HCG and elevated estrogen - ai's don't work?

[rhino5169]

Copy of article that says not to take an ai if you're taking HCG and have high estrogen.
Would love to hear from anyone in this boat, and thoughts in general.


"
HCG and Estradiol[FONT=&quot]HCG Monotherapy has proven to be a very popular method of treating low testosterone on The Peak Testosterone Forum and, as of this writing 11 out of 104 (10.6%) men polled were using this protocol. [1] Many men consider it be a more natural solution, since it keeps the testes functioning (and often preserves fertility). You can read more about it here: Treating Hypogonadism with HCG Monotherapy.
But now let's jump to one of the big problems that I see with HCG Monotherapy: estradiol management. HCG Monotherapy tends to not have the "wow effect" of standard HRT and I would guess that one of the reasons is actually not on the testosterone side of the equation, but rather the estradiol. In fact, I would sum up the difficulties with two simple observations:
a) Elevated Estradiol. HCG Monotherapy seems to artificially boost estradiol above the levels that you would see with standard HRT for the equivalent testosterone. Let me give you an example from the Forum:


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[FONT=&quot]Starry Hi guys - Would appreciate thoughts on my bloods. From Dec 2-Jan 2, i took 1,500 IU HCG mono 3X a week. Had my blood drawn Jan 2. Then i went down to 500 IU 3X a week, through today. I had been on clomid prior, which raised my T from around 220/250 to around low 500s. But my free T never got above "low/out of range." went to my urologist today and here are the results, as it reads on the printout he gave me:
Total testosterone: 874 ng/dl (300-1000)
Free testosterone: 1.32 ng/dL (0.95-4.30)
SHBG: 32 nmol/L (10-50)
Estradiol: 74.4 pg/ml (20.0-75.0)
Notice that his testosterone levels are pretty high but well below the the max. However, his estradiol is through the roof. Rarely do you see a man on standard HRT with this high of estradiol. In the case of testosterone cypionate injections, for example, some of the guys are peaking right at 1200 ng/dl and yet their estradiol is generally more in the 40's and 50's.
This is an example as to what is so common with HCG Monotherapy: estradiol levels that are 50+% over where one would expect the man to be on a typical topical or injectible testosterone.
2. Activated Aromatase. So why is estradiol often higher with HCG? The reason for this is likely one presented in an older study dating back to 1979"


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[FONT=&quot]"The data presented in this report unequivocally demonstrate that Leydig cells from mature rats have the capacity to aromatize testosterone to estradiol. Furthermore, hCG acutely stimulates aromatization in purified Leydig cells. HCG stimulation of estradiol production from testosterone was demonstrated with saturating concentrations of testosterone. This observation indicates that the effect of hCG is on stimulation of the aromatase enzyme(s) and is not due to increased production of testosterone, the substrate for aromatase." [4]
Basically, HCG will to tend to maximize the activity of aromatase itself, which is the enzyme that converts testosterone to estradiol.
3. Lowered Testosterone. Many men who go on HCG Monotherapy do so, because they feel it is a more natural way to go. HCG bypasses the pituitary but does directly stimulate the testes and thus, for men who are not primary hypogonadal, keeps the testes naturally activated. For this reason men who see their estradiol skyrocketing due to #1 and #2 will not want to go on Arimidex or any other pharmaceutical to lower their estradiol After all, they went on HCG to mimic the body's own LH (leutinizing hormone) production, so why throw in a synthetic drug into the mix?
However, what this means is that, in order to keep estradiol at a reasonable level, the HCG dosage and testosterone levels, have to lowered. This may leave their testosterone below the threshold needed to do things like bring back their morning erections, increase libido and vanquish mental fog and depression. NOTE: That said, Arimidex usage is quite common with HCG Monotherapy, and I have seen a number of men taking .25 mg three times per week for example.
CAUTION: Your Can Still Crash Your Estradiol with Aromtase Inhibitors. One other thing that I have seen is that aromatase inhibitors, such as Arimidex (anastrozole), just don't work very well. One of our forum members posted the following reason:
"Beware of AIs with HCG. I have read that they are largely ineffective with HCG because the aromatization takes place inside the testicles as opposed to in other tissues with exogenous (injected) T. The AI is out numbered in the testicles because of high concentration of aromatization, and so it crashes your serum E2 while doing nothing for your E2 symptoms. This is consistent with my AI experience where even 0.25 every week would crash me in 2-3 weeks, despite a huge amount of HCG."


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[Vince Carter]

If I expound on what Dr Saya has stated is that the AI is less effective in the testicular environment. Ive yet to see anyone, short or long term that really loves HCG mono, it just doesn't work and the E conversion is a huge reason it is not a viable way to deal with being hypogonadal.

PeakT...SMH...that forum is filled with nonsense and should be the last place any one is looking at for real answers. All Peak himself does is regurgitate what he reads somewhere else which in and of itself isn't bad but belies how someone becomes a supposed authority figure on the subject. Besides, if any of his musings actually resulted in progress he wouldn't need to be under Dr Saya's care of have Defy be a site sponsor.

 

[simeoni]

I agree that mr. Myers forum has a very different ethos than the one in here. A lot of folks there seem to rely on personal anecdotals a bit too much - in my opinion. That said I dont think that the place is "filled with nonsense". There are people who bring a sound contribution and are a good source of information to that community. You yourself also seem to post there quite regulary - under a different alias.

I also think that the man himself deserves some credit in bringing more awareness to the topic of TRT.

PeakT...SMH...that forum is filled with nonsense and should be the last place any one is looking at for real answers. All Peak himself does is regurgitate what he reads somewhere else which in and of itself isn't bad but belies how someone becomes a supposed authority figure on the subject. Besides, if any of his musings actually resulted in progress he wouldn't need to be under Dr Saya's care of have Defy be a site sponsor.

 

[CoastWatcher]

Let's return the discussion to the topic that initiated it - HCG and the control of estradiol.

 

[lowe2sucks]

I would also like to see if anyone had their progesterone increased on HCG.. honestly the sides from HCG for me wasn't "high e2" sides

 

[rhino5169]

VC - I get what you said. I was thinking of my own slightly different situation though in that im not on HCG mono but HCG is part of my protocol with Test cyp and cream.
Arguably it seems, lol, my E is high at 48 with T at 1089. I may be heading towards anostrozole but im concerned that my E wont come down based on this HCG info.
BTW, that site was only 1 I posted the info from but there are many with info the same, HCG raises E and an AI wont help.

 

[AbsoluteZ3R0]

You can't "crash your serum estradiol" but still have high E2 symptoms. It doesn't make any sense. The estradiol produced by intratesticular aromatase still makes it way to free circulation in serum. If anything, you might prevent aromatization from occurring in the majority of the peripheral tissues in your body, but the estradiol produced in the testicles is still going to float around and activate E2 receptors all over your body. At the end of the day, it doesn't matter where the estrogen is being produced. It is a lot like injecting testosterone. All of the testosterone is originating from the injection site, but makes it way throughout the bloodstream, increasing serum levels. The same is true of intratesticular estradiol, which originates in the testes and then enters circulation. There was a thread like this with one of Dr Saya's clomid patients whose sensitive E2 reading would not drop below 80 even with aromasin, due to the production of estradiol in the testes. I don't know how HCG compares to naturally produced luteinizing hormone as far as aromatase is concerned, but I do know that activating the Leydig cells to achieve X testosterone total will always result in higher estradiol than injecting testosterone to reach X total. For the most part, when you take an AI with a typical testosterone + HCG protocol, the majority of the estradiol that you control is that produced as a byproduct of the injected testosterone. This is one of the reasons HCG doses don't typically exceed 1000 iu per week.