Abandon arimidex. You’ll feel better in a few weeks 
2 Likes
For patients that do require AI, what are the symptoms you look for to make that determination?
I thought my symptoms were due to high E2 so I’ve crashed E2 on accident a few time in the past. Could those symptoms simply be the fluctuations in E2 due to Adex?
We use labs, otherwise beginners will always fail to proper determine high versus low E2 symptoms as they are very similar. There have been countless guys who thought there E2 was low and took an extra AI dosage when what was really happening is he was getting sick with the flu and bronchitis.
I do use labs. My E2 is 40 and my symptoms are listed above. Do I try to raise or lower my E2? How high is too high?
It depend if it’s the correct E2 labs, most doctors order the female E2 labs instead of the LC/MS/MS Sensitive method designed for men. Usually most men feel good in the 20-30 pg/mL ranges.
If not in the USA you don’t have access to the proper E2 test.
I’m in the US and order E2 sensitive from labcorp
The lower the SHBG, the closer to 20 pg/mL you should be. SHBG 20 = E2 of 20.
Hence my confusion. My SHBG=41 E2=40 and symptoms listed remain. This thread suggests E2 should possibly be higher with no use of AI
SHBG of 41 isn’t low SHBG. Low SHBG is defined below 20, when a guy gets below 20 he has a lot of free hormones and his SHBG level can be deceiving.
Never stated I had low SHBG. Trying to understand if removing AI makes sense for me.
It makes zero sense to remove an AI with an E2 of 40 if experiencing symptoms. If you remove the AI symptoms will get worse.
The Endocrinologist who started this thread disagrees with that statement.
All of the doctors who have been doing TRT for the past 20+ years have been doing this way.
Target 20-30 pg/mL unless you’re not experiencing symptoms because there’s no reason to lower E2 if there are no symptoms.
I haven’t seen an credentials waved in my face.
Horseshit. No one in my practice (an actual progressive endo practice) nor the above physicians group nor countless other groups push AI use or an e2 of 20. Do some docs? Yes. Is it stupid? YES.if nothing else watch the video I posted from one of the prominent men in our field.
1 Like
It’s quite common to see low SHBG guys in the 10-15 nmol/L ranges with high E2 symptoms when E2 is (example) 25 pg/mL range do to most of his hormones being free. Usually the best course of action is lower the test dosage, but that doesn’t always work since some of these guys tend to be high body fat percentage, insulin resistant and convert a lot of the test into estrogen known as a high converter.
If a guy is in the 40 pg/mL ranges and doesn’t have symptoms, it probably means liver clearance is ideal and no action be taken. However if he has symptoms of high E2 then action is needed, don’t you think?
wx14 has a lot of the symptoms I had when my E2 and test was high, shoulder acne is probably from high DHT, his levels are high and his test dosage needs to be backed off. He could forgo the AI completely and may not even need it if he lowers test dosage.
I was stating as a general rule low SHBG guys (10-15 nmol/L) need to target closer to 20 nmol/L rather than closer to 30 pg/mL do to so much of the hormones being free. wx14 is confused with my remarks about estrogen management wx14 particular problem is a different situation, estrogen isn’t always the culprit for swelling. His test dosage is too high IMO.
wx14 if you’re going to insist of pushing a Total T of 1200 you will need an AI, I assume anyone pushing those levels are doing it for building muscle if having problems and you’re not looking to lower the dosage of test. Night sweats occur when estrogen is high, at night estrogen lowers causes night sweats.
I’ll answer more later. By night sweats are caused also by low e2. Estrogen is tied directly into serotonin which is what regulates body temp.
Where are your credentials? Especially you who instead of giving your own experience gives orders on what to do with these guys on here. And with your experience not sure how you make certain statements in here when I see you on another forum asking for help because you have trouble dialing in.
We should be thankful to hear other opinions not get defensive. It’s up to the OP to decide with THEIR dr on how to proceed. this a forum to discuss ideas and experiences.
2 Likes
for obvious reasons I remain anonymous since I post in the pharmacy section on cycling and using other drugs. This shit isn’t worth losing it license over. I like to help when I can. I can tell you another doctor I mentored with is Eric serrano who used to write for this site and was called in front of congress for his knowledge on the use of AAS. Watch some videos on him discuss optimum estrogen.
1 Like
This is great info as well since there seems to be a big push on here to treat the thyroid right of the bat. I understand thyroid issues are seen with low hormones though.
Thyroid shouldn’t be touched until adrenal health is assessed. Usually the thyroid is overworked due to adrenals being stressed. When we treat adrenals the thyroid almost always comes back into optimal range. @anon10230041