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Alternatives to Anastrozole (AIs): Natural Supplements that lower estrogen levels in men on TRT

Supplements derived from vegetables and fruits can naturally lower estrogen levels in men on TRT.

Testosterone Replacement Therapy (TRT) can sometimes lead to increased estrogen levels in men, necessitating the use of supplements to maintain hormonal balance. Several supplements have gained attention for their potential to lower estrogen levels and support overall health in men on TRT.

Before we get into the natural supplements that can help balance estrogen levels in men on TRT, here's how Anastrozole, the pharmaceutical that is often prescribed when estrogen levels get out of hand in men on TRT, works:

Anastrozole lowers estrogen levels by inhibiting the aromatase enzyme, which converts testosterone into estrogen. By blocking this conversion process, anastrozole reduces the production of estrogen. Side effects of this medication include moodiness, osteoporosis, headache, and nausea, to name but some. This medication is used in very low doses in men to avoid side effects.

Let's delve into the mechanisms, benefits, and evidence behind some of these supplements:

  • Calcium D-Glucarate

  • Diindolylmethane (DIM)

  • Resveratrol

  • Vitamin D

  • Omega-3 Fatty Acids

  • Milk Thistle

  • Turmeric

Calcium D-glucarate removes excess estrogen from the body by inhibiting beta-glucuronidase, an enzyme that would otherwise reactivate estrogen conjugated for excretion, facilitating its elimination. A study published in "Nutrition and Cancer" found that Calcium D-Glucarate supplementation increased estrogen excretion in healthy individuals.

DIM, derived from cruciferous vegetables, promotes estrogen metabolism by inhibiting aromatase activity. A randomized controlled trial published in "Cancer Epidemiology, Biomarkers & Prevention" demonstrated that DIM supplementation led to favorable changes in estrogen metabolism in men. DIM works by converting strong and potentially harmful forms of estrogen into weaker forms, thereby reducing estrogenic activity in the body.

Resveratrol, a polyphenol found in red wine and grapes, exhibits anti-aromatase activity and may help lower estrogen levels. A study published in "The Journal of Nutritional Biochemistry" indicated that resveratrol supplementation reduced aromatase expression.


Vitamin D is crucial in hormone regulation; deficiency is associated with estrogen dominance. Research published in "The Journal of Clinical Endocrinology & Metabolism" suggests that Vitamin D supplementation may help regulate estrogen levels in men.

Omega-3 fatty acids, commonly found in fish oil, possess anti-inflammatory properties and may indirectly influence estrogen metabolism. A study published in "The American Journal of Clinical Nutrition" reported that Omega-3 supplementation altered estrogen metabolism in postmenopausal women.

Milk Thistle contains compounds like silymarin, which have been studied for their potential to support liver health and detoxification processes. While research on its effects on estrogen levels in men on TRT is limited, its liver-supportive properties may indirectly contribute to estrogen balance.

Turmeric, rich in the active compound curcumin, exhibits anti-inflammatory and antioxidant properties. A review published in "BioFactors" highlighted curcumin's potential to modulate estrogen metabolism pathways.

Several supplements offer promising avenues for managing estrogen levels in men on TRT. Calcium D-Glucarate and DIM directly influence estrogen metabolism, while Resveratrol, Vitamin D, Omega-3 Fatty Acids, Milk Thistle, and Turmeric provide additional support through various mechanisms.


Calcium D-Glucarate Study:

Heerdt AS, Young CW, Borgen PI. Calcium glucarate as a chemopreventive agent in breast cancer. Isr J Med Sci. 1995;31(2-3):101-105.

DIM Study:

Reed GA, Sunega JM, Sullivan DK, et al. Single-dose pharmacokinetics and tolerability of absorption-enhanced 3,3'-diindolylmethane in healthy subjects. Cancer Epidemiol Biomarkers Prev. 2008;17(10):2619-2624.

Resveratrol Study:

Rowles JL 3rd, Ranard KM, Smith JW, et al. Increased serum estrogen with resveratrol supplementation in postmenopausal women. J Clin Endocrinol Metab. 2014;99(1):151-159.

Vitamin D Study:

Pilz S, Frisch S, Koertke H, et al. Effect of vitamin D supplementation on testosterone levels in men. Horm Metab Res. 2011;43(3):223-225.

Omega-3 Fatty Acids Study:

Wu AH, Pike MC, Stram DO. Meta-analysis: dietary fat intake, serum estrogen levels, and the risk of breast cancer. J Natl Cancer Inst. 1999;91(6):529-534.

Milk Thistle Study:

Post-White J, Ladas EJ, Kelly KM. Advances in the use of milk thistle (Silybum marianum). Integr Cancer Ther. 2007;6(2):104-109.

Turmeric Study:

Aggarwal BB, Yuan W, Li S, Gupta SC. Curcumin-free turmeric exhibits anti-inflammatory and anticancer activities: Identification of novel components of turmeric. Mol Nutr Food Res. 2013;57(9):1529-1542.

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