T Nation

TRT and Klinefelter Syndrome


I found out that I suffer from a chromosome problem called Klinefelter’s syndrome “XXY 47” I am a male and been married for past 10 years with a wonderful fine lady , 6 years ago I found out about my problem and started treatments .
currently, I am taking TRT “test-E (Cidoteston 250mg” every 12 days " and Nolvadex 20 every day "
as I started to have a good level of T in my blood my life went much better and I started to take care of myself as you know low T makes people damn depressed and lazy , now I am much more alive .
so ! I went lately to talk with a trainer at the nearby gym , he told me that I should make something called " body compound analysis " before stepping in the gym and I did . please take a look on attachment .
my main problem right now is water retention he said I could lose at least 20lbs just by losing water retain .
Is my question do you guys know a safe treatment for high Estrogen / water retain that won’t kills me on a long run ? as you know I have to stay on TRT for life .
currently, I am on Ketogenic diet with 20% defect .
sorry for bad quality English , my second language :slight_smile:
many thanks



There are prescription products on the market to assist in controlling estrogen levels. However, I could not make out any note of estrogen on the image you posted. It seems to be more of a BMI chart. You will need labs first to determine where you stand. It would be unwise to modify hormones without proper blood work and follow up. In the stickies you will see what blood work would be advised.


sorry my bad I totally forgot to put my test results
E2 :216.8 max is 42.6
FSH 14.26 Max is 12.4
LH 10.31 Max is 8.6
TSH 3.94 max is 4.2
Free T : 169 min 50 max 300
TT 9.5 min 2.8 max 15
Inhabit B .07 normal is 1.5
AMU .50 normal is 2
Prolactin 7.22 max is 21.4
T3 and T4 are normal average range


Without UoM it is a bit of guesswork but yes there are many AI’s out there. Arimidex (anastrozole) is what many males use. The drug itself is used for chemotherapy for women with breast cancer (estrogen responsive) by binding to the aromatase enzyme. This inhibits androgen conversion to estrogens outside of the gonads. So use in men is off label (to the FDA). However, the same mechanism of action is the intention in use of this molecule in men. By preventing aromatase process (level of inhibition determined by dosage and individual response [see over responders]) the level can E2 can be modulated (controlled).

apologies for missing part of your question. Assuming the UoM of your Estradiol labwork is pg/ml you are high by any standard. Your free t I assume is in pg/ml and TT to be pg/dl. If you can confirm those numbers you can calculate what a “proper” value for your e2 range. As individuals vary the range for your t:e ratio should be based on symptomatic response. While acute water retention is not normally a life threatening concern (unless extreme), chronic retention of water could potentially lead to cardiac issues later on if not properly managed. So yes I would speak your doctor about anastrozole or a drug within the same class. While you could attack the water retention with a diuretic, the symptom would be treated as opposed to potentially the root cause.


is it safe “acceptable” to use it for long-term ? as I have to use AI for lifetime with TRT .


sorry did not know you responded while I was editing. Many breast cancer survivors (Estrogen responsive) are on long term. Below is a study on suppression of estrogen in hypogondal males your doctor may find of value.

ISSN (online) 1945-7197


the said news is my doctor can hardly understand English :joy: I am Currently living in Alexandria ,Egypt . so I guess I have to read it than try to explain to him hopefully he will get along …


This may be high in part if liver is not clearing estrogens properly.

But the main problem is that your dose of Nolvadex is too high for you. Suggest 10mg every day.

What these tell us is that Nolvadex is pushing LH/FSH too high and high LH is creating a lot of T–>E2 inside the testes where T levels can be ~100 times higher than serum levels. This also then means that a competitive drug like anastrozole/Arimidex will not work because it cannot compete with T inside the testes. Do not expect that you will find doctors who understand that, but if they were to read this they might.

XXY may be making your Nolvadex driven high T–>E2 inside the testes worse than what XY guys experience. So you may need to do a lot of work to see what works for you.

As I expect that your infertile, why are you using Nolvadex?

So you need to reduce Nolvadex and then anastrozole might work. Watch LH/FSH levels that need to go down. You do not need much LH/FSH when on TRT as TRT provides lots of T. So you may end up on 10mg EOD.

TSH is way too high, should be closer to 1.0.

Please provide actual T3, T4 data and ranges.
In future, test fT3, fT4, not T3, T4
Thyroid ranges are mostly useless and hide many problems that need attention.

Thyroid has a huge effect on fat storage and can make fat loss difficult or impossible.

You could have thyroid problems from not using iodized salt or vitamins that list iodine+selenium.

Please eval overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. I expect lower body temperatures. Also possible mood problems, sparse outer eyebrows, dry skin, thinning hair…

Please post more labs that you might have.
fasting glucose
fasting cholesterol
AM cortisol - at 8AM please

Read these stickies found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • thyroid basics
  • finding a TRT doc


Thank you for your nicely detailed reply , I guess I have to redo all my tests from scratch in a fancy private lab to get proper results . I don’t trust insurance here at all .
here is the list of what I will redo :slight_smile:
Fasting cholesterol
T and Free T
fT3 fT4
anything I should add or remove , as I will pay everything from my pocket out of any insurance . PS: Egyptian insurance IS @!#$ …
thank you again for your time and help


if you are overweight, you should test fasting glucose


I have done all the blood works you told me . it seems like I have very low IGF-1 LH , FSH too .
would you please take a look at it My TRT Protocol with Klinefelter's Syndrome