Estrogen and SERMs - Post SERM Syndrome?

[PointOutside]

Could the SERMs I took two years ago after taking steroids permanently crash my E2? I simultaneously have high and very low E2 symptoms combined after I took Nolvadex in a PCT. Testicles hang very high and gyno is as puffy as ever and half-working penis for a few years now. When I started Thiamine all of my symptoms temporarily went away - gyno disappeared and strong morning wood and erections came back, testicles hung low. It doesn't have that effect anymore. Testosterone is fine (higher than it was prior to steroids when everything was fine), progesterone is fine, E2 shows up extremely low (usually single digits) but also I have high E2 symptoms. It's a strange thing. There isn't anything physically wrong with my penis since Viagra gives me very, very hard erections. There's just something wrong with my Estrogen and somehow I seem to have some sort of "Post-SERM syndrome" or maybe it was the AI I took on cycle? "Post-AI Syndrome?"

At this point I'm considering going on higher dose TRT just to get my E2 to at least 10 pg/mL where I'm usually less than that. Last BW Testosterone came in the higher 500s ng/dL. My body refuses to aromatize. I'm not crazy lean either, by the way.

I'm so lost with this issue.

 

[conrad0602]

Could the SERMs I took two years ago after taking steroids permanently crash my E2? I simultaneously have high and very low E2 symptoms combined after I took Nolvadex in a PCT. Testicles hang very high and gyno is as puffy as ever and half-working penis for a few years now. When I started Thiamine all of my symptoms temporarily went away - gyno disappeared and strong morning wood and erections came back, testicles hung low. It doesn't have that effect anymore. Testosterone is fine (higher than it was prior to steroids when everything was fine), progesterone is fine, E2 shows up extremely low (usually single digits) but also I have high E2 symptoms. It's a strange thing. There isn't anything physically wrong with my penis since Viagra gives me very, very hard erections. There's just something wrong with my Estrogen and somehow I seem to have some sort of "Post-SERM syndrome" or maybe it was the AI I took on cycle? "Post-AI Syndrome?"

At this point I'm considering going on higher dose TRT just to get my E2 to at least 10 pg/mL where I'm usually less than that. Last BW Testosterone came in the higher 500s ng/dL. My body refuses to aromatize. I'm not crazy lean either, by the way.

I'm so lost with this issue.

I don't think peat believes the estrogen blood test is very accurate as you can have estrogen inside the cell but little showing up in the blood. Couldn't hurt to try some progesterone. If your high e2 symptoms worsen with progesterone it probably means you were high estrogen and it's being pulled from the cells (at which point the blood test would probably more accurately represent your estrogen level) and you'd just need to ride it out untill you're no longer estro dominant.

 

[mostlylurking]

Could the SERMs I took two years ago after taking steroids permanently crash my E2? I simultaneously have high and very low E2 symptoms combined after I took Nolvadex in a PCT. Testicles hang very high and gyno is as puffy as ever and half-working penis for a few years now. When I started Thiamine all of my symptoms temporarily went away - gyno disappeared and strong morning wood and erections came back, testicles hung low. It doesn't have that effect anymore. Testosterone is fine (higher than it was prior to steroids when everything was fine), progesterone is fine, E2 shows up extremely low (usually single digits) but also I have high E2 symptoms. It's a strange thing. There isn't anything physically wrong with my penis since Viagra gives me very, very hard erections. There's just something wrong with my Estrogen and somehow I seem to have some sort of "Post-SERM syndrome" or maybe it was the AI I took on cycle? "Post-AI Syndrome?"

At this point I'm considering going on higher dose TRT just to get my E2 to at least 10 pg/mL where I'm usually less than that. Last BW Testosterone came in the higher 500s ng/dL. My body refuses to aromatize. I'm not crazy lean either, by the way.

I'm so lost with this issue.

So the thiamine worked and then stopped working? How much were you taking? What kind?

 

[TobyBjorn]

Sorry to hear this man!
It is my opinion that a SERM would be very unlikely to cause long-term suppression of E. Indeed, even acute doses do not crush E very low, as can conversly happen with aromatase inhibitors as you mention.
The temporary ameliorating effects of thiamin you describe could be due to dopamine (D) effects; high doses of lipid soluable thiamin modulate D in such a way as to cause a transient powerful increase in D followed by a return to homeostasis. For many men, sexual response is strongly associated with dopaminergic effects, both directly and through D’s modulation of both prolactin and cortisol. Many of the estrogenic sexual effects can be caused (or at least augmented) by elevated prolactin or cortisol. Both P and C have further effects on downstream hormones, including E.
That isn’t to say I think you have high prolactin, but instead to suggest that there are complex feedback loops involved in the erectile response, and prolacin could be involved at least in your initial response to tiamin. Not to mention the involvement of the melanocortin system; do you get a lot of sun?
High T and low E2 does resemble AI use; are you using TRT from a compounding pharmacy? Some boneheaded clinics put an AI in the bottle with the T.

*despite being a Peat fan since 2010 I am uncertain of the Peatiness and/or veracity of my claims and opinions. I welcome correction. English is not my first language, so spelling is often in error.*

 

[PointOutside]

Sorry to hear this man!
It is my opinion that a SERM would be very unlikely to cause long-term suppression of E. Indeed, even acute doses do not crush E very low, as can conversly happen with aromatase inhibitors as you mention.
The temporary ameliorating effects of thiamin you describe could be due to dopamine (D) effects; high doses of lipid soluable thiamin modulate D in such a way as to cause a transient powerful increase in D followed by a return to homeostasis. For many men, sexual response is strongly associated with dopaminergic effects, both directly and through D’s modulation of both prolactin and cortisol. Many of the estrogenic sexual effects can be caused (or at least augmented) by elevated prolactin or cortisol. Both P and C have further effects on downstream hormones, including E.
That isn’t to say I think you have high prolactin, but instead to suggest that there are complex feedback loops involved in the erectile response, and prolacin could be involved at least in your initial response to tiamin. Not to mention the involvement of the melanocortin system; do you get a lot of sun?
High T and low E2 does resemble AI use; are you using TRT from a compounding pharmacy? Some boneheaded clinics put an AI in the bottle with the T.

*despite being a Peat fan since 2010 I am uncertain of the Peatiness and/or veracity of my claims and opinions. I welcome correction. English is not my first language, so spelling is often in error.*

Thanks for the thorough response. I’m actually not on any hormone replacement. Testosterone is normal right now, free and total. Following my ordeal with steroids something changed and never returned, and indeed anything dopaminergic helps my symptoms across the board including erections. However, my prolactin came back at the center of the reference range and an email from peat says my prolactin is fine.



What you say about Thiamine makes sense to me. I just can’t figure out what “broke” and it’s been puzzling me for years.

Ive tried so many things: eating Peaty, hundreds of supplements, I actually started getting a lot of sun this week and I just realized today my libido is actually really high relative to how it normally is.

I also notice when I’m on vacation my libido goes up, but that could just be the effects of having a lot of fun? But every vacation I go on I tan the majority of the day.

here’s the thing though: I’ve taken D3 (and K2) long term so many different times and brought up my D levels pretty high and never felt any change. Vitamin D supplements (of different brands) all have always done absolutely nothing for me… but it seems like the more tan I am the higher my libido and well-being is. Naturally, I’m ghostly pale while my father is pretty dark skinned.

also another thing: lately methylfolate has been giving me dopaminergic effects (MTHFR C677T homozygous mutation) and proved my baseline in terms of symptoms but not cured, still struggle with erections but they’re definitely a bit better

and last thing that could be relevant: the day after drinking alcohol (which I haven’t done in a year with the exception of last week) feels amazing… high libido, insane mood boost, I just feel so right a day after drinking. But I do avoid alcohol 99% of the time.
Any ideas?

 

[TobyBjorn]

Thanks for the thorough response. I’m actually not on any hormone replacement. Testosterone is normal right now, free and total. Following my ordeal with steroids something changed and never returned, and indeed anything dopaminergic helps my symptoms across the board including erections. However, my prolactin came back at the center of the reference range and an email from peat says my prolactin is fine.



What you say about Thiamine makes sense to me. I just can’t figure out what “broke” and it’s been puzzling me for years.

Ive tried so many things: eating Peaty, hundreds of supplements, I actually started getting a lot of sun this week and I just realized today my libido is actually really high relative to how it normally is.

I also notice when I’m on vacation my libido goes up, but that could just be the effects of having a lot of fun? But every vacation I go on I tan the majority of the day.

here’s the thing though: I’ve taken D3 (and K2) long term so many different times and brought up my D levels pretty high and never felt any change. Vitamin D supplements (of different brands) all have always done absolutely nothing for me… but it seems like the more tan I am the higher my libido and well-being is. Naturally, I’m ghostly pale while my father is pretty dark skinned.

also another thing: lately methylfolate has been giving me dopaminergic effects (MTHFR C677T homozygous mutation) and proved my baseline in terms of symptoms but not cured, still struggle with erections but they’re definitely a bit better

and last thing that could be relevant: the day after drinking alcohol (which I haven’t done in a year with the exception of last week) feels amazing… high libido, insane mood boost, I just feel so right a day after drinking. But I do avoid alcohol 99% of the time.
Any ideas?

This is certainly a complex issue that would be tricky to nail down with certainty, but I am confident you will arrive at a solution.
Interestingly, many physiological responses to sun exposure independent of vitamin D work together to support libido and joie de vivre, which themselves are an inextricably linked pair of energies. Indeed, libido in the Wilhelm Reich sense is supported by and likely dependent on direct sun exposure. Synthetic α-MSH analogs are widely used as sexual desire enhancers (bremelanotide) and have been researched for erectile disfunction.
Obviously it can be difficult to compare vacation to daily life for many of us, but could you isolate factors such as sleep and hydration?
I am no more certain about the alcohol effects you note. It makes me wonder about osmolyte balance and blood volume, but at the same time it seems so unlikely that blood volume issues would remain so elusive. Do you drink a lot of distilled or reverse osmosis filtered water?

 

[Mister]

Anything that fcks with your hormone balance can give you hypogonadal, post finasteride syndrome,... like symptoms imo.

 

[PointOutside]

This is certainly a complex issue that would be tricky to nail down with certainty, but I am confident you will arrive at a solution.
Interestingly, many physiological responses to sun exposure independent of vitamin D work together to support libido and joie de vivre, which themselves are an inextricably linked pair of energies. Indeed, libido in the Wilhelm Reich sense is supported by and likely dependent on direct sun exposure. Synthetic α-MSH analogs are widely used as sexual desire enhancers (bremelanotide) and have been researched for erectile disfunction.
Obviously it can be difficult to compare vacation to daily life for many of us, but could you isolate factors such as sleep and hydration?
I am no more certain about the alcohol effects you note. It makes me wonder about osmolyte balance and blood volume, but at the same time it seems so unlikely that blood volume issues would remain so elusive. Do you drink a lot of distilled or reverse osmosis filtered water?

Strange things happening: I took 200 IU Vitamin E yesterday and today and both times I noticed an increase in libido. I know Vitamin E lowers E2. But my serum E2 is borderline nonexistent prior to this. I don't even understand this is happening. Extremely high tissue E2 but very very low serum E2? So far it's helping but who knows how long this lasts for.