My e2 numbers are in pg/ml 
Convert that and see what you got.
No conversion necessary. We’re using the same units.
OMG, then is crazy.
I only did the one week trial without it just to see and didn’t have any issues. I am still taking cialis but not for erectile issues. I take it for the pumps I get in the gym and all the vascularity I get from it. It’s a pretty amazing compound and cheap to buy.
I agree. I also take it because in lowers my pressure a bit which is all I need to lower it at this point. I feel good on it.
I split a 5 mg tablet in two and take 2.5mg in the morning and 2.5mg late afternoon. Keeps me very consistent. I tried taking 10 mg one time and it gave me back pain. I buy 2 months worth at a time via a Canadian pharmacy. Awesome stuff.
I take 3 mg a day in the evening. Get it compounded by pharmacy about $1.30 a pill. If I ever need to up it I will go your route.
Generics available this year I think so maybe prices go down.
So do you get skin splitting pumps while lifting? Is your recovery better from the vasodilation? What benefits are you getting?
Also doesn’t Cialis cause vision sides @EyeDentist ?
Color-vision-related sides are somewhat common, but aren’t considered serious. Much more serious (and rarer) are what could be called a ‘stroke of the optic nerve’ (an NAION in the linked article). NAION are much more likely to occur in someone who is a ‘vasculopath,’ ie, has diabetes and/or HTN.
From the American Academy of Ophthalmology (a trustworthy organization):
https://www.aao.org/eye-health/drugs/erectile-dysfunction-medication-your-eyes-vision
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I’ve never experienced vision sides of any kind. The first time I took it I experienced flushing. Redness of the face. Got a little light headed after about 4 hrs. Never again after the first dose. I wouldn’t say “skin splitting” but it’s the best pre workout I’ve ever taken for pumps. I hadn’t experienced “the pump” in years prior to cialis and trt. Increased vascularity. Strong blood pumps in the gym. Girls come by and poke the veins in my biceps while I’m doing preacher curls lol. It’s awesome.
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There are too many blanket statements when qualified points should be made in an educational manner, not dumb ass directives. Useless. We have a doc saying things that are not safely/wisely actionable. But people will be hooked. It is not worth my time refuting and explaining, we have done this here before and not it is started again.
I know a doc that got hooked on this ‘drop the AI fad’ at a conference and dropped AI from his TRT. He started to get fat faced and looking like a women. He later mended his ways.
When there is an E2 range such as E2<42, we see all kinds of trouble with some “normal levels” below 42. We need to address optimal levels. We have had good results with what I have suggested for years. Yes, there are a few who need higher E2 levels and they sort of need to find there own way to optimal. None of the E2 levels recommended here have any negative effects on bone health or lipid profiles. Most here would be miserable with elevated E2 not using an AI. I can qualify deeper and have done that in stickies and countless posts. This thread will be buried after a while and its not worth the effort.
There is a need for AI use, guided by labs and symptoms. There is a large impact on mood, tolerance, libido, sexual performance, fat levels, fat patterns and energy. Elevated E2 can tear down almost all of the benefits of TRT. What is motivating this doctor?
Actual experience as a licensed Endocrinologist as stated throughout the thread.
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What is motivating this dr?? Really. You really don’t want to hear anything that contradicts your thinking. Guys are on here to hear ALL ideas especially ideas from someone @physioLojik who is in a practice with a ton of HRT clients.
Don’t you push him out of here with your condescending language. @KSman
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Here’s an interesting thread from @physioLojik
What?! Test Estrogen Ratio?! Who Knew - #11 by Hostile
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Thanks guys. Really it’s ok. I encounter this over and over with other docs who have the same ideas with e2. The problem is that being inflexible and making yourself convinced something is right based on anecdotal evidence is just that - anecdotal. What are my motivations? Clearly it isn’t to garner new patients nor is it to upset people’s Applecart. I want to be able to help the most people I possibly can and when I see people recommending dangerous medications that are unnecessary I get pissed off. Just like when @KSman recommends melatonin at 6mg. See the MIT study on melatonin showing the most effective dose is .3-.5 mg. Anything over is not beneficial and can be harmful. Oh wait and also melatonin use modulates estrogen levels.
Oh and recommending trazodone for people who can’t sleep? Why recommend so many medicines when the desired effects can be achieved with much simpler and less harmful methods. Yet I’m not here calling you out for disagreeing with me. Sounds like you’re angry someone else is in your pool and you don’t like it. I’ve spent my entire career in this field and been lucky enough to learn from some of the very best in this area of study. I really appreciate you guys coming up to defend me but it’s really ok. I’m going to go home now and enjoy my wife and kids. Have a good night guys!
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Personally, I like reading about different thoughts and ideas regarding what, I think, is a rapidly evolving approach to men’s health. Women too, for that matter.
From past anabolic steroid use as a competitive weightlifter, I know this: many of us react very differently to hormones. I know some (include powerlifters and bodybuilders here) that ended up needing surgery for gynecomastia and they weren’t doing anything that anyone else was not. I never had any signs of that, and only once did I have fairly extreme nausea, morning sickness, and that was when I was on for a longer period than typical preparing for a major competition. My training partners, doing the same AAS program, were fine. Me, I was terrible at the end and even weighed in at 11lbs under my usual competition weight. I knew estrogen was high but we couldn’t do anything about it back then, other than go off.
I also saw a large discrepancy in the response/benefit to anabolics. Some gained very little, one guy’s lifts even went down, while some had huge gains, and everything in between. I think mine were fairly moderate, not great, but significant.
Guys talk more about this topic these days, especially gym guys. I’m in my 60s and guys walk up to me all the time and ask “what are you taking?” The discussion starts from there. One guy told me when his E2 gets to 30 (he does not get the “sensitive” test) his nipples literally hurt when he puts a shirt on and he also feels terrible, whiney, sexual function, bloating, etc. I don’t get that, I even went three weeks w/o anastrozole to run my own test. But, I certainly do not doubt what he tells me.
Point being, we are all different and can learn from the experiences of others. While the discourse here may seem impolite at times, I have to think most everyone that takes the time to participate in this forum does so to learn and maybe help others learn from our experiences.
I think it is good to listen to all sides, do the best we can with the best available research, and make up our own minds. I appreciate @physioLojik for taking the time to participate, as I do all the others, including the two most active, KSman and systemlord.
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Thanks for the info.
I’m interested in the information you’ve shared. I watched the YouTube video and learned a few things I was unaware. So thank you.
I have noticed over two years of self administered hrt, the further I get from my AI doses the better I feel.
HOWEVER, I am a 40 year old man. I’m in excellent physical shape with very low body fat. But I suffered horrible with Gynocomastia as a teenager after being put on Zoloft. I suffered for many years before taking the appropriate action. I’ve had three surgeries total to correct the Gynocomastia. This was all a decade before going on trt.
I’ve been relatively free of it for over 10 years now and my QOL has been greatly improved. I don’t want to go back to that and worked so hard to get to where I am now.
I want to try letting go of the AI and from past experiences I’ve seen my E2 typically come in around 60-70 when my TT is at the top of the range.
That always freaks me out and I jump back on the AI and lose many benefits a long the way. But I really don’t want to suffer or battle Gynocomastia again.
What would you advise or suggest to someone in that situation. If you saw me shirtless, you may not even notice, but there’s still small amounts of breast tissue left behind.
I’m very paranoid the raised estrogen will promote growth which I have not experienced at all while on trt, AI, and HCG.
@physioLojik Would dropping the AI and using a very low dose of nolvadex be superior option considering my situation?
I’m guessing I’m not that only one with this exact concern.
PS - this is my first post, more to come about me later. Thanks to ALL who contribute so much information and dedication.
Just finished the video. He doesn’t talk about how estradiol binds to the androgen receptors and thus makes the testosterone essentially useless. Isn’t that why everyone is trying to decrease their estrogen levels? The video suggests estrogen is important for a variety of functions but doesn’t address this issue.
If having a high estrogen was fine then why do men have such horrendous side effects from it?
@bigbobrocks16 hey man! That’s a common misconception created by broscience. Lets look at androgen receptors like a parking lot and test / estradiol are like cars. What matters is the ratio of test to estradiol. If someone has normal test and normal e then the parking lot will be filled with almost all t and small amounts of e. Bump up the test and the e comes up but the ratio of the two is basically similar so the same results are going to happen - mostly t binding. The good news also is that using testosterone causes the body to create much higher amounts of new androgen receptors so there are even more binding spots for the high t. It’s funny people have this idea that if your e creeps up then all your t is rendered inert. If I have 5% of my t going to e I’m not going to worry about displacing 95% of my t with it. Where people run into issues is high ratios of e in the presence of low t. Then the parking lot is mostly e. That’s when we have issues seen primarily in very overweight people or people with extreme liver dysfunction.
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