Benefits of Estrogen for TRT Patients

@yeti308 - do you have any thoughts about deceased ejaculate and taking forever to finish in relation to higher levels of E2?

I’ve had a vasectomy too…seems when I’ve increased my dose (assuming an increase of E2 as well since there is more test to convert) I always have a decrease in volume and there are times I have a hard time finishing.

I think this has also happen to @alldayeveryday and @NH_Watts too. Curious if there is some link to E2 and decreased volume/increased duration to finishing?

Thanks

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Hcg doesn’t work for many and adding HCG to a protocol complicates things. If a man is having that much pain I’m sure Dr. Yeti would give the man HCG. Actually I know he would.
Simplicity is the key. Not the nonsense that goes on with “inject Monday and thursday and then add HCG on Tuesday and friday. At the same time apply part of this cream to the inside leg, just in case you have estrogen issues take an ai. .

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Guys, and @readalot, as you may have heard, I do some very simple English podcasts on the subject these days. I’m going to post the links to two of them I’ve done which are on YouTube (doubt the mods here will mind). Watch these, then send me your questions. This will prevent me from having to repeat a lot of it. Yes, I made some mistakes of saying ‘estrogen’ instead of ‘testosterone’ (and vice versa), as public speaking is harder than you’d think if you’ve never done it. I await your questions.

Do I need an AI with TRT?

Hormone optimization mistakes:

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Respectfully, you aren’t getting it. I am differentiating the two. With your logic, you call erythrocytosis harmless, therefore it must be harmless. What’s scary is you don’t seem to understand that. Go read my posts. I outline all of this. Here’s one verbatim from ExcelMale:

THE DETERMINATION OF BLOOD VISCOSITY IN MAN BY A METHOD BASED ON POISEUILLE’S LAW

THE APPARENT VISCOSITY OF BLOOD FLOWING IN THE ISOLATED HINDLIMB OF THE DOG, AND ITS VARIATION WITH CORPUSCULAR CONCENTRATION.

So the formula that does a very nice job fitting all that pretty data in mammals is referred to as Hatschek’s formula (hat tip). That is viscosity is equal to viscosity of plasma divided by the quantity of (1-hematocrit raised to the 1/3 power).

image

So if you take this formula and manipulate to take the derivative of the viscosity with respect to hematocrit (I’ll spare you), you can plot out how quickly the function is increasing (rate aka slope) at any point on the curve of hematocrit vs apparent viscosity:

image

Here I am using a plasma viscosity (eta zero in equation above) of 1.3 cP. The line in blue is viscosity (goes with the left ordinate) and the orange line is the slope of the blue line (goes with the right ordinate or secondary y-axis). You can see blue line goes up pretty linearly but really starts to take off after about 45-50% hematocrit. So going from 50 to 55% hematocrit doesn’t result in the same absolute increase in viscosity as going from 40-45% or 45-50% (it’s more!).

So what about that plasma viscosity term since the equation above isn’t just dependent on hematocrit. Why all that variability in people’s experiences with BP, symptoms and hematocrit?

Why must a practitioner be cautious? When was the last time you had your plasma viscosity measured? I haven’t done it :). Ah, finally a test I haven’t run.

So plasma behaves as a Newtonian fluid but its viscosity is a strong function of the proteins within. Take a look at these papers. Guess what really jacks with plasma viscosity, yep you guessed it, inflammation.

Plasma viscosity: a forgotten variable.

Plasma viscosity in inflammatory bowel disease

So let’s review an instructive example with two guys, Joe and Bill. Joe has a plasma viscosity of 1.3 cP and Bill (who’s got some immune issues) has a plasma viscosity of 1.5 cP (could be much worse). They both present with hematocrit of 55%. Let’s plot it:

image

Looking at the graphical construction above, Joe (at a Hct of 55%) has a blood viscosity of 7.2 cP. Bill at same Hct has a blood viscosity of 8.3 cP. Guess where Joe’s Hct would have to be to give the same blood viscosity as Bill? Just a little north of 60%! So Bill’s blood at 55% Hct is behaving the same way Joe’s blood would behave at 60%. An equivalent hematocrit reading in two persons does not necessarily indicate the same blood viscosity. Can you see now why a blanket suggestion that hematocrit levels above reference range are not a big deal is flawed practice? Individual mileage may vary.

But hold on, isn’t this example quite extreme. Are you exaggerating for effect readalot?

Well, if you substitute 1.1 and 1.3 cP (the normal range endpoints given in paper provided above) for Joe and Bill’s plasma viscosity, you draw the exact same conclusions. Modest (10% variation) in plasma viscosity combined with non-linear relationship of serum viscosity vs. Hct can result in very different serum viscosities for two individual’s with the same Hct.

Want even more fun…Here’s the plot for Joe, Bill, and their buddy Jay who all have Hct of 55%. Remember, Joe’s plasma viscosity is 1.3 cP and Bill’s is 1.5 cP. They’re jealous of their super stud buddy Jay who has a very low serum viscosity of 1.1 cP. How do they compare? Jay would need a hematocrit of 65% to match Bill’s serum viscosity even though Bill and Jay have the same hematocrit of 55%.

image

@readalot I will send this to Dr Scott Howell and I’ll let you know what he says about it.

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Please provide one study showing what you just said to be true. Let me save you time. You can’t. What in the world do you not get about over 80 years of testosterone studies and the erythrocytosis with it never causing harm in any of them. The fear comes from extrapolating the harm of PCV to erythrocytosis. Show me one study to support your opinion. The actual literature does not support your opinion.

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Fire away. You won’t get this anywhere else it appears. Good stuff and happy reading.

What makes you think it’s estrogen ?

You’re talking 7 days versus 9 days for most people not vs 4.5, they are essentially interchangeable (and I have done that when necessary without complication)

You know what caused that for me? Melatonin and those nootropics. Everytine I take them it happens again and again. I stopped taking those. Estrogen does not cause ejaculation issues if actually makes sensitivity and libido better.

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I’m not sure what you mean. Can you elaborate?

Can I ask what your free T levels were at the time and what was your exact protocol?

You know I’m really sorry man. If you didn’t word your posts as such where you are so fucking condescending, I might could actually read between the lines and actually listen to whatever your point is supposed to be.

I love that you have you passion Danny. I love that you have researched the hell out of things. I sincerely applaud that. If you weren’t such a DICK we could all probably learn something from you.

My comment regarding this was a reason, not an excuse. You talk about keeping things simple. I don’t want a fucking FB account. Simple…

If you guys can’t provide another option for correspondence (which is fine one way or the other) , then I guess I just won’t be one of the elite! Lol. Don’t tell me I “have no excuse” like I’m some kind of fucking kid that skipped out on mowing the lawn. Geez and you wonder why people can’t accept anything from you?!

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Might not be estrogen at all. Let me rephrase - do you have any thoughts about deceased ejaculate and taking forever to finish in relation to higher levels of testosterone?

When I increase my dose, ejaculate volume decreases and time to finish more often than not increases.

Only variable I change is dose size. Could it be something different down stream as a result of more testosterone? Something that effects the prostates ability to generate ejaculate?

Thanks

All of those issues vanished once I moved to daily injections and significantly increased my dose. That’s why I asked the question of your free t levels and exact protocol.

Most recent bloods. Supposed to be 40mg EOD and nothing else, but I may have overfilled syringe a few times to 42 or 44mg during backfill and just injected the dose.

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Fixed the issue with the graphs as I had to recopy them.

Was that absolutely necessary? Are you that miserable on your current protocol that you felt compelled to react that way to my post?

When you signed up here, did you not have to open an account, answer a bunch of questions, create a fake name, etc? What would be so different creating a similar one there to have direct access to some of the top doctors in the world? There are plenty of guys there that have a fake Facebook account simply to have access to the wealth of information there as they wouldn’t use the account for anything else. All the info is there, the docs are there, over a thousand pre-screened members, research papers, etc. So, if ever someone wanted to access to such things, for free, there is really no excuse. If you don’t want to have an account there nobody is putting gun to your head. I was just putting it out there for anyone interested. I wouldn’t have suspected for one moment such a crass comment like that. I help people every day. I usually get thanked. Not insulted. You are more than welcome to skip over any of my comments here. You are under no obligation to do anything you don’t want to do.

Your free T works out to 23.1 ng/dL. I only began to experience symptom resolution once I hit 28. Miles better doing daily versus EOD. My free T is currently over 40 and all symptoms resolved across the board. In your case, I would do 25mg daily and give it 6 weeks to assess.

I was just saying thanks for taking a look and sending it over. Hope it helps explain relevant variables at play in determination of blood viscosity:

Hct + inflammation (increase plasma viscosity) —>elevated blood viscosity —> potential issues depending on the patient.

You can’t make a blanket statement that erythrocytosis is harmless. I mean you could but you’d be wrong. And if you are wrong with certain compromised patients, you would be doing harm. Not good to make blanket statements.

Feel free to correct any errors.