When and How We Manage Estrogen Levels in TRT Patients

Managing #estradiol levels in men on #TRT is a highly controversial subject. At Low T Nation, We believe that estrogen is a vital and critical hormone in the male body and it should be allowed to run at very optimal levels for most men.

The exception to this is when guys convert too much #testosterone into estrogen, and they experience side effects.

You can either reduce the testosterone dose, or slow the conversion of that testosterone into estrogen utilizing and aromatase inhibiting.

Sometimes reducing testosterone is appropriate if they are running a little warm. Other times, that level of testosterone is required in order for the patient to feel relief from his low testosterone symptoms, therefore using an #aromataseinhibitor is more appropriate.

When using a drug like #anastrozole, it is highly imperative that one uses it very sparingly. It gets a bad reputation, not because it's a bad drug, but because it is overutilized and it drives men's estrogens into the dirt. This becomes a health issue over long-term, and in the short term it makes a guy feel terrible.

Understanding that a guy needs very optimal levels even if anastrozole is required is key to making sure that guy is protected long-term and feels as well as possible.

[shawnbrockman]

Best video I've seen to date regarding this.

At peak day three, morning, fasted blood testing. My total T is 1894. My free is 581. My estrogen is at 111.

But I have no symptoms. Besides a slight low libido. But when is go time, there is no ED issue.

I'm 44 and take 250mg of test cyp per week.

Numbers are just a guide line. Symptoms are the key.

[luckyg]

Couldn't agree more about anastrazole. It's potent. I was given it at the beginning when I didn't have high estrogen symptoms. It was part of my starter protocol with the men's clinic I use. Knocked my estrogen levels so low it couldn't be picked up and measured on a lab and I felt horrible. Didn't need it to begin with so why? Once it was removed from the protocol I felt a night&day difference. If you end up needing it then go ahead, but it's very strong

[LK-bzsk]

The most succinct and informative presentation on this topic. Just subbed. Thanks

[radolszewski]

Outstanding job!
You are truly helping!
Good luck!

[MrGreggthompson]

Another thought would be to treat the high estrogen before the symptoms (some irreversible or very costly) occur.

[ImTheBlade]

All of the reference ranges for male estradiol levels are based on “endogenous” levels of testosterone and an average rate of conversion. They have absolutely no appreciation for rates of aromatization while on “exogenous” testosterone. It will likely take numerous peer reviewed, evidence based studies before we can get any reliable reference ranges for the male patients E2 levels while on exogenous testosterone. And., more importantly, as the good doctor pointed out, the idiopathic response to E2 levels is a most individual thing that is highly nuanced in its management. I’ve seen guys with E2 levels greater than 100pg/ml and absolutely no side effects whatsoever. This is a completely different situation for the individual using anabolic, androgenic steroids. If their E2 is above average, then their AAS will be significantly less effective or might not work at all. So, it’s important to consider whom you’re getting advice and input from., TRT or AAS users. It’s a huge consideration.

[MrGoofinaround]

I was injecting .25mL twice a week into my dealt and started to experience ocular disturbances here and there. Where I wouldn’t be able to see well. I get these blotches in my vision where parts of whatever I was looking at were just missing from my sight. I didn’t relate it to the TRT. When I increased the testosterone another .25mL every other week the ocular disturbances started to happen a couple times a week. Really freaked me out. I mentioned what I was going through to a nurse practitioner and she said it sounded like my estrogen was spiking and causing this to take place. Anybody else have this experience?

[charlesskelnik]

Trt 200 mg wk . My total test is 1196, free 26.9 pg/ ml, e2 82.1 pg/ ml. I feel great but am worried about the number. I don't want to develop gyno. I have no symptoms. 80's seem high should I go for a slight reduction just to be safer? Any supplements that may help slightly lower with out an AI? Dr says I'm good.

[TheJLAMAR]

Great video as always man.
I’m curious to see what you think is the upper limit to both testosterone and estrogen on average is assuming the patient is side effect Free?

[joshua-nfrx]

What are the side effects of high estrogen while taking testerone

[wayneakakummerts]

The first doctor I see tell truth and know what he talking about great keep it up doc I'm not from USA but I'm jealous of your county here in stupid germoney the doctors know noting they don't even treat this disease only if you stay hard and keep sticking to the therapy with many many many bloodtests ect. In my case I started one year ago the therapy and I feel bad it's not that bad like when I was on low Testosterone but I have symptoms of high estrogen get much weight even when I make diet and training in the gym I think I need to switch to another doc and start with arimidex 0.25 MG per 5 days

[wasteman]

What dosage do you tell your patients with symptoms take at once?

[ivanrod]

Is chest discomfort and bad sleep is symptoms of low estrogen? Mine came back at 7.2 and those are my symptoms currently ..

[Billiehoyle]

can i pick up your mind for this: gonna be on bioidentical test150 sublingual ED, would you use clomid and at what dosage? many thanks

[tanclix]

I wonder what the recommended lower dosage schedule is an what are some symptoms ?

[tylerthomas]

Some of the information in your videos suggests the optimal range is 20-30 pcg/ml for long term cardiac health. Do most of your patients feel better in this range as opposed to 40-60? There is a ton of conflicting information on whether or not that is in fact the optimal range for Estradiol, or if it is relative due to symptoms. I for one have high normal total and free T levels, but the estradiol level goes anywhere from 49-55 on average. My thoughts are this is too high and to try 0.25 adex 2x weekly. I have some symptoms such as really bad anxiety.

[escapetoparadise]

How often to take when on test cream? I have horrible anxiety, can’t stand heat. Red faced. Bloated. My estrogen is 80.1 !!!😮😢

[Takeshikovac]

How often should I take anastrazole I’m on 200mg a week test c

[muhammadkamranzaman]

Can take anastrazole along with clomiphene while on trt.
Because we use enclomiohene to keep fertility and anastrazole for too high estrogen.
Can we use both in same time?

[robinhood]

Microdosing Testosterone
15 ml Testo E every other Day.
I never have Problems.