Water Retention Caused by Testosterone May Have Nothing to Do with Estradiol

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Hi Nelson,

So I might have jumped the gun when I was at my TRT doc this past Monday. I was looking up the drug you were taking for bloat (eplerenone) but then saw your new post about Metformin. He did prescribe it for me but after reading your bio (mad respect to you by the way!), I'm wondering if it will benefit me. What are your thoughts on this? I have been back on HCG since Monday and miss the boost in my libido! Just want to make sure I can keep the water retention down.

Thank you sir!
 
Defy Medical TRT clinic doctor

Nelson Vergel

Founder, ExcelMale.com
This small study shows that testosterone supplementation enhances cortisol.

Exogenous testosterone enhances cortisol and affective responses to social-evaluative stress in dominant men
Highlights
•This study tests the causal effects of testosterone on stress reactivity.
•Exogenous testosterone caused increased cortisol responses to stress.
•Testosterone increased negative affect in anticipation of and after a stressor.
•The effects of testosterone on the stress responses are more robust in dominant men.
Abstract
Stress often precedes the onset of mental health disorders and is linked to negative impacts on physical health as well. Prior research indicates that testosterone levels are related to reduced stress reactivity in some cases but correlate with increased stress responses in other cases. To resolve these inconsistencies, we tested the causal influence of testosterone on stress reactivity to a social-evaluative stressor. Further, prior work has failed to consider status-relevant individual differences such as trait dominance that may modulate the influence of testosterone on responses to stressors. Participants (n = 120 males) were randomly assigned to receive exogenous testosterone or placebo (n = 60 testosterone treatment group) via topical gel prior to a well-validated social-evaluative stressor. Compared to placebo, testosterone significantly increased cortisol and negative affect in response to the stressor, especially for men high in trait dominance (95% confidence intervals did not contain zero). The findings suggest that the combination of high testosterone and exposure to status-relevant social stress may confer increased risk for stress-mediated disorders, particularly for individuals high in trait dominance.


Source
 

Nelson Vergel

Founder, ExcelMale.com
This may be the reason I feel less bloated on metformin.

Metformin increases in vivo 11β-hydroxysteroid dehydrogenase type 1 activity in euglycaemic obese men

Endocrine Abstracts (2011) 25 OC2.8
|
Roland Stimson, Ruth Andrew, Gregory Jones, Dawn Livingstone, Kenneth Smith & Brian Walker

Author affiliations
Inhibiting cortisol regeneration by 11β-HSD1 is a promising therapy for type two diabetes. In obesity, 11β-HSD1 activity is increased in adipose tissue but decreased in the liver, the latter putatively mediated by hyperinsulinaemia. We tested whether insulin sensitisation with metformin regulates 11β-HSD1 activity in whole body and in liver in obesity.

Five obese men (age 48±5 years, BMI 39.8±3.6 kg/m2) participated in a randomised, double-blinded, crossover study comparing metformin (1 g BD orally for 28 days) with placebo. At the end of each phase, subjects collected a 24 h urine sample and attended twice after overnight fast. On a first visit, 9,11,12,12-[2H]4-cortisol (d4-cortisol) was infused for 4 h, with repeated blood sampling to measure steady state d3-cortisol appearance (whole body 11β-HSD1 activity). On a second visit, subjects took 0.25 mg oral dexamethasone at 2300 h and 25 mg oral cortisone at 0900 h, with repeated blood sampling to measure conversion to cortisol by hepatic 11β-HSD1. Steroids were quantified by RIA (cortisone test) or mass spectrometry (tracer and urinary steroids). Local ethical approval was obtained. Data are mean±S.E.M.

Fasting glucose (5.3±0.3 vs 6.0±0.9 mmol/l) and insulin (11.4±3.5 vs 21.0±7.8 mU/l) were non-significantly decreased by metformin. Metformin increased whole body rate of appearance of d3-cortisol (48±6 vs 39±5 nmol/min, P=0.01), but did not alter the rate of conversion of oral cortisone to cortisol (area under curve 29 951±11 207 vs 34 128±3741, P=0.7) or urinary cortisol metabolites (15.9±4.0 vs 18.3±4.2 mg/day).

Metformin increases whole body 11β-HSD1 activity in euglycaemic obese men. However, whether this is mediated in the liver by reversal of hyperinsulinaemia remains unproven. There has been concern that 11β-HSD1 inhibitors will be less effective in the presence of metformin, given their shared mechanism of suppressing hepatic gluconeogenesis. These data suggest, however, that metformin may increase the local regeneration of cortisol by 11β-HSD1 and provide a bigger target for 11β-HSD1 inhibitors.
 

Rhankash

New Member
Hey Nelson,

since starting TRT 2 months ago I’ve gained about 10# and i am bloated in my stomach and face area as well, i recently had a dexa scan and it showed me around 6% body fat do you recommend metformin? I have a bodybuilding show coming up soon and want to get rid of the bloating! Lol
 

Talon123

New Member
In my personal experience metformin did nothing. It made me very very tired however. I just recently tried it and WOW was I sleepy. I looked it up and it appears some get the exhaustion and some don't
 

GEORGE TOULIATOS

New Member
As far as i remember,Patrick Arnold the chemist had written an article in his website.
He said that even non aromatised AAS (flyoxymesterone in specific),elevate systemic blood pressure,although there is no estrogenic effect.Well,halotestin (stexon brand name) is one of these highly androgenic steroids that inhibit the enzyme
11 beta hydroxylase.
 

Digghy

New Member
Dear all, I have read everything about this problem on many forums without finding a solution.


I am 36 years old, practicing body building since I was 24. I have a quite stressing work (top manager) and plus a very active lifestyle (train every day 2 hours in the morning with weight-lifting + 1,5 hours of cardio in the evening). I eat clean (proteins+vegetables with a low carb diet) with a cheat meal only once a week.


I had 2 blood tests in may 2017 and september 2017 showing testosterone in the low range (290 over a range 280-900), with cortisol on the high range (18 over a range 7-19) and ACTH well above the max value (88 with a max of 46), and my doctor started a 3 months teraphy with Testim Gel (transdermal, 50 mg per day, meaning 5 mg of effective testosterone per day). The first month I felt great, good energy, good drive, my body shape was good as usual (8-10% body fat), but after that I started bloating and retaining water, my abs just disappeared, despite my diet and my training were always the same as before.


I did blood test on January 2018 just at the end of the 3 months TRT period: estradiol was low, so no problem of aromatization, of course LH/FSH at 0, but ACTH increased to 118 and Aldosterone at the high top of the range (292 over a max of 295), despite my blood sodium and potassium were in range.


I used gonadorelins to restart my HPTA, after 6 weeks I did a blood test again showing a testosterone at the same level pre TRT (286), LH/FSH restarted, Aldosterone still at the top of the range, ACTH still at 109, cortisol in range (16 over a range 7-19). Still, bloated and full of water retention, in particolar after a workput or after eating.


I tried Eplenerone (25 mg and 50 mg), Metformine, Potassium... Nothing worked.


I found this article about testosterone inhibiting 11 HSD2 therefore with cortisol binding MR. I think this is my case: testosterone in presence of high ACTH and realtively high cortisol made this cortisol binding MR and making me retaining water.


There are now some questions:
- how is it possible that my sodium/potassium in blood test are in range?
- shouldn't I have high sodium and low potassium due to this activity on MR?
- how long does it take for 11 HSD2 to reactivate and MR to unbind from cortisol?
- there is something other I can do?


Now I am 2 months off from my TRT but still bloated and full of water.


Would very very thankful if some can give me your advice.
 

Nelson Vergel

Founder, ExcelMale.com
Finally! Someone who read the article I posted and who gives me something to think about. Thank you, Digghy!

"There are now some questions:
- how is it possible that my sodium/potassium in blood test are in range?
I have no idea
- shouldn't I have high sodium and low potassium due to this activity on MR?
- how long does it take for 11 HSD2 to reactivate and MR to unbind from cortisol?
No data
- there is something other I can do?
Read below


Now I am 2 months off from my TRT but still bloated and full of water.


Would very very thankful if some can give me your advice."


The only thing that works in my experience is a short course of hydrochlorothiazide, a few sessions of sweat (sauna) and cardiovascular exercise 3-4 times per week for 30 min.
 
Last edited:
I had to stop taking HCG due to serious water retention. However, I don't like my boys not active to I got back on after finding this site and doing more research. I put on 8 lbs of water in over a week so I started taking a natural diuretic (Expel 750) and I'm down 4lbs in 3 days. Hoping my continued use will drop even more but at least I'm not waking up with numb hands from the water.
 

Digghy

New Member
Finally! Someone who read the article I posted and who gives me something to think about. Thank you, Digghy!

"There are now some questions:
- how is it possible that my sodium/potassium in blood test are in range?
I have no idea
- shouldn't I have high sodium and low potassium due to this activity on MR?
- how long does it take for 11 HSD2 to reactivate and MR to unbind from cortisol?
No data
- there is something other I can do?
Read below


Now I am 2 months off from my TRT but still bloated and full of water.


Would very very thankful if some can give me your advice."


The only thing that works in my experience is a short course of hydrochlorothiazide, a few sessions of sweat (sauna) and cardiovascular exercise 3-4 times per week for 30 min.

Hi Nelson, thanks for the reply!

Actually I tried with some saunas, there was a mild effect dropping water, but soon came back (in 1 day). I do 30 mins Cardio every morning after weight lifting, and 1,5 hours Cardio every evening after work, always sweating a lot. But nothing work.

I admit my ACTH and cortisol are probably due to some overreaching and stress by work and sport activity, but I have always been stressed (and trained much more in the past months) and never had this horrible bloat and water retention.

I drink 3/4 liters of water with no sodium and have a low sodium diet.

I do not understand why being my aldosterone and my cortisol at the top of the range, still my blood sodium and potassium were both in range (sodium at low range, potassium high range)!!!

Furthermore, my renin and ADH were both perfectly in range, and estradiol low at the bottom of the range!

How much time I should wait for my MR receptors and my enzime 11 HSD2 to restore? I did only 3 months TRT at 5 mg per day (very low dose) and now I am 2 months off but still retaining much much water, in particular on my ABS, and in particular after workout (as cortisol increase and binds MR receptor I suppose)!

Thanks for your kind reply!
 

Nelson Vergel

Founder, ExcelMale.com
Is there any possibility that your EGFR is low, you have high glucose or high GTT (liver)? Any alcohol and sweet consumption? Have you tried a low carb diet?

I wish I could answer your questions. Bloating is my number one issue also but I have IBS, food intolerances, medication-induced insulin resistance and visceral fat, and my carb intake is not the best.
 

blackebob

Member
after 2 years on cream and gel I switched to injecting January 2018. I have never had bloating in the past, and my T has been 1500+ a cople times before shots.
EFGR is 66, doing keto since xmas. Liver enzymes were elevated in Feb from fhe December test. Dr said it was from 1500+ T from initial Cypionate dosage.
I dont eat sweets or sugar drinks.I like my bourbon at night, but before injecting bloating was not an issue that was on 300mg test cream or 3pumps 1.62% gel
I stopped daily HCG 150 ml inj a week ago, and some of the bloat went away. I take Benicar fo BP. It has had no ED sides in 2 years. Why would I bloat on injections. and not Andro gel or cream?
 

Nelson Vergel

Founder, ExcelMale.com
Injections cause more bloating due to higher T peaks than gels. Have you tried smaller more frequent doses of T.

hCG can worsen water retention.

Why did you switch from a gel to injections if you reached 1500 ng/dl of T on them? I am confused
 

blackebob

Member
Injections cause more bloating due to higher T peaks than gels. Have you tried smaller more frequent doses of T.

hCG can worsen water retention.

Why did you switch from a gel to injections if you reached 1500 ng/dl of T on them? I am confused

Original dose was .5cc E3.5D. 200mg cyp per week Jan 2018. Dr reduced doseage late Febuary, and I started injecting .11cc(200mg/ml) ED, 150mg per week. March 3rd.

200 T Jan 2015, started andro gel. By November 2015 I felt great, staedy T around 800. New Dr wanted to fix me and talked me into clomid, I was ignorant,and trusted him. It wrecked me. I never felt the same again after going back on Andro gel March 2016, after 3 months of clomid. I was then talked into trying the cream by a 3rd Dr. He started me on an ultra low dose, and would only bump it slightly every 3 months. I came to find out Drs 2 and 3 were in a blind study before me and hated each other. Dr 3 was going to prove superiority of cream over clomid. So 18 month's on cream with T still troughing at low 400, and I switched to Dr number 4.

The 1500 was after the clomid before, cream.No bloating ever though til Injections and HCG started.

Sorry if this is disjointed, I hate typing on this phone.
 

Digghy

New Member
Is there any possibility that your EGFR is low, you have high glucose or high GTT (liver)? Any alcohol and sweet consumption? Have you tried a low carb diet?

I wish I could answer your questions. Bloating is my number one issue also but I have IBS, food intolerances, medication-induced insulin resistance and visceral fat, and my carb intake is not the best.

Hi Nelson, actually liver and kidneys work well, and I never had this bloating before December 2017, yes I had sometimes some water retention but due to stress, climate changes or diet, disappearing in couple of days.

No alcohol (never in my life), and yes, I have a low carb diet: from monday to sunday I eat only low fat proteic food (meat and fish) and a lot of vegetables, including some carbs only in my post workout breakfast (but it's only 2 apples and 40 grams of oat meat). On sunday I have a high sugar cheat meal (usually with a lot of icecream), but have this diet scheme since 5 years ago and never never had water retention issues.

I definetly think MR receptors are the problem, binding my high cortisol and making me retaining water. In fact I am especially bloated after workout, in particular after doing cardio, when my cortisol levels raises. And I am bloated only in my abdomen, where cortisol receptors and MR intestinal receptors are high. I am 8-10% bodyfat, but look like I am 14% now with all this water retention!

I am a little bit puzzled because I tried with Eplenerone which should bind MR receptors, but was uneffective at all.

My question is: how long does it take to my 11 HSD2 enzimes to make their job again deactivating my periferic cortisol and avoiding it to bind to my MR receptors? I am 2 months off my TRT (and having done it for a short time frame, only 3 months, and with super low dose, apart from that I never used AAS) but no progress so far, and I am becoming scared.

I do not think this can be due to something other than TRT, as I had no food intolerances before and my diet and training is always the same.

Cheers
 
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