Help with TRT - 5 years no better symptoms

[pkp382]

Hello and apologies for a long post:

I am a 36 year old male, who about 5 years ago, began experiencing low libido, hot flashes, depression, low energy, etc. I went to see the doctor, and, alas, my test levels were low, in the 200's. Over the next 6 months, I had them tested again a few times, all under 350. So the doctor put me on testim to assist.

Prior to this, I was a "typical" guy - worked out a few times a week for a few months, would take a month or two off, was off and on committed to eating properly, etc. Basically just your normal guy in his early 30's trying to keep (somewhat successfully) the belly fat to a minimum and relieve stress, nothing beyond that. Drinking was twice a week or so, maybe 3x on rare occasions. I did use other street substances while in college and a couple years after, but was done by age 27 or so.

Over the next few years (2009-2012/2013) I moved from 1 tube per day to 2 tubes per day (always with the dr approval), and at times, went without for a few months at a time. Basically, I was inconsistent with the application. During this time, I didn't really have the issues with depression or low energy, but libido was still low, and could only "perform" on myself with the appropriate visual stimulation online. I didn't have a girlfriend or a steady sexual partner (though there were sporadic interactions, they were always post-bar, so I was usually inebriated and sometimes successful, others not). I also was diagnosed with celiac disease, which I really didn't pay much attention to, which I am sure didn't help matters either. I should note during this time, a few times a year, I would get blood drawn to get my levels checked, after taking atleast a month off to allow normal production to fully resume, and the test scores were always between 275-375, so I guess I am just naturally "low" by nature.

During this time, like before, I was a "typical" guy - worked out a few times a week for a few months, would take a few months off, was off and on committed to eating properly, etc. Basically just your normal guy in his now mid-30's trying to keep (not at all successfully) the belly fat to a minimum and relieve stress, nothing beyond that. So my behavior as far as working out and diet was pretty much the same during this time as prior to this entire situation occurring, with the only exception being I would take the testim when I was committed to the gym/diet, and not so committed to using it when not. Drinking again, was twice a week, usually wine to help keep the calories off.


In 2013, I decided to switch to Axiron, since it was cheaper and easier to apply. I didn't care for it, as it seemed to make my blood levels and entire body seem to fluctuate a bit, and also led to gyno rather quickly, to the point where surgery was necessary (even though I was taking the recommended doses of 2 pumps). Frustrated by this, and by also having put on 40 pounds since 2009 when I began TRT, I decided to make significant changes.

beginning 1/1/2014, and until now, I have gone back to testim, doing 1 tube per day. I have been far more disciplined in diet and exercise, mixing in weights and cardio, and also varying activities to avoid plateau. That's not to say there haven't been a week off here and there, but for 13 months I have been fully committed to getting my body right, in all phases. I also committed to avoiding gluten so I don't disturb my celiac, and take multivitamins to help round out any vitamins/minerals I don't get in my diet. Not perfect living, but enough to see results - had I done this prior to 2009, I would be at a 33 waistline.

Now with a significant other I truly care about, the same issues from before are still present. I have very low libido, I do get morning erections but that is largely from a 2.5 mg daily assist, and have performance trouble (sometimes, not every time) even with assistance from our friend in blue. I almost never even think of sex, even when an attractive girl smiles at me/walks by, etc. Sex just doesn't come to mind much. What's more, I am simply unable to lose the weight that I have gained over the last 5 years. Steady application of testim, exercise and diet, minimal alcohol over this time have lead to the loss of maybe (maybe!) 1 inch on the waistline, while I have another 4 that I need to get rid of. So basically, while from 2010-2013, I could understand adding the weight (though it did seem very excessive compared to similar behavioral patterns prior to TRT began); what I can't understand is why I am unable to solve either the bedroom or waistline issues after the last year of healthy, serious living.

Below are my stats as of my last blood draw (they have been relatively consistent over the last year also). The only other item I ingest is a sleeping pill, so there shouldn't be any concern about other medications.

I apologize if this sounds naïve or dumb, I am just really at my wits end as to why I can't get gain traction on my two issues - bedroom performance (and desire) and the waistline. I've spoken with 2 GP's and 2 Endo's and they can't offer any help. A sincere thank you to anybody who can offer any suggestions:

Test: 481 (240-1048)
Free: 89.4 (46-224)
TSH: 1.39 (0.5-5.2)
Prolactin: 7.2 (0-18)
SHGB: 25 (10-50)
Estradiol: 25.8 (0-40)
estrogen total 143 (0-130) I have no idea why this is high when estradiol, the main component, is moderate. Should this be a concern?
LH/FSH - less than 0.2 and 0.7 - statistically nowhere near the reference ranges.

Height - 5'11
Weight - 220

Thank you again for any help.

[Low Testosterone]

The inconsistency with your TRT has been hurting you significantly. If you do not allow your body time to adjust and optimize, you will never relieve yourself from your symptoms. Once you are optimized and have remained so for a time, if you stop you will go right back to the starting point and will continue this cycle as long as you do so.

I would also consider changing TRT methods and consider injectable testosterone. Gels and creams have about a 20% fail rate. In those that they do work well with, they will typically begin to not work as well over time. In such cases, the man needs more and more gel or cream. It's not an issue with the testosterone itself but an adaption to absorption.

Your LH and FSH are never going to be significant when you are using testosterone. That's normal for a man on testosterone.

You need a better treatment plan, consistency with your treatment plan and a sold diet and lifestyle practice.

[pkp382]

Thank you for the reply. I came to a similar conclusion as I mentioned a year ago and have been pretty diligent in staying the course.

Is there anything within the values that I listed that would specifically cause the problems of weight and libido that you noticed? As I mentioned, those have remained relatively consistent over the last year.

My main curiosity is how my total estrogen level is so high, while my estradiol is pretty reasonable. I understand e2 is the predominant hormone for estrogen, so I doubted that the total estrogen level (which includes both good and bad) could be the problem, within the context of a reasonable e2. Is that your understanding as well with regard to e2 and total estrogen?

Thank you again

[OingoBoingo]

Good advice from Low Testosterone.

Exogenous Testosterone will shut down your HPTA, which means your LH and FSH will be tanked. Check out the hCG and Pregnenolone sticky for more information.

Libido and sexual performance is complicated. And can take some time to respond once you're on the right track.

What's your DHT level?

In my case, I wouldn't be happy with your Testosterone numbers. I feel better in the upper quartile of the range.

[pkp382]

Thanks oingo. I just checked my labs for the last 2 years, no dht test was done.

As an aside, I spent some time in the upper 1/4 you mentioned while on the axiron and it got me gyno surgery for $5500. Only took a few months to develop also. That's why the additional interest in estrogen ratios like I asked above, e2 and total, because for me (by my thinking anyway) too much aromatase when I was at 700-800.

Thank you for your interest and in advance of any further feedback.

[OingoBoingo]

Happy to help. We're all in this together.

There's a lot of good information on this forum. It would be worth your time to read everything that has been posted in the last year or so.

DHT *should* be good on transdermals, but you won't know without the test. And DHT is important for libido and sexual performance.

I can't recall any doctors getting excited about total Estrogen, but managing E2 is crucial.

Testosterone itself doesn't cause gynecomastia, but it can cause E2 to raise, which can cause problems.

What's your body fat percentage? Do you drink? Have your doctors been routinely monitoring E2?

Higher BF% causes more Testosterone to convert to E2.

The liver removes excess E2 from your system, but it sees removing toxins as a priority, thus E2 can rise with surprisingly little alcohol intake.

Check out the Finding a Physician sticky for a list of tests you might want to get.

[pkp382]

I do drink, and frankly, it can be a bit much. Years ago, it was far more common, nowadays, objectively, twice a week with once being in excess. Periodically also, I have to take painkillers for a recurring back issue. It's very moderate, maybe 8-10 per month. I know that affects the liver also (and I don't mix the two), but my liver tests were always fine, so I wasn't concerned. I also did street chemicals fairly regularly in my 20s, tho nowhere near the point of addiction. Any effects from that should have normalized by now.

What you say about prioritization makes sense regarding the liver though. To assist with the e2 metabolism I take d glucarate and dim with every meal to help facilitate.

As for bf% I don't know offhand. Before all this occurred, from say 2002-2009 I could add 20 lbs in 6 months (bad weight) and take it off after a few months of hardcore diet and exercise. Now, 13 months later, not so much. I realize metabolism isn't what it was a decade ago but still expected better results. I'm considered obese on a bmi but I always thought those were a tad extreme in the ratios.

Objectively, I'd say I'm 30 lbs from "perfect" and 20 from my "normal". I know the cycle too - more belly fat = high estrogen and when you can't break that ratio a vicious cycle ensues. Hence the frustration - put in the work with no result. I've got a 36' waist, which oddly enough I had years ago while "overweight" at the time weighing about 190 which id kill for now lol.

I guess at the end of the day I just can't figure out why a 500 test avg with a 25-27 e2 avg just isn't yielding any results. I mean I am literally dripping with sweat after a workout. Like I mentioned before, because of the gyno from 3 months of 7-900 total, I'ts obvious (to me anyway, feel free to correct) that my best bet is to stay under 550 or so.

Thanks for easing my concerns on total estrogen and by the sounds of it the other values are not an impediment. Maybe I just need more healing time for the intestines from the celiac abuse to heal to help absorb my multivitamins, etc. the daily 2.5 mg helper assists with function too for intimacy- just wish I could solve the desire part as easily.

Again, many thanks and keep the tips coming if you have them. I'll look into that dht test also.

[jasondd1]

Creams gels did nothing for me even at high doses. id consider injections

[OingoBoingo]

I do drink, and frankly, it can be a bit much. Years ago, it was far more common, nowadays, objectively, twice a week with once being in excess. Periodically also, I have to take painkillers for a recurring back issue. It's very moderate, maybe 8-10 per month. I know that affects the liver also (and I don't mix the two), but my liver tests were always fine, so I wasn't concerned. I also did street chemicals fairly regularly in my 20s, tho nowhere near the point of addiction. Any effects from that should have normalized by now.

What you say about prioritization makes sense regarding the liver though. To assist with the e2 metabolism I take d glucarate and dim with every meal to help facilitate.

I live in Bangkok, and spend a lot of time in bars. Although the temptation to drink from girls half my age and guys just here to party can be overwhelming, I try to remember what even a little booze is going to do to my E2. I haven't stopped completely, but have cut down quite a bit. Baby steps...

If taking D-glucarate and DIM makes you feel good, keep at it. But be sure to supplement with Zinc. I take 75mg spread throughout the day.

And find a doctor who will prescribe Anastrozole if you need it. As good as Zinc is, it can't compare to Anastrozole for controlling E2. .

As for bf% I don't know offhand. Before all this occurred, from say 2002-2009 I could add 20 lbs in 6 months (bad weight) and take it off after a few months of hardcore diet and exercise. Now, 13 months later, not so much. I realize metabolism isn't what it was a decade ago but still expected better results. I'm considered obese on a bmi but I always thought those were a tad extreme in the ratios.

Objectively, I'd say I'm 30 lbs from "perfect" and 20 from my "normal". I know the cycle too - more belly fat = high estrogen and when you can't break that ratio a vicious cycle ensues. Hence the frustration - put in the work with no result. I've got a 36' waist, which oddly enough I had years ago while "overweight" at the time weighing about 190 which id kill for now lol.

As mentioned above, more body fat will convert more Testosterone to E2. The good news is that your metabolism should improve on TRT, and with a little effort the fat should melt away.

I guess at the end of the day I just can't figure out why a 500 test avg with a 25-27 e2 avg just isn't yielding any results. I mean I am literally dripping with sweat after a workout. Like I mentioned before, because of the gyno from 3 months of 7-900 total, I'ts obvious (to me anyway, feel free to correct) that my best bet is to stay under 550 or so.

It could be that TT 500 is too low for you. In my case, there's a world of difference between 750 and 850: life at 850 is good, but 750 not so much. Dr. Crisler, Dr. Gordon, and the Life Extension Foundation say the upper quartile is the place to be, and that is my experience as well.

Also, it's not Total Testosterone that matters, but rather Free Testosterone. You can have all the Testosterone in the world, but if it's bound, it is not doing you any good.

Testosterone did not give you gynecomastia; it's a good bet that failure to successfully manage E2 did.

[pkp382]

Thanks for the tip on the zinc and e2. I used to take zma and will now start again, adding to dim and glucarate. Like I mentioned though my e2 is right around where it should be - from what I understand, mid-20s is about right, depending on ratio to t. From what I recall, about 25-1 was the ratio that was ideal from what I read somewhere, so I'm a bit behind at 20-1, based on appx of 500 test (free notwithstanding) and 25 e2.

At this point, since I'm reluctant to uptake my test too much higher than 550, I guess the best thing to do would be to lower my e2 to improve the ratio. Other than anast...(sp) and the obvious eat well, exercise, curb alcohol, etc any other
"Tricks of the trade" to lower e2?

[OingoBoingo]

You should forget what you know about E2/Testosterone ratios. Using the standard E2 assay for men, E2 should be kept between 20 and 30. It doesn't matter if your Testosterone is 500 or 1,000, between 20 and 30 is where you want to keep your E2.

I spent some time at 1,170 (which was fun), and it's hard to believe anyone would think an E2 of 47 would be okay.

Your fear of gynecomastia is understandable, but you really should figure out how you got it. If Testosterone in the upper quartile was the cause, most of the guys on the forum would have it.

You might do a forum search for gynecomastia. Would also be a good idea to Google E2 and gynecomastia. Read everything posted on this forum in the past year or so; this subject has come up a few times, and you might learn other things as well. Have a look around the Life Extension Foundation website for lots of good stuff, including information on optimal levels.

There are a lot of things to learn, and a few to unlearn as well.

[Beethoven]

Gels didn't do it for me either , testosterone shots helped a lot but hCG made a bigger difference within my protocol . That and 5 mg of cialis and I'm rarin' to go. That being said you will then have to do your part and clean up your lifestyle a bit.

[pkp382]

Beethoven - thank you for the reply. When you mentioned lifestyle, I'm curious what you mean exactly. As I mentioned years ago I was a bit wild, but I have toned it down considerably. I suppose I could (should) curb the drinking, but I never imagined going from 2x per week to 1x (as an example) would make such a huge difference. As I mentioned I've been consistent for the last year with the gluten free diet and exercise.

I just want to make sure I'm not overlooking anything you mean when you mention clean up the lifestyle. Thanks again.

[pkp382]

Oingo, when you say "cause" of gyno: I've read online that drinking, drug use, flab, etc all can cause gyno.

My understanding is those things can (among other things) contribute to low e2, which causes gyno. Is that accurate?

Or is it common for one to have a stable and healthy e2 and still get gyno? To me, all other things being equal, gyno would nearly always be hormone-related, and if e2 was in check, along with a healthy testosterone level, something very unlikely would have to occur for a 36 year old man to develop?

I know why it happened to me this summer - sky high e2, which I knew nothing about. Moving forward, I'm under the assumption that keeping e2 in the 20s for all intents and purposes there will be no gyno. Would that be accurate?

[Beethoven]

Pkp, if you aromatise that much, drinking will only make it worse. Trt already has sides you want to control and heavy drinking will only add to it. Now that's not to say you can't drink some but frequent heavy drinking will just add to your to your problems, imo.

[OingoBoingo]

I know why it happened to me this summer - sky high e2, which I knew nothing about. Moving forward, I'm under the assumption that keeping e2 in the 20s for all intents and purposes there will be no gyno. Would that be accurate?

^^^^^^ This is the important part of your post.

A few things must happen to get gynecomastia, but it's important to understand that you can control E2. Maybe not with DIM or even Zinc alone, but certainly with an AI such as Anastrozole.

So if you forget about E2/Testosterone ratios and keep your E2 between 20 and 30, you can safely raise your Testosterone to a reasonable level (such as the upper quartile) without worry.

You might enjoy the higher Testosterone in the gym.

And it's also important to mention that your body makes DHT from Testosterone. If there isn't enough Testosterone to go around, it could be DHT is suffering as well.

[OingoBoingo]

... I never imagined going from 2x per week to 1x (as an example) would make such a huge difference.

My doctor is a nice old guy who will right script if I can make a compelling argument and does offer some good advice, but sometimes he leaves me scratching my head.

While discussing my DHT levels and supplementation options, he said if I wanted to raise DHT, just lower E2. It's tempting to think it could be that easy, but the sceptic in me won't allow it. Although it did get me wondering if something could be done to increase the 5alpha-reductase conversion from Testosterone to DHT.

While researching 5a, I found some E2 information you might find interesting.

Although it's often written on the forum that E2 follows Testosterone, some guys who include hCG in their protocol will tell you that hCG seems to raise E2 higher than they think the small amount of Testosterone manufactured as a result of using hCG really should. This is because there is more than one pathway to E2.

Most of us are familiar with Aromatase (CYP19) conversion from Testosterone to E2, and that excess adipose tissue, alcohol, Zinc deficiency, and stress can actually increase the conversion.

Pregnenolone (check out the hCG and Pregnenolone sticky for more information), has two pathways (DHEA and Progesterone) that leads to Androstenedione, which leads to Testosterone and Estrone (E1), and both can convert to E2.

It turns out that the 17-hydroxylase conversion (from Pregnenolone to 17-OH-Pregnenolone before converting to DHEA) can actually be increased by alcohol consumption.

Alcohol also increases the conversion of Progesterone to 17-OH-Progesterone.

A real double whammy.

If we go back to DHEA, that is converted to Androstenedione and Androstenediol, which then converts to Testosterone. Alcohol increases the conversion from DHEA to Testosterone, which leads to E2.

The conversion from Androstenedione to Estrone (E1) is also Aromatase, which means it too is increased by alcohol.

From E1 we have the 17beta-HSD conversion to E2, and guess what! That conversion is also increased by alcohol!

It looks like alcohol is just bad for those having a problem managing E2.

So yeah, cutting from two days a week to one could have a significant impact.

As an aside for those who take big doses of D3, it looks like D3 can also increase Aromatase. (Vitamin D3: Lou YR et AL. J Steroid Biochem Mol Biol. 2005 Feb;94(1-3);151-7, Epub 2005 Feb 17.)

I've been taking D3 at 10,000IU daily for the past six months or so. Starting tomorrow I will drop that to 5,000IU daily to see how it goes.

[pkp382]

Oingo,

Thanks again for the info. Previously I had asked my doctors for an AI, and they wouldn't do it. I quite literally had to beg my endo to allow a test for estradiol - he insisted total estrogen was more important, hence my concern on the total estrogen value above, higher than the norm.

Pretty surprising since they wrote the testim without much thought. I'll try in the meantime with zinc, dim, and glucarate. I also take multivitamins so that should help, especially with the intestines on the heal from staying gluten free.

You mentioned before the prioritization of the liver in removing toxins vs hormones. Random thought - would an OTC liver metabolism enhanced work (along with reducing alcohol)? Just trying to think outside the box to assist until I can find a doc that will write for an AI. My lipid profile was always fine, but if I can accelerate then so be it.

And to anybody else,

Any suggestion on dosage for dim, glucarate and zinc to control e2?

Thanks again oingo

[OingoBoingo]

Some people just convert more to E2. If your doctor doesn't appreciate the importance of controlling E2, it's time to find a new doctor.

Honestly, until I see some of the top TRT doctors getting excited about total Estrogen, it doesn't really interest me. Although, after finding all that information about alcohol increasing so many conversions, it occurred to me that if one were sitting on a big pool of E1, consuming alcohol is just a bad idea.

If I could take NAC for liver support I would, but after 6 months of looking, it's not available where I live.

After doing just a little research on DIM and D-Glucarate, I don't think they will be very effective.

My doctor takes and recommends 90mg of Zinc daily. LEF recommends 80mg of Zinc daily. I take 75mg spread throughout the day, and really didn't notice any improvement until I got over 60mg.

It's important to understand that Zinc will have a negative impact on Aromatase, but it will not control E2 the way an Aromatase Inhibitor (such as Anastrozole) can.

[pkp382]

Oingo (or anyone else)

Forgive me if this is a dumb question: I know that taking trt significantly slows down natural production of T. I read on here though and other places the value of for example vitamin d, zinc, b vitamins, etc. as regards increasing your body's natural production. I read on here people taking these and other things for that purpose.

if taking trt slows it down, can your natural production simultaneously be increased by taking these OTC supplements? It would seem, logically, to be nowhere near enough of an increase in the natural production, as opposed to the force of slowdown caused by trt to have much of an effect. That said, I take a lot of multivitamins etc along with my testim.

In other words, is it worth (generally speaking) the effort of OTC supplements to stimulate production in conjunction with trt? And if you are able to increase natural production simultaneously to trt-induced increased levels could such an increase lead to aromatizatiom (hypothetically, without getting into the specifics of managing e2 like we did above)?

Did that make sense? I'd be happy to clarify if not. I just want to make sure I'm not wasting a whole lot of money on vitamin d (as an example) if it will have no impact against trt-Induced natural production slowdown.

[OingoBoingo]

In other words, is it worth (generally speaking) the effort of OTC supplements to stimulate production in conjunction with trt? And if you are able to increase natural production simultaneously to trt-induced increased levels could such an increase lead to aromatizatiom (hypothetically, without getting into the specifics of managing e2 like we did above)?

IMO, no, it's not worth it. If one has a vitamin deficiency, supplementing may increase levels a little, but I don't think it would get one from clinically low upper quartile.

Although, supplementing Vitamin D3 if low (and almost everyone living in civilized countries are indeed low) can have a positive impact.

If one has the factors that increase Aromatase conversions (excess adipose tissue, alcohol consumption, Zinc deficit, and so on), it doesn't matter if the Testosterone is exogenous or natural.

[pkp382]

IMO, no, it's not worth it. If one has a vitamin deficiency, supplementing may increase levels a little, but I don't think it would get one from clinically low upper quartile.

Although, supplementing Vitamin D3 if low (and almost everyone living in civilized countries are indeed low) can have a positive impact.

If one has the factors that increase Aromatase conversions (excess adipose tissue, alcohol consumption, Zinc deficit, and so on), it doesn't matter if the Testosterone is exogenous or natural.

Thanks Oingo.

Without getting too far "into the weeds" on the subject of aromatase, let me ask one more question:

It always seemed kind of contradictory to me that aromatase occurs once T gets to a certain point and beyond. As we know, certain things (eating right, exercise, diet, supplements, alcohol containment) can increase T, and in the case of this forum, exogenous supplementation does the same. If we were to combine all of these things, and our T increases, hypothetically it could lead to the point beyond optimal levels, at which point aromatization occurs, following that line of thought.

So the question is, if I am doing all that I just mentioned above, should I be concerned about T going too high, leading to aromatase? Or should I look at it to the contrary, where doing these things (exercise for example, while on TRT) minimize the aromatase enzyme, therefore leading to the results we want (High T, Low E)?

I'm not sure if I'm stating it right but if we do all of the things we are supposed to do (including TRT for guys like us), should there be a concern about leading ourselves beyond the optimal point and into increased aromatase (thus the negative e2 effects), or do all of these things, combined, always minimize aromatase and support optimal results?

I'm sorry if this is a dumb question ,but I'm committed this time to doing this right, in all facets, and I don't want to (as an example) take my multivitamins, limit alcohol, stay consistent with TRT timing/volume, get my sleep, etc., and then, say, exercise myself into increased aromatization. Thanks again for all of your assistance - as a novice, your input on this thread has been valuable beyond words.

[Low Testosterone]

If you truly have low testosterone, meaning your testicles cannot produce enough or your pituitary cannot send a strong enough signal, there is no vitamin regiment that is going to correct this, no diet change, no exercise or other lifestyle habits. That isn't said to imply lifestyle habits aren't important. It also isn't said to imply lifestyle habits cannot have an affect on testosterone production. You can certainly lower your testosterone production through poor lifestyle choices, but lowering your output of testosterone versus actually having low testosterone are two different things.

Aromatization - some of your testosterone is going to aromatize regardless of where your testosterone levels are. There isn't a point that's reached where we can say "at this number aromatization begins." We also cannot say excess adipose tissue will in fact lead to heavy aromatization and the lack of will not. Some men with excess adipose tissue to experience a higher level of aromatization; however, there are plenty who do not and equally as many lean men who aromatize very heavily.

I've said many times, TRT isn't a complicated process. However, there are not exact formulas that fit all men as all men are unique in one way or another. You can find a guy online that says he follows XYZ protocol, takes X amount of testosterone along with this or that and his numbers are what he considers perfect. You can then follow the same protocol and your numbers will not end up anywhere near similar to this man's, why? Because you are different people. Do not over complicate things. Do not freak out about the possibility of higher E2 then you want. You are not going to develop gynecomastia over night. If you end up a little bloated it's easily remedied. And no, you cannot exercise yourself into higher E2. The concern you have, I understand the question you're asking but it's not a concern.

[pkp382]

If you truly have low testosterone, meaning your testicles cannot produce enough or your pituitary cannot send a strong enough signal, there is no vitamin regiment that is going to correct this, no diet change, no exercise or other lifestyle habits. That isn't said to imply lifestyle habits aren't important. It also isn't said to imply lifestyle habits cannot have an affect on testosterone production. You can certainly lower your testosterone production through poor lifestyle choices, but lowering your output of testosterone versus actually having low testosterone are two different things. Aromatization - some of your testosterone is going to aromatize regardless of where your testosterone levels are. There isn't a point that's reached where we can say "at this number aromatization begins." We also cannot say excess adipose tissue will in fact lead to heavy aromatization and the lack of will not. Some men with excess adipose tissue to experience a higher level of aromatization; however, there are plenty who do not and equally as many lean men who aromatize very heavily. I've said many times, TRT isn't a complicated process. However, there are not exact formulas that fit all men as all men are unique in one way or another. You can find a guy online that says he follows XYZ protocol, takes X amount of testosterone along with this or that and his numbers are what he considers perfect. You can then follow the same protocol and your numbers will not end up anywhere near similar to this man's, why? Because you are different people. Do not over complicate things. Do not freak out about the possibility of higher E2 then you want. You are not going to develop gynecomastia over night. If you end up a little bloated it's easily remedied. And no, you cannot exercise yourself into higher E2. The concern you have, I understand the question you're asking but it's not a concern.

Ok thanks. I just wanted to make sure I don't overdo the "good" and have lead me into the "bad". By way of your answer, that's not the case. Thank you for your answer as well as the other information.