High testosterone and estrogen levels

[RobRoy]

Do you believe throwing things like say “oxandrolone” in the mix can skew said metabolites in an unfavorable manor. Even in relatively low dose.?

I don't believe in throwing oxandrolone in the mix. That's not to be disrespectful but it's because it's not a part of True bio dentical hormone optimization. Honestly outside of true muscle wasting diseases or burn victims etc... I haven't seen the need to utilize an anabolic steroid. When you have optimal levels like the OP had there usually isn't a need unless there's a true medical reason. Thousands of men I have seen just like the OP and when they have the levels that he had they feel great. Not all need that but many do. No one aims for that but when they get it and they feel great and every parameter of their health improves why would we change it. There's just so much misinformation and fear mongering out there and in here. And not to get too technical but you live in a poisoned environment and those EDCs are affecting not only your production of testosterone but your ability to utilize it. Many men need so-called supraphysiological levels in order to overcome their symptoms and there is no harm in those levels. There is no denying what the forever chemicals are doing to men's testosterone

 

[Charliebizz]

I don't believe in throwing oxandrolone in the mix. That's not to be disrespectful but it's because it's not a part of True bio dentical hormone optimization. Honestly outside of true muscle wasting diseases or burn victims etc... I haven't seen the need to utilize an anabolic steroid. When you have optimal levels like the OP had there usually isn't a need unless there's a true medical reason. Thousands of men I have seen just like the OP and when they have the levels that he had they feel great. Not all need that but many do. No one aims for that but when they get it and they feel great and every parameter of their health improves why would we change it. There's just so much misinformation and fear mongering out there and in here. And not to get too technical but you live in a poisoned environment and those EDCs are affecting not only your production of testosterone but your ability to utilize it. Many men need so-called supraphysiological levels in order to overcome their symptoms and there is no harm in those levels. There is no denying what the forever chemicals are doing to men's testosterone vs

I don’t disagree with you one bit On the above post. and will admit I’m just looking for a little short cut. I’m feeling pretty good on my current protocol but just looking to get a little stubborn fat off. I believe I have room to increase my t dose a little bit. And I’m sure that’s a better long term solution then adding oxandrolone.

that said was just curious if you think it’s a risky move adding that in in regards to throwing of the balance of t-e2-dht?

 

[Charliebizz]

"you were feeling pretty great" and had great numbers. No matter what some others will tell you there is no harm with your numbers. There is no harm with your E2 at 96...none. You should have left everything as is and you would have continued to feel great. Once again another doctor that doesn't understand estrogen. Testosterone is essentially a pro hormone and as you raise levels you raise levels of its active metabolites and those are what makes you "feel great". What you measure in the serum with regard to E and DHT are not reflective of what the levels are in the target tissues because those tissues have tightly controlled homeostatic mechanisms to keep stable levels.

Check my post above I said the exact same thing as you. However I just can’t get on board with letting your hemoglobin and hematocrit. Go unchecked. If going slightly over the range and not experiencing any side effects. I’ll take the chance. But if you having all sorts of issues and then bring those numbers down alleviate those symptoms. How was that not the problem ?

 

[tareload]

Please read up on your physiology before you post. Can produce same for estradiol if you want but you should have it and know it already right ?

You mean like these questions I posed to you about this exact paper that you never took the time to respond to?

Trans scrotal testosterone cream application is a game changer

Why scrotal testosterone cream produces higher DHT, how to dose and time it, and the lab quirk that throws blood levels out of range if tested early.

www.excelmale.com

Or all the questions on my TRT thread?

Ya know the thread you conveniently ducked out of when you took your ball and went home?

Again and again you show a lack of basic good faith to engage in substantive debate on the topics. You ignore and move on to spread your impotent mental seed to the next hapless thread and poster.

An E2 of "96" is harmless? How in the holy F did you determine that in this particular individual's case? Because your mentor says young men routinely have E2 in the 90s? What a joke.

 

[Charliebizz]

You mean like these questions I posed to you about this exact paper that you never took the time to respond to?

Trans scrotal testosterone cream application is a game changer

Why scrotal testosterone cream produces higher DHT, how to dose and time it, and the lab quirk that throws blood levels out of range if tested early.

www.excelmale.com

Or all the questions on my TRT thread?

Ya know the thread you conveniently ducked out of when you took your ball and went home?

Again and again you show a lack of basic good faith to engage in substantive debate on the topics. You ignore and move on to spread your impotent mental seed to the next hapless thread and poster.

An E2 of "96" is harmless? How in the holy F did you determine that in this particular individual's case? Because your mentor says young men routinely have E2 in the 90s? What a joke.

if looking at this from a logical stand point. I don’t believe a level of 96 is harmful when the tt is 1400. Could the overall treatment be harmful if blood pressure is through the roof and hemoglobin and hematocrit are running wild? I would say yes. that’s my only true issue with @RobRoy is he hasn’t addressed that part. A lot of the tot guys duck That question by saying “how do you know it’s the trt causing the side effects” well let’s see blood pressure was perfect until we added t and now it’s high after adding t lol.

 

[RobRoy]

if looking at this from a logical stand point. I don’t believe a level of 96 is harmful when the tt is 1400. Could the overall treatment be harmful if blood pressure is through the roof and hemoglobin and hematocrit are running wild? I would say yes. that’s my only true issue with @RobRoy is he hasn’t addressed that part. A lot of the tot guys duck That question by saying “how do you know it’s the trt causing the side effects” well let’s see blood pressure was perfect until we added t and now it’s high after adding t lol.

I don't see testosterone causing blood pressure to go "out the roof". People make adjustments based on short-term issues that resolve over the long term. When a man gets optimal levels fairly quickly with testosterone in certain instances there's going to be some fluid retention because usually they're already insulin resistant began with and have too much sodium in their diet. This will cause a transient increase in blood pressure which will resolve over a period of months. There's only a minor increase in blood pressure in studies utilizing testosterone and most showing a decrease in blood pressure. Testosterone does not cause a man to have hypertension over the long term in fact it's the opposite. Hematocrit and hemoglobin do not " run wild". This is literally all forum talk that you don't see in a clinical setting. We don't see anything running wild and we don't see me and develop hypertension from just testosterone. Testosterone improves longevity and 99.99% of people that are being treated with hypertension or not on testosterone. The hematocrit that everyone is afraid of has never caused harm in men on testosterone. The 54% cut off is an arbitrary number and was not based on any studies at all showing harm with that number is exceeded with testosterone. The problem is baseline studies in men not on testosterone and the hematocrit is increased there's usually a medical problem that needs to be addressed. When you treat a lot of people that live at high altitude you see a secondary erythrocytosis all the time in excess of 54% and these people don't have to donate blood and they don't have an increased risk of heart attacks or strokes. The normal hematocrit for some areas of the world is 61%. Yes I said 61%. So all fear of testosterone is essentially fearing a boogie man that does not exist.
To summarize the answer to your question the scenario that you proposed doesn't exist in a clinical setting and has not for 85 years. People forget that when men were first given testosterone and in high doses (for decades) there were not many commercial labs available to measure levels. So men were treated with testosterone for medical conditions and they didn't even know their levels and yet there was no increase in heart attacks, strokes, blood clots, hypertension, or hemoglobin and hematocrit running wild causing the above forementioned problems.
People want to continue to think that it's dangerous and want to promote that narrative then they're welcome to do that. Everyone can continue to believe what they want even if there is no actual medical data to support it.

 

[RobRoy]

You mean like these questions I posed to you about this exact paper that you never took the time to respond to?

Trans scrotal testosterone cream application is a game changer

Why scrotal testosterone cream produces higher DHT, how to dose and time it, and the lab quirk that throws blood levels out of range if tested early.

www.excelmale.com

Or all the questions on my TRT thread?

Ya know the thread you conveniently ducked out of when you took your ball and went home?

Again and again you show a lack of basic good faith to engage in substantive debate on the topics. You ignore and move on to spread your impotent mental seed to the next hapless thread and poster.

An E2 of "96" is harmless? How in the holy F did you determine that in this particular individual's case? Because your mentor says young men routinely have E2 in the 90s? What a joke.

Women are dying every day aren't they because their estradiol gets above 96 right? You keep thinking all you want that it's dangerous and that you should control estradiol. You just keep thinking that because it keeps me really busy repairing the damage from men following that type of advice or logic. To show just how little you know about the big picture and about true clinical practice. How many man if you treated for prostate cancer? I would assume zero. Guess what we get them to overcome the devastating side effects of androgen deprivation therapy. Their estradiol in the hundreds and it provides them with symptomatic improvement as well as protection against cardiovascular disease. So not only does it not cause harm it does the exact opposite and provides protection. Just like a dose in women. Men are now being treated with oral estradiol for severe dyslipidemia. Guess what? It improves their lipid profile and also guess what? It doesn't cost them any harm but instead provides them with protection.
You don't understand estradiol just like you don't understand a lot about this because you absolutely have zero clinical experience. I tire of you quite easily now.
So when they first started giving men testosterone many decades ago they used high doses and they had no laboratories to measure levels in. So in many instances these men had significantly elevated estradiol. That's what testosterone does. Testosterone converts into its active metabolites. So to you those active metabolites are harmful instead of helpful. When we block those active metabolites we cause harm. When we leave them alone we see benefit. So for decades men were treated with high doses of testosterone with no levels tested and elevated estradiol and yet no harm was caused in all of those decades.
Your narrative is old and outdated and not based on science or clinical acumen. Like I said I've tired of you already.

 

[Charliebizz]

I don't see testosterone causing blood pressure to go "out the roof". People make adjustments based on short-term issues that resolve over the long term. When a man gets optimal levels fairly quickly with testosterone in certain instances there's going to be some fluid retention because usually they're already insulin resistant began with and have too much sodium in their diet. This will cause a transient increase in blood pressure which will resolve over a period of months. There's only a minor increase in blood pressure in studies utilizing testosterone and most showing a decrease in blood pressure. Testosterone does not cause a man to have hypertension over the long term in fact it's the opposite. Hematocrit and hemoglobin do not " run wild". This is literally all forum talk that you don't see in a clinical setting. We don't see anything running wild and we don't see me and develop hypertension from just testosterone. Testosterone improves longevity and 99.99% of people that are being treated with hypertension or not on testosterone. The hematocrit that everyone is afraid of has never caused harm in men on testosterone. The 54% cut off is an arbitrary number and was not based on any studies at all showing harm with that number is exceeded with testosterone. The problem is baseline studies in men not on testosterone and the hematocrit is increased there's usually a medical problem that needs to be addressed. When you treat a lot of people that live at high altitude you see a secondary erythrocytosis all the time in excess of 54% and these people don't have to donate blood and they don't have an increased risk of heart attacks or strokes. The normal hematocrit for some areas of the world is 61%. Yes I said 61%. So all fear of testosterone is essentially fearing a boogie man that does not exist.
To summarize the answer to your question the scenario that you proposed doesn't exist in a clinical setting and has not for 85 years. People forget that when men were first given testosterone and in high doses (for decades) there were not many commercial labs available to measure levels. So men were treated with testosterone for medical conditions and they didn't even know their levels and yet there was no increase in heart attacks, strokes, blood clots, hypertension, or hemoglobin and hematocrit running wild causing the above forementioned problems.
People want to continue to think that it's dangerous and want to promote that narrative then they're welcome to do that. Everyone can continue to believe what they want even if there is no actual medical data to support it.

I actually am more on your side than not. To be honest follow all the “forums” advice over the years has pretty much been a negative experience for me. I micro managed everything and worried about keeping my levels mid range. Wasn’t until I decided to stop worrying, switched to cream and let my go of the fear of ”to0 high levels” did I start finally getting better. While my numbers are still pretty modest I do believe I have room to go up without experience any side effects. And you’re right (in my case) I did have some sides even switching to cream and I let them ride and they all resolved and I’m much better for it. and I have to give credit where credit is do. I learned a lot of this from the XXXXXXXX group that you had a lot of influence over. that Said I love this forum and what a lot of guys bring to the table. I think the debate between you and @tareload is phenomenal and people can learn a lot from it so I hope you stick around.

 

[Charliebizz]

Women are dying every day aren't they because their estradiol gets above 96 right? You keep thinking all you want that it's dangerous and that you should control estradiol. You just keep thinking that because it keeps me really busy repairing the damage from men following that type of advice or logic. To show just how little you know about the big picture and about true clinical practice. How many man if you treated for prostate cancer? I would assume zero. Guess what we get them to overcome the devastating side effects of androgen deprivation therapy. Their estradiol in the hundreds and it provides them with symptomatic improvement as well as protection against cardiovascular disease. So not only does it not cause harm it does the exact opposite and provides protection. Just like a dose in women. Men are now being treated with oral estradiol for severe dyslipidemia. Guess what? It improves their lipid profile and also guess what? It doesn't cost them any harm but instead provides them with protection.
You don't understand estradiol just like you don't understand a lot about this because you absolutely have zero clinical experience. I tire of you quite easily now.
So when they first started giving men testosterone many decades ago they used high doses and they had no laboratories to measure levels in. So in many instances these men had significantly elevated estradiol. That's what testosterone does. Testosterone converts into its active metabolites. So to you those active metabolites are harmful instead of helpful. When we block those active metabolites we cause harm. When we leave them alone we see benefit. So for decades men were treated with high doses of testosterone with no levels tested and elevated estradiol and yet no harm was caused in all of those decades.
Your narrative is old and outdated and not based on science or clinical acumen. Like I said I've tired of you already.

I know you said you do not use oxandrolone in practice. But since we are talking about estrogen. Can using it be detrimental to a man on trt. from Shifting the balance of androgens/estrogen ?

 

[tareload]

Like I said I've tired of you already.

Convenient for you as previously.

Good faith - Wikipedia

en.m.wikipedia.org

I am glad @Charliebizz has enjoyed our back and forth. What is not to enjoy when I've done about everything humanly possible to daylight the science here and counterpoints to your ridiculous blanket statements? Convenient for you to duck the topics under the cover of your considerable "clinical experience". Amazing your patients are all doing dandy and you never encounter issues that other providers have encountered. Congrats!

I always give Dr. Saya credit for being much smarter than me. An example is cutting his discussion with you very short. I wish I would have learned sooner. Glad at least one person did enjoy the countless hours spent trying to pin you down. I give you credit, you are slippery and may sound convincing to the naive layperson. Everything easy and simple over in RobRoy land.

85 years and counting and not one issue on the T replacement front because Robroy says so and he knows definitively. Make sure you spread your message far and wide to save so much time and effort for any future clinical trials.

So for decades men were treated with high doses of testosterone with no levels tested and elevated estradiol and yet no harm was caused in all of those decades.

 

[TLR]

I don't see testosterone causing blood pressure to go "out the roof". People make adjustments based on short-term issues that resolve over the long term. When a man gets optimal levels fairly quickly with testosterone in certain instances there's going to be some fluid retention because usually they're already insulin resistant began with and have too much sodium in their diet. This will cause a transient increase in blood pressure which will resolve over a period of months. There's only a minor increase in blood pressure in studies utilizing testosterone and most showing a decrease in blood pressure. Testosterone does not cause a man to have hypertension over the long term in fact it's the opposite. Hematocrit and hemoglobin do not " run wild". This is literally all forum talk that you don't see in a clinical setting. We don't see anything running wild and we don't see me and develop hypertension from just testosterone. Testosterone improves longevity and 99.99% of people that are being treated with hypertension or not on testosterone. The hematocrit that everyone is afraid of has never caused harm in men on testosterone. The 54% cut off is an arbitrary number and was not based on any studies at all showing harm with that number is exceeded with testosterone. The problem is baseline studies in men not on testosterone and the hematocrit is increased there's usually a medical problem that needs to be addressed. When you treat a lot of people that live at high altitude you see a secondary erythrocytosis all the time in excess of 54% and these people don't have to donate blood and they don't have an increased risk of heart attacks or strokes. The normal hematocrit for some areas of the world is 61%. Yes I said 61%. So all fear of testosterone is essentially fearing a boogie man that does not exist.
To summarize the answer to your question the scenario that you proposed doesn't exist in a clinical setting and has not for 85 years. People forget that when men were first given testosterone and in high doses (for decades) there were not many commercial labs available to measure levels. So men were treated with testosterone for medical conditions and they didn't even know their levels and yet there was no increase in heart attacks, strokes, blood clots, hypertension, or hemoglobin and hematocrit running wild causing the above forementioned problems.
People want to continue to think that it's dangerous and want to promote that narrative then they're welcome to do that. Everyone can continue to believe what they want even if there is no actual medical data to support it.

This is slightly off topic, but I have two questions. First, what do you do when a patient goes on cream and feels better in most every way EXCEPT for erections? I was on two clicks of 20% cream (100 mg) and free T was 30 and estradiol was 59, with estrone twice the normal value. I ask this because I’ve noticed any time my estradiol gets into the 40s even on injections I have soft erections.

Second….have you had patients with pre existing anxiety issues that seemed to worsen with TRT and how do you handle that?

Not trying to get free medical advice, but I’ve seen you on several podcasts and read several of your posts and I’ve never heard you address either of these.

Thanks in advance

 

[Systemlord]

Second….have you had patients with pre existing anxiety issues that seemed to worsen with TRT and how do you handle that?

TRT induced anxiety and panic attacks can be caused by Monoamine Oxidase A gene.

MAOA gene Monoamine Oxidase A The MAOA gene provides instructions for making an enzyme called monoamine oxidase A. This enzyme is part of a family of enzymes that break down molecules called monoamines through a chemical reaction known as oxidation. Among the monoamines broken down by monoamine...

www.excelmale.com

 

[Charliebizz]

This is slightly off topic, but I have two questions. First, what do you do when a patient goes on cream and feels better in most every way EXCEPT for erections? I was on two clicks of 20% cream (100 mg) and free T was 30 and estradiol was 59, with estrone twice the normal value. I ask this because I’ve noticed any time my estradiol gets into the 40s even on injections I have soft erections.

Second….have you had patients with pre existing anxiety issues that seemed to worsen with TRT and how do you handle that?

Not trying to get free medical advice, but I’ve seen you on several podcasts and read several of your posts and I’ve never heard you address either of these.

Thanks in advance

How long have you been on the cream. I had anxiety creep back in at first. Maybe 2 or more months. but it went away. Also cream gave me amazing erections. but they started to slow down a bit and daily tadalafil (some times eod) has worked wonders.

 

[TLR]

How long have you been on the cream. I had anxiety creep back in at first. Maybe 2 or more months. but it went away. Also cream gave me amazing erections. but they started to slow down a bit and daily tadalafil (some times eod) has worked wonders.

I’m not currently on cream….I tried the Empower cream for a few months a couple years ago, but went back to injections due to the erection issue…I honestly felt pretty good on the cream vs. injections in all respects except for that (I take daily tadalafil also). I’m honestly just stuck in this trap where 60-80 mg of TC is all I can tolerate injection wise, and I get predictable erections with that dose….but I don’t “feel” like I think I ought to feel on it (I know from what I remember our cases are quite similar). I’m also a little concerned about the DHT (mine got up to 250 on 100 mg a day) as I’ve had a TURP at 53 for BPH….what a pain in the ass, huh?

 

[HSLD]

This is slightly off topic, but I have two questions. First, what do you do when a patient goes on cream and feels better in most every way EXCEPT for erections? I was on two clicks of 20% cream (100 mg) and free T was 30 and estradiol was 59, with estrone twice the normal value. I ask this because I’ve noticed any time my estradiol gets into the 40s even on injections I have soft erections.

Second….have you had patients with pre existing anxiety issues that seemed to worsen with TRT and how do you handle that?

Not trying to get free medical advice, but I’ve seen you on several podcasts and read several of your posts and I’ve never heard you address either of these.

Thanks in advance

My first trial with cream was 2 clicks AM of 20% cream. I had similar issues.

Adding one more click in the evening (2 clicks AM, 1 click PM) resolved that issue. I imagine 2 clicks AM, 2 clicks PM would also work.

I’m not convinced that E2 has a negative effect on erectile function for me. I regularly have E2 in the 70s on injectable protocols and actually have better erectile function at that level than when E2 is within range but TT/FT are lower.

 

[Charliebizz]

My first trial with cream was 2 clicks AM of 20% cream. I had similar issues.

Adding one more click in the evening (2 clicks AM, 1 click PM) resolved that issue. I imagine 2 clicks AM, 2 clicks PM would also work.

I’m not convinced that E2 has a negative effect on erectile function for me. I regularly have E2 in the 70s on injectable protocols and actually have better erectile function at that level than when E2 is within range but TT/FT are lower.

I had same issue. When transitioning from injections to cream. I assumed my levels were sky high !! They were actually low. now take 4 clicks of atrevis base to get respectable numbers.

 

[Charliebizz]

I’m not currently on cream….I tried the Empower cream for a few months a couple years ago, but went back to injections due to the erection issue…I honestly felt pretty good on the cream vs. injections in all respects except for that (I take daily tadalafil also). I’m honestly just stuck in this trap where 60-80 mg of TC is all I can tolerate injection wise, and I get predictable erections with that dose….but I don’t “feel” like I think I ought to feel on it (I know from what I remember our cases are quite similar). I’m also a little concerned about the DHT (mine got up to 250 on 100 mg a day) as I’ve had a TURP at 53 for BPH….what a pain in the ass, huh?

as of now I have no side effects from my high dht levels (in serum) I’ve heard more then one dr speak on the fact that blood doesn’t reflect what’s going on in the tissue. I feel night and day difference from injections to cream. So I’m riding with it. I stay on top of all my blood work and exams so time will tell.

 

[TLR]

as of now I have no side effects from my high dht levels (in serum) I’ve heard more then one dr speak on the fact that blood doesn’t reflect what’s going on in the tissue. I feel night and day difference from injections to cream. So I’m riding with it. I stay on top of all my blood work and exams so time will tell.

Yeah…I actually got up to 30 ng/dl FT with TT in the 1200s on just 100 mg and I didn’t want to go up anymore because I just can’t get my hands wrapped around the idea it’s okay long term to run higher than that! I probably should’ve tried lowering it first before I threw in the towel on it. The thing I liked about it was I seemed to have more energy but I didn’t feel “overstimulated” like I do when I get my levels that high on injections. Anxiety was still there (it’s an old friend from waaaayy back), but it seemed lessened. To quote U2 “but I still haven’t found what I’m looking for!”

 

[Charliebizz]

Yeah…I actually got up to 30 ng/dl FT with TT in the 1200s on just 100 mg and I didn’t want to go up anymore because I just can’t get my hands wrapped around the idea it’s okay long term to run higher than that! I probably should’ve tried lowering it first before I threw in the towel on it. The thing I liked about it was I seemed to have more energy but I didn’t feel “overstimulated” like I do when I get my levels that high on injections. Anxiety was still there (it’s an old friend from waaaayy back), but it seemed lessened. To quote U2 “but I still haven’t found what I’m looking for!”

While I know it’s very controversial still. I do believe to some degree that what @RobRoy speaks about with regards to receptors being clogged and edc and all the environmental factors Leading to why some of us need higher levels. I just try and use logic. If I didn’t have these symptoms and I had decent t levels. Then my t levels crash. But then only boosting my levels mid range offers me now relief. And even up at top it’s minimal. But I push higher than that all the sudden I feel like my old self again. How can that be detrimental. Especially when all my vitals and health parameters are in a good spot ?

 

[Systemlord]

While I know it’s very controversial still. I do believe to some degree that what @RobRoy speaks about with regards to receptors being clogged and edc and all the environmental factors Leading to why some of us need higher levels.