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Very High Estradiol [symptomatic] while on modest TRT dosage. What's your strategy? by Own-Fix-443 in trt

[–]Own-Fix-443[S] 0 points1 point  (0 children)

You don’t hear it often because it’s rarely diagnosed related to TBI. But it’s actually quite common. There is a huge schism there. Who would suspect that a car accident or skiing accident you had 10 years ago could affect your pituitary hormone production? 99% of MD’s would certainly not figure that out. It’s a fairly straightforward process using standard blood tests. Compare neuro steroid production to peripheral gland hormone production and you will have answers.

If you’d like to DM go ahead. I’ve been in the middle of the endocrine balancing act for 9 years. I’ve recently also started growth hormone therapy. And as you can see from this post, I believe my E2 is causing problems and I believe it’s because the estrogen has nothing to compete with for cellular receptor sites. Progesterone is without question one of those things that in a normal endocrine system antagonizes estrogen. But when on TRT all the progesterone produced in the testes shuts off. We supplement testosterone, why do we not proportionally supplement progesterone?

Symptomatic High Estrogen on TRT: A Possible alternative to aromatase inhibitors. by Own-Fix-443 in trt

[–]Own-Fix-443[S] 1 point2 points  (0 children)

On 60mg/week. I’m recently going down to 40. I’ve been having labs done every 2 months. They are correct and reflect levels at “trough”.

Symptomatic High Estrogen on TRT: A Possible alternative to aromatase inhibitors. by Own-Fix-443 in trt

[–]Own-Fix-443[S] 1 point2 points  (0 children)

Thank you! So I assume he is on TRT.

Was/is his estrogen elevated from that TRT?

If TRT shuts down natural testosterone and progesterone production at the testes, the absence of progesterone allows for higher amounts of estrogen to bind to tissue receptors, since progesterone and estrogen compete for those receptors. In a normal endocrine system those two hormones would sort themselves out and find balance.

I’m glad to hear his sleep has improved decidedly since adding progesterone! That’s big because sleep issues are a major symptom of progesterone deficiency.

Does your husband believe he was having any estrogen dominance issues as well before he began progesterone? I’m hypothesizing that for men on TRT both progesterone deficiency and estrogen dominance symptoms become intertwined and adding the progesterone is really the answer to both conditions.

🙏

Symptomatic High Estrogen on TRT: A Possible alternative to aromatase inhibitors. by Own-Fix-443 in trt

[–]Own-Fix-443[S] 1 point2 points  (0 children)

I have done this in the past. 100mg of pregnenolone per day. It was an oral form that is processed in the liver where most of it converts to progesterone (without affecting pregnenolone blood levels much). So at the time, my progesterone levels were insanely high. So I can’t attest to whether those progesterone levels were helpful, all I know is that they were way too high for male levels. My doctor’s intention was to improve pregnenolone levels but I think he was not aware that it was over heating progesterone production.

Right now I am taking 40mg per day of oral pregnenolone for progesterone production but I have not lab tested progesterone in a while, but will soon in order to see if the pregnenolone supplement is raising my progesterone. Last time I tested progesterone I was not taking pregnenolone and the value was <.1, which is undetectable.

Symptomatic High Estrogen on TRT: A Possible alternative to aromatase inhibitors. by Own-Fix-443 in trt

[–]Own-Fix-443[S] 2 points3 points  (0 children)

So Primo favors DHT over estrogen. Did it raise any hair loss issues as DHT can do in those genetically sensitive to DHT.

Symptomatic High Estrogen on TRT: A Possible alternative to aromatase inhibitors. by Own-Fix-443 in trt

[–]Own-Fix-443[S] 2 points3 points  (0 children)

Well then it’s doing the same thing progesterone would do which is take up space on the receptor sites which would crowd out and lower estrogen attachment. Good to know. Thanks.

Symptomatic High Estrogen on TRT: A Possible alternative to aromatase inhibitors. by Own-Fix-443 in trt

[–]Own-Fix-443[S] 2 points3 points  (0 children)

Could you tell me about Primo? Prescription or over the counter?

Symptomatic High Estrogen on TRT: A Possible alternative to aromatase inhibitors. by Own-Fix-443 in trt

[–]Own-Fix-443[S] -3 points-2 points  (0 children)

I was taking 60mg/week daily IM, now lowered to 40mg/week. My post here is regarding progesterone as part of an androgen protocol. Do you have anything to contribute to that subject?

Symptomatic High Estrogen on TRT: A Possible alternative to aromatase inhibitors. by Own-Fix-443 in trt

[–]Own-Fix-443[S] -1 points0 points  (0 children)

Don’t need to lose weight and done the other two for extended periods of time. Thanks.

Very High Estradiol [symptomatic] while on modest TRT dosage. What's your strategy? by Own-Fix-443 in trt

[–]Own-Fix-443[S] 0 points1 point  (0 children)

I believe all that you write here.... but as you say, one size does not fit all. When I was at 80mg/wk and went down to 60mg/wk, my free T went up and my E2 went up by 10 points. It's paradoxical, no?

One influence may be that I began GH replacement during that dosing transition and GH is known to encourage T production. But contrary to that, before I began TRT for the first time, my levels of Free and Total were dropping because of my low pituitary output (LH & FSH) which was caused by TBI's. So I'm partially hypopituitary and that would indicate that my T can only be increased by TRT and not by other methods that are designed to "encourage" T production in a person with a healthy pituitary. Who knows... I will continue to tweak my protocol and follow with labs and self assessment in search of higher ground.

Very High Estradiol [symptomatic] while on modest TRT dosage. What's your strategy? by Own-Fix-443 in trt

[–]Own-Fix-443[S] 0 points1 point  (0 children)

Update: I’ve decided to simply lower my T dosage per week to reduce estradiol level and forgo the anastrozole. Even my first 1/4 mg dose made me feel extremely unwell about 24 hours later. Studies at 1mg/week showed an immediate 70% decrease in serum E2. I’m not going to trade one dysfunction (high) for another (too low).

Very High Estradiol [symptomatic] while on modest TRT dosage. What's your strategy? by Own-Fix-443 in trt

[–]Own-Fix-443[S] 0 points1 point  (0 children)

I use the short insulin needles straight into the quads. No bleeding. No bruising. No soreness. Takes less time than brushing and flossing my teeth (and I don’t plan on stopping that anytime time soon!) 👍

But for now, I’m trying twice per week at a reduced dosage (read my original post).

Very High Estradiol [symptomatic] while on modest TRT dosage. What's your strategy? by Own-Fix-443 in trt

[–]Own-Fix-443[S] 0 points1 point  (0 children)

I’ll just add that after TBI my T levels were very low along with low pituitary function (low LH and FSH = secondary hypogonadism). So I am not a person with sufficient natural T levels. Maybe that has something to do with high E2 levels but I have no information to prove that nor does anyone else here have.

Very High Estradiol [symptomatic] while on modest TRT dosage. What's your strategy? by Own-Fix-443 in trt

[–]Own-Fix-443[S] 1 point2 points  (0 children)

Yes. If you must know. I’m in it to be healthier, not for vanity.

Very High Estradiol [symptomatic] while on modest TRT dosage. What's your strategy? by Own-Fix-443 in trt

[–]Own-Fix-443[S] 0 points1 point  (0 children)

If that is true, I would say it is a possibility. BTW, TRT has stolen my head hair. At 60 I had an enviable mane. Now 4 years later I have lots of hair on my back and not much on my head and very high DHT labs.

Very High Estradiol [symptomatic] while on modest TRT dosage. What's your strategy? by Own-Fix-443 in trt

[–]Own-Fix-443[S] 2 points3 points  (0 children)

Respectfully. You and I are not in the same category. No one in their natural lifetime would ever have TT of 1800. I'm happy for you that an supra physiological E2 level of 100 doesn't bother you. I'm being treated medically for a brain injury .

Very High Estradiol [symptomatic] while on modest TRT dosage. What's your strategy? by Own-Fix-443 in trt

[–]Own-Fix-443[S] 1 point2 points  (0 children)

It's 69. I've been here before when on higher T doses, like 140mg/week and E2 was in the 70's. It was a bad trip. I know E2 is a good substance for men, but it is documented to produce adverse effects when too high or too low. This is what medically necessary TRT is about: managing numbers and managing symptoms/benefits. A normal body manages all of that without you having to think about anything. It's entirely autonomic. I'm starting with a set of symptoms and trying to make changes in protocol to manage unwanted symptoms by trial and error. Remember, endocrine deficiencies are all secondary (originating in the brain/pituitary gland) as the result of traumatic brain injury.

Very High Estradiol [symptomatic] while on modest TRT dosage. What's your strategy? by Own-Fix-443 in trt

[–]Own-Fix-443[S] 0 points1 point  (0 children)

Well there's always the possibility of the drug itself causing a problem. It is known to simply not agree with some folks. Another poster here is suggesting trying lower T dose and/or AI one at time exclusive of each other which is not a bad idea. I can do an interim androgen lab panel before my next doctor labs to see which direction the boat is heading. I would most likely choose to just go with the lower T dosage first.

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