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Symptoms of Elevated Estradiol in Men on TRT Gynecomastia (breast tissue growth) Nipple sensitivity Water retention or bloating Emotional lability Decreased libido or erectile dysfunction Increased body fat Worsening prostate symptoms or LUTS Testing and Monitoring Estradiol Initial Panel Before TRT: Total testosterone Estradiol (LC-MS/MS sensitive assay is the best but most expensive) FSH and, occasionally, prolactin PSA, CMP, CBC Follow-Up: Recheck estradiol 48 weeks after TRT initiation or dosage change Ideal range: 2040 pg/mL , but varies per individual How to Manage Elevated Estradiol Aromatase Inhibitors (AIs) Anastrozole (Arimidex) Mechanism : Inhibits the aromatase enzyme

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D.) 277282 (Pergamon Press, 1985)

Similar to niacinamide, the color contribution is minimal on its own

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