T Nation

E2 Will Not Come Down

I have been on TRT for more than two years. The common theme has always been high E2.
Currently I am on a low dose of TCyp, e3d 20mg. This dose keeps me fairly level at about 750 ng/dL Total and 100 pg/mL Free. The problem has always been estrogen.

When I started injecting about a year ago, my E2 levels were in the 70s. 1mg Arimidex per week, brought it down to 40. Doc and I were shooting for mid 20s, so he upped me to 2mg per week. That brought me to 37. Now we are at 4mg per week (I take .5mg per day, rather than all four at once) still no change. How is that even possible?

I am 43 years old, healthy. I am slightly overweight. My diet is good. I exercise. I drink a 4-5 times per week (not to excess).

I see the effects of the T. Energy and mood are much better. Body composition is better. Libido is still fair at best and my erections are iffy. Morning wood is barely there. What is going on? After two years, I am ready to give up.

Are you on HCG or just T-Cyp? Drinking alcohol will greatly increase E2 levels for someone already overweight, why don’t you give up alcohol instead of giving up TRT. Overweight men convert more estrogen from their testosterone, drinking will increase this aromatase activity and drive estrogen up.

Thanks for replying!
I stopped drinking completely for four months during the last year. My E2 did not go down by even 1 point. You are right of course, and it’s a factor, but I doubt its overriding the aramatose inhibitors I am taking at such a high dose. I have been gradually losing weight, but again, I am 30 pounds lighter than I was a year ago and my E2 didn’t budge.

I was on HCG, which I discontinued 4 weeks ago.

Did you workout after stopping the alcohol? If not this explains things, you must lose weight and stop drinking alcohol, you can’t expect for your situation to improve by choosing a lifestyle without exercise.

You must improve your metabolism if you want things to change. The HCG link, your problem with estrogen control lies in the fact that when on HCG estrogen can get out of control in the testicles that not even an AI can control. It doesn’t matter how much AI you throw at it.

Have you ever reduced your dosage? That’s usually effective at lowering E2.

Thanks again for your help.
I did work out and continue to. Another 20 pounds to go and I will be in a very healthy place. I guess my argument is that my E2 numbers have not moved, on or off alcohol, with or without exercise and regardless of my substantial weight loss. (not quibbling and I know you have a lot of contributors here who do little to help themselves and can’t figure out why nothing is working!)

Interesting what you said about HCG. I was on 200 iu eod for two months. Doc added that and the extra Arimidex at the same time. I stopped it because I literally went crazy. After 4 weeks I am just beginning to feel really normal again. This is first blood work after stopping the HCG.
Regarding AI conversion in the testicles, I did not know that was a “thing”. I have not encountered it in my reading. Can you site a source for me so I can read up? If what you say is correct, then yes, no amount of AI will do a thing.

Ok, to be honest I was expecting a bit more than lose weight (I am… and have been. I am already at a healthy weight) and stop drinking (my weight and my drinking are hardly enough to justify the results I am reporting here). Further I can find no research to suggest that HCG injections result in aromitization in the testes. So you take the company line, you state research you cannot support and fade away? Thanks for the help.

Two years of struggling, a few responses on a forum and you are ready to give up?

What were your symptoms like at 37 E2? What kinds of symptoms were/are you having?

Have you considered another AI? Have you tried adding something like DIM?

In my first year of TRT, I read so much every single day that it was driving everyone around me nuts. Have you not looked into alternative reason, and methods to bring down E2?

Here’s a possibility that took me 5 seconds to look up. Is this something you discussed with your doc?

Feminizing adrenal tumors (FATs) are very rare as they account for less than 2% of all the adrenal neoplasms. Their prognosis is deemed to be very poor. We aimed to present a mono centre (adult and pediatric) experience over a long period of time (January 1980 to Jun 2012). During the study period, we observed only three cases in men aged 22 (2 cases) and 45 (1 case). They all consulted for a painful gynecomastia, decreased libido and impotency. Estradiol was high in two cases at presentation, and after a relapsing tumor in the third one.

ALSO, what is your protocol? Try switching up to sub Q maybe also.

Exact same thing for me ahah!

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You say you drink 4-5 times a week.

And you’re ready to give up on TRT?

You need to understand not much is written about male hormones, usually what’s learned is trial and error, look how doctors fumble at TRT.

I believe all your problems is caused by depression and hypertension. Either the medications are or lack thereof can be causing all your problems.

If you think for a second these medical conditions don’t cause weight gain think again. Are you still on beta blockers? These cause ED.

Thanks for all the responses gentlemen. Here is the whole story, which I present so that you won’t think I have not been there, done that and not done my homework. It will likely be a familiar story, so skip to the *** if you just want the current situation.
About 2.5 years ago my libido went from extremely healthy and active to zero in the course of 1 week. I was 42 years old, otherwise healthy. 6’5" tall, 238 pounds, 18% body fat.
I went to my GP who was not even interested. As I recall, he told me that, “we can’t feel like we’re 17 forever.” He gave me a sampl pack of Cialis and sent me on my way. The Cialis barely helped with the ED, and so what… I wasn’t interested in sex anyways. I went back and pushed him harder for action and got nowhere, so I did some research and found a urologist.

We are now 1.5 months into the problem. The urologist was not especially interested either. He ran blood. Just T. It came back at 362. He then started me on gel and told me to come back in six months and not to expect much for the first two months on the gel. Now, bear in mind that up to this point in my life I had been entirely healthy. I had no reason to doubt what the doc told me. I assumed he knew what he was talking about.


I stayed on the gel for about 5 months. There were minor improvements and major losses. I lost muscle mass. I gained weight. I was bloated. Mood swings. Hot flashes. I went in for a follow-up, at my insistence. He ran another blood for T only. It came back at 560. He told me I was fine. I told him that was bullshit. So he told me that T wasn’t gonna work for me and put me on Clomid eod for two months. Predictably, at the end of this, I was no better off than I had been. I continued to gain weight. I was deeply depressed. This is where my every day reading finally started. I learned how the T cycle worked. I learned about different protocols. Aramitose. AIs, HCG, etc… I read about what worked and what didn’t. I went back to my doc and demanded help. He in turn sent me to another urologist. I went in well read and told him what blood work I wanted, and while he seemed a little surprised, he willingly ran T, TT, E2, Prolactin,. SHBG, LH, FSH, TSH. Results below: bear in mind I had been off Clomid for a few weeks.

TSH: .708
LH: .44
FSH: .8
E2: 64.2
Prolactin: 9.9
TT: 732.6
T Free: 14.9
SHBG: 34.4

He then started me on injectible T Cyp 200mg eow. I asked for an AI to go with it and he said to try this for a month and get more blood. One month later, E2 was still high >70 so he put me on Arimidex 1mg per week. This brought it down to about 42, which is where is stays.

What followed was a long period of experimenting with dosages while getting my own blood work done. In that time, as I mentioned, I stopped drinking completely for 4 months, while ramping up my exercise. Today I drink substantially less than I ever have at any point in my adult life. The weight I had gained slowly came off. My strength came back. Body composition was better… but my libido was a tenth of what it had been. Still had ED to an extent. Poor sensitivity. So back to the doctors again, this time to add HCG. The rest you know from prior posts.

I am frustrated because I have been doing the work and trying everything I can think to try for two years and my sex life is in the toilet. I am frustrated because it shouldn’t be this difficult and I see so many success stories, but running the identical protocol doesn’t work for me. I am frustrated because I have been to 3 different doctors, and no one can seem to get their head out of their rear. I am frustrated because their last round of stupidity (and my own) tanked my balance and I am still trying to get it back.

Today, I am 6’5inches tall, and I weigh 250. My body composition is about 22% and I am still working to lose the weight. I exercise. I eat well. I get good rest. I take a mineral supplements.
My current protocol is:
18 mg Test Cyp E3d
.5 mg Arimidex daily.

I stopped the HCG a month ago and just got new blood work back today:
TT: 581
FT: 101
E2: 37

I will be upping my Test Cyp to get that number up around 900 which is where I feel best.

When it is there, as I said way back at the start, my E2 is around 40 and will not budge from there. My erections are weak. My orgasms suck. My sensitivity is low. If you have read all he above, you will see that I am not morbidly obese, nor am I a drunk. I have done the work, I have made changes, and I think my frustration is legit and I am asking you all for help.

Did you ever take Finasteride or Accutane?

You are aromatizing at a very high rate, OR there is something else causing the increased estrogen. You said that you went almost instantly from having libido to having zero. Makes me think some kind of damage, or maybe there was a massive increase in estrogen. That would definitely TANK your libido if e2 went up so high.

You need to find a doctor that is willing to look into WHY you are aromatizing that much e2, or if your body is producing it some other way.

Another option is maybe your liver is not flushing out the estrogen and its backing up in your system. Get your liver checked. SHBG looks Ok. So check other enzymes, ALS/AST

Again, have you tried DIM? It doesn’t work the same way as an AI, it metabolizes E2 to different less damaging estrogens. It might help you get that little push that your AI cannot.

Be careful with any supplement dealing with e2 though, ive tanked mine even using OTC stuff.

No. I was doing well to get a doc to prescribe arimidex. And yes, at this stage, I am fairly certain that estrogen conversion has been my problem all along. Never had proper bloods done back at the beginning, so it’s hard to be sure.

Two things. I found out that my zinc levels were extremely low and have spent the last month bringing them back up. Wondering if that alone would have been enough to start this whole cycle 2 years ago.

I tried Dim, but I tried to go cheap and didn’t get indoxplex. Not surprisingly, it did not work. I just ordered some up and will carefully try that. Liver numbers were a little high last physical. Right on the cusp. That could be something.