Chip,
After 5 years of being overweight, sugar cravings, flying off the handle, what felt like high adrenaline coursing through my veins, terrible energy and sleepiness, being diagnosed with adrenal fatigue, ADD, dysthymia, too much partying, not getting enough sleep, all of which did not seem right to me, I sought to find an answer at any cost. The cost has turned out to be about $40,000 in tests, docs, supplements, travel, etc. and yet the problem was found, by accident within a set of tests that I took that included an ESTRONE level. After reading up on Estrone and realized it, in part, regulates the chain-reaction cascade of cholesterol to Pregnenolone and both testosterone and cortisol, I asked my doc to put me on Arimidex to stop the aromatization of testosterone to the various forms of estrogen and thereby stop the negative feedback which was stopping the chain reaction of cholesterol to Pregnenolone to DHEA to testosterone (over simplification but you get the idea).
After 2 weeks on Arimidex, sure enough, my high cholesterol came down from 290 to 230, my Pregnenolone went up from 7 to 192 (I won't be too technical with units of measurement, but you get the idea), and more importantly my sugar craving are gone, energy is back, and my weigh has come down on its own from 219 to 205 (I'm 6'1"), not to mention my stress seems to have relatively disappeared--almost to the point that I feel I am too calm and want it back. I believe I have been running on adrenaline that was taken from derived from what little Pregnenolone (the substance made from Cholesterol and can either be made into cortisol (from your adrenals) or made into androgen).
Ask your doc to test for estradiol (which he may have done), but more importantly, ESTRONE (another form of estrogen). (Some labs/docs may even resist giving you this test due to the fact that those without experience relative to the condition I describe may tell you the test is not pertinent for males.) The reason is, as you know, that testosterone is aromatized into estrogen, but estrogen exists in the body in various forms, one of which is estrone. Estrone and Estradiol for that matter, provide negative feedback for the conversion of Cholesterol (the mother of all hormones) into Pregnenolone which can then take the cascading chemical pathway of either producing DHEA & Testosterone AND/OR CORTISOL (as well as aldosterone but that is not pertinent to this discussion). Cholesterol is made into Pregnenolone when the body needs it and then Pregnenolone normally splits into both cortisol and testosterone pathways as needed. Health people have a balance of these 2 pathways...or more testosterone than cortisol (stress hormone).
In other words, Testosterone is actually regulated by the amount of estrogen that is derived from the aromatization of itself, i.e., the amount of estrogen that is produced from aromatization of the testosterone. High aromatization can equate to high levels of estradiol and/or estrone. If your body has an unusually high rate of aromatization into these forms of estrogen, then you could essentially have a low testosterone value, and high estradiol and/or estrone that is "tricking" your body into thinking too much testosterone is being made, therefore, despite your bodys testosterone being low, the body shuts down ACTH, which is needed to convert cholesterol to Pregnenolone and begin the process of making cortisol and/or testosterone.
Bottom line: estrone was shutting down the conversion of cholesterol to Pregnenolone which kept my body from naturally converting Pregnenolone to cortisol and/or testosterone. Since the body will literally die without cortisol, and since the body makes its cortisol from Pregnenolone and I had a minuscule amount (of pregnenolone) in my blood, the body "stole" the Pregnenolone that existed and made what cortisol it could from it. This is called "Pregnenolone steal" and it is basically diverting all of your Pregnenolone to cortisol, leaving you with little to no testosterone being made because it is being aromatized to estrone and the estrone shutting down the production of Pregnenolone and round and round. Because of this you end up with little to no androgens to balance your cortisol due to the chemical reaction being diverted away from them. It is this phenomenon that resulted in docs telling me I had adrenal fatigue.
This is the reason why people who are stressed have problems sexually, because the Pregnenolone pathway is diverted to the cortisol avenue instead of the testosterone avenue. Healthy people have a balance. It turned out that I couldnt maintain a balance due to ESTRONE "tricking" my body into thinking that it was making too much testosterone and shutting down the entire process or at least slowing it. Since are bodies will do anything to keep us from dying and zero cortisol would kill us, it takes the only thing it can to make cortisol--it takes your Pregnenolone (I was running on fumes). This is what leaves you stressed as hell and frazzled--your body has no chance of making androgens to balance the cortisol and maintaining a calm, natural homeostasis.
Check your Cholesterol, Pregnenolone, DHEA, Estrone and estradiol levels (don't worry about your cortisol levels as I am sure you have been through all the tests on your own), take arimidex (I take .5mg on Tues and 1mg on Fri) and watch your entire system come around (IF INDEED THIS IS THE PROBLEM YOU ARE HAVING). Then if you begin to feel better on Arimidex, you know that you are on the right path, so retest all of the above in 3 weeks and you should see your cholesterol come down, your Pregnenolone rise, stress decline, and your DHEA and testosterone rise (at least I did).
As it pertains to the problems listed above, I feel amazing now. However, the 2 months use of arimidex may have brought my estrogen levels down too well. Estrogen is needed in part by the male body for many things, among them, cognition, memory, and sexual response (as estrogen releases Nitric Oxide from cells of the brain, etc.), as a result, my memory is off and my libido is down from where it used to be. But no problem, I only now have to search for a good alternative to arimidex (a very powerful aromatase inhibitor and known to lower libido), and that you can find on your own or with help of your doc. But for purposes of aromatase inhibition (if estradiol and/or estrone too high), use Arimidex as it will leave no questions unanswered as to its power to stop your testosterone from aromatizing into estrogen.
Sorry for the redundancy and possible over simplified ramble but I stumbled upon this site looking for this arimidex alternative and don't intend to contribute any further and wanted to get everything down in the shortest period of time.
Hope this helps somehow.
Will