TRT without the use of Aromatase Inhibitors

[Gman86]

Guys if you listen to the whole thing Dr. Rouziers rntire point, from my understanding, is more estrogen the better.

The method of testing is really moot at this point when he says things like most are several times over reference range, with 2 dozen doctors themselves in the 200 to 300 range for E2, regardless of the method of testing the E2 is going to be high with numbers like this...

So the real question is this high E2 good or not and is there an adjustment period to feel good with high estrogen?

That’s a good point about there possibly being an adjustment period.

But you’re right, the way we’re testing for E2 is literally pointless if we should all be having E2 levels in the 200-300 range. I mean, even if we wanted to, none of us can even get E2 that high. I haven’t finished listening to the whole thing yet, but how are they getting their E2 this high, are these guys supplementing with exogenous E2?

I wish we could do a mass experiment where every guy on excel got our E2 up into that range. Because studies are just so flawed. Dr Rouzier explained really well how studies are even more flawed than I originally thought before his interview. He presented studies showing high E2 being bad in men, or high testosterone in women being bad, are not accurate. When both genders have naturally high levels of these hormones, yes it is bad, but when we exogenously raise E2 in men it is healthy, and when we exogenously raise testosterone in women it is healthy. Btw, you’ll have to watch the interview to understand why this is true. But anyways, I trust anectodal experiences from hundreds of intelligent members on excel, much more than I trust studies. So I wish all of us could jack our E2 levels up, and report back with our experiences. But don’t you guys think that all we would have would be hundreds of dead dicks?? I know for me personally, my dick turns into a wet noodle when my E2 gets too high, and many others report the same thing. Why are we all so different here on excel compared to the thousands of patients that Rouzier speaks about. Are we all outliars? Is it all in our heads?

 

[Gman86]

The downside on Free E is that is pricey and I nearly always have to add that caveat that if be affordable for the guy...huge detractor when youre paying retail/out-of-pocket. But, when you're in that space of not having found the problem or problems persist when conforming to the TRT "norm" then it could offer you a better picture.

Very well said. If you’re feeling great, just keep trucking. No need to test for free E2, unless you just want to help out the community and show everyone where your free E2 sits while you’re feeling great. But for guys that are still struggling, I definitely think it could be worth the extra $50 to see where your free E2 is at. Everyone’s different. Sometimes those free E2 calculators are not super accurate. Total testosterone, SHBG and albumin don’t tell the entire picture. Two guys with the same SHBG level are not the same. One’s SHBG could be much stickier, and bind drastically more to sex hormones than another guy with the same exact SHBG. I’ve personally seen this happen. There was another guy on here that had the same total T as me, same SHBG as me, and even had a higher Albumin level than me, yet still had a free T 30% higher than mine. The higher the albumin, the lower your free T should be. So he technically should of had a lower free T than me, not 30% higher. Testing free T and free E2 bypasses all the guessing and calculating. They go right to the source, elimating all the guess work. Just think in your head if getting free T tested is worth an extra $50 over the total testosterone test. That’s how our brains should view testing free E2, imo.

 

[Deleted member 16042]

Regarding free E2, just like the rest of this topic, are there optimization guidelines other than conjecture and anecdote? Seems certainly there is even less data and anecdote than basing E2 assessment on LC/MS/MS. Maybe you have to start somewhere with such changes, but how does one even start to base E2 optimization off free E2 other than individual trial and error experience?

 

[Gman86]

Regarding free E2, just like the rest of this topic, are there optimization guidelines other than conjecture and anecdote? Seems certainly there is even less data and anecdote than basing E2 assessment on LC/MS/MS. Maybe you have to start somewhere with such changes, but how does one even start to base E2 optimization off free E2 other than individual trial and error experience?

Good question. It was definitely one of the first things I thought of, as well. The answer is pretty easy, I think. In regards to E2, I think it has become extremely clear, that we want it on the higher end. E2 is extremely beneficial. E2 is responsible for at least 50% of the benefits of being on TRT. There is just no if’s, and’s, or but’s that we want E2 as high as we can get it without having negative symptoms, and/ or risking long term consequences that we might not be aware of yet.

So to be on the safe side, I always look at Mother Nature. I look at where Mother Nature likes to have our hormone levels while we are in our prime. Luckily, we somewhat have that information. The top of the free E2 range, should be the highest free E2 level that is seen in males today. This might be slightly lower, however, than men 100’s of years ago had. So I would just add roughly 30% to the top of the current free E2 range, which is currently (0.2-1.5).

So to answer your question, I think we should all be striving to get our free E2 levels as close to the top of the free E2 range, if not slightly higher, as long as we are not experiencing any negative symptoms. If you are, obviously lower your free E2 until symptoms dissipate. But to receive all the objective benefits of E2, like cardiovascular protection, improved lipid profile, increased bone density, improved joint lubrication, we should all be trying to get as close to the top of the range as we can, imo. Dr. Rouzier’s opinion is to get our free E2 waaayyy above this, but I’m with Dr. Crisler on this one, we just don’t know what levels like that can do to us long term. Plus, when in doubt, ALWAYS trust Mother Nature. It’s hard to believe that we know where our hormones should be better than millions of years of evolution is telling us. Better to be optimal, not greedy, imho.

 

[Deleted member 16042]

Re: trusting mother nature, Sorry my friend, I am not a believer. I am hypogonadal, have a coronary stent, arthritis and have monoclonal B-cell lymphocytosis. This is nature taking its course. Mother nature eventually causes disease and mutation. It is just a matter of time/age. This is the natural order of things.

If mother nature took care of things you too would not be fretting over hormone balance and TRT.

 

[Airborne Warrior]

Surely you would want E2 levels to be sitting at where you feel your best rather than getting it as high up the range as possible for no real benefit.

 

[Gman86]

Re: trusting mother nature, Sorry my friend, I am not a believer. I am hypogonadal, have a coronary stent, arthritis and have monoclonal B-cell lymphocytosis. This is nature taking its course. Mother nature eventually causes disease and mutation. It is just a matter of time/age. This is the natural order of things.

If mother nature took care of things you too would not be fretting over hormone balance and TRT.

Literally couldn’t agree more. I am 100% for taking your health into your own hands and fighting aging tooth and nail. The only reason we exist, is to grow, reproduce, and then die. You better believe that I am going to keep my body in the “reproduction” phase as long as humanly possible, and do literally whatever I have to do to achieve this. Whether that’s taking exogenous hormones, taking vitamin/ mineral supplements, getting stem cell injections, getting fecal matter transplants, replacing my blood with blood from a younger person. I mean, there is no limit to the interventions that I would implement to last as long as I can on this planet. And I would absolutely get a stent put in if I had to, like yourself.

But what I am talking about is trusting Mother Nature in regards to what our hormone levels look like in our prime, when everything is functioning perfectly. I’m recommending using these men as a baseline, in regards to optimal hormone levels. I’m not saying we should just trust Mother Nature to take care of us and never intervene and just let normal aging take its course. HELL NO to that haha.

 

[Gman86]

Surely you would want E2 levels to be sitting at where you feel your best rather than getting it as high up the range as possible for no real benefit.

Exactly! Goal should probably be to get your level to as high as you can without losing any of the subjective benefits. Hormones are all about balance. Even if there are objective benefits to raising E2 higher, the most important thing should be the balance between subjective and objective benefits.

 

[DragonBits]

Literally couldn’t agree more. I am 100% for taking your health into your own hands and fighting aging tooth and nail. The only reason we exist, is to grow, reproduce, and then die. You better believe that I am going to keep my body in the “reproduction” phase as long as humanly possible, and do literally whatever I have to do to achieve this. Whether that’s taking exogenous hormones, taking vitamin/ mineral supplements, getting stem cell injections, getting fecal matter transplants, replacing my blood with blood from a younger person. I mean, there is no limit to the interventions that I would implement to last as long as I can on this planet. And I would absolutely get a stent put in if I had to, like yourself.

But what I am talking about is trusting Mother Nature in regards to what our hormone levels look like in our prime, when everything is functioning perfectly. I’m recommending using these men as a baseline, in regards to optimal hormone levels. I’m not saying we should just trust Mother Nature to take care of us and never intervene and just let normal aging take its course. HELL NO to that haha.

Ok, but men aged 25 have average total T of 617, 668 at age 35. Standard div of 212. So even the top of the range it's maybe 900. Typical E2 conversion of 3-4% say E2 would as much as 36 at the top of that range.

I doubt there is any data on what free E2 is in younger men. But we can guess from the data.

I would be curious if there is any data anywhere on typical E2 levels or free E2 is in younger men. You know, actually test results and not word of month from a webinar.

I existed 15 years with E2 below 5. That was before I went on TRT. I gained weight, had a hard time gaining strength, but IMO it's mostly because of the low T.

More recently, after 5 years of TRT and then stopping, my E2 again went below 5, though sometimes as high as 11. I "think" it caused some tendonitis, I say "think" because I had never had tendon soreness while on TRT and I started to get this more often with a lot of repetitive cardio.

Because of all the studies, I do think E2 above at least 20 is important, I don't see ANYTHING from a study that says above 40 is some sort of a benefit. And if your E2 is low, it takes a long time, like 5 years, to really see bone loss. It happens, but it takes a while.

Now, I don't feel the need to either take an AI or boost my E2. Likely my E2 is around 20 -30 and no tendon issues. I wouldn't be concerned if my E2 was at 40, I don't like it above ~55. BUT the only way I could get E2 above 50 would be to get my total T above 1200.

 

[bkb33]

Ok, but men aged 25 have average total T of 617, 668 at age 35. Standard div of 212. So even the top of the range it's maybe 900. Typical E2 conversion of 3-4% say E2 would as much as 36 at the top of that range.

You make some great points, though if you had tested my TT at 25, it would have read 1200 -- but my SHBG was binding almost all of it up.

 

[Vince Carter]

Guys if you listen to the whole thing Dr. Rouziers rntire point, from my understanding, is more estrogen the better.

The method of testing is really moot at this point when he says things like most are several times over reference range, with 2 dozen doctors themselves in the 200 to 300 range for E2, regardless of the method of testing the E2 is going to be high with numbers like this...

So the real question is this high E2 good or not and is there an adjustment period to feel good with high estrogen?

There is absolutely no one walking around with a 200-300 E2, and if they are, they're lying, and too, lying about how they feel and the sides that they're experiencing. It's all total BS to think that. No one is getting an erection with that kind of E2 and no drug is going to overcome that.

 

[Chopsuey]

There is absolutely no one walking around with a 200-300 E2, and if they are, they're lying, and too, lying about how they feel and the sides that they're experiencing. It's all total BS to think that. No one is getting an erection with that kind of E2 and no drug is going to overcome that.

I'm just reporting what dr rouzier said, he said these 2 dozen or so men take 2 to 6 mg of oral estradiol dsily with testosterone and only see benefits, it's in the last 15 minutes of interview

 

[JimBob]

Ok, but men aged 25 have average total T of 617, 668 at age 35. Standard div of 212. So even the top of the range it's maybe 900. Typical E2 conversion of 3-4% say E2 would as much as 36 at the top of that range.

I doubt there is any data on what free E2 is in younger men. But we can guess from the data.

I would be curious if there is any data anywhere on typical E2 levels or free E2 is in younger men. You know, actually test results and not word of month from a webinar.

I existed 15 years with E2 below 5. That was before I went on TRT. I gained weight, had a hard time gaining strength, but IMO it's mostly because of the low T.

More recently, after 5 years of TRT and then stopping, my E2 again went below 5, though sometimes as high as 11. I "think" it caused some tendonitis, I say "think" because I had never had tendon soreness while on TRT and I started to get this more often with a lot of repetitive cardio.

Because of all the studies, I do think E2 above at least 20 is important, I don't see ANYTHING from a study that says above 40 is some sort of a benefit. And if your E2 is low, it takes a long time, like 5 years, to really see bone loss. It happens, but it takes a while.

Now, I don't feel the need to either take an AI or boost my E2. Likely my E2 is around 20 -30 and no tendon issues. I wouldn't be concerned if my E2 was at 40, I don't like it above ~55. BUT the only way I could get E2 above 50 would be to get my total T above 1200.

Why? Do you feel symptomatic?

 

[Sean Mosher]

That part of the interview really made me question a lot of what Rouzier is claiming.
Otherwise normal men supplementing with estradiol and pushing their numbers probably 5-10 times what we would find at a normal/healthy baseline?
So we would bring T levels back to what would be a healthy baseline level in a man and then push his estrogen 5-10 times over what would be a baseline/normal?
Why?
I thought the goal was optimization......

 

[Vince Carter]

I'm just reporting what dr rouzier said, he said these 2 dozen or so men take 2 to 6 mg of oral estradiol dsily with testosterone and only see benefits, it's in the last 15 minutes of interview

If that's even true its extremely irresponsible on the part of the Physician, administering an oral E to a man.
That you're clinging to this is not a good position to try and defend as something a guy should do or be fine with it.

 

[Tommy Wall]

Aren´t we done with this issue, it´s getting really boring, back and forward and the never ending non stop of speculations? E2 is related in most cases to your dosage of testo.

 

[Deleted member 16042]

Aren´t we done with this issue, it´s getting really boring, back and forward and the never ending non stop of speculations? E2 is related in most cases to your dosage of testo.

A lot of guys want a magic bullet.

 

[Tommy Wall]

Personally I stick with the founder´s opinion of this forum until more and new profound back ups come around.

 

[Chopsuey]

If that's even true its extremely irresponsible on the part of the Physician, administering an oral E to a man.
That you're clinging to this is not a good position to try and defend as something a guy should do or be fine with it.

If that's even true its extremely irresponsible on the part of the Physician, administering an oral E to a man.
That you're clinging to this is not a good position to try and defend as something a guy should do or be fine with it.

Not sure how your comprehending this from my comments:

1) I'm not clinging onto anything, this is a discussion on not using an AI, Dr. Rouzier has a very convincing presentation that seems well backed on science on why not to use an AI and the BENEFITS of elevated estradiol. I don't know what to believe I just brought it up here for discussion.

2) Please let me know where I said someone should do this or I deffend that they do it? Again I'm presenting it for discussion, thats the point of this conversation no?

3) If you read my comment, the docs aren't prescribing it to patients but themselves for the oral E2, although in the second presentation I believe Dr. Rouzier says he uses oral E2 in men for certain conditions but I have to go back in check.

4) Acording to Dr. Rouzier your opinion is exactly the opposite of correct. The research would indicated the higher E2 is beneficial in all aspects of life. Now, just to clarify, I'm not saying this is true or not its just interesting to see all points of view to make an educated decision...

 

[Gman86]

So I finally finished watching both parts of the interview with Dr. Rouzier, and I just can’t get behind this guy. Any doctor that sites a study where they are taking 1mg anastrozole per day, I just can’t support. He even mentions that it’s obviously a huge dose. So why site it then?? Probably because there are not enough valid studies to back up his claims.

But overall, there are just so many holes in his argument. Normally I would write a book on here about all of them, but there’s just too many to even talk about. Plus, hormones work in balance, it’s just human biology. Why would E2 be the one hormone that has magical powers when raised 5-7 times higher than what is ever seen in nature. Does this mean there are benefits to having a 7000 testosterone level, or having 7x the normal Dhea, dht, or progesterone level? It just doesn’t make sense that E2 is this one special hormone that has benefits when raised way passed levels ever seen naturally in men. It is much much more likely that E2 has all the benefits he speaks of when raised to the top of the range, or slightly over, and does not need to be exceeded to the levels he speaks of to achieve the benefits he’s talking about. That, to me, is way more likely.

To me, it seems like he was one of the first guys that figured out how beneficial E2 was in guys, and it became his shtick, and he decided to run with it. It probably made him feel special that he knew about this and everyone else had no idea. Then, just like every human usually does, because it’s in our nature, he thought that if estradiol was this beneficial, maybe more is better. As a species, we are naturally greedy and always want more. It’s obviously a beneficial quality that evolution has ingrained in us over the past however many thousands of years. But it comes with negative consequences as well. Either way, I commend him for figuring out how beneficial E2 is, and getting the word out on it. But I just can’t get behind him talking about levels of 200-300 being beneficial. Even the studies he referenced were all a joke. None of them referenced specific levels of E2, and none of them talked about subjective reports of the patients. All the studies just mentioned “higher” E2 levels and its benefits. Ya, durr, E2 has a ton of benefits, a monkey understands that at this point. But “how high”, what is “high”? None of the studies site specifics. I could pick apart every single one of the studies he referenced. To me, it was a little embarrassing to see him manipulate studies to back up his claims the way he did. Then when he referenced a study where they were taking 1mg of anastrozole/ day, I was like ok I’ve had enough.