T Supression Avoidance With Prog And AI

vulture

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According to things I’ve read here and there when you use exogenous T:
1.- Supression of endogenous T mainly happens because there’s an increase in E levels due to aromatization
2.- Progesterone and AIs would reduce E levels

If we use Progesterone and AIs along with frequent and reasonable exogenous T (or HcG?), wouldn’t it prevent shutdown? This last thing would be measurable in LH levels.

Of course, I’m being pretty simplistic, but the main idea is that. I have tried and posted some things before, but certainly enemies though this idea seems reasonable, I’m not willing to risk my current good T levels with it.

I’m interested in your insights on this idea. Sincerely, this seems too good to be true for me, I mean, it would allow bodybuilders to start injecting and enjoying high anabolic levels while preventing suppression and PCTs...

thanks
 

NextLevel_

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I think there will always be suppression when using exogenous AAS.

Some of them are more suppressive while others are more „mild“.

When just talking T, I think it depends on the ester used (propionate aromatises less than cypionate for example), the dosage and length you have used the compound and individual genetics, body composition etc.

I don’t think that just by controlling estrogen that you don’t have a Suppression.

However HCG is always a good idea in my opinion as it stimulates LH, and therefore helps with regulation of the system.

I wouldn’t use progesterone and AI on cycle. AI only when absolutely necessary (when side effects of too much aromatization / too high estrogen occur.) or maybe in PCT.
I would rather manage or keep estrogen in control with adding a DHT based compound let’s say like proviron or masteron, or even androsterone, who all have (a little) anti estrogenic effects on their own, as well as reducing SHBG so more free T is available which is a good thing.
 
OP
vulture

vulture

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I think there will always be suppression when using exogenous AAS.

Some of them are more suppressive while others are more „mild“.

When just talking T, I think it depends on the ester used (propionate aromatises less than cypionate for example), the dosage and length you have used the compound and individual genetics, body composition etc.

I don’t think that just by controlling estrogen that you don’t have a Suppression.

However HCG is always a good idea in my opinion as it stimulates LH, and therefore helps with regulation of the system.

I wouldn’t use progesterone and AI on cycle. AI only when absolutely necessary (when side effects of too much aromatization / too high estrogen occur.) or maybe in PCT.
I would rather manage or keep estrogen in control with adding a DHT based compound let’s say like proviron or masteron, or even androsterone, who all have (a little) anti estrogenic effects on their own, as well as reducing SHBG so more free T is available which is a good thing.
Then Supression is not a thing that occurs only by estrogen rising
 

Mark21

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Jul 12, 2019
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I've read free T levels don't matter nearly as much as total T, that SHBG and Albumin are largely transporter molecules, and that testosterone becomes unbound from them at the androgen receptor site, often even being converted into DHT as well before coupling with the receptor.

I imagine there are other feedback mechanisms beyond Est levels, but I think that's the primary one so, your approach might work. Thing is it would be pretty hard to tell beyond roughly estimating the size of your balls as time goes on and if you're using Hcg I doubt you'll have any real way of knowing whether or not your approach is working.
 

tallglass13

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I don't think that is how it works, from what I have learned. Taking too much testosterone, like anything over the limit that we make normally, could cause HTP Axis supression. Ray said a young health male makes 7mg daily of testosterone. taking too much would spill over to estrogen , and cause shut down. If your brain and pituitary sense too much of a hormone , it seizes to make any more. Taking a AI can cause PCOS in females, and the same can happen in the male version of PCOS>
 
Last edited:

schultz

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Edit: Hopefully this post doesn't bore people... I found it interesting :yawn:

Taking a AI can cause PCOS in females, and the same can happen in the male version of PCOS>

I just checked Pubmed because I found this interesting. It seems as though, if anything, AI's have no effect on PCOS.

Here's a meta analysis: Aromatase inhibitors for PCOS: a systematic review and meta-analysis. - PubMed - NCBI

I've been researching the 4th generation AI's (I think they are 4th...) recently trying to figure them out. I haven't made much progress but there are some strange adverse reactions that people have had from them described in some case reports, like calcium metabolism going haywire and some vitamin D things, aside from the well known arthralgia. My current theory is that they mess with some other CYP enzymes, apart from CYP19A1, and probably pituitary and parathyroid hormone (which might all be connected with some CYP enzymes). This one - CYP24A1 - Wikipedia - plays an important role in calcium and vitamin D homeostasis. It, along with the PTH and pituitary, might explain the arthralgia people seem to get taking these things. I have trouble believing the low estrogen causes arthralgia theory personally.

Vitamin D and arthralgia
Relationship between unexplained arthralgia and vitamin D deficiency: a case control study. - PubMed - NCBI
"These findings indicate significant association of vitamin D deficiency and arthralgia."


There is some evidence vitamin D can help prevent the arthralgia from AI's (but also some evidence suggesting it is not a factor).


Vitamin D threshold to prevent aromatase inhibitor-induced arthralgia: a prospective cohort study. - PubMed - NCBI
"In the whole cohort, there was an increase in joint pain (mean 1.16 points SD 2.66; P < 0.001) and the increase was significantly (P = 0.02) attenuated in those that reached concentrations of 25(OH)D of ≥40 ng/ml, with a lower risk of incident arthralgia"

Vitamin D insufficiency and musculoskeletal symptoms in breast cancer survivors on aromatase inhibitor therapy. - PubMed - NCBI
"Patients reported muscle pain in the neck and back, and there was a significant inverse correlation between pain intensity and serum 25(OH)D levels (r = -0.422; P < .05 [2 tailed]). This sample of BCSs [breast cancer survivors] taking AIs had below normal levels of serum 25(OH)D despite vitamin D supplements. This is one of the few studies to document a significant relationship between vitamin D levels and muscle pain in BCSs on AI therapy."


Apparently 75-90% of women taking AI's are vitamin D deficient, and I would think almost all of these women are being treated for breast cancer. Just an interesting statistic. Is low vitamin D a factor in the development of breast cancer? Arthralgia as a side effect of AI's is mostly reported by women taking AI's (the majority of the people using these drugs) and 99.99% of these women are being treated for breast cancer.


Error - Cookies Turned Off
Moreover, musculoskeletal pains are common in breast cancer women, even before the initiation of AIs and in association with low vitamin D in the majority.

Vitamin D deficiency in newly diagnosed breast cancer patients Imtiaz S, Siddiqui N, Raza SA, Loya A, Muhammad A - Indian J Endocr Metab
"The mean serum vitamin D level in the breast cancer patients was 9.3 ng/ml... Vitamin D deficiency was seen in 95.6% (86) breast cancer patients"

Vitamin D Levels, Vitamin D Receptor Polymorphisms, and Inflammatory Cytokines in Aromatase Inhibitor-Induced Arthralgias: An Analysis of CCTG MA.27. - PubMed - NCBI
In a study by Khan et al, 1260 women who were beginning adjuvant AI therapy were supplemented with vitamin D at 50,000IU per week for 12 weeks if they had low baseline vitamin D levels (≤40 ng/mL). They reported that that the supplementation was effective in raising women’s vitamin D levels, and higher vitamin D level (25OHD>66 ng/mL) correlated with less joint pain and disability from joint pain.12In contrast, another prospective study with similar design only supplemented the women with vitamin D levels of<40 ng/mL with 16,000 IU of oral vitamin D3 every 2weeks. Half of the women failed to achieve vitamin D levels ≥ 40ng/mL at 3 months, and there was no improvement in joint pains.


https://www.ncbi.nlm.nih.gov/pubmed/21290264
A 65-year-old woman on anastrozole treatment because of a recurrent breast cancer developed hypercalcaemia and increased parathyroid hormone (PTH) levels 2½ years after start of the treatment. A diagnosis of hyperparathyroidism was suspected and the patient underwent neck surgery, but only normal parathyroid glands were found. Postoperatively, the hypercalcaemia as well as the PTH level continued to rise, and 9 months after exploration of the parathyroids her calcium level was extremely high (adjusted serum calcium = 3.39 mmol/l). Anastrozole was then withheld, and within 2 weeks the severe hypercalcaemic state turned into hypocalcaemia. A month later, anastrozole treatment was started again, and after 6 weeks her calcium and PTH values had returned to extremely high levels. After withdrawal of anastrozole, calcium and PTH concentrations again fell toward normal values. The urinary excretion of calcium was very low during anastrozole treatment and high after cessation of the drug. The mechanism(s) by which anastrozole can cause hypercalcaemia are unknown.
 

tallglass13

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Joined
Dec 29, 2015
Messages
836
Edit: Hopefully this post doesn't bore people... I found it interesting :yawn:



I just checked Pubmed because I found this interesting. It seems as though, if anything, AI's have no effect on PCOS.

Here's a meta analysis: Aromatase inhibitors for PCOS: a systematic review and meta-analysis. - PubMed - NCBI

I've been researching the 4th generation AI's (I think they are 4th...) recently trying to figure them out. I haven't made much progress but there are some strange adverse reactions that people have had from them described in some case reports, like calcium metabolism going haywire and some vitamin D things, aside from the well known arthralgia. My current theory is that they mess with some other CYP enzymes, apart from CYP19A1, and probably pituitary and parathyroid hormone (which might all be connected with some CYP enzymes). This one - CYP24A1 - Wikipedia - plays an important role in calcium and vitamin D homeostasis. It, along with the PTH and pituitary, might explain the arthralgia people seem to get taking these things. I have trouble believing the low estrogen causes arthralgia theory personally.

Vitamin D and arthralgia
Relationship between unexplained arthralgia and vitamin D deficiency: a case control study. - PubMed - NCBI
"These findings indicate significant association of vitamin D deficiency and arthralgia."


There is some evidence vitamin D can help prevent the arthralgia from AI's (but also some evidence suggesting it is not a factor).


Vitamin D threshold to prevent aromatase inhibitor-induced arthralgia: a prospective cohort study. - PubMed - NCBI
"In the whole cohort, there was an increase in joint pain (mean 1.16 points SD 2.66; P < 0.001) and the increase was significantly (P = 0.02) attenuated in those that reached concentrations of 25(OH)D of ≥40 ng/ml, with a lower risk of incident arthralgia"

Vitamin D insufficiency and musculoskeletal symptoms in breast cancer survivors on aromatase inhibitor therapy. - PubMed - NCBI
"Patients reported muscle pain in the neck and back, and there was a significant inverse correlation between pain intensity and serum 25(OH)D levels (r = -0.422; P < .05 [2 tailed]). This sample of BCSs [breast cancer survivors] taking AIs had below normal levels of serum 25(OH)D despite vitamin D supplements. This is one of the few studies to document a significant relationship between vitamin D levels and muscle pain in BCSs on AI therapy."


Apparently 75-90% of women taking AI's are vitamin D deficient, and I would think almost all of these women are being treated for breast cancer. Just an interesting statistic. Is low vitamin D a factor in the development of breast cancer? Arthralgia as a side effect of AI's is mostly reported by women taking AI's (the majority of the people using these drugs) and 99.99% of these women are being treated for breast cancer.


Error - Cookies Turned Off
Moreover, musculoskeletal pains are common in breast cancer women, even before the initiation of AIs and in association with low vitamin D in the majority.

Vitamin D deficiency in newly diagnosed breast cancer patients Imtiaz S, Siddiqui N, Raza SA, Loya A, Muhammad A - Indian J Endocr Metab
"The mean serum vitamin D level in the breast cancer patients was 9.3 ng/ml... Vitamin D deficiency was seen in 95.6% (86) breast cancer patients"

Vitamin D Levels, Vitamin D Receptor Polymorphisms, and Inflammatory Cytokines in Aromatase Inhibitor-Induced Arthralgias: An Analysis of CCTG MA.27. - PubMed - NCBI
In a study by Khan et al, 1260 women who were beginning adjuvant AI therapy were supplemented with vitamin D at 50,000IU per week for 12 weeks if they had low baseline vitamin D levels (≤40 ng/mL). They reported that that the supplementation was effective in raising women’s vitamin D levels, and higher vitamin D level (25OHD>66 ng/mL) correlated with less joint pain and disability from joint pain.12In contrast, another prospective study with similar design only supplemented the women with vitamin D levels of<40 ng/mL with 16,000 IU of oral vitamin D3 every 2weeks. Half of the women failed to achieve vitamin D levels ≥ 40ng/mL at 3 months, and there was no improvement in joint pains.


Anastrozole can cause severe hypercalcaemia mimicking primary hyperparathyroidism. - PubMed - NCBI
A 65-year-old woman on anastrozole treatment because of a recurrent breast cancer developed hypercalcaemia and increased parathyroid hormone (PTH) levels 2½ years after start of the treatment. A diagnosis of hyperparathyroidism was suspected and the patient underwent neck surgery, but only normal parathyroid glands were found. Postoperatively, the hypercalcaemia as well as the PTH level continued to rise, and 9 months after exploration of the parathyroids her calcium level was extremely high (adjusted serum calcium = 3.39 mmol/l). Anastrozole was then withheld, and within 2 weeks the severe hypercalcaemic state turned into hypocalcaemia. A month later, anastrozole treatment was started again, and after 6 weeks her calcium and PTH values had returned to extremely high levels. After withdrawal of anastrozole, calcium and PTH concentrations again fell toward normal values. The urinary excretion of calcium was very low during anastrozole treatment and high after cessation of the drug. The mechanism(s) by which anastrozole can cause hypercalcaemia are unknown.
I am not sure a PubMed will offer that information, however, I found that Letrozole was used in studies to induce PCOS. I don't remember at the moment for what it was for, I think I was researching Diol-G or something. When you completely block estrogen, people are at risk for health problems. Estrogen is needed , otherwise our bodies would no make it. I will try to find the studies.
 

schultz

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Jul 29, 2014
Messages
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I am not sure a PubMed will offer that information, however, I found that Letrozole was used in studies to induce PCOS. I don't remember at the moment for what it was for, I think I was researching Diol-G or something. When you completely block estrogen, people are at risk for health problems. Estrogen is needed , otherwise our bodies would no make it. I will try to find the studies.

Thank you, if you can find it that would be awesome.

We definitely need estrogen at some points in our life, I just doubt the sore joints people experience on AI's is because estrogen is too low. I may be wrong though. The idea that aromatase inhibitors act solely on 1 enzyme in the body and don't have any other effects is ludicrous IMO. The question is, why other enzymes is it acting on? What else are these AI's doing in the body? I'm not sure they really care to find out TBH as they would like these drugs to neatly do 1 single thing, which, again, I think is highly unlikely.

They brought men's estrogen down to almost undetectable levels using high doses of DHT for 2 years and nobody complained of sore joints. There were actually no side effects. Libido was unaffected as well. Growing humans and cycling women probably need more estrogen. Adult men probably need very little. Even if it is completely and totally blocked, we might be able to get by without it. Ray talked about histamine being able to mimic the effects of estrogen. There may be other things in the body that can do this. Also, bacteria may be able to synthesize estrogen like hormones which could be absorbed through our intestine. There can also be various estrogens in our food. It is quite ubiquitous. Bacteria can do so wacky stuff, like this one which can convert glucocorticoids into androgens.

Ray Peat
"Histamine mimics estrogen's effects on the uterus, and antihistamines block estrogen's effects"
 

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