Where to begin, this touches on a nitpick I've had for a really long time. So, to each is own. But for me, the short answer is yes.
One of the most annoying things I see in the TRT community (particularly on Youtube) is bros spreading pro-estrogen dogma. Everything from "don't worry about E2," "aromatase inhibitors are toxic," to shit as bizarre as "estrogen is a systemic health hormone!"
I agree with essentially none of it, except for maybe the idea AI's are toxic. Half the risks from androgen therapy is due to the aromatization process. High blood pressure, edema, thrombosis and heart attacks, irritability, sexual dysfunction, and depression are all made worse when estrogen is out of control. Now, what constitutes as "out of control?" Smarter minds than me might could help answer that.
As a general rule of thumb I typically always question pre-designated reference ranges on labs. And estrogen is no exception. As long as nothing looks majorly out of whack, then I'm far more supportive of going by personal symptoms (or lack thereof).
I think overall androgenicity to estrogenicity ratio plays an important role. It's not uncommon for hypogonadal men to have low estrogen just as much as low testosterone. But their T:E2 ratio is what's damaged the most, leading to the adipose accumulation, lack of drive, sexual dysfunction, depression, etc. And since estrogen stimulates CRH and ACTH, it increases the level of cortisol being secreted, which can increase the depressive (glucocorticoid antagonists have been studied for possible treatment to depression) effects of estrogen dominance even more, while eliciting an irritable hostility.
Estrogen also increases the action of tryptophan hydroxylase, which creates higher amounts of serotonin, both estrogen and serotonin can synergize in suppressing gonadotropin and LH, while increasing prolactin. Which can contribute to a really nasty feedback loop keeping you stuck in this situation until you intervene and fix it.
The one thing I do happen to agree with is the toxic effect of many aromatase inhibiting drugs, like Arimidex. Which can increase autoimmunity. Exemestane can be bad as well if you fuck up and take too much, because being a suicidal inhibitor you'll be in a prolonged state of low estrogen until you can make more aromatase. Low estrogen is also bad, which I'm sure you're well aware of. But there's much safer ways to control estrogen than AI's anyway.
Lower more frequent dosages of T can help prevent the rise in estrogen. Fat soluble vitamins A, D, & E can help. Vitamin E is actually an antagonist at the estrogen receptor. Zinc and/or aspirin act as mild aromatase inhibitors. Various flavonoids have been used and being researched for aromatase antagonism, some of them being quite potent in fact (look up 7-hydroxy-4-imidazolylflavan). 5ar androgens such as DHT can also keep the lid on estrogen. Interestingly, another commenter mentioned cialis for helping with erection quality, it also seems to help with the testosterone:estradiol ratio, and the mechanism behind which is hypothesized to be aromatase inhibition! (
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So if you ask me, yes I do fear estrogen. But this is a personal thing for me. I am also biased, and I deal with a condition that makes me more sensitive to estrogen and higher aromatase activity. When people like Derek get on Youtube and talk about the glories of estrogen, I think they forget they're talking to a much wider audience than just heavy cycle users who also use very potent and potentially toxic AI drugs that can easily crash E2. To those people, low estrogen is certainly a problematic situation. But to tell the "Average Joe" out here he shouldn't worry about estrogen is misleading and potentially dangerous advice.