E2 control with Primo on TRT

[goulash_ragu]

It does.

To answer your question, I'm not a doc, just a well educated and experienced user.

I'm just going to echo my previous wordings: adding another androgen to trt is not healthy. It's not trt anymore, it's a cruise. Important to make that distinction. However, your e2 readings suggest that your are on cruise already. What does your other blood work say, total test and free test? You should have shared that in the OP and how experienced you are with aas as with your age and other info ...

You should take into account that there is much, much more to it then just the impact on lipids. Primo is a dht derivate anabolic steroid and is impacting everything, from your brain to your liver and kidneys ... Impacting things like neuroinflammation (anxiety and depression), it modulates the glucocorticoid system (impacting water homeostasis and also impacting behaviour), it inhibits certain enzymes, it's going to compete with other androgens systemically in your tissues and organs, consequently having a multitude of outcomes, etc. etc.

It's one thing being on primo for a short while, but it's a completely different thing being on it for years on end. The internet is filled with brosky's advising or advocating the use of extra androgens to modulate your trt, but don't be swayed brother, this are just layman, they don't know what they're talking about. Things are much more complicated then an average seemingly educated gym rat can imagine.

You want health, stick to trt levels, you shouldn't need an Ai. And if you do, use an Ai. We don't have a full picture of how primo lowers e2 anyway. There are a handful of anecdotes connecting primo to low libido (my experience also) with estrogen still in normal range, suggesting it doesn't lower estrogen equally in all tissues and it also might be competing with normal DHT at systemically important sites, changing normal physiological functions of varying systems ... Again, it's complicated.

75mg also wont lower your high estrogen to adequate levels.

Thanks for a level headed response. My total test was 1110, e2 was 75. The labs didn’t measure free test (it was the hormone panel with CMP from quest). I’m 43, with over a decade of fitness experience, but mainly in combat sports (BJJ & judo) and previously powerlifting.

Main reason I’m looking at primo is due to recently taking 3mg of Aromasin (yes, an eighth of a 25mg tab) and kinda not feeling super great after. I lost ~2lbs of water weight, which was fine, but also a bit of strength. Libido didn’t really improve either. So I was hoping to control e2 with something that would help with strength, but lack of libido on primo is indeed a bad news.

I just got back from my first training (combat) in a long time where I got myself injured, so I probably will be focusing on recuperating. Gonna pound those peptides hard, and not worry about primo or AI (I heard e2 helps with healing) for now. Now Mast though… j/k hehe.

 

[Jin23]

Now Mast though… j/k hehe.

Haha

But seriously, 75 is too high and it's not healthy. While it lowers oxidative stress in the brain (amongst other things), which is the reason why it's better to have higher estrogen in the brain during a cycle (it's also an anti-inflammatory in the blood and it's an vasodilator) it's a different story in the body when levels are chronically elevated. High serum levels predispose you to venous thrombosis. You can do genetics (think 23andme) and see if you are predisposed, as this is a fairly well studied field and see how susceptible you are to it. (however, having low androgens and high e2, predisposes you more to this, so this is a slight plus for you).

I'm sorry to hear that aromasin did you in, the 1kg loss of water would seem to indicate that your e2 levels were impacted more then you'd expect a 3mg dose to do. Was this UGL or pharma?

There is the chance of false blood work too as normal e2 testing isn't the most accurate.

1100 ngdl is high, that is going beyond trt, which should be around 600 - 700ngdl. With that high of a TT, your free T is definitely very much so in the supraphysiological range (so again, not trt but a cruise) especially when you couple it with the high e2 reading, it's logical.

If you want to be healthy, lower your trt dosage and your estrogen will take care of it self. If you insist on having such high levels, then consider doing more injections per week, as that will let your SHBG raise a bit and your free test and consequently e2 will drop. But the effect is not that pronounced. If you are fat, loose the fat, that will also help. This are the steps that avoid the use of an Ai.

 

[Joesmoke1]

Great and actionable feedback, thanks! Do you feel e2 lowering effects immediately or does it take a little while to kick in? I thought it’d take about 3 weeks due to saturation.

Most everything takes some time to "take effect" with the exception of No ester products like Tren base or even Halo tabs in my experience.

 

[Joesmoke1]

Ofc there is a problem with that. You are adding an anabolic steroid to your trt. If you want to lower e2 first check your bloods, how high is your testosterone. You shouldn't have 71 e2 with normal testosterone levels. And further on, you should use an Ai to lower estrogen. There is nothing wrong with that. There is a lot wrong with adding an anabolic to the regime though. But you're on the wrong forum for this discussion. If you want confirmation bias, then yes, this is the place.

I agree with the AI to lower. I use Arimidex and do bloodwork, start low like .25-.5mg week. Some people aromatize more and depending on BMI makes a difference too. People seem to aromatize much more with higher percent bodyfat.

 

[Runtro]

It does.

To answer your question, I'm not a doc, just a well educated and experienced user.

I'm just going to echo my previous wordings: adding another androgen to trt is not healthy. It's not trt anymore, it's a cruise. Important to make that distinction. However, your e2 readings suggest that your are on cruise already. What does your other blood work say, total test and free test? You should have shared that in the OP and how experienced you are with aas as with your age and other info ...

You should take into account that there is much, much more to it then just the impact on lipids. Primo is a dht derivate anabolic steroid and is impacting everything, from your brain to your liver and kidneys ... Impacting things like neuroinflammation (anxiety and depression), it modulates the glucocorticoid system (impacting water homeostasis and also impacting behaviour), it inhibits certain enzymes, it's going to compete with other androgens systemically in your tissues and organs, consequently having a multitude of outcomes, etc. etc.

It's one thing being on primo for a short while, but it's a completely different thing being on it for years on end. The internet is filled with brosky's advising or advocating the use of extra androgens to modulate your trt, but don't be swayed brother, this are just layman, they don't know what they're talking about. Things are much more complicated then an average seemingly educated gym rat can imagine.

You want health, stick to trt levels, you shouldn't need an Ai. And if you do, use an Ai. We don't have a full picture of how primo lowers e2 anyway. There are a handful of anecdotes connecting primo to low libido (my experience also) with estrogen still in normal range, suggesting it doesn't lower estrogen equally in all tissues and it also might be competing with normal DHT at systemically important sites, changing normal physiological functions of varying systems ... Again, it's complicated.

75mg also wont lower your high estrogen to adequate levels.

Thank you for the detailed response. Never knew DHT can have an impact on neruoinflamation. I have anxiety so I am very glad I read this. I have been curious about primo on a trt protocol but haven't gone as far as to order some. Thank you for grounding me

 

[Rido]

There is no evidence that low dose primo long term is safew, and there isn't any that it isn't.

I have a feeling we will find out in the next 10 years.


What is your height, weight, and bodyfat OP?

 

[Jin23]

Thank you for the detailed response. Never knew DHT can have an impact on neruoinflamation. I have anxiety so I am very glad I read this. I have been curious about primo on a trt protocol but haven't gone as far as to order some. Thank you for grounding me

All androgens (outside of resolving hypogonadism) are going to be contraindicated for anxiety phenotypes. There are multiple pathways for this, the most notorious being activation of the HPA (fight or flight) axis, which is already chronically activated in anxiety disorders.

Amygdala, which is already hyper sensitive in anxiety disorders, has a lot of androgen receptors (maybe the most in the brain) to which anabolic's bind, some with greater affinity then testosterone and with greater second messenger responses, and that will aggravate any preexisting conditions.

There are plenty other mechanisms at play, like heightening excitatory neurotransmission directly via glutamate modulation, dopamine transmission upregulation and concomitantly serotonin downregulation, gaba downregulation, norepinephrine upregulation, etc. Everything consequently contributing to higher levels of inflammation as a common shared outcome, which then leads to even higher anxiety and depression. So even if there are no direct studies of this or that androgen causing inflammation, the pathways to it are still there as regardless of the type of androgen, it's still an androgen, the question is just which one is a worse offender then the other ...

Anyway, steroids are not healthy, they are a tool for you to get shit done, get you out of a bad situation, but beyond that, they need to be lowered. So this trt + / cruise protocols are really, really an unhealthy thing. Just because something is popular atm, has nothing to do with it being ok.

 

[Type-IIx]

Hello,

Did labs recently while on 140mg/week TRT protocol and my e2 came a bit high. I’m thinking about using ~70mg/week of Primo to control it, and then do another lab test around 3 weeks after starting Primo (according to steroidplotter it should be enough to saturate my system with it) to adjust if necessary.

Anyone else is doing it? How’s your experience and what ratio are you using?

I have Aromasin and about to receive Arimidex too, but would like to not use them. Maybe it’s foolish and lowering e2 is lowering e2, regardless of the route.

Lastly, my reasoning for going this route is due to primo helping with joints/tendons (I’m doing a combat sport), so anything extra is a plus. I don’t care about my hair.

Thank you!

The only thing foolish here is seeking to lower E2 because it came back "a bit high," rather than because of intolerable symptoms.

Aside from that, the use of a nonaromatizing androgen that increases the effective T/E2 ratio & has estrogen-lowering functions (rather consistently reduces serum E2 elevations & may prevent uptake of estrogens into certain cells/tissues) in addition to exogenous T is not foolish per se.

Considering your additional goal (to reducing serum E2) of deriving sports performance benefits, adding an AAS that augments bone & joint function, muscle size & strength, and enhances recovery from intense exercise could very well be the most rational choice.

Risk/Reward Balancing Example

Risks
AI:
AIs generally are associated with i) increased cardiovascular risk (though Aromasin seems to have reduced risk versus Anastrozole & Letrozole) by increasing LDL & increase risk for vascular injury and attenuated peripheral endothelial function), ii) arthalgia (bone/joint pain), largely because synovial cells express aromatase, that yields aromatic products & reduces local IL-6 expression. AIs cause a relative increase in IL-6 production, which is known to act as both a pro- & anti-inflammatory cytokine. & iii) hair loss (we won't discuss how/why, and we'll disregard it - because you stated that you "... don't care about [your] hair..."

AAS:
Risks: there are a plethora, see Peter Bond's work, Anabolic-androgenic steroids: How do they work and what are the risks? (2022). Without covering them all here, we can assess that you've already accepted them by being on TRT. Then, we should consider the magnitude of increased risk posed by 70 mg/w metenolone + 140 mg testosterone. Since 140 mg/w TRT is a high dose, above which cardiovascular risks & increased hematocrit/hemoglobin (HCT/Hb) tend to accrue for many, this will require an individual tradeoff assessment. Primo, more potently than testosterone, is a powerful hematinic agent, stimulatory of HCT/Hb. It is likely that you may end up with elevations to these parameters that indicate for routine (e.g., every 3 - 6 mo) therapeutic phlebotomies, that can be associated then with further unfavorable hematologic changes like iron transport status & blood iron levels.

Rewards:
AI
i) Reduced E2

AAS
i) Enhanced bone & joint function (opposite of arthalgia!) by increased BMD and anabolic actions in osteocytes, etc.
ii) Enhanced sport performance (by increased strength, speed, and recovery from intense exercise)
iii) Reduced E2

So, in conclusion here:

Nobody can stand in another's shoes and make their risk/reward assessment for them (but can frame objectively the important factors to consider). Those are the major risks & rewards to balance on your own.

Versus AIs, that similarly increase CV risk - the decisionmaking essentially boils down to, as the most significant factor, whether you are willing to accept an increased risk of a significant atherosclerotic cardiovascular or thrombotic event that may cause death (since taking no additional drugs is a third option, one can obviate risk by staying the course) & potentially with routine bloodlettings if necessary (they may very well not be, for you) in order to derive the benefit of enhanced sports performance (within the rules of your organization) & reducing E2 (if symptoms are unbearable).

 

[goulash_ragu]

Haha

But seriously, 75 is too high and it's not healthy. While it lowers oxidative stress in the brain (amongst other things), which is the reason why it's better to have higher estrogen in the brain during a cycle (it's also an anti-inflammatory in the blood and it's an vasodilator) it's a different story in the body when levels are chronically elevated. High serum levels predispose you to venous thrombosis. You can do genetics (think 23andme) and see if you are predisposed, as this is a fairly well studied field and see how susceptible you are to it. (however, having low androgens and high e2, predisposes you more to this, so this is a slight plus for you).

I'm sorry to hear that aromasin did you in, the 1kg loss of water would seem to indicate that your e2 levels were impacted more then you'd expect a 3mg dose to do. Was this UGL or pharma?

There is the chance of false blood work too as normal e2 testing isn't the most accurate.

1100 ngdl is high, that is going beyond trt, which should be around 600 - 700ngdl. With that high of a TT, your free T is definitely very much so in the supraphysiological range (so again, not trt but a cruise) especially when you couple it with the high e2 reading, it's logical.

If you want to be healthy, lower your trt dosage and your estrogen will take care of it self. If you insist on having such high levels, then consider doing more injections per week, as that will let your SHBG raise a bit and your free test and consequently e2 will drop. But the effect is not that pronounced. If you are fat, loose the fat, that will also help. This are the steps that avoid the use of an Ai.

All my AI is Mexican UGL/pharma. But it could be marketing. I will see if I can take another AI and check how I feel. I am eating at a deficit and doing tons of cardio, but not as lean as I was before pandemic. No visible rolls of fat, but I’m sure I could continue to lose.

There is no evidence that low dose primo long term is safew, and there isn't any that it isn't.

I have a feeling we will find out in the next 10 years.


What is your height, weight, and bodyfat OP?

I’m 5’8”-9” and about 190. Like I said above I don’t have rolls of fat or my love handles are about one finger thick when I pinch it, so around 20%+. I’m not kidding myself, I am fat. I do 3 hours of cardio per week and still am getting leaner, but for whatever reason it’s the legs that lose fat (I do stationary bike with HR of 120-140).

 

[goulash_ragu]

The only thing foolish here is seeking to lower E2 because it came back "a bit high," rather than because of intolerable symptoms.

Aside from that, the use of a nonaromatizing androgen that increases the effective T/E2 ratio & has estrogen-lowering functions (rather consistently reduces serum E2 elevations & may prevent uptake of estrogens into certain cells/tissues) in addition to exogenous T is not foolish per se.

Considering your additional goal (to reducing serum E2) of deriving sports performance benefits, adding an AAS that augments bone & joint function, muscle size & strength, and enhances recovery from intense exercise could very well be the most rational choice.

Risk/Reward Balancing Example

Risks
AI:
AIs generally are associated with i) increased cardiovascular risk (though Aromasin seems to have reduced risk versus Anastrozole & Letrozole) by increasing LDL & increase risk for vascular injury and attenuated peripheral endothelial function), ii) arthalgia (bone/joint pain), largely because synovial cells express aromatase, that yields aromatic products & reduces local IL-6 expression. AIs cause a relative increase in IL-6 production, which is known to act as both a pro- & anti-inflammatory cytokine. & iii) hair loss (we won't discuss how/why, and we'll disregard it - because you stated that you "... don't care about [your] hair..."

AAS:
Risks: there are a plethora, see Peter Bond's work, Anabolic-androgenic steroids: How do they work and what are the risks? (2022). Without covering them all here, we can assess that you've already accepted them by being on TRT. Then, we should consider the magnitude of increased risk posed by 70 mg/w metenolone + 140 mg testosterone. Since 140 mg/w TRT is a high dose, above which cardiovascular risks & increased hematocrit/hemoglobin (HCT/Hb) tend to accrue for many, this will require an individual tradeoff assessment. Primo, more potently than testosterone, is a powerful hematinic agent, stimulatory of HCT/Hb. It is likely that you may end up with elevations to these parameters that indicate for routine (e.g., every 3 - 6 mo) therapeutic phlebotomies, that can be associated then with further unfavorable hematologic changes like iron transport status & blood iron levels.

Rewards:
AI
i) Reduced E2

AAS
i) Enhanced bone & joint function (opposite of arthalgia!) by increased BMD and anabolic actions in osteocytes, etc.
ii) Enhanced sport performance (by increased strength, speed, and recovery from intense exercise)
iii) Reduced E2

So, in conclusion here:

Nobody can stand in another's shoes and make their risk/reward assessment for them (but can frame objectively the important factors to consider). Those are the major risks & rewards to balance on your own.

Versus AIs, that similarly increase CV risk - the decisionmaking essentially boils down to, as the most significant factor, whether you are willing to accept an increased risk of a significant atherosclerotic cardiovascular or thrombotic event that may cause death (since taking no additional drugs is a third option, one can obviate risk by staying the course) & potentially with routine bloodlettings if necessary (they may very well not be, for you) in order to derive the benefit of enhanced sports performance (within the rules of your organization) & reducing E2 (if symptoms are unbearable).

I am honored to see such a well put well researched response for my question, thank you!

Sounds like we have two camps now… but at least one thing you both agree on is that I should lower my test. Maybe I should go 120mg/week. As for primo, it’s really tempting. Maybe I should do it for 3-4 weeks, get the bloods and check if that dose helps with AI? Still kinda scared of running it for a long time.

 

[Rido]

All my AI is Mexican UGL/pharma. But it could be marketing. I will see if I can take another AI and check how I feel. I am eating at a deficit and doing tons of cardio, but not as lean as I was before pandemic. No visible rolls of fat, but I’m sure I could continue to lose.

I’m 5’8”-9” and about 190. Like I said above I don’t have rolls of fat or my love handles are about one finger thick when I pinch it, so around 20%+. I’m not kidding myself, I am fat. I do 3 hours of cardio per week and still am getting leaner, but for whatever reason it’s the legs that lose fat (I do stationary bike with HR of 120-140).

Your test is clearly too high. You should drop it to a reasonable dose like 700-900 instead of adding more drugs to control symptoms.

 

[goulash_ragu]

Your test is clearly too high. You should drop it to a reasonable dose like 700-900 instead of adding more drugs to control symptoms.

Quest’s range ends at 1100, and I still see numbers like that or 1050 as the high end on the internets. Do you have any studies I can read about it?

 

[Rido]

Quest’s range ends at 1100, and I still see numbers like that or 1050 as the high end on the internets. Do you have any studies I can read about it?

I don't need studies to say that your range is too high for you to handle.

You don't need to be in the high end if it requires for you to add more drugs so you can be in the high normal.


Since you wanna go off of reference ranges. Your e2 is outside the normal range. How about that?

 

[Jin23]

can be associated then with further unfavorable hematologic changes like iron transport status & blood iron levels.

I can not stress this enough, as it is very often overlooked, but I just found out for my self, that this has apparently been at the crux of my issues as well: androgens lover hepcidin, (basically the hormone which controls how much iron you absorb from food) which in turn starts raising your transferin saturation and your unbound iron levels. While doctors might look at your unbound serum iron levels, they don't ever look at your transferin. Maybe they check your ferritin, but that raises later in the game, after years on end of weird symptoms, anxiety, stuff like common yeast, fungal infections, hair loss, glucose metabolism problems, etc. you name it. Then your ferritin levels also gets raised and you finally might get diagnosed with hematomacrosis.

High transferin sat is a pita, get it regularly checked if you cycle friends. I found out that 5 months after being on cycle, my transferin sat was still at 70% (upper range limit is 45%), which means that on cycle it could have been in the 90's. After a quick blood donation (first one I ever did), my hair is coming back, my SHBG is falling (was at 100) and my libido is finally coming back, anxiety is dropping, my mind is more clear, etc.

High serum iron levels (high transferin sat) is more dangerous then old medical scripts would have one believe and I don't see anybody talking about it, everybody is talking mostly about hematocrit only ... However, I don't know how big of a problem this is, for people which are not genetically predisposed and I don't know how quickly hepcidin levels return to baseline. But seeing as there are many people who are either perma blasting or are on high trt+ / cruise dosages, this might be an issue that is plaguing many (whom don't need to donate blood), but can't seem to find out why they're having issues.

 

[Jin23]

Sounds like we have two camps now…

There is only one camp brother; this is not healthy, but if you are willing to risk your health, then go right ahead. The problem is that most people just aren't aware of all the potential problems and outcomes that cruising comes with, so they decide to do it. Having high dopamine and high motivation/drive and aggression/assertiveness is addicting.

 

[goulash_ragu]

I don't need studies to say that your range is too high for you to handle.

You don't need to be in the high end if it requires for you to add more drugs so you can be in the high normal.


Since you wanna go off of reference ranges. Your e2 is outside the normal range. How about that?

I mean that’s why I’m trying to lower it right. And that’s why I posted this whole thread.

There is only one camp brother; this is not healthy, but if you are willing to risk your health, then go right ahead. The problem is that most people just aren't aware of all the potential problems and outcomes that cruising comes with, so they decide to do it. Having high dopamine and high motivation/drive and aggression/assertiveness is addicting.

Yeah I see it now. It sucks to “downgrade”, but sometimes it’s what needs to be done. Thanks for your input again! No /s.

 

[Rido]

I mean that’s why I’m trying to lower it right. And that’s why I posted this whole thread.

Yeah I see it now. It sucks to “downgrade”, but sometimes it’s what needs to be done. Thanks for your input again! No /s.

Lower the T and it lower lower e2. Really that simple

 

[strongsafety41]

I see all points here, in the end it’s a personal decision as every reacts differently. Op is monitoring his labs which is a plus.

I don’t recall @goulash_ragu mentioning how long he planned to run this low dose primo with his TRT dose. Also, what ester are you running for your TRT, how many injections per week (the time of the draw), and how long after your pin was your lab draw?

 

[Rido]

I should be a little more understanding. If you wanted additional anabolism. "Trt plus" and stay that dose then that's fine.

If you simply want e2 control for full harm reduction, then you should drop down the test dose

 

[strongsafety41]

I should be a little more understanding. If you wanted additional anabolism. "Trt plus" and stay that dose then that's fine.

If you simply want e2 control for full harm reduction, then you should drop down the test dose

Nothing wrong with the way you stated it… but the your second response does add more clarity. Just about everyone that answered reads like they assume he was either calling it TRT or an addition to TRT.
I agree with what you said though, less drugs the better and if lowering your test dose achieves the goal of lowering your e2, then why not?
There still lies the question of accuracy of the lab test, in particular E2 and testosterone.