AI monotherapy for low T due to excess body weight

[maxrebo]

When I was at my highest weight (300lbs) I was diagnosed with low T with a total testosterone of 250ng/dl. I've since lost 50lbs over a year and while my TT first went down even further, it has recently increased to 385ng/dl with an e2 level of 32pg/ml in my latest test a few days ago. I assume this means that my HPG axis is still functional.

Now since the low T seems to be due to the increased aromatization from all the excess fat this made me wonder if it would be possible to reduce aromatase activity with an AI and therefore increase total T to reduce the low T symptoms while I lose the rest of the weight.

• Has anyone done this / can share some experiences?
  
  
• What AI would be suitable for this use?
  
  
• What dosage / dosing frequency would you recommend to improve T without crashing my e2?

Thanks!

 

[BigBamBoo]

Hello.
Interesting theory. Not sure if it will help/work. But there are lots of folks here that know way more than I do and will likely chime in.

That being said. From my understanding of weight loss, is that fat cells actually just shrink.
When you lose weight, your fat cells are “losing weight” weight but not actually leaving your body.

Now if you were stranded on a dessert island and were actually starving, then your body may “eat” the fat cells...along with your muscles.

This is why so many people who lose weight end up gaining it back later on.

The only way to actually get rid of the fat cells is via liposuction/surgery.

And even that only gives you localized removal of the fat cells. And when you gain weight, it will go to the areas where there is still fat cells.
So if you had abdominal lipo, the weight will be gained in your butt, thighs, chest, face, etc.

Yes, not probably what you wanted to hear. But I know for myself, I like having information and understanding of the why of things.

Good luck on your journey. Sounds like you have made some great gains.

From your numbers, it would be safe to say you could benefit from TRT.

Do you know your SHBG number? Your E2 is not that high.

For me, AI is a no go. Even on a very low dose, it tried to kill me. So I adjusted my dosing schedule to lower my E2.
Some folks can tolerate AI....others...not so much.

 

[maxrebo]

From your numbers, it would be safe to say you could benefit from TRT.

Do you know your SHBG number? Your E2 is not that high.

For me, AI is a no go. Even on a very low dose, it tried to kill me. So I adjusted my dosing schedule to lower my E2.
Some folks can tolerate AI....others...not so much.

My SHBG is at 25.6 nmol/L. I actually thought about getting TRT (even found a doc who would be willing to prescribe me) but since I've seen my latest blood test I've decided against it since it seems my body is still able to produce enough T if not for the excess weight. So before I do commit to TRT for life, I want to see if I can get up to good T levels with just weight loss.

Still I wonder if I can "bridge the gap" in my T with an AI until I've reduce body fat enough to where my HPG axis produces enough T on its own.

 

[BigBamBoo]

Well...you T numbers are those of a 80+ yo man.

You do not have have high SHBG or really high E2 levels.

Getting your T levels up and dialing it in so you do not have to use an AI would probably really help you on many levels...including weight loss.

My pre TRT T number was 600. But I have high SHBG (75) and my free T was around 10.
My E2 was around 20, but once I started TRT it shot up to 75. Thankfully for the high SHBG, it did not effect me too bad.

I since have changed my protocol and am waiting to pull labs in a week or so to see here my E2 is at.
Based on how I am feeling, I think it is lower now.

My last labs had me at 900+ TT and my free T was around 18-20.

I know feel MUCH better all around. Mood, gym, etc.


But it is a personal choice to go on TRT and totally understand the hesitation.
I have had second thoughts, but since changing my protocol, I am happy to be in it.

Good luck to you.

 

[MarkM]

Are you taking the proper E2 test, which is the Estradiol Sensitive LC/MS/MS assay? I would not be taking an AI with any E2 reading of 32 unless I had severe high E2 symptoms.

 

[maxrebo]

Are you taking the proper E2 test, which is the Estradiol Sensitive LC/MS/MS assay? I would not be taking an AI with any E2 reading of 32 unless I had severe high E2 symptoms.

The test says "CLA" as testing method, so I'm guessing not sensitive? I'm just wondering if I lower my E2 with an AI (and assuming my HPG axis is still functional) wouldn't my body respond by increasing LH and therefore testosterone until E2 is at a similar level again?

 

[BigBamBoo]

What is your target goal number for your T?

I highly doubt suppressing your E2 will increase your FT and TT in any significant way.

Remember, your T fluctuates daily so you could test every day and you will be higher or lower on every test.

 

[Nelson Vergel]

Using anastrozole monotherapy to increase your T may achieve a total T level of 300-500 ng/dl max and will crash your estradiol. Low estradiol will make you fatter and less sexual.

I would review these:

Nelson's Top Tricks for Fat Loss

Role of Estradiol in Men and Its Management

Anastrozole Monotherapy?