Benefits of Estrogen for TRT Patients

Pharma TRT
182

I would say more symptoms of high testosterone :wink:

Hereā€™s the thing:

There are many guys in this forum that wound up in our group because they were curious. They wound up changing their protocols. Within a months time, these same guys are creating threads saying, ā€œI never would have beleived it but itā€™s true. I feel amazing.ā€

There are a lot of doctors in that group. None of them have patients on an AI. Not a SINGLE patient. None of the patients have ā€œE2 issuesā€. Some of their patients know what an AI is, some donā€™t. Some know about the bro science 20-30 range, some donā€™t. Changes nothing. NONE of them have ā€œE2 issuesā€.

You need to get your free T levels WAY up there. Bare minimum 30 nd/dL. Some guys need as much as 60. None of them are measuring E2. None have issues. Every single guy Iā€™ve worked with to get off the AI have had amazing benefits. Every one that had initial side effects was easily corrected without an AI.

The vast majority of benefits from TRT come from the aromatization from testosterone to E2. If you lower E2, even in the slightest, you are lowering the benefits. Period.

For every single one of you who have had an issue doing this, there is a simple explanation. You absolutely do not want to take an AI unless you are running massive levels of anabolics and even then it is currently debatable if that is even necessary.

In 70 years of research, testosterone and estrogen have not been demonstrated to cause harm. There are only benefits. Guys doing TRT need a higher dose that ever before due to EDCs. Dr Nichols and Dr Howell are doing studies on that as we speak. In fact, any area where there is insufficient research you will be seeing studies by themā€¦ All self funded. You will be seeing their names appear quite a bit over the coming months and years.

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183

@equel, Iā€™m just curious, in everything I had said today what came off as arrogant? The not getting laid joke was following by ā€œthis is sarcasmā€ so Iā€™m confirming Iā€™m just kidding around. What got you so upset? I canā€™t see anything Iā€™ve said today that could have been interpreted as arrogant.

184

Iā€™ve tried pregnenelone but it affects my libido negativly. I avoid it now. For some men it does wonders. You just need to try it for yourself.

185

Seems like youā€™re just pushing Supra levels of trt. More like legit test cycles.

186

@equel can you tell me exactly what you were doing that resulted in poor erections? I had poor erections for 4 years because of the bro science I got brainwashed with. I know the feeling. It SUCKS. If I can help you, I will.

187

You think this way because you are stuck with ranges and numbers. This will be your shortcoming when trying to get optimized. Guys that had total testosterone of 1500 5 years ago, which was considered normal range, are now considered above normal or supraphysiological because the ranges keep going down year after year.

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188

@anon18050987 I wasnā€™t going to let you down. Here it is from the smartest man I know.

There is some semblance of a chain of reasoning but several aspects are ignored. What does viscosity mean to healthy men without hematological disorders? Do the kinetics of the blood favor developing conditions like VTE, PE, or any thromobotic event? I believe they do not unless a hypercoagulable state is present. See Virchowā€™s triad. Almost everyone points to developing these outcomes but where is the evidence to support it. Hypercoagulability is a completely different ball of wax which is why only a very small and special subset of the population should be concerned with blood viscosity or increased HCT. Hemostasis kinetics actually improve with secondary erythrocytosis resulting from T therapy. A couple recent studies have addressed this issue. The big picture here is that vasculotoxicity and hematotoxicity have to be present at the same time setting the ideal conditions for a hypercoagulable state that is either genetic thrombophilia or acquired thrombophilia. To develop a thrombotic episode there has to be 1) Hypercoagulability (which people equate to greater viscosity erroneously), 2) hemodynamic changes (stasis [no blood movement] or turbulence [a critical Reynolds number threshold is exceeded] - note viscosity is not considered here), and 3) direct endothelial injury (or dysfunction) [this causes local clotting factors ie the fibrin cascade to initiate clotting of the platelets inside the vessel under non-normal physiologic conditions. Ask yourself, where does changing the protein compartment and fluid compartment content change any of these three factors? My point is that the individual is looking at one component of an extremely complex process and equating some implication for caution. Hemodynamic changes are not tilted towards developing a thromobotic condition with T UNLESS the individual has a genetic or acquired thrombophilia. Look up the epidemiology of thrombophilias associated with hypercoagulable states. The incidence and prevalence are extremely low for genetic causes and acquired occurs mostly in the elderly as a result of severe disease and treatment for cancers. If this guy can show how increased HCT factors into development of a hypercoagulable state, he has only addressed one aspect of three requirements for thrombotic disorders. Pull up the Martinez et al. 2016 study that assessed VTE and the Gluek et al. studies. You will see that even in millions of observations that extreme statistical fuckery are required to associate VTE with T therapy and the only people at risk (would well know they had a thrombophilia) would be those with genetic or acquired thrombophilias.

My own dissertation research looked at 43 million inpatients over a six year period as the sample size and higher VTE risk was associated with a diagnosis of androgen toxicity. Guess what? 90% of the 488 exposures (our of 44 million inpatients) were being treated with chemotherapy (a known primary cause of acquired thrombophilia and hypercoagulable state). Point-most of the literature ignores the three required aspects and biasedly focuses on secondary erythrocytosis equating viscosity to hypercoagulability. These two concepts are not interchangeable.

Unless this guy has more than viscosity studies, what he states is meaningless in the context of the true etiology of thrombotic events with or without androgens.

Scott Howell, MD (NL), PhD, CSCS

Research Director

Tier 1 Health & Wellness, Center for Research

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189

I donā€™t doubt that a bit. Hereā€™s the problem with thatā€¦

  1. The main stream has touted extremely high testosterone levels to be harmful since the 70ā€™s. Not saying thatā€™s true, but that itā€™s a hill that is going to be hard to climb over.

  2. There is not ONE legal means of obtaining sufficient prescriptions of testosterone to produce those levels, unless you are very well off and can afford to pay a private specialist like Dr Nichols out of pocket, and Iā€™m not quite sure that he could even legally retain a license to practice if he is pushing patient levels this high. Iā€™ll bet that their consultation fees are DOUBLE any others out there. If Iā€™m wrong, Iā€™ll eat that one. I for one couldnā€™t afford them, so I guess Iā€™m just screwed if this ā€œget those levels highā€ theory turns out to be true.

  3. There are ZERO studies on the LONG TERM effect of elevated E2. There are however plenty testimonies of former body builders who have pushed supraphysiological levels of testosterone for many years. Very few, if any of them reported any positive outcomes. Now granted, these are way higher levels than we are talking, but it does make the point that higher isnā€™t necessarily better. There is a point of diminishing returns.

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190

Was just thinking about that too. What dr will write these scripts?!

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191

Guys, if you want to use a GP for this and put it through your insurance I wish you luck.

Injectables have a number where physicians get nervous to prescribe more. That number is 200mg a week. If you need more, like I do, youā€™re shit outta luck.

Compunded transcrotal cream does not have this limitation. If you are lucky enough to have a doc that knows how to use this, the benefits are VASTLY superior to injections and nobody gets in trouble to treating symptoms, not numbers. I will be moving to the cream as soon as my wife stops breastfeeding as the benefits are too numerous to deny.

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192

Short version, then: 27 year old male, was starting to noticing low energy, low motivation, ā€œgezt for lifeā€ was gone. Libido was OK, but not like just a few years back. Erection was OK, often strong.

Checked my testosterone, 260ng/dl, SHBG 19.

Got put on TRT, tried all kinds of dosages with and without AI. 200mg once a week, 250mg once a week, 50mg 3 times a week, testosterone cycles of 500mg a week (I do bodybuilding), subQ EOD 30mg.

Gone with AI, without AI (arimidex). Some times 2mg a week, some times 0.25mg a week.

Libido is extremely hit or miss. Could have days when its super strong, but erections are week. Erections hit or miss, can have days when its strong, 90% of the time its weak, WAY weaker than when not on testosterone and ā€œlow Tā€.

Currently trying 20mg test E, every day. Im on week 2, energy is low, I feel bad and nervous, the exact type of nervous energy I seem to get when I use very large dosages without AI, most likely due to T/e2 imbalance, Im not sure.

Erections were pretty great just a few days ago, libido too, right now, both are dead.

And yeah, Im impatient and dont stick to protocols long enough, thats probably the main issue and I need to stick to a protocol for a longer time and try it out.

I dont know my current shbg, probably lower than before TRT, as androgens seem to decrease it.

Oh, and my prolactin was high before TRT, 23 on a scale 8-15, checked MRI, no tumour. I would imagine its even higher now cause e2 seem to increase prolactin, maybe thats the main issue, e2 fucking up my prolactin even more destroying my erections, but thats just a guessing game.

So yeah, im all over the place and im pissed off. 2.5 years on TRT, soon to be 30, cant even hold a damn erection with a girl and no light in sight.

193

So are you saying that if I could afford to pay Dr Nichols, he can legally write me a script for that much testosterone, in the USA, without repercussions?

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100 years ago, before the advent of EDCs and processed foods etc, men were walking around with significantly higher levels of testosterone compared to todayā€™s men (who are slowly turning into women). The numbers you have in your head were taught to you. The studies are being done as we speak. We already have decades of research with no study demonstrating harm. The long term are being done and they see no evidence of the contrary.

195

Iā€™m glad to hear that. When those studies have concluded, we will all have our answer.

Can you PROVE that men had these levels 100 years ago?

And I would still love to have an absolute answer, perhaps from @yeti308, on the legality of pushing these levels.

196

@equel I saw your post. I just picked up some sushi I will reply to you and I know what your issue is.

@bmbrady77 doctors like Dr Nichols will increase dose over time until you report that your symptoms have been resolved. That becomes the dose for you. The MINIMUM amount required to resolve symptoms.

To the both of you, where does your free T stand? Forget about E2. If that number scares you, get rid of it and stop measuring it.

197

My free T was 19 on the last blood test. That was a few months back.

198

Can the two of you find a way to watch this tonight and then come back to me with your questions?

199

See, these are the kind of things that give me pause. On one side of the argument, itā€™s being touted that we just want to ā€œhelpā€ people, which I believe on your behalf Danny. What I donā€™t believe is that the doctors that you are staking your entire belief system on feel the same.

Itā€™s not like they couldnā€™t make a very lucrative living if they charged the same as every other doctor out there. I know GPā€™s, and even TRT specialists that are VERY well off, and they donā€™t have near the patient clientele, or charge near as much as your docs do.

This makes me wonder if they really do have the same motives that you do. Do they really want to help people who are suffering, or do they want to make money? Iā€™m not accusing, Iā€™m just saying that you have to ask the question.

And before you say that these guys spend a lot of time in your group giving out free adviceā€¦

I commend that. I really do. But what youā€™ve told me so far (by avoiding the question) is that the advice they are giving cannot be legally followed, unless that person can fork up the money to come to them (and right now the jury is still out on the legality of that as well)ā€¦ so is that charity? I argue no.

200

Lol what, if u really know what my issues is and how to solve it, and u manage to do it, i will forever worship your ground, cause right now im an impotent 29 year old who lose relationship on relationship due to this.

201

Itā€™s a good question, but a simple answer. The vast majority of docs donā€™t have a clue how to do this properly. It sucks, but itā€™s true. When you want something like this done right, you go to the best. It is what it is. The literature hasnā€™t been brought forth sufficiently enough for the ā€˜best practisesā€™ to become accepted common knowledge. We are not there yet. The docs are working on this. In the meantime they have found a way to get it done because they understand it.

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