Hello everyone, welcome to the TRT and Hormone Optimization YouTube channel. I'm Danny Bossa, joined today with Dr. Jordan Grant and Gil T. How are you guys doing? Doing well.
Doing well. Awesome. So today's video, yet another YouTube video, but not just another YouTube video. We've done a one-hour YouTube video, Jordan Grant and I, doing an absolute deep dive into why you should never use an AI. Why?
Estrogen should not be blocked, what is the rule of men, and so on and so forth. And we went into a lot of depth. The problem is that when we send this video to people that are not quite agreeing with the point of view we're trying to get across, the initial reaction is, oh the video is too long.
So we're going to take this opportunity and do a very short, condensed, layman's terms explanation in hopefully 10 minutes, so that hopefully you guys can take 10 minutes and watch it. And we will also be providing a link to the Google Drive that Jordan Grant put together. in the description of the video so you can go in and check everything out.
If you're going to do that, I would strongly suggest looking at the one file called estradiol as a meal hormone. If you're going to choose any of them to read, that will be the one to read. And then by all means, you can come back with your thoughts, comment on the video.
So guys, I leave it to you. Gil. Jordan, you want to start by explaining the benefits of estradiol, specifically being that it's the most potent of the estrogens and it is the direct descendant of the romanization.
of testosterone, maybe explain some of the key benefits so people understand why estrogens are important in both men and women. Sure. And yeah, it's very closely related to testosterone. Obviously, they're molecular. They're not that different, but they do very different things.
Outside of what they do in development, I think is not applicable here when we're developing in the womb and all that, as far as sex goes. Estrogen is very important in reproduction, but outside of that... In general, there's a few things that are the most important that we talk about.
Number one would be cognition and brain health. Aromatase is expressed in the brain. E2 is made there directly at neurons.
It is there for neural protection. And aromatase actually increases during traumatic brain injury to try to protect the brain. They've shown that it helps with certain types of memory. When you block E2 in men or castrate a man, you can tell right away they don't think like they used to. So from a CNS standpoint, it's neuroprotective and helps their bone.
Is it the big one that we all think about? We think about women who are postmenopausal losing bone density. Estradiol is very important in bone turnover and preventing that. Androgens are important as well for that. But without the estradiol there, you still lose bone mineral density as a man if you don't have estradiol.
Estradiol is made there in the bone tissue as well. Another big one is protection on the cardiovascular system or the endothelial lining of your blood vessels. So E2 seems to promote nitric oxide production and promotes basically the safety there, basically the protection. And that's what nitric oxide does. And there's probably other factors at play, too, and blood pressure regulation, everything like that.
But that's a big one. And then libido also. I forgot to mention that.
E2 is a big driver of libido. They've done all kinds of studies where they block aromatase in animals, a lot of them, and it decreases their mating behavior, changes mating behavior and all that. We see it in men, too. When they don't have adequate E2, they don't have adequate libido.
I'd say those are the big ones. Another one is metabolism, actually. People don't think about it that way. They think of E2 as making you fat. And it actually doesn't work like that.
E2 is a huge driver of insulin sensitivity. And people who have low E2 tend to be more insulin resistant. E2 is a big driver of growth hormone secretion as well, whereas testosterone is not so much.
So that's a big one. And there are some studies showing that even in adipocytes, fat cells, E2 actually helps with lipid metabolism or trying to get the body to protect itself. It doesn't make you fatter. You increase aroma taste with fat cells for a reason.
increases leptin levels and things like that. So that's another big one. It also helps with visceral fat loss. So those are kind of the top, I think, some of the big ones that we talk about all the time, at least.
Okay, good. So now here's a really important factor. This is where people really need to follow this and understand what's going on.
Now that we kind of understand in a nutshell, how important estrogen is to the body, both in men and women, we need to understand how it's made, okay, and where it's made. So when guys go out there, and they get what's known as a serum estradiol test, whether it's ultra sensitive, or clear, or whatever panel you're getting, what you're testing is how much estrogen or estradiol specifically is present in your plasma, this is the liquid part, the non you know, erythrocyte, leukocyte, or thrombocytes within your blood. It's the plasma in your blood, which is responsible for carrying hormones and nutrients. This is simply a spillover of the actual amount of estradiol in your tissues, and here's the reason for it. What you need to understand is there's various types of glands in your body, primarily glands known as endocrine and glands known as exocrine.
Exocrine glands are glands that contain ducts, and they excrete blood. secretions and hormones outside of the body. These would be sebaceous glands, sweat glands, saliva glands, things that essentially excrete outward.
Endocrine glands are glands that secrete directly into the bloodstream or into the serum for transport throughout your entire body to every cell and organ and tissue. So endocrine hormones are secreted specifically by endocrine glands, and these could be your hypothalamus, your pituitary, your testicles, and so forth. So when testosterone is produced in a man, it is primarily produced in the testicles via a gonadotropin signal from the pituitary gland. Testosterone then enters the serum or the plasma of the blood and travels throughout the body. Now notice in men and in postmenopausal women, estrogen is not an endocrine hormone.
What does this mean? It is not produced by a gland and secreted into the blood like testosterone is. So this means that when we're testing the serum level. In a man for estrogen, that would be equivalent to looking inside Bill Gates'wallet to find out how much he's worth.
Because if he's got $200 in cash there, we don't go back and say, okay, well, he's worth 200 bucks. We don't know what he's got elsewhere, right? So when we're checking our estrogen levels in our serum, we're taking a snapshot in time of how much is actually traveling around. But Jordan, why don't you explain how estrogen is actually produced via aromatization and where this actually takes place?
Sure. So I used to be under the misconception, like most of us are, that testosterone is just converting to estrogen just out in the bloodstream, out there in the body and floating around. And aromatase is actually an intracellular enzyme. So estradiol is actually made within the cells, which is a huge game changer in thinking that it's floating around acting systemically. So In every cell and every target tissue, there's varying levels of the aromatase enzyme.
So testosterone, as it diffuses through the cell, attaches to aromatase, for lack of a better explanation. And that is then converted into estradiol, which acts locally and probably in a paracord manner as well on nearby tissues, but in the tissue, in the target tissue, and is deactivated there as well. a tiny amount will spill over into the systemic circulation, and that's what you're picking up on the serum E2 test.
Every tissue where aromatase is present will have different levels of E2. That is the game changer here. You have maybe 50% less in your bone than in your serum, whereas in other tissues you have 100-fold greater than in your serum. When you block E2, you block it everywhere. So essentially, just for those that don't understand, an enzyme is essentially a catalyst.
It's something that attaches to a molecule. and creates a chemical reaction and reduces the amount of energy required to create that reaction. So enzymes could be anabolic or catabolic. So aromatase is a catabolic hormone. It attaches to a testosterone molecule, knocks a few carbons off, knocks a few hydrogens off, and converts it to estradiol.
That estradiol conversion does not happen in the bloodstream, right? It happens in the cells of the tissues where it is needed. This is a self-regulating negative feedback system.
So When we are blocking the aromatase enzyme or inhibiting it by using aromatase inhibitors, what we're doing is we're preventing the formation of aromatase in our entire body and therefore depriving the tissues that require it, like you spoke earlier, our heart, our brain, our prostate, testicles, liver, kidneys, et cetera. All of these organs that require this hormone are essentially now being deprived of the hormone for the sake of adjusting a serum level, which as we know is not even in effect, right? So everything we just said is in the studies. These are random clinical trials and peer-reviewed studies that were published, and they're all going to be linked in this video. So everything we just said could be verified.
Think of this video more of it as like an abstract or a CliffsNotes version of what these studies actually... contained because we've read these thoroughly. We've discussed them for the course of about a year now back and forth.
And no matter how much of this we put out there, people are still going back to that old fashioned thinking of estrogen is bad, block it, block it, block it. And they're blaming all of these issues on estrogen. So I know this question is going to come up and maybe you could touch on this a little bit. All of these so-called estrogenic side effects that guys are getting.
Okay. I know that this is more of an umbrella or general type of an approach to try to answer it in one. But what would you say is related? Would you say that it's mostly that they haven't tied in a balance of hormonal harmony per se, or they haven't adjusted their protocol accordingly yet, and they're looking for something to blame?
It could even be nutritional, right? What would you say to that? I'd say there's a few top contenders there.
Number one, most guys have never been dialed in on testosterone alone. That's the number one thing we see are just bad protocols. The second thing is they'll be started from the get-go on testosterone, ACG, and an AI, so they never know what's doing what. And they're also fed mentally from the providers that are giving these things that estradiol is bad.
So then there's a nocebo effect that if they do test their estradiol and they see that it's out of range, which it will be naturally taking testosterone without an AI, they think they're supposed to have symptoms. They look for the ways they're feeling. They blame it on E2, and they get back on their AI. And I see this.
We see it all the time. Guys say this every day. And the guys that we've gotten off their AIs used to say it. And they can attest to this that they don't say it anymore. And it's not their E2.
So the main takeaway from this, if you had to summarize this in a sentence, would be don't block aromatization. Don't worry about your estrogen. It is self-regulating.
Worry about optimizing your androgens and leading a healthy lifestyle and everything else falls into play. Would you agree? I would agree with that.
I would say that something other people do need to know is that estradiol is made in men in the testes and it is secreted into the bloodstream. It's about 15% of the circulating estradiol. When men are on TRT, that is shut down.
Obviously, if they take HCG, that's where some of the issues probably can come into play. If you're spiking it too often or not or in too big of spikes, you may get a mismatch there where estrogen could act as an endocrine hormone if you're flooding the system non-physiologically. That is something I did want to mention. So as a urologist, would you confirm also that the estradiol that actually aromatizes within the testicles, its primary focus is to be present for fertility? Absolutely.
And then once you're on T, if fertility is no longer a concern, it becomes moot and you really shouldn't have to worry about it, even if it is picked up in serum. Absolutely. In fact, I think I posted a study recently on the intratesticular levels of estradiol. And I mean, they were enormous compared to what eventually makes it into the bloodstream. Right.
which explains again why producing intratesticular testosterone with gonadotropins like HCG improve fertility because it's not necessarily the LH directly. It is more so the intratesticular estrogen that allows the Sertoli cells to go to work. Yeah. Plus FSH, but that's a different, it's not a hundred percent needed. Exactly.
Danny, anything to add? Yeah. One of the big things we hear often about guys who we're on the, I need an AI, I need an AI, I can't go do well unless I have an AI, that are starting to get towards the point of realizing that they don't.
When they are right in the middle, they're saying, well, I don't want to block it all the way. I only want to block it a little bit. So I'm just going to take a little bit. So if you guys are one of those, or when I say you guys, the people watching, if you're in that frame of mind where, but I only want to block it a little bit, rewind the video. Listen to it one more time and ask yourself why you would even want to block it a little bit.
You're probably going to say, I want to block it a little bit because I have these issues. I have water retention. I'm getting this, I'm getting that, whatever. In virtually every single case, and Jordan, Gil, and I are in the same Facebook group, and we see this on a daily basis.
It is either due to taking too much testosterone, too little testosterone, or a frequency of injection that isn't optimal for you. If you're having fluctuations, especially the guys doing once-weekly injections, The ones that come in the group that are doing once weekly injections right away, we say, there's your issue. Get off the AI, do at least twice weekly, get back to us eight weeks later.
And virtually every time they come back, they said it's made a world of difference. And we've now seen this. I mean, it's hundreds, if not thousands of times, it's been demonstrated over and over and over.
Okay. So I did one video about optimizing protocol in regards to how to figure out how often you need to inject or how to, if you've got to lower your dose or raise your dose, uh, Definitely go check that out. Get off the AI.
Give it time. Like I say in every single video, if you're getting off the AI, you might feel worse before you feel better because now estrogen will start to rise. Everything is going to start to fluctuate.
There's going to be a little bit of chaos with the hormones. You might feel a little weird. And after a given number of weeks, everything should start to stabilize and then you'll start feeling better than you felt previously. And we see this.
Constantly, constantly. So that's my piece there. Welcome to this channel.
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