First post. Can’t get E2 under control, starting to worry

[Seagal]

Take a look at Rebecca Glaser and women and learn a little bit.

Similar to T’s decline with age, DHEAS and androstenediones production also decreases with age [3]. This decline in proandrogens markedly reduces the amount of T available at the cellular level. While androstenedione is found in 5–10-fold higher concentrations than T in serum, DHEAS levels may be thousands of times higher than T levels [4]. Thus, in comparison to T, the contribution of these prohormones to bioavailable T at the AR exponentially declines with age. With this marked decline in local production, increasing amounts of T (i.e., from replacement therapy) would be needed to supply a greater portion of bioavailable T to the AR. There is also concern of AR ‘resistance’ [29]. Theoretically, with aging the AR, similar to the insulin receptor, may become resistant to T and require higher levels to elicit the same response.
...
We no longer routinely monitor serum T levels in all patients. However, because of aromatization and the adverse effects of excess estrogen in men and some women, we do measure estradiol and testosterone levels in subgroups of patients. Patients are treated with aromatase inhibitors, combined in the pellet implant based on history (e.g., breast cancer, endometriosis, fibroids etc.), symptoms (e.g., fluid retention, weight gain, anxiety etc.) and serum levels [11].

 

[BigTex]

All I can say at this point is I am observing vastly different anecdotes on this type of dosing on nearly every forum I've ever read in the 10 years I've been on TRT, including this one. They all have threads about daily low dose injecting and if it was as successful as you're claiming it would be to give all the benefits and alleviate all risk, we would see more people sticking with it. If the goalpost is being moved to say it has to include all of the other things you mentioned in your protocol, then I agree probably nobody else has tried it. I would also argue that you would get a near zero compliance rate for even a dedicated population, let alone the average, and that the risks of 120+ are minimal and mostly fear-mongering based off extrapolation and assumption on what may or may not be possible, to be quite honest.

Cut the vitamin D and zinc doses in half or less then, you know the exact point I was trying to make. The body was never intended to get even 1000iu of vitamin D orally every day, it is a hormone that is not being dosed in an amount or delivery method that would be natural. Its supraphysiological dosing by the same standard. Minerals and vitamins at the doses in common supplements were would never be found in nature.

Your protocol is interesting. I was a patient of Dr Gordon for a long time. He was having me take a low dose testosterone blend of prop/cyp, first every 3 days but eventually on daily injections at physiological doses. He also had me taking clomid which he believed would keep hpta function at normal levels, and if my LH and FSH being zeroed out were any measures of that, it definitely did not, all it did was cause side effects. As well as a laundry list of other supplements and hormones. I can see how you thought I was referencing yours since there are a couple of similarities.

As you saw from my posting where I put up the old Quest/Labcorp standards before 2017, the goal post has been moved.

First post. Can’t get E2 under control, starting to worry

I definitely agree with this. Most guys really want to take 150mg to 200mg a week for bodybuilding purposes. I can definitely say that muscle growth effects of a test dosage of 150 to 200mg a week will wear out after 3 months of bodybuilding. It is really wrong to take TRT for bodybuilding...

www.excelmale.com

Before 2017 highs were almost 1200 and lows were about 250. So medical science has cut off a huge portion of people in the 250 range that most like are very symptomatic and told them they are fine. Now we are calling old norms, supraphysiological. Honestly makes no sense. Again, why did we not keep the norms the same but put a little effort into discovering why testosterone levels are in a decline and maybe solve the problem. Might then be possible to keep so many man from having low T issues in the first place. We know this is not healthy to have some of these low T problems especially at such young ages.

Now has anyone played around with low dosing testosterone more closer to the Circadian cycle of testostereone pulses? Absolutely I tried and posted it here. I believe I was using 25mg of test base dissolved in BA and DMSO and used as a transdermal. I felt fine with the dose and managed to keep my testosterone levels up until the testosterone undecanoate hit peak. @Cataceous I have played around with every dose imaginable and every ester I can get my hands on, cypionate, decanoate, enanthate,
isocaproate, phenylpropionate, proprionate, undecanoate, and base. I know what worked best for competition and now for TRT for my individual genetics. I can promise what works for me and the dose I use may not work for anyone else. The amazing thing about the human race, is we are all very unique. Their lies the challenge for our doctors.

Hey, thanks to ALL who have participated in this discussion. It has been very stimulating. I hope none of us takes any of this personal because that is not what this discussion is about. Keep it up, we are 7 Pages strong now!

 

[TLR]

Man….let me be gone awhile and come back and see a good thread (it had been dragging around here for a bit)! All I have is my 13 years of personal experience to offer. I’m in no way a textbook study, and I’m similar to Charliebizz in many ways. I’m on my second well known TRT doc, and seem to be one of those “hard cases” (lucky me).

I have preexisting anxiety that seems to be exacerbated by higher levels, and my erectile function seems to be affected by E2 once it reaches the upper 30s / 40s (although I stop short of blaming the E2 all the way….it could very well be the T level).

Which leads me to where I come down on this….like most things there is a “bell curve” and typical protocols will work for the majority of men. I have NUMEROUS friends that are on the cookie cutter 1/2 cc once a week and they cruise along just fine. I have a former boss that does 250 mg a week and has no problems. As we always say everybody is different, and I don’t care what any doctor tells you, they don’t have all of the answers on why that is and what exactly to do about it because there is still so much about this we DONT know.

We are dealing with a lot of unknowns tinkering with Mother Nature and hormones. I don’t believe the overwhelming majority of guys will screw themselves up too badly in the long haul unless they go way off the reservation, but again, I’m totally guessing because the type of LONG TERM studies we need don’t exist, and has been mentioned, may never exist due to ethical and liability reasons.

I agree with the start low / go slow, minimum effective dose philosophy, but I’m open minded enough that some people will need more, and some people can tolerate enough to kill a moose and their health markers will be fine.

I too am somewhat enamored with Rob Roy’s (let’s just call him Dr Nichols) thoughts, and from what I have seen I agree that he seems to care about his patients….I have also searched for negative reviews from people who were former patients and have not found any. I know he doesn’t have time to sit and have a cocktail and answer my questions, but I have considered having myself managed by him on more than one occasion….the thing that stops me is I have spent so much money on the two doctors I have gone to that I don’t feel like spending $500 just to talk (which is a me problem and has nothing to do with him.)

I had the perception of him for awhile that he was just all about blowing all of your levels through the roof till you felt good, and I still have some questions about some things he says. However, after listening to him more I have softened on that stance quite a bit.

At the end of the day, do what works for you, be patient, seek out a good doc, keep expectations in line, keep an open mind and good luck!

 

[FunkOdyssey]

That's what makes you a lot smarter than Cataceous. Taking thyroid, and raising thyroid levels in a person with sub clinical hypothyroidism or hypothyroidism itself, is not the same in anyway, as a person with true hyperthyroidism. In other words, taking thyroid does not cause the same medical sequela as a person with true hyperthyroidism. And hyper thyroidism there is an auto immune component, and that's what does the damage. So once again, an example of why cat, TaciousAnd hyper thyroidism there is an auto immune component, and that's what does the damage. So once again, an example of why cataceous should not be giving advice. He also doesn't understand the difference between a baseline observation and an interventional study.

I tend to agree with some of your views on testosterone and I appreciate your taking the time to participate here. I wish you would be more respectful though. The insults and condescension detract from your postings, which are otherwise valuable.

I'm with Cataceous on thyroid hormone -- I think there's a strong case to make against overenthusiastic thyroid optimization if we consider experimental evidence together with the observational studies. I'll try to post on that tomorrow.

 

[TLR]

I tend to agree with some of your views on testosterone and I appreciate your taking the time to participate here. I wish you would be more respectful though. The insults and condescension detract from your postings, which are otherwise valuable.

I'm with Cataceous on thyroid hormone -- I think there's a strong case to make against overenthusiastic thyroid optimization if we consider experimental evidence together with the observational studies. I'll try to post on that tomorrow.

Speaking from personal experience, I have a friend that got his thyroid “optimized” and he ended up in the ER with his heart doing all kinds of funky shit after feeling like death for about a week (don’t know if it was AFIB, PVCs or what the actual diagnosis was)….when he had his pre treatment labs looked at by another doc, all of his numbers were fine except his TSH was a little elevated. The doc told him he should never have been on thyroid, and that due to the pulsatile nature of TSH you can’t rely on a “snapshot” of what was in the blood at the time….Im no “study” geek or thyroid expert, but I can see where it would be a lot easier to cause some seriously bad shit to happen with thyroid than with testosterone.

 

[Mastodont]

I view this as a problem more with the distribution than the amount of testosterone. Delivered as one injection weekly it yields unnaturally large oscillations, likely leading to the reported problems. Delivered as 7.14 mg TC — 5 mg T — daily, a significant fraction of men would do well, setting aside potential issues related to HPTA shutdown. This is in the context of the 6-7 mg of testosterone that's typical of endogenous production in healthy young men. How many have actually tried this?

Was going to say this, totally different scenario, if someone aromatizes easily, 50mg as a bolus will do that, and not raise t levels enough to compensate. Danny Bossa would call physiological levels chemical castration though. If you creep around, reddit etc there are plenty of daily microdosing stories and many seem to stick to them.

I believe there is virtually no evidence for this — the claim that most men on TRT somehow require more testosterone than 99+% ever make naturally. If you're relying on anecdotes then I have plenty of my own where guys fare worse on such doses.

Nah, RobRoy finally provided the evidence, science is settled, see "Testosterone implants in women: Pharmacological dosing for a physiologic effect" Skyhigh HCT and loss of libido with some bloat are part of the optimization game.

The core is 3.2 mg testosterone enanthate and 2.4 mg testosterone propionate injected daily early am. There's also 600 mcg of progesterone injected at bedtime. For HPTA activity, 15 mg of enclomiphene is taken daily PO, and 20 mcg of GnRH is injected 5.25 times per day.

How do you know how much enclomiphene and gnrh are not contributing to your total testosterone? Measured with only the blend?

 

[jmbb]

Danny Bossa would call physiological levels chemical castration though. If you creep around, reddit etc there are plenty of daily microdosing stories and many seem to stick to them.

That guy probably had good intentions to stop guys from needlessly crushing their E2 with poor T mill protocols, but overall his combative personality and that whole "anti-AI no matter what" crowd probably set back the overall TRT community by a good amount until the pendulum started swinging back to a more reasonable approach. Agreed, definitely not chemical castration.

When I have gone through the old daily injection reddit threads, one year old or more, and actually click on the usernames for a lot of the guys doing dailies to see if the protocol is still being used, it seems most revert back to 2x per week, MWF, or an EOD protocol. They are usually enthusiastic at first but end up saying they didn't see much difference over time.

There are always people that it works well for that don't suffer from injection fatigue, but going over the old threads, I got the opposite impression - it doesn't seem the majority that try daily injections are sticking with it a year or more later. You'll also find a lot of people saying they felt flat and like they lost the benefits of TRT - maybe this would be different for some with the blended prop Cataceous mentioned.

 

[Mastodont]

There are always people that it works well for that don't suffer from injection fatigue, but going over the old threads, I got the opposite impression - it doesn't seem the majority that try daily injections are sticking with it a year or more later. You'll also find a lot of people saying they felt flat and like they lost the benefits of TRT - maybe this would be different for some with the blended prop Cataceous mentioned.

Must say i do know someone who recently went from dailies to e3d also, for me personally daily worked well for a couple of months, even with a tiny dose of 7.5mg test E, until e2 started creeping on me, or could be something else, anxiousness none the less, levels of free T were midrange. Low shbg always.

I just recalled something, RobRoy used to prescribe ARBs with testosterone, still the case?

 

[jmbb]

Must say i do know someone who recently went from dailies to e3d also, for me personally daily worked well for a couple of months, even with a tiny dose of 7.5mg test E, until e2 started creeping on me, or could be something else, anxiousness none the less, levels of free T were midrange. Low shbg always.

I just recalled something, RobRoy used to prescribe ARBs with testosterone, still the case?

What's your protocol like now? I wonder if estrogen metabolism can make a difference, where it can kind of compound on more frequent injections before having time to clear it from the last shot. Naturally our bodies are a lot smarter than we all are, and would shut off T production once E2 started creeping up too high for any individual.

But that's just pure speculation off the top of my head without really thinking it through before having coffee this morning. Probably wrong, lol.

 

[Mastodont]

What's your protocol like now? I wonder if estrogen metabolism can make a difference, where it can kind of compound on more frequent injections before having time to clear it from the last shot. Naturally our bodies are a lot smarter than we all are, and would shut off T production once E2 started creeping up too high for any individual.

But that's just pure speculation off the top of my head without really thinking it through before having coffee this morning. Probably wrong, lol.

Yes i have wondered the same, if every injection for some reason results in more estradiol, and the amount is not linear with doses, it's kind of a slippery slope, even possibly too much so. Currently i'm just starting out with test E after playing with nebido and sustanon for a while, tried subq at first but i just never feel right with them, going to try weekly shots but not sure how much, have to decide between 80-125mg, just introduced it with 200mg, first two days was miserable but after that pretty good. Its a test E with no BA or BB so it should have a slightly more sustained release.

Edit: With daily injections playing with ai is a no go in my book, so it's kind of a hit or miss, sure the answer may lie in going higher or lower, my theory is many end up staying pretty low to prevent e2 sides.

 

[jmbb]

Yes i have wondered the same, if every injection for some reason results in more estradiol, and the amount is not linear with doses, it's kind of a slippery slope, even possibly too much so. Currently i'm just starting out with test E after playing with nebido and sustanon for a while, tried subq at first but i just never feel right with them, going to try weekly shots but not sure how much, have to decide between 80-125mg, just introduced it with 200mg, first two days was miserable but after that pretty good. Its a test E with no BA or BB so it should have a slightly more sustained release.

I use test E these days as well and despite people telling me they're the same thing, I significantly shed water and that underlying sense of anxiety seems to just disappear when using E over cyp. The enanthate I use from Empower still has BA but not BB, maybe that has something to do with it like you mentioned?

I notice when I do weekly shots I feel better as the week goes on. People generally say that means to lower your dose, but I haven't been able to replicate that on lower doses/frequent injections.

I do know there are some guys out there like a friend of mine that do fine by just keeping things simple and take a dose of 100-200mg whenever they feel like their test is starting to get too low, could be 7, 10, 14 days, whatever. Interesting concept, but you'd definitely have to be in tune with your body and not a reactionary person who would just pin because they got a bad night's sleep etc.

 

[Mastodont]

I notice when I do weekly shots I feel better as the week goes on. People generally say that means to lower your dose, but I haven't been able to replicate that on lower doses/frequent injections.

This is common, i think its because of the initial aromatization after introducing a dose in to the system, and that being followed by some regulatory measures in the body, i have not been able to get the same good feeling by mimicking those feelgood-levels by injecting more frequently.

I do know there are some guys out there like a friend of mine that do fine by just keeping things simple and take a dose of 100-200mg whenever they feel like their test is starting to get too low, could be 7, 10, 14 days, whatever. Interesting concept, but you'd definitely have to be in tune with your body and not a reactionary person who would just pin because they got a bad night's sleep etc.

yeah i have been contemplating that concept as well, many times i have felt good especially libido-wise and then it was time for the next shot as per schedule and i pretty much know in advance it will ruin that to some extent.
Are you taking HCG?

 

[jmbb]

This is common, i think its because of the initial aromatization after introducing a dose in to the system, and that being followed by some regulatory measures in the body, i have not been able to get the same good feeling by mimicking those feelgood-levels by injecting more frequently.

That definitely makes sense. Have you ever attempted a low dose AI at the initial peak to counteract those effects? My experience is the same as yours, I can't seem to replicate that feeling with frequency.

yeah i have been contemplating that concept as well, many times i have felt good especially libido-wise and then it was time for the next shot as per schedule and i pretty much know in advance it will ruin that to some extent.
Are you taking HCG?

No HCG for me at the moment, I feel good for a shot or two but then its nothing but sides. I saw a guy on a youtube channel recently play an old Leo and Longevity clip (so take that with a grain of salt) where he said that after the testicles are shut down long enough that libido/erections/orgasms would be diminished no matter what. If that's true, that has to mean that some guys are naturally resistant to shutdown of the testes more than others and can maintain at least some intratesticular function without LH or HCG.

 

[FunkOdyssey]

I use test E these days as well and despite people telling me they're the same thing, I significantly shed water and that underlying sense of anxiety seems to just disappear when using E over cyp. The enanthate I use from Empower still has BA but not BB, maybe that has something to do with it like you mentioned?

I think the difference is real, it has nothing to do with the ester, and everything to do with the excipients. The viscosity of the formula and consequently the speed of absorption is greatly affected by the presence of these excipients. Not only that, but the excipients have pharmacological and toxic effects themselves in the body. Benzyl benzoate represents the bulk of excipients in most formulas, so the absence of BB in Empower's enanthate is a big deal and brings it close to a BA/BB free formula in terms of purity.

 

[jmbb]

I think the difference is real, it has nothing to do with the ester, and everything to do with the excipients. The viscosity of the formula and consequently the speed of absorption is greatly affected by the presence of these excipients. Not only that, but the excipients have pharmacological and toxic effects themselves in the body. Benzyl benzoate represents the bulk of excipients in most formulas, so the absence of BB in Empower's enanthate is a big deal and brings it close to a BA/BB free formula in terms of purity.

I've seen you make a few posts about this but didn't get a chance to read into it too much yet, and its really interesting - would that mean the inclusion of BB slows down the absorption? What types of effects in the body does it have?

@Charliebizz I did try the cream for a bit, although maybe not long enough, about 6 weeks. I felt a little anxiety/overstimulated, poor sleep and libido, although erections were solid. I was using the twice daily scrotal application and my balls felt greasy all day lol. I was also running a pretty extensive year long ketogenic diet at the time which may have been contributing to overall negative feeling.

 

[Charliebizz]

I've seen you make a few posts about this but didn't get a chance to read into it too much yet, and its really interesting - would that mean the inclusion of BB slows down the absorption? What types of effects in the body does it have?

@Charliebizz I did try the cream for a bit, although maybe not long enough, about 6 weeks. I felt a little anxiety/overstimulated, poor sleep and libido, although erections were solid. I was using the twice daily scrotal application and my balls felt greasy all day lol. I was also running a pretty extensive year long ketogenic diet at the time which may have been contributing to overall negative feeling.

what pharmacy did you use? What base was it compounded in? Did you ever get labs on cream ?

It took me 6-8 weeks for the anxiety to subside when I got on a proper dose. But don’t assume it’s because your levels are too high. I thought mine were turned out my t was low. I base to use a good amount of cream now to reach good levels.

 

[jmbb]

what pharmacy did you use? What base was it compounded in? Did you ever get labs on cream ?

It took me 6-8 weeks for the anxiety to subside when I got on a proper dose. But don’t assume it’s because your levels are too high. I thought mine were turned out my t was low. I base to use a good amount of cream now to reach good levels.

Empower - I am not sure of the base, whatever their standard cream is made in? I didn't get labs honestly and 6 weeks probably wasn't a fair try, especially since I still had some cyp circulating in my system at the beginning. It may be worth revisiting if I don't see some progress by my next appointment.

 

[FunkOdyssey]

I've seen you make a few posts about this but didn't get a chance to read into it too much yet, and its really interesting - would that mean the inclusion of BB slows down the absorption? What types of effects in the body does it have?

Benzyl benzoate greatly speeds up the absorption of testosterone while it is present. However, the benzyl benzoate itself is absorbed quickly, and when it is gone from the solution, the rate of absorption for the remaining testosterone in the oil depot slows down. Consequently, you have a biphasic pattern of absorption with a BB formula: a fast spike in the beginning, followed by the slower, normal release pattern for the unadulterated ester.

Benzyl benzoate is rapidly hydrolyzed to benzyl alcohol in the body, so we want to consider the effects of benzyl alcohol. From the Encylopedia of Toxicology:

High doses of benzyl alcohol cause nausea, vomiting, diarrhea, CNS depression, and vertigo. Dilute solutions (1%) produce local anesthesia and slight irritation when instilled into the eye. Pure benzyl alcohol produces corneal necrosis. Following acute exposure lethargy, seizures, intraventricular hemorrhage, and neurological sequelae (cerebral palsy, developmental delay) have been seen in neonates with parenteral benzyl alcohol toxicity. Metabolic acidosis was a common finding with parenteral toxicity in neonates. Thrombocytopenia was a delayed feature of parenteral toxicity in neonates. Deaths associated with intravenous or endotracheal administration of benzyl alcohol-containing solutions in neonates were preceded by symptoms of respiratory distress progressing to gasping respirations, metabolic acidosis, CNS depression, hypotension, renal failure, and occasionally seizures and intracranial hemorrhage. Thrombocytopenia was a delayed feature of parenteral toxicity in neonates. Severe striated keratopathy, progressing to chronic edema of cornea, was noted following intraocular use of a sodium chloride solution containing 2% benzyl alcohol.

A typical dose of testosterone cypionate delivers more benzyl benzoate and benzyl alcohol than testosterone. For each 100 mg of testosterone, you get about 110 mg of these excipients.

 

[jmbb]

Benzyl benzoate greatly speeds up the absorption of testosterone while it is present. However, the benzyl benzoate itself is absorbed quickly, and when it is gone from the solution, the rate of absorption for the remaining testosterone in the oil depot slows down. Consequently, you have a biphasic pattern of absorption with a BB formula: a fast spike in the beginning, followed by the slower, normal release pattern for the unadulterated ester.

Benzyl benzoate is rapidly hydrolyzed to benzyl alcohol in the body, so we want to consider the effects of benzyl alcohol. From the Encylopedia of Toxicology:

High doses of benzyl alcohol cause nausea, vomiting, diarrhea, CNS, depression, and vertigo. Dilute solutions (1%) produce local anesthesia and slight irritation when instilled into the eye. Pure benzyl alcohol produces corneal necrosis. Following acute exposure lethargy, seizures, intraventricular hemorrhage, and neurological sequelae (cerebral palsy, developmental delay) have been seen in neonates with parenteral benzyl alcohol toxicity. Metabolic acidosis was a common finding with parenteral toxicity in neonates. Thrombocytopenia was a delayed feature of parenteral toxicity in neonates. Deaths associated with intravenous or endotracheal administration of benzyl alcohol-containing solutions in neonates were preceded by symptoms of respiratory distress progressing to gasping respirations, metabolic acidosis, CNS depression, hypotension, renal failure, and occasionally seizures and intracranial hemorrhage. Thrombocytopenia was a delayed feature of parenteral toxicity in neonates. Severe striated keratopathy, progressing to chronic edema of cornea, was noted following intraocular use of a sodium chloride solution containing 2% benzyl alcohol.

A typical dose of testosterone cypionate delivers more benzyl benzoate and benzyl alcohol than testosterone.

Awesome information. Thank you for posting this.

 

[TLR]

Must say i do know someone who recently went from dailies to e3d also, for me personally daily worked well for a couple of months, even with a tiny dose of 7.5mg test E, until e2 started creeping on me, or could be something else, anxiousness none the less, levels of free T were midrange. Low shbg always.

I just recalled something, RobRoy used to prescribe ARBs with testosterone, still the case?

I had not heard of him prescribing ARBs, but that seems to be something a lot of the TRT docs are doing….especially telmisartan. I think a lot of them are doing it more for the longevity/ age management aspect, especially with the “older” set. I watched a podcast with Dr Andrew Winge and he and his guests (other docs) were all over being proactive with ARBs and Bystolic (beta blocker)…..don’t know enough about it to run my mouth too much, but I always thought the idea was to try to minimize drug use unless necessary..?