Crashed E2, Sensitive Nipples - What to Do?

[fitnessguy]

Hey guys,
So I have been having a bit of an issue with libido/energy/pumps in the gym with my TRT. The last blood test I had done my numbers were
T 927
E 19.6

From what I have read ( and Nelson has said) this is not a desirable ratio. So I decided to lower my Anti E dose (which is pretty high) to see if I can get improved libido. It worked and I feel better for sure but I also realized why I had been taking so much Anti E in the first place. Gyno started up again and both left and right nipples are sore/sensitive.

From what I have read Nelson has recommended people keep the higher level of Estrogen and use Tamoxifen Citrate to get ride of gyno. Now how does this work? Do I take the Tamox and then eventually gyno stops acting up forever and I can keep the higher estrogen levels ( better ratio and better libido). Or do I need to crash my Estrogen just to not get more and more gyno and deal with with side effects of low estrogen forever?

 

[Vince Carter]

Please post your labs...you post is so devoid of details like your therapy dosing and what you're using and how frequently that it's pretty hard to have any sort of informed discussion.

I will say that there is some nipple issues that are HRT related and completely benign that can be mistaken for gyno, guys can overreact in this area. Growth of tissue/lumps...are much different than some itch and/or stiffness but again we know nothing of what you're using and any labs you have.

 

[fitnessguy]

thanks for reply in what circumstances is it not related to Estrogen? Nipples feel different and tender when touched also small amount of fluid can come out.



150mg per week Test E ( 2 doses)
12.5mg-50mg Aromasin ED ( has changed lately)
1.25mg finasteride

 

[Vince]

Nelson has a warning thread on finasteride, you definitely should read over.
https://www.excelmale.com/forum/sho...steride)-or-Proscar-can-cause-erection-issues

 

[Vince Carter]

What labs do you have that you can share with us...attachment/screenshot...labs are key.

 

[fitnessguy]

I have read it, unfortunately I have also been on finasteride for close to 10 years. I'm afraid if I stop taking it I will surely lose the majority of my hair ( right now it hasn't moved much since). I just really hope I can get to normal levels on TRT. Unfortunately I don't have further blood work other than T and E levels Also SHBG was 17 (11-80). Which numbers should I get or look at that could possibly be causing this gyno?

 

[Vince Carter]

Is gyno your only concern here? Libido, fatigue, ED...any concerns there? I would go back and get the proper for males testing for E which is the (ultra) Sensitive LC/MS/MS. Any other test is for females and will typically overestimate E in men. In the mean time, read up about Fin and how it blocks DHT, DHT typically opposes Estrogen, so maybe there's a connection in that scheme for you and Gyno. You can also read (google) about Progesterone (test for it) and there are reports that guys are having some improvement with Gyno by supplementing Progesterone.

 

[fitnessguy]

Is gyno your only concern here? Libido, fatigue, ED...any concerns there? I would go back and get the proper for males testing for E which is the (ultra) Sensitive LC/MS/MS. Any other test is for females and will typically overestimate E in men. In the mean time, read up about Fin and how it blocks DHT, DHT typically opposes Estrogen, so maybe there's a connection in that scheme for you and Gyno. You can also read (google) about Progesterone (test for it) and there are reports that guys are having some improvement with Gyno by supplementing Progesterone.

Thanks Vince I appreciate this. So I have both concerns really. At a dose of 50mg Aromasin no gyno issues but poor libido,energy,ED. BUT at anything below 25mg Aromasin I feel much better but I feel first signs of gyno coming on (but not nesscarily bloat,acne or being emotional). I've read something that Nelson wrote about sometimes you can have a healthy estrogen level and get gyno in which case Nolvadex 20mg ED use is recommended (while staying on lower dose of AI). I'm just unsure if that is meaning Nolva for ever or for a period of time until gyno subsides.

I will get more blood work done but is hard in my state. And by the way the estrogen test was called Enhanced Estrogen is this the same or no (I asked for sensitive test btw)? Because if so my estrogen was really low since that test gave me a 19.6 estrogen level!!!

As far as progesterone goes I will get that tested but is it typically low or high progresterone that creates gyno?

 

[Vince Carter]

Look at your lab report next to the Estrogen or Estradiol, if it doesn't state "LC/MS/MS", it's the wrong test. We can also tell the test by the lab range that is given with the results, if you have that, post it. Im not completely sure on the Progesterone level but guys stating that they supplement and alleviate some symptoms would indicate that they were low.

 

[fitnessguy]

Look at your lab report next to the Estrogen or Estradiol, if it doesn't state "LC/MS/MS", it's the wrong test. We can also tell the test by the lab range that is given with the results, if you have that, post it. Im not completely sure on the Progesterone level but guys stating that they supplement and alleviate some symptoms would indicate that they were low.

So the Ref Range says 39.6 (literally doesn't have a range just that number). I'm assuming it's not the right one, also def don't see LC/MS/MD

 

[fitnessguy]

Also can I assume my estrogen is actually much higher if that indeed is not the right test? Maybe I was never low E after all (19.6)

 

[CoastWatcher]

Also can I assume my estrogen is actually much higher if that indeed is not the right test? Maybe I was never low E after all (19.6)

The standard (incorrect) test TENDS to over-estimate estradiol levels. Your actual level is likely to be lower that than the value indicated on your current test. The key thing to understand is that it is inaccurate and unreliable. Men need to rely on the sensitive, LC, MS/MS, estradiol test. Making decisions on any other lab value is perilous.

 

[fitnessguy]

Ok wow so it's definitely crashed then. And anything but "crashed" is giving me gyno sensitivity, ridiculous. Only thing I can think of now would be low progesterone or I need gyno surgery to get rid of gland before I can have normal E levels circulating. I guess I have to travel out of state to get the better test unfortunately.

 

[CoastWatcher]

You keep using the word "gyno." Sensitive nipples occurs in the vast majority of men who undertake TRT. In my case, three years in, I still have nipple pain, itching, and enlargement off and on. Classic gynecomastia presents with excess tissue in the breast area AND a hard, rubber-like area beneath the nipple. You are self-directing your protocol, or working with a doctor?

 

[fitnessguy]

Thank you for your responses!
My understanding of gyno is that it first presents itself in sensitivity and tenderness (sign you are getting it) and eventually just develops if you let that go on too long. I also had a bit of gyno as a teen in my right nipple so there is definetly a lump there just not sure if this sensitivity is causing it to continue to grow. Right now both nipples are sensitive and puffy. Or maybe just sensitivity like you said.....

So I was seeing a doctor but moved to a metropolis and I honestly don't think I could afford it now here. What I will do is post and see if anyone has recommendations for places to go and than see how much it costs in this area.

 

[CoastWatcher]

I'm not saying you do, or don't, have gynecomastia. I am suggesting that not every nipple issue, by any means, is gyno.

 

[fitnessguy]

Ok also my SHBG was 16 which isn't out of range but probably low right? How does one raise SHBG? Does an increase in estrogen increase SHBG? Is it typically low if your estrogen is also low?

 

[CoastWatcher]

Ok also my SHBG was 16 which isn't out of range but probably low right? How does one raise SHBG? Does an increase in estrogen increase SHBG? Is it typically low if your estrogen is also low?

SHBG seeks its own level for the most part. One works with it, designs a protocol taking that into consideration. One can have low SHBG and high estradiol, and one can have low SHBG and have normal or high estradiol.

 

[Vince Carter]

SHBG is what it is you can't change it up or down, but only work with and around it.

As Coastwatcher says the E2 tests TEND to overestimate in men, we say tends because there are a few guys and I am one that has had *higher E2 with the sensitive test, so we say tends to be lower just a a guideline as it's true for most guys but it can't be a rule.