47,XXY and why the "t gut" is not based on testosterone

 

I wrote this in response to a question on a facebook group regarding the horrible Testosterone GUT that XXY people develop which is similar to but not the same in most cases of XXY to natal XY males.  XXY people are not natal males, for the most part, some few are fortunate to be able to exist in the male paradigm and experience male based care without issues.  Most XXY people require a balanced approach with charts in both MALE and FEMALE with all aspects of both genders openly discussed and dealt with.  Just like women, balancing estradiol is perhaps the single most important issue for most of the people whom are 47,XXY or variants.

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When you take testosterone the presumption from the Doctor is that it will give you a HUGE kick in the ass to get out and DO life, ie .. lots of physical work. Some people would call it play, because they are working .. HARD.. at playing and having a great time doing it. Others spend alot of time riding their bikes long distance, in gyms trying to impress other guys, or hiking, skiing, etc. Men whom do not actively participate in life end up with fat, primarily in the gut. What it means to have the T gut when you are on testosterone is that you get too many calories and don't use them.

Now there is a second group whom should not call their gut a "T" thing, and this includes people who do not have so much testosterone like the average XXY person whom on Australia's  scale of nmol/L would be down around 5 nmol/L or less, or in the USA on ng/ml would be under 300 ng/ml. That is because when your hormone levels are low, fat develops so that you can process what little testosterone you have into estradiol. The fat is an organ of the body which translates Testosterone into Estradiol.

My point is this... regardless of how much testosterone you take, the Body NEEDS estradiol. And it will get it one way or another. The body could really care less about testosterone, despite that it takes testosterone to be a Man. The body HAS TO HAVE estradiol or it DIES. There is no ... oh you only need estradiol to be a woman. The BODY, Organs, Brain, and everything in it NEEDs estradiol. If you starve your estradiol supply then you will get fat when the body goes into survival mode and starts converting testosterone to estradiol.

So if you are doing it all "right" taking T and working out, and eating right... and you cannot get rid of the "T gut" then your estradiol level is low. Simple. Most guys do not require alot of estradiol. Most XXY people require anywhere from 3x to 10x as much estradiol as Men, and generally about half as much as women average in their middle years. I wrote REQUIRE for a reason.. starving yourself of estradiol will make you fat. The body/brain system will get its estradiol one way or another, regardless of what you want to happen.

Now.. I often talk about the banding study I did for my own research. Anyone in the left 4 bands (of 5) will absolutely need to balance their estradiol levels despite any desire (generally the 4th band) to take testosterone. The only group which can for the most part not worry about estradiol balance are the 5th group or right most 20th percentile of the XXY population, whom identify as male, take only testosterone and need nothing else barring significant other problem. About 80% of the known... based on my research of actual people whom are known to be XXY, need to balance their estradiol levels.

ps... most Guys.. do not eat well, exercise enough, or take care of themselves in any way. Which is why hormone balance is among the last things doctors will look for.