T Nation

Estrogen's Role in Glucose Disposal


Here is a pretty cool study showing significantly impaired glucose disposal with modest amounts of arimidex. Just food for thought. Decrease in insulin sensitivity and increase in abdominal body fat yet some people on these forums think estrogen is the damn devil. Be careful guys.


“Here is a pretty cool study showing significantly impaired glucose disposal with modest amounts of arimidex.”

Your statement that 1mg/day Arimidex/anastrozole is modest is absolutely insane. In a TRT context, most guys are using ~1mg/week. The needs are roughly 1mg/100mg testosterone ester. How far this linearity goes with extreme gear doses is unknown because there is so little lab data been posted here.

“Aromatase inhibition reduces insulin sensitivity, with respect to peripheral glucose disposal, in healthy men.”

More correctly, they studied the effects of lower E2 and increased TT. [There is absolutely no evidence that any of these effects was directly driven by anastrozole.]

There is no control for the effects of increased T levels and FT was not tested at all. With less estrogens, did SHBG decrease, FT fraction increase and the net increase in T status would then be greater that TT implies? How is glucose management affects by increased T? We know that TRT can increase insulin sensitivity.

It is odd that young males do not crash E2 with 1mg/day anastrozole, seen in other studies. We know that would happen in a TRT context. I have surmised that low E2 is increasing LH/FSH that then might drive more T–>E2 inside the testes. Would have been interesting if the study checked LH and FSH. LH is pulsatile and has a short half-life; often FSH with its long half-life is a better indicator of LH status that LH itself.

If doing lab work, E2=22pg/ml - 80 pmol/L would be a good goal.

Yes we need estrogen. Too much is bad for fat patterns, mood, libido, energy and initiative. TRT guys who crash E2 feel terrible, these events happen often because a good number of guys are anastrozole over-responders who need 1/4th the typical anastrozole dose - genetic variations of enzymes.


As I’ve said before, you’re a smart guy. That being said, you’ve also said things like e1 and e3 don’t matter which is absolutely bananas. You’re an engineer by training if I remember correctly, and your research methods are clearly great; that being said, a lot of the info you pass along isn’t good and is in fact harmful. If you ever find yourself in Ohio let me know. I run a low t clinic in Columbus. We can get together and discuss it. Interning with dr Serrano and dr. Mauro Di Pasquale taught me a lot. Less than 5% of our trt clients are on an AI. Out of over two thousand.


Since you mention Eric, whst are your thoughts with him and Mountain Dogs ideas on controlling estrogen receptor sensitivity and total estrogen. Last I heard it is a combo of nolva and I do believe very low dose aromasin.


Yes John and Eric are both friends. The vast majority of people don’t need to worry about estrogen receptor sensitivy but if there is a need for any type of AI aromasin at very low dose is the way to go. For instance it would look like 20 mg tamoxifen daily and 6.25 aromasin weekly. Eric also states that the majority of his patients feel best with an e2 around 70 ( yes that’s 70 - not the bullshit 22 that gets thrown around this place daily) and estrogen is crucial in getting lean.

This is an old but good link.


So you’d suggest modulating/lowering T levels or tamoxifen with aromasin if E levels are high?

Also “70” was used in that video but no mention of units?


PG/ml is common and what he was referring to. I wouldn’t mess with aromasin unless you were WAY out of range which to me would be somewhere above 100 pg/ml on cycle. Bear in mind certain drugs appear as e2 on this assay ( tren) and will throw numbers much higher yet be totally false.


Very interesting topic. I’m on TRT myself since 12/2016 at 160mg test/w and currently on my first blast for 12 weeks 430mg/w.
During my TRT phase at 160mg I have had E2 at 50 pg/ml, so I took about 0,25mg of Armidex per week and my E2 came down to 30. I noticed nipple sensitivity and softer erections at 50, the Arimidex helped with both.
On blast now I take 0,25mg Arimidex per day (total 1,75mg/week) and with that dosage I maintain E2 at 25-30.

However, I have a very hard time this year to lose both weight and fat, I had to decrease my caloric intake much further than during my previous cutting phases as a natural athlete. Also I’m not putting on any muscle during the cut so far (which was the reason I highened my test dosage in the first place, to be able to completly hold my muscle or put on even a bit while cutting), but so far it seems to not be working, it only has made my cut more difficult but no benefits, except of very small strength gains.

2 questions:

  1. Could the reason of my worse ability to lose fat this year be due to a too low estrogen level?
  2. Why do people actually use nolvadex over arimidex to manage estrogen levels? To keep the positive effects of estrogen while preventing gyno? That would be my biggest concern, if I let my E2 rise… because I do get nipple sensitivity immediatly if I lower my arimidex dosage.


Hey bro. Yea estrogen is needed for a ton of metabolic processes, one of which being fat loss. I recommend using tamoxifen on cycle as it keeps your LH intact and prevents any buildup at the breast tissue of estrogen. So you get all the benefits of estrogen with none of the bad. Also nipple sensitivity isn’t necessarily a function of estrogen - increased androgen activity can make nipples sensitive.


What dose in mg of nolvadex/tamoxifen do you suggest for those on TRT?


20 mg per day year round.


Do you prescribe generic or brand. Do you have a ig


Generic is totally fine :slight_smile: I don’t actually bro.


hey, @physioLojik.

I know you were offering up a “meeting of the minds” with @KSman but I am wondering if you are taking on new clients.

Sounds like you have a better understanding of this TRT thing than most and would be willing to work with a client to get him feeling "right"
I recently moved to Pittsburgh and am in need of a good doc

Don’t want to put my whole case history down here (it’s in my own thread for reference)
Wondering if you’d be up for discussing treatment with a primarily remote (190 miles away) patient?


Do you know any Drs in the Milwaukee area you feel are competent?


I don’t - that being said, I went to medical school and did my endo fellowship in Chicago. Would you be willing to travel down there? Or are you ever in Minneapolis? I was with Mayo for a time and could refer you over there if that’s helpful.


How have you been feeling ?


Man, just getting by right now with a protocol that I’m not 100% confident in but worried more about stopping TRT. I don’t think we can PM on this board, but if you give me some clues to the name of your practice, I’d love to look you up and discuss things.


thanks for the read


Indeed! IL isn’t out of the question. I’m concerned my current Dr will be retiring soon. Who would you recommend so I can check my insurance? Thanks for your help.