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Controlling E2... It's actually a little difficult

24K views 77 replies 32 participants last post by  swole troll 
#1 · (Edited by Moderator)
This one is far from clear cut, all I'm providing with this thread is some information for you to go off and experiment with the amount of AI / aromatase inhibitor you require on cycle, I will also loosely cover SERM's or selective estrogen receptor modulators for use in gynecomastia prevention

Ok so what are aromatase inhibitors and why do we need them?

"Aromatase inhibitors (AIs) are a class of drugs used in the treatment of breast cancer and ovarian cancer in postmenopausal women and gynecomastia in men. They may also be used off-label to reduce increase of estrogen conversion during cycle with external testosterone. They may also be used for chemoprevention in high risk women.

Aromatase is the enzyme that synthesizes estrogen. As breast and ovarian cancers require estrogen to grow, AIs are taken to either block the production of estrogen or block the action of estrogen on receptors."

a healthy male between the ages of 20-30 will produce on average 7mg of testosterone per day or 50mg per week

there is obviously variation to this figure for a whole host of reasons such as genetics, drug or alcohol use, certain diseases and conditions, stress... the list goes on, but on average most males will produce somewhere around the above figure

now at this amount of testosterone a certain percentage aromatizes into oestrogen (ive heard the figure 10% but i've found no exact data)

"Aromatization is a process that occurs naturally in the body to convert testosterone into estrogen. The reason for the name is because the enzyme aromatase performs the conversion. "

the balance between T / E is called homoeostasis and the body is tuned in a manner that in healthy males just the right amount of each is present, so what happens when we decide we want 10x the amount of testosterone our body produces naturally? the body fights to maintain that T / E ratio and as a result oestrogen shoots right up outside of the healthy range along with the exogenous testosterone (the body has no mechanism to decipher the difference between endogenous and exogenous so reacts accordingly as if it were your body producing that amount)

so we implement an aromatase inhibitor in order to keep the E2 within healthy range even whilst testosterone is at supra physiological levels

there is a whole host of side effects that elevated E2 can bring in males:


1. Gynecomastia/Male breast growth


The growth of male breasts is called gynecomastia. When estrogen is present in high levels in men, the cells in breasts change their behavior. They begin to grow and this leads to the breasts becoming larger and more firm instead of the distinct pectoral fat deposits most men have. This condition can occur in around half of boys in puberty, but if it continues into adulthood, there may be an underlying reason.


2. Low sex drive


Men who have high levels of estrogen may have a problem known as erectile dysfunction. This means he is unable to maintain an erection. Any man who is experiencing sexual problems should talk to his doctor about a possible hormone imbalance.


3. Infertility


A man's fertility is determined by the number of sperm he has, the movement of the sperm and whether they can survive long enough to reach and fertilize an egg. Men who are exposed to high levels of estrogen have a higher rate of infertility than men who are not. This is because estrogen lowers the sperm's mobility.


4. Stroke risk


Because excess estrogen may cause blood clots, if a man has too much estrogen in his system, he may be at a higher risk of having a stroke.


5. Heart attack


The bodies of older men produce less testosterone. This causes a hormonal imbalance with estrogen becoming more dominant. An imbalance like this is often overlooked as a possible cause of cardio disease.


6. Prostate problems


High levels of estrogen in men can cause differing results. Some studies show that excess estrogen may cause prostate cancer, but once the cancer occurs, the estrogen may have some anticancer effects.


7. Weight gain


High estrogen levels in men can cause weight gain and that weight gain may cause higher levels of estrogen. It is a cycle that is not easily broken.

so since we are looking for the benefits of raised testosterone whilst avoiding the negatives of raised oestrogen we use an aromatase inhibitor, so what are the most commonly used (3rd generation) aromatase inhibitors and what are the therapeutic doses?



Table 1


Efficacy of aromatase suppression by three generations of AIs


Drug

Dose

% Inhibition

First generation

 Aminoglutethimide (1,3)

1 g

91

Second generation

 Fadrozole (100)

2 mg

82

 Vorozole (5)

1 mg

93

Third generation

 Letrozole (100,101)

2.5 mg

99

 Anastrozole (100,102)

1 mg

97

 Exemestane (100,103,104)

25 mg

98

AIs, aromatase in

source - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2228389/

"Although aromatase inhibition by anastrozole and letrozole is reported to be close to 100%, administration of these inhibitors to men will not suppress plasma estradiol levels completely. In men third-generation aromatase inhibitors will decrease the mean plasma estradiol/testosterone ratio by 77%"

NOTE - they say "third-generation aromatase inhibitors will decrease the mean plasma estrdiol/testosterone ration by 77%" they didnt specify which AI as theyre all of such similar strengths of aromatase inhibition and makes little overall difference to plasma estrodiol levels

source - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3143915/

with all of the above said my real life experience of all of the 3rd gen AI's has noted a noticeable increase of E2 inhibition whilst using letrozole over arimidex or aromasin once it has reached peak plasma levels

what are the external side effects of elevated oestrogen?

High estrogen sides

Acne, water retention (Bloat), moon face, very small testicles, scrotum hanging too high, soft testicles, extreme oiliness all over, soft erections, sensitive nipples (sore, itchy, burning, enlarged aerola)

Low estrogen sides

Dry skin, dry lips, good morning wood no wood when its time for sex, loss of wood while having sex, loss of sensitivity, dry gland (penis), white gland, hesitation just before urinating, night sweats

bear in mind these are only some of the external side effects and people can still suffer from a wide array of negative effects of elevated E2 without displaying any apparent ones, this is why blood work is highly advisable at the very least when first starting out to get a baseline of how much you aromtase and how much AI is needed to keep you within range

why in some cases is there a need for selective estrogen receptor modulator on cycle?

" Selective estrogen receptor modulators (SERMs) are a class of drugs that act on the estrogen receptor (ER).[1] A characteristic that distinguishes these substances from pure ER agonists and antagonists (that is, full agonists and silent antagonists) is that their action is different in various tissues, thereby granting the possibility to selectively inhibit or stimulate estrogen-like action in various tissues. "

there are certain scenarios where someone may opt to implement a SERM into their cycle namely raloxifene and tamoxifen alongside their AI

the reason the two (aI and serm) are used concurrently is because SERM's do not actually prevent any of the circulating E2 but rather block its effects on certain parts of the body

generally a SERM will be used as a safety net for those that have previously developed glandular growth (gyno) which will be more susceptible to elevated E2 or with certain compounds where the user hopes to keep an elevated level of oestrogen such as with metandienone commonly known as dianabol which is often tooted as yielding greater strength gain via excessive water retention from elevated e2 although I do not agree with or condone this ideology as the same could be said for all aromatasing compounds

with only a serm on board we are merely protecting the breast site whilst allowing massively elevated E2 levels to still cause all of their negative health effects around the body (listed above)

it is for this reason that your first plan of attack should always be an AI, you implement a SERM when you are struggling to control glandular growth (gyno)

i've heard the interaction between SERM's and AI's renders AI's useless?

this is a common fallacy thrown around forums, the interaction between tamoxifen and anastrazole and femara causes a blood plasma reduction of 27% in anastrazole and 38% in femara

the reason this happens is because tamoxifen speeds up the process at which your liver processes the arimidex and letrozole

all you need to do is merely adjust your dosage as needed to allow for the slight reduction in potency.

It is also worth noting that there is no interaction with raloxifene or any of the 3rd gen AI's

Also there is no interaction between tamoxifen and exemestane (aromasin)

Doesn't nolvadex inhibit your gains?

tamoxifen does have a slight impact on IGF-1 that is overstated on internet forums, the overall reduction in IGF-1 is massively trumped by the use of exogenous hormones and will result in no notable decrease in overall gains

which AI do you recommend?

aromasin for the following reasons

* zero impact on lipids

* suicide inhibitor

* no interaction with tamoxifen

* no oestrogen rebound

note - first time steroid users who do not understand how their body responds to steroids and aromatase inhibitors it is a lot easier to rectify mistakes with anastrazole (arimidex) than it is exemestane (aromasin)

if you push your e2 too low with anastrazole you can rebound it back up fairly quickly and adjust as needed, with exemestane you get no such privilege and you can end up spending a long time waiting for your e2 to rise again which will have a negative impact on lipid profile, joint integrity, mental health, libido and overall gains

it is for this reason that i advise new steroid users to use anastrazole (arimidex) in order to get a feel for how much overall AI they require and then switch to aromasin in future cycles (use table below to decipher the equivalent doses)


I've been using X compound, what is the equivalent dose of the other common AI's?

for a rough guide think of 2.5mg of letrozole as 2mg of arimidex or 50mg of aromasin

letro 2.5mg (1 tab)
adex 2mg (2 tabs)
arom 50mg (2 tabs)

letro 1.25mg (1/2 tab)
adex 1mg (1 tab)
arom 25mg (1 tab)

letro 0.612mg (1/4 tab)
adex 0.5mg (1/2 tab)
arom 12.25mg (1/2 tab)

this is by no means concrete however for myself and others I have advised, this table has been for the most part effective in the conversions

where do i get blood work done?

https://www.medichecks.com/find-a-test/test/Oestradiol-blood_OEST/

how much AI do i require?

Oestrogen control is the most individual need of a male using AAS, we can safely assume that 500mg of testosterone for a newer steroid user is ample however the percentage at which that testosterone aromatases we cannot predict

i for example need to take 1mg of anastrazole ED for anything over 500mg of testosterone, some guys this would completely crush their E2 but others require even more AI or sometimes the inclusion of a SERM

you basically need to trial and error your dosages ideally with blood work but its fairly easy to 'feel out' your required dose if you know the signs of both high and low oestrogen

this guide is pretty accurate for sussing out where your levels are at if youre not willing to pay for bloods - https://www.anabolicarchitect.com/topic/5530-estrogen-handbook/

in closing

I wrote this entire thread out this morning and for me to write out all of the relevant information I felt necessary in determining your approach to on cycle E2 control it took me the best part of 2 hours only for me to delete the entire thread with a keyboard shortcut i was unable to reverse

after going through somewhat of an outburst that wasn't helped by the fact I'm 4 weeks deep into a TTM blast and a heavy caloric deficit, I managed to get majority of my thoughts back on 'paper' for you

so apologies if some sections appear rushed (copy and pastes of previous info I've put out) or I've missed certain points

please feel free to fire any questions below as I have an overwhelming feeling I've missed some of the information I had written out this morning

(i was literally on the last line of text when I deleted the entire page by mistake)
 
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#5 ·
thanks mate,

actually one thing I everyone should remember is that when estimating if E is too high/low you need to make it relevant to your state before you started a cycle . For example if you think you are becoming aggressive / depressed / erection problems and so forth, ... well you need to ask if there is any other reason for this in your life and not necessarily roid related. Are you like this anyway as a person,? Its the same with sexual dysfunction. Estrogen imbalance and its effects get a lot of attention, it's easy to lead yourself into thinking you have a high or low count based on your state of mind, developing a set of man tits is an easy indicator but personality issues can be harder to analyse.

Thoughts?
 
#7 · (Edited by Moderator)
thanks mate,

actually one thing I everyone should remember is that when estimating if E is too high/low you need to make it relevant to your state before you started a cycle . For example if you think you are becoming aggressive / depressed / erection problems and so forth, ... well you need to ask if there is any other reason for this in your life and not necessarily roid related. Are you like this anyway as a person,? Its the same with sexual dysfunction. Estrogen imbalance and its effects get a lot of attention, it's easy to lead yourself into thinking you have a high or low count based on your state of mind, developing a set of man tits is an easy indicator but personality issues can be harder to analyse.

Thoughts?
a very good point

some of the sides will be purely oestrogen related as you say but yes in all use of AI's and hormones we ideally need to evaluate from a base level to try to determine what is actually causing said side effect

for instance a lot of people will assume that when test goes up and E2 is within range their libido will shoot through the roof, this isnt always the case, there are many factors that come into libido as there is mental health and state of well being

unfortunately it's difficult to get most people to get blood work at all, let alone pre cycle
generally people will only seek out the help of blood work when something is going wrong

with this in mind the best we can do is advise on side effects to try to establish where things are and further to that to get blood work and aim to be within range.

who'd have thought taking control of a major bodily function would be so difficult?
 
#12 · (Edited by Moderator)
@swole troll how far into a cycle should you start AI? Straight after 1st pin, 2 weeks in or is it dose dependant?

Also say you've had to run 12.5mg aromasin eod while on 500mg test, would you then run 6.25 eod with 250mg test? Or would you even need an AI at 250mg?
you would start from the moment you introduce exogenous hormones into your body (assuming we're talking ones that aromatase)

the reason being is that most people confuse blood levels with 'kicking in' time, the compound is active in your system the same day you inject it, it just takes a few weeks to build up to a level that you start seeing changes

here's a table displaying the build up of a medium chain ester like enanthate or cypionate

Week 1- 500mg used........After 7 days 250mg left - so active test delivered in that wk 250mg

Week 2 - 500mg used.......+ 250mg (left over) = 750mg - test active for that wk = 375mg

Week 3 - 500mg used.......+375mg (left over)= 875mg - test active for that wk=437.5mg

Week 4 - 500mg used........+437.5mg(left over)=937.5mg - test active for that wk=488.7mg

Week 5 - 500mg used........+488.7mg(left over)=988.7mg - test active for that wk=494.3mg

Week 6 - 500mg used........+494.3mg(left over)=994.3mg - test active for that wk=497.1mg

Week 7 - 500mg used........+497.1mg(left over)=997.1- test active for that week=498.5mg

from the first week you have over 5 times the amount of testosterone that a natural male produces, you've already taken hormonal homoeostasis into your own hands at this point so as you bring up the test you must keep the oestrogen down within the healthy range

in fact in the case of fast acting esters or no ester oils and waters like suspension or base and orals i actually advise people to start their AI a few days prior to their first administration to allow it to build up in their system
 
#14 ·
Remember referring to the original post a few times. Can be difficult to determine between high and low E sometimes.

Blood work really is the only way to be sure.
this is the most accurate way of keeping things safe and within range, problem is most people would prefer to try and feel things out by sides (save money)

in all honesty i only get my oestradiol tested 2-3 times per year pre blast when i get all my other bloods done

i do agree with what youre saying and advise at the very least for people to get an oestrogen test done on their first cycle to decipher roughly how their body reacts to X amount of testosterone so they have a base figure to work with in future
 
#17 ·
Thanks for the info. I am intending to do a first cycle. What is the experience with blood test? Following your other thread on a first cycle - if that one is followed what timing would be good to do a blood test? Is it best practice to do this on a regular basis? Sorry, may be obvious questions but new to this...
 
#18 · (Edited by Moderator)
in an ideal world you would:

pre cycle - full hormone panel (luteinizing hormone, follicle stimulating hormone, testosterone, oestradiol) so that you have your base numbers

4-6 weeks into the cycle - oestradiol only to make sure you are staying within range

6-8 weeks post PCT - another full hormone panel (same as above) to see how youve responded to the SERM therapy

you test your blood pressure every week

prior to starting another cycle regardless of time off you get a full blood screening (primarily checking RBC and cholesterol)

youd then repeat the above

do i do this personally? no, i just get a full blood screen (lipids, kidney function, testosterone, oestradiol, RBC) pre blast so usually 2-3 times per year and i test my BP every week

https://www.medichecks.com/find-a-test/
 
#19 ·
Top read mate.

Just one question, when you say 1mg of anastrozole will inhibit 97% of the estrogen in the body. Now, suppose the person doesn't further inject any external Test, will the body have only 3% of the Estrogen remaining or it can increase after the declined affects of Anastrozole.

You may find it a stupid question, but this is really what came up in my mind.
 
#20 ·
Top read mate.

Just one question, when you say 1mg of anastrozole will inhibit 97% of the estrogen in the body. Now, suppose the person doesn't further inject any external Test, will the body have only 3% of the Estrogen remaining or it can increase after the declined affects of Anastrozole.

You may find it a stupid question, but this is really what came up in my mind.
the suppression isnt quite so profound in men

"Although aromatase inhibition by anastrozole and letrozole is reported to be close to 100%, administration of these inhibitors to men will not suppress plasma estradiol levels completely. In men third-generation aromatase inhibitors will decrease the mean plasma estradiol/testosterone ratio by 77%"

1mg of anastrazole would reduce oestrogen by 67% within a 24 hour period but you still need time for peak plasma levels to be reached in order to get the full effect which takes around 10 days and would reduce serum oestradiol levels by up to 77%
 
#23 · (Edited by Moderator)
doesnt really warrant a thread so ill nutshell it for you

19nortestosterones can raise progesterone levels which can pose psychological side effects as well as lactating nipples if E2 is allowed to get above range

effectively control E2 and generally there is no need for a dopamine agonist in regard to gyno however you may still suffer some of the psychological side effects of elevated progesterone in which case you might opt to employ B12 injections or preferably and a dopamine agonist

0.5 - 1mg of cabergoline per week (ideally split dose) will be adequate in nearly all cases in controlling progesterone sides

i do not advise pramipexole despite its rumoured minor GH boosting properties as the hassle of taking it daily and getting the dosing right by titrating up isnt worth it as prami comes with its own host of nasty sides

please note that a D2 receptor agonist will do nothing for oestrogen so you will still need an AI on any 19nor cycle that also contains an aromatizing compound like test which i highly advise to use along side trenbolone or nandrolone

hope this clears things up for you
 
#26 ·
Swole: I just got labs back.Test level was 1362-estrogen serum level was 617 (teh range is 60to 190) e2 level was 32.Igf1 was 225.Ive been running 3 iu Nordi,200mg primo,50 mg prop,100 mg mast.12.5 aromasin ed .I feel like crap and I'm pretty much shut down. Can I add HCG and Nolva to spark things up again.Do I need to stop and do PCT ? I thought i could lower doses which i have done on the primo to 100 mg ed.

AlsoI want to re test my blood in a few weeks.Which lab test should I order to get the basic picture?
 
#27 ·
Swole could you advise me as to the optimal range of e2? Just had my bloods done and the results have come back as 59 with a range <192.

Is this too high? Having sleep issues and a bit of acne but no other sides.

In my 6th week of your suggested first cycle taking .5 arimidex ED and HCG twice weekly.

Your advice would be appreciated.
 
#30 ·
Swole could you advise me as to the optimal range of e2? Just had my bloods done and the results have come back as 59 with a range <192.

Is this too high? Having sleep issues and a bit of acne but no other sides.

In my 6th week of your suggested first cycle taking .5 arimidex ED and HCG twice weekly.

Your advice would be appreciated.
you need a baseline reading to know what's the best level for you

im assuming you dont have one (most dont) so just keep it within range (which you are) to the point you still feel good / arnt suffering sides associated with high or low E2
 
#32 ·
#36 ·
That's a great article thanks

@swole trollor others, one other question on AIs; if adex is non suicidal how do you deal with that at the end of cycle? Whether it be cruise or PCT? How do you stop the rebound?

Excuse if it's been mentioned but I've read through your posts and it certainly isn't obvious to me
When you stop taking so much aromatizing gear your oestrogen lowers

Around the time you stop taking the gear you taper off your AI

If you're cruising you'd drop to a cruise dose that may or may not require an AI and if you are running a PCT I reccomend people run a low dose of AI for a period of time during their PCT to help with any excess aromatization that may still be going on as this will help with side effects and negative feedback to the hypothalamus (elevated prog, test or oest and it won't release gnrh)
 
#40 · (Edited by Moderator)
@swole troll , trying to work this without bloods..

going into week 3 of this cycle now, i don't think my libido has decreased drastically from the norm but I'm sure I remember it being higher on my last cycles. Face skin feels slightly more greasy than usual. Other than that I can't spot anything, cock still doing it's thing, solid when needed, etc. Does any of that sound like it's worth slightly increasing adex dose this week? Or should I give it a bit longer to see how things pan out?

Currently on 0.5mg eod
 
#41 ·
@swole troll , trying to work this without bloods..

going into week 3 of this cycle now, i don't think my libido has decreased drastically from the norm but I'm sure I remember it being higher on my last cycles. Face skin feels slightly more greasy than usual. Other than that I can't spot anything, cock still doing it's thing, solid when needed, etc. Does any of that sound like it's worth slightly increasing adex dose this week? Or should I give it a bit longer to see how things pan out?

Currently on 0.5mg eod
No leave it as is for now

You're only on week 3 and everything sounds about right so far

We're pissing in the dark without bloods but typically it's erectile issues with high e2 and decreased libido with low e2

This is far from clear cut but anecdotally this does seem to be the most common complaints of each however in reality you can have low libido and or ed with either high or low e2 so as I said it's a pure guessing game without blood work
 
#42 ·
Yeah I accept it's guess work. But even considering it is a step in the right direction for me. Never used an AI before on 400mg of test but can't really remember how I reacted sides wise.

My main concerns are not crashing and not getting tits, so as long as I can keep my levels between those too I'll be happy for now

thanks again for for your help!
 
#44 ·
I guess it's your decision whether you want to start high and work back or low and work up. I'm really struggling with it in my head if I'm honest.

I started on 0.5 eod and all seemed ok as far as I could see, slightly greasy skin. Dropped to 0.5 m/w/f and spot breakout on shoulders. I've now just gone the other way and trying 0.5 m-f daily to see how I feel at a higher weekly dose.

I think without bloods it's about experimentation. I have a feel for how I was at mid range , I'll try higher then if I need to I'll try lower.
 
#45 ·
Question then, I have my blood work coming in today. When on cycle should I be trying to keep my oestradiol numbers at the same as they were prior to starting the cycle? Or should they be 'allowed' to creep up because of the fact my test will be higher?

thanks in advance
 
#46 ·
Question then, I have my blood work coming in today. When on cycle should I be trying to keep my oestradiol numbers at the same as they were prior to starting the cycle? Or should they be 'allowed' to creep up because of the fact my test will be higher?

thanks in advance
My view on oestrogen on cycle is as high as you can comfortably manage

You'll grow better with healthier joints, cholesterol and generally libido as well.

Provided you don't get erectile dysfunction, mental health issues / highly emotional or irritable, gynecomastia or lowered libido then your oestrogen is fine running high on cycle

If you get issues take just enough AI to resolve these issues.

I still advise a basal dose of AI for first time cyclers and then slowly reducing assessing as you go.

Again this is on cycle only, cruisers and trt users should not be allowing oestrogen to run high year round.
 
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