T Nation

High Aromatase Advice?

Looking for a bit of advice.

The backstory as to why I’m here is long and I don’t to bore you with details so I’ll try to keep this short.

TDLR at the bottom if you haven’t got the time.

I could just really use some advice.

I’ve been on TRT in the past. I decided around 2 years ago that I didn’t like the idea of being on it for the rest of my life so I quit, cold turkey.

After a while my T came up to fairly normal levels (24 n/mol/L) for someone my age/build (30, 5’ 9, 165lbs).

Since then life has been no different with or without TRT and I experience the same symptoms which get better for a while, then much worse at random intervals.

Symptoms are as follows:

  • constant fatigue/no energy

  • poor/too much sleep

  • bouts of depression/anxiety

  • hair loss

  • poor memory

  • poor libido

  • brain fog

  • abdominal fat on belly that won’t go, regardless of exercise, calorie control…

Going on TRT didn’t help these symptoms until I added an AI (anastrazole) then I saw some relief.

I always had high estrogen and it seems that I aromatise most of the T that is in my body,

Some other things that make me suspect high E2 is to blame:

  • If I do anything that would promote high T such as interval training or weight lifting, I feel good for a day then suddenly get hugely depressed and anxious and all my regular symptoms get worse.
  • E2 suppresses thyroid. My body temperature is always low (95f and never more than 97) I had thyroid checked including bloodwork (low-normal) and an MRI which came back normal. Iodine supplementation had no effect.
  • Zinc levels are low. I supplemented with high-quality zinc as low levels are correlated with high E2 but this had no effect on symptoms.
  • Symptom relief when I have smoked in the past (cigarettes) - There’s a link between low E2 and smoking.

My diet is pretty good - I eat clean (most of the time), track and get plenty of macros, I don’t drink or smoke and run 3 times a week.

I have tried an AI-only protocol which brought my numbers down but had no real effect on the symptoms. The best I ever felt was a week into taking clomid but this was short-lasted and I quickly went into the complete opposite direction which caused me to try TRT.

So, I’m just looking for some advice as to what the hell I should do as I feel like my health is just out of control at the moment and it’s messing my life up.

I’m speaking to the Doc today to try and get some more bloodwork done and see what’s going on.

Ideally I don’t want to be on TRT, so if I can get to root of why my body converts too much T into E then I can fix it but I don’t know where to start. If I can’t control this naturally then I will consider getting back on TRT and focusing on dialling in my numbers.

What would you do if you were in my shoes?

TLDR: Not on TRT. Normal T production but high E2. High aromatase suspected. Can I fix this naturally or is TRT the best route?

Need more details. Labs, protocols and labs that go along with them that you’ve tried, etc.

The whole low body temp thing is a myth. It’s not true and should not be seriously entertained or worried about. I doesn’t rreveal anything about your thyroid at all, and is probably harmful if anything. E2 is not suppressing your thyroid.
How about some lab numbers? You say it’s high, what are we talking about her?
It sound to me more like a dopamine/epinephrine problem to me. How is your sleep? Been checked for apnea? What’s the diet like? What exercise specifically helps (And how strenuous does it need to be for effect)?

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When I first came to the docs complaining about problems, the results were:

Serum T: 9.9 nmol/L (8.4 - 28.7)
Free T: 0.175 nmol/L (0.169 -0.588)
SHBG 37.6 nmol/L (17.3 - 65.8)

The urologist did a test 6 monrhs later, before treatment:

FSH: 3.4 IU/L (1.4 - 18.1)
LH: 2.9 IU/L (1.5 - 9.3)
Oestradiol 168 pmol/L (0 - 145)
Prolactin: 153 mIU/L (45 - 375)
Testosterone 15.7 mnolI/L (8.4 - 28.7)

4 weeks into clomid therapy (25mg EOD)

Testosterone 18 mnolI/L (8.4 - 28.7)
Oestradiol 249 pmol/L (0 - 145)

5 weeks later w/ anastrazole added (0.5mg 3x p/w):

Serum Test 21.2nmol/L (11-42 range)
Serum Oestradiol 192pmol/L (0-145 range)
Zinc 9.52 umol/L (11-24 range)
Plasma C Reactive Protein <4 mg/L (0-10 range)

Then changed to 300iu HCG EOD, 0.25mg Anastrozole EOD, 125mg Sustanon 250 E7D, results after 6 weeks were:

Testosterone: 32.8 nmol/L (8 - 26.1)
SHGB: 26.6 nmol/L (14.6 - 94.6)
Calc Free Test 0.817 nmol/L (0.174 - 0.729)
Oestradiol 156 pmol/L (0 - 145)
25-OH Vitamin D 84 nmol/L (75 - 200)

Changed protocol to 150iu HCG ED, 50mg Sustanon 250 E3.5D, Anastrazole 0.5mg M W F - results after 6 weeks:

TT 37.8 nmol/L (8 - 26.1)
E2 112 pmol/L (0- 145)
Progesterone 2.7 nmol/L (no range)
Red Blood Count 5.29 10(12)/L (4.5 - 5.6)
DHT 4487 pmol/L (860 - 3400)

6 weeks after going cold turkey and testing thyroid:

E2 125 pmol/L (0-145)
TSH 1.3mu/L (0.35 - 5.0)
Free T4 15.3 pmol/L (9 - 24)
Free T3 5.9pmol/L (3.5 - 6.5)
Serum B12 418 ng/L (200-900)
Zinc 13.15 nmol/L (11-24)
Vitamin D 98 nmol/L (75-200)

Around 18 months after going cold turkey:

Free T - 0.501 nmol/L
Serum T - 23.8 nmol/L
SHGB 35.4 n/mol/L

Some of the details might not be exact, it’s been a long time since I was on TRT and seems like a distant memmory.

Interesting to know on the body temp thing. When I was last on here there was a user, KSman I think, who couldn’t stress more the importance of body temps and thyroid function. Like I said I tried to supplement with iodine but this had little effect.

I’ve posted the labs above.

One of the reasons I first came to the docs was due to bad insomnia but I have since connected this directly to over-training and under-eating and can replicate this symptom if I train too hard and don’t eat enough.

On the whole I would say my sleep is good, I usually get 7/8 hours and don’t wake up in the night. I haven’t been tested for sleep apnea.

Exercise, I normally do 3/4 runs a week, around 5km at a <6min/km pace. I used to train 5 days a week at the gym (mostly callisthenics, no heavy lifting.) but obviously haven’t been lately with the current situation and generally felt pretty good.

My last symptom flair-up came from doing a 45 minute crossfit session followed by an hour of HIIT.

Diet-wise, I eat 2500 cals a day - 160g protein, 280g carbs and 110g fats. Generally eat pretty clean, lots of lean meats, veggies and carbs from sweet pots, wholegrain rice etc and maybe have a takeaway once a month.

These are all perfectly fine and in no way an indication of high aromatase. The high number on Clomid is no surprise, that’s Clomid. It all points to - none of this is your problem. Something else is.

Did reply to your previous lifestyle questions if you didn’t see.

What do you suggest the problem could be?

He was regurgitating Dr.Wilson nonsense. He believed it, and it’s complete rubbish. I know, my wife actually went to Dr.Wilson’s “Clinic” to get checked out. Total scam prescription mill, the guy ran into some serious legal and licensing issues over what he was doing and relocated to a different State.
It sounds like mild overtraining, you probably need something post-workout to replenish you and maybe cut back on the cardio occasionally to allow some recovery.

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Yeah. He told a lot of people a lot of stuff that was a whole hell of a lot of wrong. He was a decisive sounding guy that came across as intelligent and like he knew what he was talking about… unfortunately, not so much.

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Very interesting to hear about KSman, certainly sounded like he knew his stuff, I assume he’s not active here anymore.

Actually pretty relieved to hear that I probably won’t need TRT, but my E2 seems high no?

And what about my other symptoms? They’re not only there when I train.

No, the only time it was really elevated was on Clomid, and as someone else said, that’s expected.

Height, weight, age, snoring/apnea, TSH test (nm I see it)? And based on your range your vitD looks low.

Snoring is a problem, stayed with a friend this weekend and she was moaning that I was snoring loudly. My doc has requested a sleep apnea test but it’s a long waiting list apparently.

People with sleep apnea tend to have high hematocrit.