Should Men Block Their Estrogen on TRT?
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- čas přidán 2. 03. 2024
- There is no need for managing estrogen by using an aromatase inhibitor, and there are dangers of using this drug in men. Dr. Keith Nichols explains how estrogen in men on Testosterone Replacement Therapy is cardio protective and healthy.
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Episode Takeaways:
• Hormone Management: Dr. Nichols emphasizes evidence-based medicine over anecdotal advice, cautioning against the indiscriminate use of aromatase inhibitors (AI) to block estrogen.
• Normal Range Fallacy: He highlights the lack of scientific basis for the normal range of estradiol (E2), urging a critical reevaluation of established norms based on outdated data.
• Tissue-Level Estrogen: Dr. Nichols explains that serum E2 levels are an indirect reflection of estrogen at the tissue level, cautioning against indiscriminate use of AI, which can hinder the beneficial effects of testosterone in various tissues.
• Bodybuilding Misconceptions: The confusion surrounding AI stems from misconceptions in the bodybuilding community, where blocking estrogen was erroneously believed to increase free testosterone levels for muscle gain, despite lacking evidence and posing potential health risks.
TIMESTAMPS:
⏱️ 00:00
Introduction
⏱️00:32
Setting the Record Straight: Evidence-Based Medicine vs. Non-Evidence-Based Approaches
⏱️02:54
Decoding Normal Estradiol Ranges: The LabCorp Revelation
⏱️06:12
Estradiol: A Vital Hormone for Men's Health
⏱️09:27
The Problem with Aromatase Inhibitors: A Bodybuilding Misconception
⏱️12:45
The Perils of Blocking Estradiol: Implications for Brain, Bone, and Heart Health
⏱️15:02
Conclusion
If you have any questions, please leave them in the comments or DM me over on Instagram @victorymenshealth
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Still the way I see it ,if a guy is having symptoms due to higher levels of estradiol ,why suffer .I otherwise hate the thought of taking something unnecessarily.I am running around with an estradiol level of 126 pg/ml which should be much lower .
I feel so bad for anyone who has this aggressive angry guy as a doctor and isn't allowed anastrozole when they are crying their eyes out uncontrollably from high estradiol. Reality means nothing to a doctor with a handful of 'studies' that sampled a few hundred people out of the 7 billion who live on this planet. The reality is that some people are just very sensitive to the effects of estradiol in their brains and they get insomnia and extreme crying and anxiety episodes. In order to have estradiol low enough they have to bring their testosterone all the way down to 300 to 400 ng/dL. It is also disingenuous to make up a fantasy that everyone with high estradiol is an obese alcoholic. Many of us have not had any fast food or alcohol in over 20 years and are not overweight, we just convert to estradiol at a high rate. Even on 1 mg of anastrozole I'm still at 57 pg/mL.
LOVE this comment... i listened to these assholes for 3 years and walked around with estrogen in the 60's pg/mL--- got on anastrazole and now I feel like a million bucks, blood pressure went down, insomnia went away, no anxiety and oh, I can cut diamonds with my erections!!!! all the sensitivity that i lost due to high estrogen is back and orgasm quality is through the roof
If my estrogen is over 55 I have the worst anxiety and if it’s under 15 I’m dead tired
It follows your testosterone levels and it is your testosterone that's doing that no estradiol. Testosterone has to be converted into estradiol and if your estradiol is 55 that means your testosterone is high. It's testosterone. Androgen not estrogen that are causing your anxiety.
@@keithnicholsmd6896 how do I fix it?
@@keithnicholsmd6896 If your taking an AI, the estrogen levels aren't necessarily following the testosterone levels. I've personally never experienced anxiety from high testosterone, but I do get anxious with high estrogen.
@@keithnicholsmd6896 LMAO--- horseshit... prove it keith... I've run my total T upto 2200 ng/dL and kept my estradoil at 20-28 and had ZERO anxiety--- i've also done it your way and the other anti-ai groups and let it run and have every symptom in the book... no one and i mean no one is saying to CRUSH your estrogen, but there are a ton of guys suffering out there because they're walking around with estrogen levels of woman about to have their period and wonder why they feel like shit!
I'm a thin and fit 39 year old male and started developing gyno and lumps in my chest with total T levels of 554 and an Estradiol sensitive level of 41.4. How have none of your patients experienced this? And if so, what do you prescribe besides Anastrozole to combat gyno?
This doctor doesn't care about your reality. He has a study that shows these other guys didn't have unusually high conversion to estradiol so that means that no one does.
I'm on TRT and had horrible symptom I thought was high estrogen (70 pg/mL) and everytime I tried to treat it with an AI, things went downhill fast! I found out it was iron deficiency, potassium deficiency, vitamin D deficiency and vitamin C deficiency.
That’s good advice to people who are on a cycle, take some electrolytes, vitamin d and a multivit
I pin 100mg twice a week, just reviewed my labs and T is 1005 and E is 74. Should I be concerned. Im new to this
I’m in the same boat I just started TRT yesterday 100mg twice week I’m concerned it’s gonna turn to estrogen
@@lenny_miller2357 that's how you get the benefits from testosterone. Testosterone works through its active metabolites. If you raise testosterone to healthy level, you're going to have a healthy level of its active metabolite, which is estradiol. Quit referring to the normal range, which is for men with testosterone levels, men with healthy optimal levels. If we only measured in men with healthy optimal testosterone levels, then the estradiol range would be much higher.
Some people feel great with estradiol at that level but others do not. If you experience insomnia, anxiety, stressed out all the time, cry easily, then your estradiol might be causing those symptoms.
@@jaybearsmusings none of us see that in a clinical practice. It's the guys on forums and the Internet. There's no such thing as estrogen symptoms in a mature, intelligent man. None of them have them. And believe me I see some of the best testosterone levels in the country. None of them have estrogen symptoms, and none of them need an aromatic inhibitor none of them are stressed out all the time and cry easily, etc. That's what these younger, weak minded forum boys get
@@keithnicholsmd6896 no such thing as estrogen symptoms in mature, intelligent man? So people don't get gyno from high estrogen. Right. Only unintelligent and immature men get gyno, lol.
Estradiol at 48.5 ph/ml I feel good 🤷🏻♂️ (on trt 100mg/ml and I split it Monday,Thursday twice a week)
That is great!
@@victorymenshealth is 1005 T and 74 E cause for concern
@@Nick-ye6rd How do you feel? Those numbers aren't concerning but we don't know anything about you so you need to consult with your Dr. for medical advice.
I had to, mine was sky high
What is sky high?
Probably had a bad protocol and needs to increase frequency
No, what actually needs to happen if someone needs to teach you about how testosterone actually works from a physiology standpoint. Testosterone works through its active metabolites. The benefits you get from testosterone actually come from estradiol and DHT. When you wanna block the benefits of testosterone just block the active metabolites and that will happen. Of course, when you raise testosterone, you're going to raise levels of its active metabolites. That's how it works and that's what you want.
@@keithnicholsmd6896benefits? Bodybuilders aren't getting jacked off estradiol and DHT, it's the testosterone that's facilitating muscle growth.
TRT referring to dosages in the 100-200mg weekly range wouldn't require an Aromatase Inhibitor typically unless the patient has really high body fat percentage. Bodybuilders on the other hand which are using supraphysicolgical dosages would require an AI to keep estrogen in the normal range and this would be a better outcome than having skyhigh E2 levels
What are sky high levels?
@@victorymenshealth I've read blood work with over 1000pg/mL before on a different coaches client who was running testosterone with nolvadex. As far as deploying an aromatase inhibitor if the levels are 75-100 and they don't have gyno developing or excessive water retention then avoid the AI. It's dependent on the individual. We obviously need estrogen for brain and heart health so if you can get around excessive aromatization with more frequent administration and or losing bodyfat this is much more ideal and agree 100% with what you guys said
First of all, you can't get sky high levels because there is a saturation point of the aromatase enzyme and it's going to plateau and it can't be raised any further after that. The water retention has nothing to do with estrogen but instead testosterone. Testosterone increases sodium absorption in the distal renal tubes, and is what causes your water retention. Gynecomastia is genetic, and if you don't have the genetic predisposition, it doesn't matter how high you raise your estradiol you're not going to get it. In addition, gynecomastia is multifactoral and not just related to estrogen and testosterone. There is no such thing as excessive aromatization. I can provide you with literally dozens upon dozens of studies where we gave testosterone to morbidly obese men, and it improved everyone of their parameters of health. Their lipids improved, their hemoglobin A1c improved, their waist circumference went down, their inflammatory markers went down etc... And none of the studies utilized aromatase inhibitors. What you are repeating is what you have read and learned from the bodybuilding community and it is incorrect. It is what kills the bodybuilders. It is the aromatase inhibitors. And when you talk about sky high levels, they can't do anything because the estrogen receptors become fully saturated just like androgen receptors become fully saturated in most tissues except for muscle tissue, where the androgen receptors are up regulated. And what bodybuilders don't realize is that they create more problems than they fix. When they take the aromatase inhibitors to control estrogen, what they do is they prevent testosterone from decreasing visceral body fat because the way it does that is through estrogen. DHT will control, subcutaneous body fat, but it is the visual body fat that estrogen controls through testosterone. So when they block that estradiol, they increase their visceral body fat and therefore increase their aromatase enzymes which will then have the opposite effect of what they want to do which is lowering their estrogen. So when they don't take an aromatase inhibitor and are just on testosterone they're going to have more conversion because they've created more visceral body fat by using the aromatase inhibitor. They would have been better off doing what the morbidly obese men do that take testosterone and leaving their estradiol alone so that it will do the work of testosterone. You guys just can never understand and just refused to physiology of testosterone and that is that testosterone works through its active metabolites which are DHT and estradiol. When you raise testosterone levels, you want to raise levels of its active metabolize because that's how you get the benefits from testosterone. What do you guys not understand about that? And lastly, we have been giving testosterone for 85 years or more and then every study that we gave men testosterone in those 85 years that showed benefits and we didn't block estradiol.
Plenty of people have testosterone at less than 900 ng/dL and still have high estradiol due to unusually high aromatase activity. You do not get to make up a fantasy that they are obese either and then smugly tilt your head back like you are so awesome and they wouldn't have problems if they were perfect like you. Shame on you and grow up dude
@@keithnicholsmd6896 Let's just start one line at a time--- please provide evidence.... first that high levels of estoen do NOT cause water retention and that high levels of testosterone do... Let's start there. Research please.