What do you consider too high for E2 if you aren’t exhibiting any other symptom like bloating? I’m mainly concerned that I don’t have symptoms but may develop gyno if it stays too high

AlphaMD's Answer

We generally are concerned when someone starts to be near 40+ & want to do something about it at 50+. Most times this does come with symptoms, and some men get them even earlier, though others have reported being content in this range. Basically, some men are more estrogen sensitive than others. I have treated men who get high E2 symptoms at 35, and had some men with E2 over 100 with absolutely no symptoms. TRT is an incredibly individual treatment, and men vary widely in their response to treatment doses, frequency, and rates of aromatization.

We would suggest just getting tested to be sure. If you're testing for high E concerns, you can do it 1 day after an injection so you can see what your highest spike may be. It's certainly possible that you may be having high E symptoms like mild mood issues or ED without having sensitive nipples etc.

Nearly all cases of gynecomastia start with nipple sensitivity, so be mindful of that symtpom. Also, be reassured that gynecomastia takes months and months of prolonged exposure to high E2 to develop. No one grows boobs overnight. And in those that do develop it, most mild cases (grades 1 and 2) can be completely cured with tamoxifen or raloxifene.