My Long PFS Journey

Hi bro. Sorry you’re going through this, it really sucks wasting years to feel normal and functional!

I’ve looked into your results and symptoms. First off, your Testosterone level is great with respect to your LH & FSH. Apparently, you don’t suffer from primary or secondary hypogonadism. I’d surmise your issues are mainly caused by an imbalance in E2 & DHT. I don’t see E2 & DHT tests and they are needed to draw a better picture.

On the other hand, your SHBG is borderline normal now and this could mean your free Testosterone is in good range. But having very low SHBG also means that you may have less Testosterone (and estrogen) floating around in your blood since unbound Testosterone has a very short half life (I read 10 to 100mins). This may explain why you have mild ED in the evening and dry eyes. How did your SHBG get so low?

Moreover, SHBG is determined by multiple hormones: Estrogen (higher estrogen drives SHBG up), Progesterone, Thyroid hormone, Testosterone, DHEA, Growth Hormone, Insulin, etc. But I read that insulin is the most important one. Did you check for diabetes particularly type 2? Also have you checked your Thyroid?

As for your B-12, try to take B-12 supplements to raise it.

B12 supplements are extremely dangerous, as they are methyl donors. Don’t take any risk with B12!

Well that depends. In my case, I’ve got my serum B12 measured twice and in both times it came out way above normal lab ranges even though I’m not on any B-12 supplements. There’s a growing body of research suggesting that specific gut flora is able to produce B-12 internally so this might explain my supraphysical levels. Did it really affect me in a negative way? I can’t say for sure but I’ve been feeling great generally without major crashes for the past month. I suppose it affects us differently though.

2 Likes

Yes i did, ratio is around like 38-40 difference with TRT and my case is; i do not take any exogenous Testosterone so, when i inhibit aromatase, my Gonadotropins went up then, balls generates crazy amounts of Testosterone also Sertoli cells will overgrow for filling up reduced estradiol and this increases testes size so, aromatase inhibitors will not inhibit estrogen completely in man with working gonads but, if you suppress your gonadotropins with TRT then, yes AI’s will eradicate all estrogen in body and you have to be careful with dosage that’s why bodybuilders Took tiny amounts of AI’s.

I have started with arimidex then, switched to aromasin without taking a break, now i am reducing dosage to every 4th day 25 mg / 3th day 25 mg / 2nd day 25mg and once a week 25 mg.

Also i have discovered that Tribulus and exemstane has synergetic effects especially on libido.

Be careful with how much AIs you take since you’re natural and like I said it’s way too easy to crush your E2 hard. AIs shouldn’t be a long term solution and its best that you find the cause for having high E2. This could be due to finesteride. Low and high E2 symptoms are similar in many ways with a few exceptions. Low E2 symptoms include achy dry joints, dry skin, terrible mood, great erections but low libido, frequent urination, increased hair loss, emotional blunting, bad gut function, night sweats among others. Keep track of these symptoms as you adjust your AI dose.

Btw, how did you get your E2 level tested? Was it a sensitive or an ordinary assay? It is suggested on many trt forums that ordinary tests usually overestimate E2 so the actual result may be less.

Both Tribulus and exemestane worked great for me in the past when my E2 was high but as it went too low they did exactly the opposite. Have you experienced with Zinc, Vitamins A,D,K? If you’re deficient in them then they might help. Lowering body fat% also helps.

@Dvir @doomed80

Time to fill out the survey, guys.

If you can’t do it please post here with why so I can stop nagging you.

Filled and done.

1 Like

Thanks @Dvir, you should have a completionist tick on your avatar (please choose an avatar too!). Can you check that you didn’t have any final clicks to do? Click the bar chart above to open your survey and see if there’s anything left.

@axolotl, any ideas here?

This invitation has already been used.

Hi Doomed80

Nice to hear from you. I’m not so often on this forum I guess.

What are the symptom of high E2 ?

I take both vitamin D and A, I stopped K2 but get a lot of K from spinach. I’m still taking a bunch of supplements everyday and I’m still eating ketogenic. No carbs.

My last remaining symptom is insomnia, but it’s not getting better at all. Some good nights, some bad ones, no way to know why.

Do you think E2 could have something to do with that ?

I might try stopping vit A and D and see if it makes a difference.

What would you suggest to get better sleep ?

That must have somehow done it, you have your tick now!

Thankyou :slight_smile:

Welcome back Man! Same here, I’m not checking the forum as often as I did a year ago but I still log in to try and help others in here. I always hated how many recovery threads had loose ends without proper closure!

May I ask why did you assume you have high E2? Did you have a recent bloodwork done? If yes, then please share your results so I could be of more help. It’s worth noting that high and low E2 symptoms are almost identical with a few exceptions.

E2 is definitely linked to sleep. E2 is linked to Serotonin levels in the brain and Melatonin is a metabolite of Serotonin.

Check this out:
" Estrogen acts everywhere in the body, including the parts of the brain that control emotion. Some of estrogen’s effects include: Increasing serotonin , and the number of serotonin receptors in the brain. Modifying the production and the effects of endorphins, the “feel-good” chemicals in the brain."

For more just Google “estradiol serotonin”.

Bottom line is that E2-Serotonin relationship is scientifically proven. Having optimal E2 level would revive Serotonin levels and this would result in optimal Melatonin level that promotes sleep. That being said, you need to ensure proper conversion of Serotonin to Melatonin by making sure you are not lacking any of the co-factors such as Iron, B6, Vit C, & Folate. Did you have your ferritin tested before?

You also need to have your Cortisol level checked. Naturally it’s high in the morning and lower in the evening so that’s something to consider.

Check and see if you’re taking any sort of stimulants through diet or supplements including caffeine, high dose B vits or any other herbals such as yohimbe or others. I recall you were taking Tyrosine & L-Dopa and both boost Dopamine (as you already know) and DE is further converted to norepinephrine & epinephrine (adrenaline) and they’re known to be sleep disruptors and deplete Serotonin. I know you are supplementing 5-htp but balancing everything out is near impossible.

Vitamins D, A & K have an anti-aromatase effect. Personally, I stopped supplementing them in isolated forms and I’m feeling better already and my sleep improved.

How is your gut doing? I read on forums about a specific bacterial strain that may help with sleep. I’ll try and check to find out its name.

Get well soon!

1 Like

I don’t know if I have high or low E2. That’s why I’m asking for the symptoms of high E2, considering you already gave those of low E2. If they are similar, never mind.

I’m in Thailand and blood tests are expensive and in different units than in western countries. Rather than doing the tests, I’ll just stop Vit A and D for a while and see what happens. I may be low on iron, but I’m ok with the others.

Cortisol was high but within range last I checked. I also stopped caffeine and will stop L-Dopa and L-Tyrosine in the afternoon.

Gut is fine, I take probiotics once a week.

I will try those few changes and see what happens. It looks to me like the supplementation makes us feel better by externally shifting our body’s balance to a better place, but I’m not sure it’s doing any permanent repairs. I’m hoping that butyrate and BHB will repair the epigenetic damages. It does so for some diseases but I have no idea if pfs is one of them.

High and Low E2 symptoms are very, very similar and can be quite tricky to differentiate. For years, I assumed (without actually proving it) that I was having high E2 and acted accordingly. I literally was ingesting umpteen supplements and Rx drugs to fight it off. Reading through all those scaremongering nonsense online articles about high E2 epidemic didn’t help either. How wrong was I!

E2 primarily is a metabolite of T just like DHT. Finesteride shifts this balance toward more E2 since 5AR is inhibited. That said, I urge others to learn from my mistakes and get tested first for T & E2 before embarking on the long recovery journey. I don’t necessarily think DHT testing is of great importance because I’d theorize that having optimal T:E2 is all it takes for normal well-being and sex drive.

I think I didn’t explain myself clearly. What I meant to say, E2 shouldn’t be way out of range if DHT is in healthy range because E2 & DHT balance each other out. There are properly other issues related to PFS but balancing T:E2 is an pivotal step toward recovery.

Now back to high E2 symptoms: these include water retention, low libido, being very emotional, flushing, night sweats, lethargy, very oily skin and hair among others. Dry achy joints, dry skin, increased hair loss/thinning, anxiety, sleep disorders, fat gain mainly around mid section, and depression are more related to low E2.

btw, I find 100-200mg magnesium around bedtime is also helpful with sleep.

Well, I don’t normally have any of those high or low E2 symptoms. I usually have a single symptom: I wake up after 3-6 hours of sleep and after that I keep waking up and falling asleep until it’s time to get up. If the night was particularly agitated, I would be tired, groggy and demotivated all day. But usually, it takes 2 bad nights in a row to get me there.

However, today, I didn’t have caffeine, didn’t take Vit A and D after my coffee, and didn’t take L-Dopa. I’ve been so brain-fogged all day despite having had 6 hours of straight sleep last night, I’m barely functional. I took 5-HTP and L-Tyrosine around 11am, hoping to fix that, and it’s now 3pm: I’m still as brain-fogged and demotivated as I was this morning.

Considering I felt sleepy a few hours ago, I guess I will succeed at having a better night of sleep but to be honest, that’s not my objective as sleeping is not productive by itself.
I’m aiming at being productive during the day, no matter how was my night even if I slept only 4 hours straight and another 4 of waking up and falling asleep.

I find the experiment interesting. Considering Vit A and D is stored in fat, it would not have such an immediate effect after stopping only one day. Also considering I took L-Dopa, L-Tyrosine and 5-HTP first thing when I woke up at 6:30 am and what was unusual about today was being brain-fogged after 10am, which is before my usual second dose of L-Dopa, L-Tyrosine and 5-HTP, the only remaining element that changed is not having caffeine in my morning bulletproof coffee (which still had MCT oils, reputed for giving mind clarity)
My conclusion: I’m addicted to the caffeine in my single cup of bulletproof coffee I’m having everyday at 8am.
I’m used to caffeine as a way to clear up the effects of the Clonazepam, Hydroxyzine and Valerian I take before sleep.

I want to sleep better, but it’s secondary to my desire to have productive days. I will resume drinking coffee with caffeine and taking a second dose of L-Dopa, L-Tyrosine and 5-HTP before lunch. That will leave 14 hours for the caffeine to clear out and 10 hours for the aminos.

If I get a chance, I’ll have my blood tested for ferrite, E2 and TT.

I am supplementing my self with almost every thing, i eat fish at breakfast and dinner. I had mild hyperlipidemia 250 triglycerides 300 cholesterol but i reduced them to 80 Trg 160 cholesterol with 1g niacin and 2g fishoil. I believe e2 test is a sensitive array but even if not, it is required for ranges under 15 pg/ml mine was already at the upper range 34 !!

Problem is yes you can crash e2 very hard with AI if you use it first time but, if you continue to take an ai it will not crash again

How’s the survey coming?

Nag, nag, nag.

So how we do balance that ratio?

This theory makes sense but it doesnt explain why i got only low semen volume when the first years of my PAS? I mean my libido was fine, erections were fine… if something happened to my AR, why i didn’t have any other symptoms… also its not only me, i have talked with few people like me, who had particular sexual symptoms instead of full ED and Crash… weird eh?
nobody can know this i guess. Anywasy thanks for the info man!

Hehe oops. You sound exactly like my boss at work ;p

How can I access the survey?

Hit the button at the top of the screen, the one that looks like a bar chart. It’ll take about an hour but it will save your progress if you need a break.

Thankyou :slight_smile: