Interview with Dr Ranjith Ramasamy- Author of Estradiol Papers

[Nelson Vergel]

I am excited that one of the most published and respected uroogists in the United States has agreed to do a video interview to help me educate men on the role of estradiol in men.

Here are his publications:

Ranjith Ramasamy - Google Scholar Citations

In particular, we will be discussing his review:

The role of estradiol in male reproductive function

Any questions not covered in my article?
Role of Estradiol in Men and Its Management

 

[KSPhD]

It's clear that low esterogen and elevated estrogen both cause serious morbidity and mortality in men. If you plotted this out with estrogen on the x-axis and morbidity and mortality on the y-axis, you would get a U-shaped curve. Where does he believe the "estrogen sweet spot" (the bottom of the U) is for men? What is the best way for men on TRT to hit that sweet spot?

 

[Jason Sypolt]

It looks like a lot of guys try to hit the low 20's no matter what. I think that the optimal point in the curve is not only different for each person, but the curve itself is a function of his testosterone levels at any given time.

 

[Nelson Vergel]

I am inviting you to a ******** Live Lecture tomorrow April 9. 2020 at 3 pm central with Dr. Ramasamy. Go to our FB page and "like" it.

https://www.********.com/ExcelMale/

 

[DS3]

@Nelson Vergel

Potential questions to add (if they are no good, toss them):

1. What is the effect of low estradiol on glucose metabolism within skeletal muscle, as well as its impact on insulin resistance? What does this mean for muscle growth?

2. Is there a theoretical cut-off point where elevated estrogen levels in TRT patients can confidently be stated to pose health risks?

For example, if a man feels positive symptom relief while microdosing 200 mg Test per week with the concomitant use of HCG, yet his estrogen remains elevated to ~70 pg/dL with no AI, is this cause for concern? If this level of estrogen, theoretically, poses health risks, should the protocol be to add in a small dose of an AI? Decrease T dosage? Decrease or eliminate HCG? Other?

 

[Nelson Vergel]

Thanks @DS3

You guys can also use this link instead.

Topic: Interview with Dr. Ramasamy About Men's Hormones and Fertility
Time: Apr 9, 2020 03:00 PM Central Time (US and Canada)

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[Nelson Vergel]

Previous interviews:

Estradiol in Men: Interview with Urology Professor Dr Ranjith Ramasamy

Nelson Vergel, founder of ExcelMale.com and DiscountedLabs.com and author of Testosterone: A Man's Guide, interviews Dr Ranjith Ramasamy. Dr Ramasamy is the Director of Male Reproductive Medicine and Surgery as well as an Assistant professor in Department of Urology at the University of Miami...

www.excelmale.com

New Testosterone Nasal Gel (Natesto) Data- Interview with Dr Ramasamy

Interview Transcript : Part 1 of 3 Nelson Vergel: Hello everybody, Nelson Vergel here with ExcelMale.com and DiscountedLabs.com. I'm very happy here to have Dr. Ramasamy, we've done a webinar before, on estradiol and anastrozole, that was very popular, so he's a great speaker...

www.excelmale.com

 

[DS3]

@Nelson Vergel

Two more potential questions after looking through your previous interview:

1. For men on TRT who experience E2 levels above 60 pg/mL yet are unable to use AIs due to joint pain, what are viable long-term alternative treatments? Lower T dosage?

2. In men with lowered bone mineral density and osteoarthritis (either as a result of previous anastrozole use or though other causes), do you use Toremiphene or any second-generation SERM for its beneficial effects on bone mineral density within the skeletal system? Is the use of Toremiphene a viable treatment option in these cases?

 

[Fernando Almaguer]

@Nelson Vergel

Two more potential questions after looking through your previous interview:

1. For men on TRT who experience E2 levels above 60 pg/mL yet are unable to use AIs due to joint pain, what are viable long-term alternative treatments? Lower T dosage?

2. In men with lowered bone mineral density and osteoarthritis (either as a result of previous anastrozole use or though other causes), do you use Toremiphene or any second-generation SERM for its beneficial effects on bone mineral density within the skeletal system? Is the use of Toremiphene a viable treatment option in these cases?

How much AI use would cause osteoporsis?

 

[DS3]

How much AI use would cause osteoporsis?

In the first interview with Nelson, Dr. Ramasamy said that 1 mg ED and potentially 1 mg EOD could contribute to osteoporosis, but that can only be confirmed via a DEXA scan. However, what was continually referred to in the video was that creating an atmosphere in the body where 'negligible' amounts of E2 are maintained by anastrozole (ab)use is what largely contributes to osteoporosis.

However, I hypothesize that this may not be totally correct as I have suffered severely in the past by taking 0.25 mg adex 3 x per week and keeping my E2 at 20 pg/mL (not negligile). During that time my bones and joints hurt so bad I could barely workout, and years later have still not recovered very well. This is part of the reason i place emphasis on the proposed question because I am not the only TRT patient this has happened to, nor will I be the last.

Note that the dosage I had to take to experience profound negative effects on my bones and joints (that 3 years later i still haven't fully recovered from) is far less than the dosage that Dr. Ramasamy said he typically prescribes for high E2 (1 mg weekly or twice weekly).

 

[Fernando Almaguer]

In the first interview with Nelson, Dr. Ramasamy said that 1 mg ED and potentially 1 mg EOD could contribute to osteoporosis, but that can only be confirmed via a DEXA scan. However, what was continually referred to in the video was that creating an atmosphere in the body where 'negligible' amounts of E2 are maintained by anastrozole (ab)use is what largely contributes to osteoporosis.

However, I hypothesize that this may not be totally correct as I have suffered severely in the past by taking 0.25 mg adex 3 x per week and keeping my E2 at 20 pg/mL (not negligile). During that time my bones and joints hurt so bad I could barely workout, and years later have still not recovered very well. This is part of the reason i place emphasis on the proposed question because I am not the only TRT patient this has happened to, nor will I be the last.

Note that the dosage I had to take to experience profound negative effects on my bones and joints (that 3 years later i still haven't fully recovered from) is far less than the dosage that Dr. Ramasamy said he typically prescribes for high E2 (1 mg weekly or twice weekly).

Alarming info. I take .25 every week or everyother week. I just don't see anyother way to get it undercontrol. My left knee sometimes aches. I look foward to more research on this matter. Thanks for sharing your wisdom.

 

[Nelson Vergel]

Here is the video. Please post questions here to forward to him. Thanks

 

[Vince]

I just got done listening to the full interview with Dr. Ramasamy. I thought it was great and very interesting. It should be a must for anyone interested or already on trt. I plan on listening to it again tomorrow.

Thanks Nelson.

 

[DS3]

I just got done listening to the full interview with Dr. Ramasamy. I thought it was great and very interesting. It should be a must for anyone interested or already on trt. I plan on listening to it again tomorrow.

Thanks Nelson.

Agreed. I think all 3 videos should be filed under TRT Essentials. Dr. Ramasamy and Nelson provides more valuable information in those three videos than any other source I’ve been exposed to.

 

[Vince]

Agreed. I think all 3 videos should be filed under TRT Essentials. Dr. Ramasamy and Nelson provides more valuable information in those three videos than any other source I’ve been exposed to.

You are so right. Too bad there's not more doctors that have the knowledge, that Nelson and Dr Ramasamy have about trt.

 

[DorianGray]

Excellent resource. Looking forward to the additional videos. Interesting info on the use of HCG alone, but noted that it was in younger guys. Standby for report in a few more weeks of its use alone in an old guy. Maybe Vince will be right and it may be minimal effect. We'll see.

 

[Vvs1]

Here is the video. Please post questions here to forward to him. Thanks

Ask him about what he thinks is the cause of persistent side effects of Post Finasteride Syndrome (Accutane,SSRI,Saw Palmetto). Also one guy claims that he has a similar case by taking only an AI. He was super into fitness and training to become a doctor or scientist until he experienced persistent symptoms.

Tons of cases over on Propecia Help where guys take a single pill or less than a week’s worth. Many stories of guys that try AIs w/o TRT and become worse off.