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E1 Remains High on Arimidex

Hello all.
Question: Is it normal for E1 to remain above normal ranges while E2 reacts as anticipated on TRT while using Amridex?

Background: 53 year old male, heavy lifter 30+ years. I’ve been on TRT for approximately 6 years with declining efficacy until did my own research and discovered I had moderately high SHBG @ 50.2 nmol/L, low free T, and was converting at a high rate driving my E1 out of normal range to 111pg/ml with E2 @ 39 pg/ml. Changed my T injection schedule to 25mg x weekly (Sunday and Wednesday), started taking Boron 6mg daily, and Amridex @ 1 mg twice between injections.This protocol worked fantastic, energy and libido through the roof but resulted in a high total T of 1,221 ng/dl, E1 @ 94 pg/ml, E2 @ 10.9 pg/ml. Insurance wouldn’t cover the TRT with the total T above 900 ng/dl so put 2 or 3 more days between injections to get a lower total T and changed the Amridex to 0.5 mg x 3 between injections starting the day after I inject - this predictably dropped total and free T but also crashed E2 @ >5 pg/ml with E1 remaining high @ 86 pg/ml.

I’m a bit surprised my E2 crashed so hard but my question is why would my E1 remain high regardless of the Armidex and lower total T? Is there a way to lower E1 without affecting E2? I’ve had the assumption that E1 and E2 would rise and fall together, is this incorrect? E1 is reacting but remains above normal levels.

I’ve already reverted to my previous protocol but haven’t restarted the Amridex, rather I’m going to allow my high conversion rate to restore my E2 level then ease back into Amridex if needed but I’m concerned about my E1 also rising to such a high level.

Thank you in advance for any constructive responses and suggestions.

What is the reason you want to control E1? Awfully long paragraph with no issues mentioned besides frequent crashing of estrogen. The AI dose you’re using is nuts. Most folks aren’t using any AI on TRT even with 3x the levels you have.

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:man_facepalming:

This protocol is a disaster, you say you feel fine with very low estrogen, to this I say give it more time and you’ll see how bad things can get keeping estrogen suppressed. If you don’t mind being diagnosed with osteoporosis and hollow bones, knock yourself out.

I actually recall a couple of members being diagnosed with osteoporosis and estrogen in the low teens. I suggest you inject daily doses to control estrogen, unless of course you want to continue crashing your estrogen on what amounts to an insanely high anastrozole dosage.

If you must use anastrozole, start out at .125 and/or 0.050. Those 1mg anastrozole pills were created for women with breast cancer, not men on TRT. The anastrozole was designed to block estrogen, not control it.

The issue is posited in the opening question (why does E1 remain above normal when E2 responds to AI), the rest is providing information on my experience thus far getting my TRT dialed in, something I assumed would be beneficial to anyone answering my question. E2 has only crashed this one time, my mistake due to inexperience but I’ve certainly learned from it. As I noted I have stopped the Amridex for now. I’m asking about high E1 because I can’t find much information on it but I’d have to think that having chronically high E1, even if it is a weaker form of Estrogen, can’t be good in the long term.

Why do people on-line feel the need to be condescending to someone asking for help? The beauty of hiding behind I keyboard I suppose.

You may feel my dosing is a “disaster” but my results before changing it long enough to satisfy my insurance company disagree with you. I may not need the AI and as noted have stopped it so I’ll soon find out. I’m fully aware of the dangers inherent to chronically low E2, my goal was never to get it this low; I’ve been experiencing with dosages and frequency while getting regular labs to find a sweet spot, changing it to satisfy my insurance company and my inexperience threw a wrench into it. However, along the way I noticed my E1 never drops back into normal range which was the subject of my original question that no one has answered.

Your T is above “normal” so it only makes sense that your body would seek to maintain that ratio of estrogen to testosterone. If you want lower estrogen then lower your testosterone. Your body keeps a hormonal balance.

I asked you why you want to lower E1? You didn’t answer that. You’re wanting to keep estrogen at the level it normally would be with a much lower testosterone level. Using arimidex is just going to have you yoyoing your levels for no reason. Your body will regulate your levels naturally.

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The range for E1 and E2 etc is based on men not on exogenous testosterone.

Your issue is that you are seeing a number. The number, in your case, is irrelevant.

Stop the AI. You do not want to block/control/manage (whatever word you want to use) estrogen under any circumstances. Let the body find the appropriate balance based on your raised T levels. Do not be concerned if these go over the range just as you don’t need to be concerned if your T levels go over the range. The issue here is symptom resolution. Don’t get paranoid over the numbers.

@thecoffee, I’m curious about this too. Have you experienced any side effects that are directly related to E1 where you’d want to try to reduce it?

Is it even possible to target E1 specifically?

I’ve barely even heard of e1. Does it really do much either way for men? Just curious.

I would disagree, as your 10.9pg/ml reading was also crashed in my eyes. Especially in relation to your t level at the time.

This might satisfy you in the short term, but not the long term. The aromatase process more than likely has other down/upstream effects on the body and blocking this process has other unforeseen consequences down the road. I have seen a couple of members using anastrozole long term and almost lose the ability to make estrogen and are stuck with low estrogen for the foreseeable future.

You have different parts of the body relying on different amounts of aromatase enzymes and now you are blocking estrogen equally throughout the body. @dextermorgan makes a good point, the anastrozole will likely produce a yo-yo effect and you’ll constantly be adjusting the dosage and realing the side effects of this yo-yo E2 rollercoaster.

The anastrozole has an E2 rebound effect that is 10 times worse than any high estrogen I’ve ever felt, you may or may not experience this rebound effect if you choose to stop. My post may have sounded condescending and is frustration that should have been aimed at the person prescribing the anastrozole and not the thread creator.

For that I apologise.

If you’re interested in more detail about your estrogen, the free estrogen testing is available. You can have a normal estrogen and high free estrogen in the same way you can have normal Total T and high Free T, but the ranges aren’t really helpful because not enough patients participated any meaningful data to determine reference ranges.

Estrone(E1) is one of the three biologically active estrogens. Estradiol(E2) is the strongest so it garners the most attention. Some men may be more sensitive to E1 or exhibit higher conversion rates vs E2. Arimidex should lower both. Tho it’s been shown to be less effective at lowering E1 vs E2. Just another factor to consider when the standard panel doesn’t show numbers that match symptoms.

As noted in my post I stopped the AI, the total T I had to lower in the short term due to insurance coverage otherwise I’m ok where it was in the 1200’s. The only number I had a concern about and was the only real question in my post was about E1. Thanks

Ok great, thanks for the informative reply. Is an elevated E1 cause for concern long term as it is clear I won’t be able to keep it within the range set out by Labcorp.

The 10.9 was definitely indicative of a downward trend but without another lab test and any history with AI I couldn’t know it would go lower or wouldn’t rebound when I switched to 0.5mg from 1.0mg. Changing my T injection frequency short term to satisfy my insurance company certainly was a final nail in my E2 coffin. As I’ve repeatedly noted in my OP and responses I had already stopped the AI, the only real question posited concerned E1. Too many people are focusing on the background info instead of what I’ve asked about.

Unfortunately I haven’t found a way to affect E1 without creating a greater effect on E2. Assuming this isn’t possible my concern going forward is the health affects of a chronically elevated E1 and I’m not finding much info either way. The other concern is that I’ve read that E1 has the ability to convert to E2 but I am unsure under what circumstances this occurs.

The above normal T is due to my physician and I trying to dial in my TRT by altering dosages, frequency, and using AI to find a sweet spot where I had good results physically and my labs were all in acceptable ranges. I’m fortunate to have a primary care that, while as ignorant about this as I am, gives me a free hand to experiment and sort it out. Once my E2 rebounds I’ll extend the T injection frequency again to lower the total. Again, I’ve already stopped the AI, this is no longer an issue.

My question was really if there was a way to divorce E1 from E2 in lowering it, and secondly if I cannot is there a health risk associated with chronically elevated E1. I’m concerned about the lack of information on this and so am not very happy with the idea of leaving it elevated as anyone should be.

I’d suggest trying aromasin(Exemestane). It has the highest relative affinity for E1 suppression.

‘ All three AIs effectively reduce E2, E1, and E1S: anastrozole by 81–94% ; letrozole by 88–98%; and exemestane by 52–72%.’

Less chance of crashing E2 along the way. And many men actually report feeling better with aromasin(likely due to its steroidal nature) vs arimidex.

The thing I don’t quite understand is, correct me if I’m wrong, but you felt great. If you felt great, why change anything based on the number? You have no symptoms and libido is through the roof. Isn’t that the whole point?

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