to be lower. I did a trial with mucuna - which has L-dopa - and my reaction to that was really weak. I didnt really feel any kick from it. Now in the past, the same dosage definitively brought a clear sensation of increased dopaminergic activity.

I cannot say for certain, but this would point to a downregulation in my dopamine receptors. My T dose was too high for months and perhaps that lead to a downregulation in my dopamine receptors. I remember Mariano also speaking about this. Hopefully now that my dose is lower, things will stabilize. Ill just have to keep things steady and wait.
 

nurselyfe

Member
Overall im definitively seeing improvement in my low dopamine symptoms. That said I still feel that things are not fully back to normal with this. My "pleasure response" still seems to be lower. I did a trial with mucuna - which has L-dopa - and my reaction to that was really weak. I didnt really feel any kick from it. Now in the past, the same dosage definitively brought a clear sensation of increased dopaminergic activity.

I cannot say for certain, but this would point to a downregulation in my dopamine receptors. My T dose was too high for months and perhaps that lead to a downregulation in my dopamine receptors. I remember Mariano also speaking about this. Hopefully now that my dose is lower, things will stabilize. Ill just have to keep things steady and wait.

It has nothing to do with your high T dose.
 

simeoni

Member
Care to elaborate?

If this is related to your theory that in some estrogen crash causes a desensitization of estrogen receptors, then I would like to see some reference for it. Could you post an open link to that full study?



It has nothing to do with your high T dose.
 
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