I'm just trying to figure out what Arimidex does for various types of estrogens in the body, and if high/normal level of "Total Estrogen" has any negative impact on HPTA recovery. And, if so, would arimidex be helpful in this context??
How about Total Estrogen??.. Confused here...It decreases E2 I dont think it has much effect on E1, not sure about E3.
Why isn't Total Estrogen important in the equation of the HPTA?... My gut feeling is that it does play a big role... still confused...Not sure but it doesnt make much diffrence I know that, Total estrogens isnt too important anyways.
Why isn't Total Estrogen important in the equation of the HPTA?... My gut feeling is that it does play a big role... still confused...
Yes... Jawohl.. Thank you for your post. I know Dr. Swale. He's also Dr. John on this board and very famous in his field. You prob. didn't know that as you're new to this board I think. But, Yes.. I have just found your thread inquiring about the same issue here. Hopefully Dr. John would come around and shed some light on this topic.BigAk, that's precisely the question i've been trying to search an answer for. Im glad Im not the only one that's wondering what role Estrone (or Total Estrogens for that matter) has in the negative feedback loop of the HPTA, if any. I did find some interesting posts elsewhere from a doc who treats men with hormonal issues such as hypogonadism, and found a high correlation with patients' complaints of estrogen-like symptoms with elevated Total Estrogens, despite maintaining E2 in mid range. I think the problem he was having was how to lower Total Estrogens (say with an aromatase inhibitor) without lowering E2 too low, since E2 in these men were already at the desired range. Do a search on the web for Dr.Swale.
When I did suffer from hypogonadism 4 months ago, my total estrogen was 116 on a scale of (40 - 115)... So, yea.... my total E was elevated. My E2 then was very low though <15 on scale (0 - 53). Now that I have recovered my HPTA using PCT, my E2 is 7 (same scale) but I have no idea what my total Estrogen is as I didn't have it measured. What prompted my inquiry in this thread is that my Total Testosterone levels have not gone above 300 since my last bloodwork 8 weeks ago, and I'm wondering if there could be a connection to my total Estrogen being too high originally before PCT. However, my Free T is going up; so is my bioavailable T. Maybe my body is trying to stabilize my Total E but taking a long time?? not sure!!!Do you have secondary hypogonadism too? If so, are your Total Estrogens elevated as well?
Wow... That's very impressively informative!!! It's interesting that you're mentioning the liver role in detoxifying the body form excessive Total Estrogen (news to me!!). It just happened that my ALT value in my very recent bloodwork has climbed up to 66 (0 - 55) which was very puzzling to me since it's always been in the normal range. Could it be that my body is trying hard to reduce my total E in an effort to reach normal equilibrium??Simpliest answer to this problem is most likely your liver detoxification pathways are imbalanced meaning that methylation is the primary source of estrogen detoxification followed by glucoridation. This is for all estrogens not just estrodial. So a good start would be 500 mgs of calcium d glurate 2 times a day and eat more broccoli and brussel sprout, cauliflour to aid in toxifiction. You may want to look into methylcobalin, folinin acid, NAC, TMGS, p5p. All of this must be takin in balance unless other wise clnically noted by testing because it can cause major problems. If you are hypothyroid this can cause estrogens to build up and estrogens can depress thyroid and liver function to detoxify the estrogens. Excess estrogen can cause hypomethylation if in excess as well as being in deficiency. We are bombared by enviormental toxins every day and they can over whelm our bodies with xenostreogen which can suppress our HPA. I believe a total estrogen would be a good indicator of this possible. Basically ramp up your thyroid and balance liver pathways will reduce total estrogens and possible balance out the HPA axis. might want to look into organic acids test (covered by insurance from great plains) to access your enviromental exposures. This area is highly over looked and may aid some people in returning to normal homrone statues.
How does estrogen cause cancer it interfers with the homocysteine pathway (suppresses methione synthase pathway) and causes gene mutations due to hypomethylation and hyper methylation. I have researched this for nearly 2 years and finally starting to master it and people that could barely move are now starting to get there life back again once these pathways are balanced
Dr may want to check your homocysteine levels to see where the metabolic blockage is. Most of the time is would be due to the underactive CBS pathway which can be supported by 600 mgss NAC and 50 mgs P5P 2 times a day to aid in gluthione production, or one can use TMG as alternative pathway, but main pathway is the methionne synthase pathway (b-12/folate acid) Now here is the kicker people with liver disfunctions have a b-12 and folate serum off the chart dispite no extra supplementation reason being is because they can not convert into active forms methycobalin or folinic acid and when this happens you are opening your self up to cancer due to the malfunctioning of DNA from one celll to the next gives miss information. This is referred to as undermethylation which probably 50-60% of bodybuilders suffer from some degree or another (as do 30-40% of population). Give the fact that we play around with estrogen levels so much we are not knowing increasing our chances of cancer down the road. How may you ask. Most people cancer people are either over methylated or undermethylated research this and you will seeWow... That's very impressively informative!!! It's interesting that you're mentioning the liver role in detoxifying the body form excessive Total Estrogen (news to me!!). It just happened that my ALT value in my very recent bloodwork has climbed up to 66 (0 - 55) which was very puzzling to me since it's always been in the normal range. Could it be that my body is trying hard to reduce my total E in an effort to reach normal equilibrium??
I need to take time and study your posts some more, but if I want to get some help in the mean time;Simpliest answer to this problem is most likely your liver detoxification pathways are imbalanced meaning that methylation is the primary source of estrogen detoxification followed by glucoridation. This is for all estrogens not just estrodial. So a good start would be 500 mgs of calcium d glurate 2 times a day and eat more broccoli and brussel sprout, cauliflour to aid in toxifiction. You may want to look into methylcobalin, folinin acid, NAC, TMGS, p5p. All of this must be takin in balance unless other wise clnically noted by testing because it can cause major problems. If you are hypothyroid this can cause estrogens to build up and estrogens can depress thyroid and liver function to detoxify the estrogens. Excess estrogen can cause hypomethylation if in excess as well as being in deficiency. We are bombared by enviormental toxins every day and they can over whelm our bodies with xenostreogen which can suppress our HPA. I believe a total estrogen would be a good indicator of this possible. Basically ramp up your thyroid and balance liver pathways will reduce total estrogens and possible balance out the HPA axis. might want to look into organic acids test (covered by insurance from great plains) to access your enviromental exposures. This area is highly over looked and may aid some people in returning to normal homrone statues.
How does estrogen cause cancer it interfers with the homocysteine pathway (suppresses methione synthase pathway) and causes gene mutations due to hypomethylation and hyper methylation. I have researched this for nearly 2 years and finally starting to master it and people that could barely move are now starting to get there life back again once these pathways are balanced
That's what I thought originally actually. During this blood draw, I happened to have just had a very painful lower back injury which took place squatting in the gym. This injury presisted for a while now, but it's getting much better lately. You're right Dr. John; I think the tissue breakdown and rebuilding may have increased my ALT values. Also, I had started taking 1 gram of vitamin C daily.Working out, taking a couple Tylenol, etc will elevate ALT that much.
Dr. John; you have explained to me a while back why the total E was not a valid assay for adult males, but I didn't really grasp it fully. Could you please explain this again? I know that many have wondered why... Thank you.BTW, the Total Estrogen, for adult males, is not a valid assay.
If it is not valid, it is of no use. Simple as that. Worthless.
So we have at least two popular blood tests that are worthless;I think what BigAk is probably asking is what makes it an invalid assay for males.
Some questions that come to mind are "What were Labcorp,Quest and other Labs thinking when they came up with the reference range for Total Estrogens in males?"
And "If the tendency is for laboraties to go ultra-conservative when it comes to reference ranges, so as to avoid having too much of the population in an "abnormal" state therefore labeling a huge chunk of hypogonadics, hypothyroidics, and those with adrenal fatigue as "normal", why would they reverse that trend by creating a reference range that makes the majority of men show up with elevated Total Estrogens?"
And also.. "If the Total Estrogen assay is completely worthless in males, why is it of any use to females? What makes it credible there?"
The list of questions grows, but in deference to you and your busy schedule, I won't ask any of them.
Jawohl
To low for me I do much better at 20 pg/ml are you taking anything to keep E2 down or anything that can lower it.Is E2 at 7 -- (3 - 70) too low to cause any adverse health effects? My lipid profile seems pretty good... even at this level.
No Phil... I'm taking nothing at all. Actually I feel pretty good on this value. My morning wood is good and my erection is excellent since my SHBG have gone from 48 to 28 yeilding more bioavailable Test. and free Test.To low for me I do much better at 20 pg/ml are you taking anything to keep E2 down or anything that can lower it.
Phil
We learn lots from you Dr. John. I look forward to our upcoming follow-up consult next week; once I schedule it with Kim this Monday. I have quite a few questions. Thank you..Phil, have you had your SHBG measured at the same time?
We must always value E in light of SHBG level, as we do T.
Not every test my Dr. does a test every 6 weeks the last time we did SHBG it was the first of the yr. It was 22 range 7 - 50 nmol/l. And E2 was 15 pm/ml at that time. We should be checking every test you think. In the past we had to do high doses of T and HCG to keep my levels up. Now that we are treating my low Cortisol levels and Thyroid I am not useing up the meds as fast so we started cutting down on the dose. My T shot went from down from 65mgs to 50mgs every 3 days and my HCG we just dropped down from 400 IUs the 2 days each in between my T shot to 250 IU's. In 6 weeks we will test again and if all is good and it feels like it is we will cut the HCG to 250 IU's the day before my next T shot. I am finding so far my levels are still the same as we needed to keep them over the yrs. but now we can do this on less.Phil, have you had your SHBG measured at the same time?
We must always value E in light of SHBG level, as we do T.
Would you please discuss this relationship of E2 to SHBG Dr. John, and why it is so?An E2 of 20 is VERY high if SHBG is low.
Thanks I will be sure to have this on my Hormon assays from now on. At the time this test was done I was on 1mg of Arimidex a day and doing my shots once a week. All I know is this is dam hard to conrtol this E2. It may well be doing .5mgs. of Arimidex every other day is not enough.Hormone assays should never be run without assessing binding globulins. An E2 of 20 is VERY high if SHBG is low.
No problem Dr. John. I understand; you're a very busy guy. Again; I appreciate all your help.Sorry I missed you the other day. Kim ambushed me when I got back from A4M Vegas with a full schedule, and what I really needed was a whole day to just sleep.
Dr John this could be absolutely crucial to me and why I have failed on TRT for two years.Hormone assays should never be run without assessing binding globulins. An E2 of 20 is VERY high if SHBG is low.
Do you mean low as in below range or low normal?Hormone assays should never be run without assessing binding globulins. An E2 of 20 is VERY high if SHBG is low.
Hormone assays should never be run without assessing binding globulins. An E2 of 20 is VERY high if SHBG is low.
SHBG 13.8 nmol/L (13.0-71.0) 31/07/06Dr John this could be absolutely crucial to me and why I have failed on TRT for two years.
My SHBG is low being 11 to 12 nmol/l in a range of 12-78.
I have never felt well irrespective of the method of TRT, no matter what the level of replacement and no matter how good testosterone has appeared.
My estradiol has been between in the last few months has been between 118pmol/l and 148pmol/l in a range upto 200.
I developed gynecomastia which has been removed, but might be coming back. I have severe symptoms of T deficiency.
Even when treated with arimidex to lower my estardiol to 70pmol/l I have still felt ill.
I have worried as to whether I should take arimidex because i have osteoporosis.....but!!!
Well if what your saying is the case could it be that my estradiol level is greatly amplified bythe very low SHBG level and that this is the problem????
I can't begin to explain how important this could be to me...
So we have at least three (or mre) dimensional relationship:If SHBG is low, then more of the E is bioavailable.
On the other hand, when SHBG is high, even though much less E is Bioavailable, since SHBG preferentially binds androgens over estrogens, bioavailable T/E goes down.
NEVER assess hormones without considering their Free/Bioavailable concentrations.
You guys are asking alot of Dr. John. He's a very busy man; and some of your questions can't have simple answers. Nothing is set in stone when it comes to numbers you know. Therefore, I would imagine that it's hard to conclude final certain values for the question above without doing a very involved study that will record how people feel in relation to their numbers. It's easy to understand as Dr. John puts it; that lowering SHGB means that more testosterone and E2 is bioavailable and free. I don't know... but I would think it's hard to put final numbers for the above question.So we have at least three (or mre) dimensional relationship:
SHGB
Estradiol
Testosterone
Would you please elaborate, possibly present a table with desirable values, specially how they change when,
hard to adjust SHGB is a certail levels.
=====================
A>B>C
when SHGB is between A and B
then desired
E2 should be between AX and BY
and
T should be between AXa and BYb
but
when SHGB is between B and C
then desired
E2 should be between BX and CY
and
T should be between BXa and CYb
Sorry, this is discusion board, I just learned that this three way or more relationship is strong and important.You guys are asking alot of Dr. John. He's a very busy man; and some of your questions can't have simple answers. Nothing is set in stone when it comes to numbers you know. Therefore, I would imagine that it's hard to conclude final certain values for the question above without doing a very involved study that will record how people feel in relation to their numbers. It's easy to understand as Dr. John puts it; that lowering SHGB means that more testosterone and E2 is bioavailable and free. I don't know... but I would think it's hard to put final numbers for the above question.
To be fair to Dr. John and his expertise, it would be more suitable to consult him privately as everyone is different and will require customized treatment.... Just my 2 cents....
==========================So we have at least three (or mre) dimensional relationship:
SHGB
Estradiol
Testosterone
Would you please elaborate, possibly present a table with desirable values, specially how they change when,
hard to adjust SHGB is a certail levels.
=====================
A>B>C
when SHGB is between A and B
then desired
E2 should be between AX and BY
and
T should be between AXa and BYb
but
when SHGB is between B and C
then desired
E2 should be between BX and CY
and
T should be between BXa and CYb
The problem with estrogen is the 16-OHE and 4-OHE metabolites are mutagenic, genotoxic, and procarcinogenic.
Favoring the CYP1A1 pathway, towards good 2-OHE and against the CYP3A4 (which makes 16-OHE) decreases the risk of cancer. We can do this with 300mg of DIM QD. But it also increases CYP1B1 enzyme, bringing more nasty (and I do mean nasty!) 4-OHE. Therefore never take DIM without also adding in TMG. The methyl groups it provides washes the 4-OHE downstream via support of COMT enzyme to make 4-methoxyestrone. Generally 500mg BID TMG will do the job.
Why not split the dosages up. 150 mgs mroning and 150 mgs at dinner time? Could this be due to the circadinen flow of elevated hormones in the morning? Duh I think I answered my own question LOLI am currently recommending 300mg DIM QD.
I-3-C can cause GI motility issues.
I was using DIM with Indolplex from PhytoPharmica and only taking 50mg a day.I am currently recommending 300mg DIM QD.
I-3-C can cause GI motility issues.
So you cut the tablet in half = 60mgs best to do a blood test to see where your at. I did good a long time at this does.I was using DIM with Indolplex from PhytoPharmica and only taking 50mg a day.
Would you recommend upping that dose to the one you have spoken of, or is there a difference between the DIM you are recommending at that dose and I one I use?
Cheers
A start dose is 120 mgs or one tablet at dinner time. If men take more then one tablet they can do down so fast they miss feeling better. A lot of guys that do indolplex/DIM go good on one half a tablet. So after starting on it do a test in 4 weeks and if to low cut the does. I have see a lot of DIM and tried them none worked to bring my levels of E2 down like this brand did.The Indolplex version is supposed to be much "stronger" (bioavailable) than straight DIM, isn't it? I do not know what a comparable dose would be.
Yes phil agree the estrogen thyroid connection is a vicous cycle in order be compeltely resolved thyroid aids in estrogen detoxifcation and then estrogn cloggs up thyroid. Have to deal with both to get them resolved, but you willA start dose is 120 mgs or one tablet at dinner time. If men take more then one tablet they can do down so fast they miss feeling better. A lot of guys that do indolplex/DIM go good on one half a tablet. So after starting on it do a test in 4 weeks and if to low cut the does. I have see a lot of DIM and tried them none worked to bring my levels of E2 down like this brand did.
PhytoPharmica Indolplex with DIM
As I am getting my Cortisol levels up, I just got my ACTH test back and it's dam low 5 range 7 - 50 pg/ml. So my Dr. gave me Cortef the Isocort was not doing the job. I feel once I get my Thyriod in balance I will not be eating up my TRT so fast and will be down to a lower dose and will stop using arimidex and go back on Indolplex/DIM.
Phil
Yes but trying to tell a traditional medical dr that they would look at you with 2 eyes for being a male. But when it comes to a females it said specifically on birthcontrol that thryoid medication may need to be adjusted. I think that should tell you something how bad estrogen can be. Nice report i found that mothers that are hypothyroid tend to have childern that have emotional and CNS dysfunction, learning problems. Kind of scarey to wonder how many pregnant women that are misdiagnosed as well as men with subclinical hypothyroidism.Yes. We have to appreciate the thyroid as the "gas pedal" for the entire body. When it slows, so does everything else--including breakdown/detoxification processes.
Dr John I have a DIM related question and I wondered if you could help clear it up?I am currently recommending 300mg DIM QD.
I-3-C can cause GI motility issues.
In all honesty I don't it is just something that I have heard widely quoted by a whole host of people, from pharmocologists to hypogonadal patients. It has been stated so often that I assumed perhaps incorrectly that it was true.Do you have a reference for that handy please?
Isn't binding to the same receptor as DHT, and thereby keeping the DHT from doing it's thing (which is "all things male," to quote Dr John) the same net-effect as lowering the DHT itself?It's in this from this link. I don't think it states it lowers DHT.
<snip>
A study of the molecular structure of DIM showed that it is similar to the androgen-blocking drug Casodex. Lead author Hien Le, PhD, explained, “DIM works by binding to the same receptor that DHT uses, so it's essentially blocking the androgen from triggering the growth of the cancer cells."