Should Men Block Their Estrogen on TRT?

There is no need for managing estrogen by using an aromatase inhibitor, and there are dangers of using this drug in men. Dr. Keith Nichols explains how estrogen in men on Testosterone Replacement Therapy is cardio protective and healthy.

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Hi, I’m Amy Stuttle, CEO of Victory Men’s Health. We specialize all things Hormones 💪 ~ Sexual Health 🍆 ~ Vitamin Deficiencies💧~ Weight Loss 👊for men. We serve clients in Missouri and Illinois via our telehealth services and also in office in O’Fallon, IL, O’Fallon, MO, Town & Country, MO

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Episode Takeaways:

• Hormone Management: Dr. Nichols emphasizes evidence-based medicine over anecdotal advice, cautioning against the indiscriminate use of aromatase inhibitors (AI) to block estrogen.

• Normal Range Fallacy: He highlights the lack of scientific basis for the normal range of estradiol (E2), urging a critical reevaluation of established norms based on outdated data.

• Tissue-Level Estrogen: Dr. Nichols explains that serum E2 levels are an indirect reflection of estrogen at the tissue level, cautioning against indiscriminate use of AI, which can hinder the beneficial effects of testosterone in various tissues.

• Bodybuilding Misconceptions: The confusion surrounding AI stems from misconceptions in the bodybuilding community, where blocking estrogen was erroneously believed to increase free testosterone levels for muscle gain, despite lacking evidence and posing potential health risks.

TIMESTAMPS:
⏱️ 00:00
Introduction

⏱️00:32
Setting the Record Straight: Evidence-Based Medicine vs. Non-Evidence-Based Approaches

⏱️02:54
Decoding Normal Estradiol Ranges: The LabCorp Revelation

⏱️06:12
Estradiol: A Vital Hormone for Men's Health

⏱️09:27
The Problem with Aromatase Inhibitors: A Bodybuilding Misconception

⏱️12:45
The Perils of Blocking Estradiol: Implications for Brain, Bone, and Heart Health

⏱️15:02
Conclusion

If you have any questions, please leave them in the comments or DM me over on Instagram @victorymenshealth

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[MrPoohbear]

I started TRT and initially experienced nipple sensation, which made me feel worse than before starting therapy. However, by the third week, I felt like a 'superhuman' - but this sensation leveled out.

As time passed, I began feeling worse than before starting TRT. I experienced bloating, nipple sensation, and suspected high estrogen levels. Blood tests confirmed rapid estrogen elevation.

My doctor introduced an estrogen blocker (Anastrozole) to my regimen, taken once a week. Within three days, I noticed significant improvements: restored erections, increased energy, reduced bloating, and even improved thyroid function.

While I don't want to rely on this medication forever, it has greatly alleviated my symptoms. I'm considering more frequent TRT dosing to stabilize my estrogen levels and potentially reduce my reliance on the estrogen blocker.

[CamperMan]

I'm a thin and fit 39 year old male and started developing gyno and lumps in my chest with total T levels of 554 and an Estradiol sensitive level of 41.4. How have none of your patients experienced this? And if so, what do you prescribe besides Anastrozole to combat gyno?

[jaybearsmusings]

I feel so bad for anyone who has this aggressive angry guy as a doctor and isn't allowed anastrozole when they are crying their eyes out uncontrollably from high estradiol. Reality means nothing to a doctor with a handful of 'studies' that sampled a few hundred people out of the 7 billion who live on this planet. The reality is that some people are just very sensitive to the effects of estradiol in their brains and they get insomnia and extreme crying and anxiety episodes. In order to have estradiol low enough they have to bring their testosterone all the way down to 300 to 400 ng/dL. It is also disingenuous to make up a fantasy that everyone with high estradiol is an obese alcoholic. Many of us have not had any fast food or alcohol in over 20 years and are not overweight, we just convert to estradiol at a high rate. Even on 1 mg of anastrozole I'm still at 57 pg/mL.

[lawrencemunroe]

Still the way I see it, if a guy is having symptoms due to higher levels of estradiol, why suffer .I otherwise hate the thought of taking something unnecessarily.I am running around with an estradiol level of 126 pg/ml which should be much lower .

[hoofmaster]

If my estrogen is over 55 I have the worst anxiety and if it’s under 15 I’m dead tired

[brieast]

You state that there is evidence / science that running high above reference range E2 levels is beneficial. Can you please provide the studies?

[Systemlord]

I'm on TRT and had horrible symptom I thought was high estrogen (70 pg/mL) and everytime I tried to treat it with an AI, things went downhill fast! I found out it was iron deficiency, potassium deficiency, vitamin D deficiency and vitamin C deficiency.

[kilner]

Im at 82 pg/ml estro been told to take an ai i used an ai before ended up with bad joint pain dry skin pins and needles in lips just not feeling good and loosing lots of strength unsure if i should start ai again but ultra low dose

[Reggielo]

My estrogen is at 54, and im rocking 851 in test. Over the last month my anxiety and irritabily has been through the roof, just mental wreck. Is this because of the high estrogen??

[biglou]

Doc do you put your guys on HCG? It makes me feel like shit

[Nick-yerd]

I pin 100mg twice a week, just reviewed my labs and T is 1005 and E is 74. Should I be concerned. Im new to this

[NoahR-wf]

Spot on, until recently I hadn't realized that Mario updated his favorite way to tackle ED and it's a relief! Although what he previously suggested was pretty good, it was a real pain to follow... I just go'ogled the latest by Mario Volpstein, it's so much simpler and potent now!

[michaelvodinelich]

TRT referring to dosages in the 100-200mg weekly range wouldn't require an Aromatase Inhibitor typically unless the patient has really high body fat percentage. Bodybuilders on the other hand which are using supraphysicolgical dosages would require an AI to keep estrogen in the normal range and this would be a better outcome than having skyhigh E2 levels

[ciikorea]

Estradiol at 48.5 ph/ml I feel good 🤷🏻‍♂️ (on trt 100mg/ml and I split it Monday, Thursday twice a week)