How Do you Control your Estradiol Levels?

[MarkM]

Some say we shouldn't be messing with the estradiol and that our body is self-regulating and modulates the estradiol based on what our testosterone levels are. They say that we shouldn't be trying to control it at all.

Jay Campbell and Jim Brown, authors of The Testosterone Optimization Therapy Bible and who have their own podcast on YouTube called TOT Revolution state that their E2 levels are up as high as 65 and they don't take any type of AI and have great libido's. Dr.Keith Nichols, a TRT doctor, claims his E2, is upwards of 70, has great libido, and takes no AI.

Once, some time back, I was trying to find my sweet spot and was on a high dose of Cypionate and it ended up being a supra-physiological dose. Levels came back at about 1600 Total T and something like 70 Free T on LabCorp ranges. I backed it down because it raised my hematocrit to extremely high levels. My E2 was 67 and I would have never guessed it. My libido was great, I had no symptoms of high E2, although the number was high.

I think there is a place for an AI in some people. I think we should try not to use it if we don't have to, especially just because a number is considered high. Like most on this forum, I believe in treating symptoms not numbers. I felt really good on that supra-physiological dose and the only reason I backed it down was because the hematocrit got so high. Some people are very sensitive to E2 while others, like me are not. Maybe you aren't that sensitive to it. If you are not having symptoms, you might consider letting it inch up a little bit and see if that helps the libido.

I'll bet there are lots of men out there who are not on TRT and have healthy levels of testosterone and without even knowing it, have very healthy levels of E2 and a great libido. Maybe you consider raising your dose to 125 mg a week. That will raise your Free T which I think you need and but it will also inch up your E2. That might sound cray to you.

Not telling you what to do, just thinking out loud what I might try to do if I were in your shoes. You've got to find out what works for you and that might mean thinking outside the box a little bit. You can always pull the E2 down and it is easier to pull down vs get up after it has crashed.

 

[DragonBits]

I'm pretty sure the estradiol went down more because of the huge drop in dosage, but I do think switching to 3x per week would help it come down a little bit more. I'm reluctant to change the protocol until I've spoken to a doctor, but is changing the frequency considered a protocol change?

It was a large drop in dosage, but I noticed the measured TT didn't change much, while the FT did change, but since you used two different lab companies, and since fT is difficult to measure and measurements vary even with the same sample same lab.

I am not sure how long you have been on TRT, sometimes it takes a while to get the benefits. Though libido is often the first thing that changes.

Your consult with defy is in 11 days, just discuss it with them, protocol change and an AI. I am sure they will prescribe an AI if you want to try it, just be careful to take the lowest dose and to go by lab tests to see if you need to increase it. I think some people go by their feelings and increase dosage of the AI when they shouldn't.

If it were me, I would want to try 3 injections of 33-40 ml 3 times a week, have an AI on hand then measure your E2, not sure how soon to measure after that sort of protocol change, but you can ask Defy

I do agree that "5-6 times per year" indicates some sort of problem. I can see that happening when you do have low T.

But I also think it's impossible to determine what sort of hormone levels will achieve the best results for libido. It's a very individual thing and varies quite a bit from man to man. A lot of men say too high a TT isn't the best and they do better by lowering their total dose.

 

[madman]

This is one key piece and overlooked by many men on trt dealing with excess e2 issues.

Loosing adipose, especially visceral adipose which can have a drastic effect on reducing e2 and if your body fat levels are above 15% than lowering it will help immensely.

If your body fat levels are closer to 30% than you have a lot of work to do and it is critical to get your levels down.

Many can eventually avoid the use of an aromatase inhibitor when they achieve a leaner physique.

 

[KenLowT]

This is one key piece and overlooked by many men on trt dealing with excess e2 issues.

Loosing adipose, especially visceral adipose which can have a drastic effect on reducing e2 and if your body fat levels are above 15% than lowering it will help immensely.

If your body fat levels are closer to 30% than you have a lot of work to do and it is critical to get your levels down.

Many can eventually avoid the use of an aromatase inhibitor when they achieve a leaner physique.

I totally agree with this and I know for a fact that my BF% is really high. This definitely exarcebates the problem. However it's not for a lack of trying. I have been in the gym 6 days a week for more than a year doing a combination of strength training and cardio along with maintaining a healthy caloric deficit. I've seen my GP and my endocrinologist, tested positive for Hashimoto's disease, but neither will treat it because all of my numbers are still in range. Have I mentioned that most of the women in my family have hypothyroidism Still, they won't treat it since I don't display any other symptoms other than an inability to lose weight. That's why I'm hoping the doctors at Defy will listen and believe me when I tell them that I'm doing everything right, but my body is not or will not respond. I believe that if they can get my thyroid optimized that controlling estrogen will be much easier w/o medication.

 

[blackebob]

I never see free E mentioned. I too have had very high T with an E in the 70's with no side effects, but once I started checking my free E i noticed a diifference. When my free E is elevated I suffer symptoms even if my E is almost or actually in range. I wonder if the Free E is the more important factor much as Free T is?

 

[MarkM]

I never see free E mentioned. I too have had very high T with an E in the 70's with no side effects, but once I started checking my free E i noticed a diifference. When my free E is elevated I suffer symptoms even if my E is almost or actually in range. I wonder if the Free E is the more important factor much as Free T is?

I believe you hypothesis is correct. It is my assumption, as well as others, specifically @Vince Carter, that Free E is extremely important and is very much like Free T, in that it is that small fraction of the total androgen or estrogen, that does all the hard work.

Typically we believe that if you have high Free T you will have high Free E. It has not been studied to any great deal but I believe will be studied more in depth in the future. Until recently you could not even test for Free E. Discounted Labs offers specific testing of Free E.

 

[Vince Carter]

I never see free E mentioned. I too have had very high T with an E in the 70's with no side effects, but once I started checking my free E i noticed a diifference. When my free E is elevated I suffer symptoms even if my E is almost or actually in range. I wonder if the Free E is the more important factor much as Free T is?

Getting guys to change their train of thought about Free E has been a drum Ive been beating pretty hard but it's even more, crucial, for the low SHBG guy. We know low SHBG = high Free T, in turn, Free E. We know SHBG binds to E just like it does T so there in lies (most) of the problems for the low SHBG guy.

 

[blackebob]

Vince Carter, that would be me then. My SHBG runs in the teens.

 

[KenLowT]

Well I finally got E2 sensitive results based on my new protocol and not surprisingly it was high.

I have stayed away from my anastrozole prescription after I took too much too soon. Last week I started back up and did not feel the same bad effects. No shoulder pain or sore clicking joints. Libido is still not better with this in my system, but that's a complex issue.