There is an enzyme in adipose tissue called aromatase.

This enzyme converts testosterone to estrogen.

Converting fat (adipose) tissue to muscle will raise T because less will be converted to estradiol [other reasons as well].

Many times, in obese patients, if you start TRT and the levels do not rise, it’s because it’s all being converted to estrogen.

You can use an aromatase inhibitor such as anastrazole to prevent this, but it’s best just to lose the weight (do your part!).

I don’t like using enzyme blockers because you are tinkering with a complex biological system and risks start to go up.

Giving T, the end product, for the right patient can contribute to improved health. 

 I think it would be cool if you had a specialized # tag for notes like this so we could all learn. Something like:

#medicalnotes #medicalthoughts