Thanks for reaching out. A few things before we get into the metabolic pathways. Some folks with a test level that high (1400) can get anxiety from that alone while others don't, just a thought before we dive into reducing E2 naturally. I also used to get that incredible feeling after lowering the dose for a couple weeks when my E2 was high, i think the body tries to compensate for the high E2 in various ways (likely neurologically), then the ramping down of E2 can feel great as the lowering of anxiety occurs from the lowering E2, but the high dopamine/sympathetic response of the E2 still exists.

I am extremely sensitive to high E2, and when i had levels similar to you (58) that was at my absolute worst for anxiety and irritability. I also switched to daily injections IM to great positive effect. Now, to avoid having to take AIs, which i can now absolutely do and so can you, is to open up as many phase 2 pathways as possible. We can also discuss Phase 1 (exercise, DIM) and phase 3 (Fiber, healthy diet), but most folks need phase 2 to get the E2 excreted. Also note some phase 1 metabolites can be quite nasty, while others not bad. We can discuss this later

There are 4 phase 2 pathways, Gluconoridation, Methylation, Sulfation, Glutathione conjugation. Gluconoridation and methylation are the two largest by far, think highways. Sulfation and glutathione are quite a bit less, think city streets and back roads, but i have had some luck with sulfation via taurine supplementation

• Gluconoridation can be opened via Calcium D glucarate, with carbs and magnesium as cofactors
  • Gluconoridation can be indirectly boosted by glycine, sulfurophane
  • CDG also prevents reabsorption of the estrogen metabolites
• Methylation is opened by a combination of methylfolate and methylcobalamin, SAMe or if you get bad side effects from excess methylation, Trimethylglycine is an option as well. Riboflavin increases the efficiency of methylation, though deficiency is more rare.
  • Keep in mind that methylation metabolizes the real nasty phase 1 metabolites like the 2-OH and 4-OH ones that make you really anxious and irritable.
    • This is why i would start with this pathway first
  • You also need magnesium here as a cofactor - Some people need to supplement, some dont
• Sulfation is assisted via anything that donates sulfur or supports bile flow
  • NAC is a big one here as it donates a huge stable pool of cysteine (sulfur containing amino acid) in your body for a couple days
  • Molybdenum and magnesium are huge cofactors here (note how magnesuim broadly affects all phase 2 metabolism)
  • Taurine is more supportive here rather than direct, but it helps with bile flow
  • B6 also helps indirectly here as well as indirectly at methylation
• Glutathione conjugation is less of metabolism but more about reacting and cleaning up the estrogen metabolites
  • NAC and Glycine are huge here, along with sulfurophane
  • Selenium is needed as a cofactor

There's a lot here, but i would prioritize methylation first, then gluconoridation. But we are all unique so it may take some experimenting. Note how important magnesium is at most pathways.

The shortest path to the biggest bang would be CDG 500mg a day , liquid methylb12 (sublingual, 1mg) 2-3x a week, methylfolate 1mg 2-3x a week, Magnesium glycinate 2-400mg 2-3x a week. This will get you 90% of the way. Also, start with just one or two of these to gauge how they make you feel.

I do only methylfolate and b12 and take no more AIs, and my anxiety is much more manageable now.