Age 42, Started TRT in January. Testosterone Has Gone Up. Estradiol Down

Pharma TRT
1

age 42

Script is test cyp 100mg per week - 2 sub q .5 cc injections friday am and monday night.
No AI as estrogen has stayed loNo HCG as it was not an option of my GP to prescribe.

I am in canada and working with government msp -

-height 5’11"

-waist 36"

-weight 213 pounds

  • little body hair - don’t have to shave daily

-describe where you carry fat and how changed - fat is proportionally spread out around my body

-health conditions, symptoms [history] hypo thyroid - on synthroid

-Rx and OTC drugs, any hair loss drugs or prostate drugs ever- was on any depressants for years and non opiod pain killers after a car accident.

-lab results with ranges

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Not sure if the lab results will show but

Testosterone is at 26 mol/l (8.4-28.8) = (749 ng/dl)
E2 57 pmol/l (range <157) = 15.5 pg/ml)
TSH 0.95 0.32-5.04 mU/L (canada labs won’t do t3/t4)

-describe diet [some create substantial damage with starvation diets]

Wife is into the Whole 30 which is basically eating real food all the time and avoiding anything artificial. we have been eating like this for a few years

-describe training- some weights and cardio (i really enjoy cardio so do a lot fo it - although i no longer run due to back injury)

-testes ache, ever, with a fever? NO

-how have morning wood and nocturnal erections changed - have not experienced this since my early 20’s

I have had 3 sets of labs done since january- the first shows T at 14.4 mol/l and no Estrodial test.

feb blood tests T at 20.3 mol/l and estradial at 64 pmol/l (17.4 pg/ml)

Yesterday prior to injection T came back 26 nmol/l and E 57 pmol/l (15.5 pg/ml)

Estrogen is going down???

As my testosterone is getting into the upper limits of the ranges and estrogen is still pretty low any suggestions on how to increase it?

ideas as to why my estrogen would be going down? Would it be wise to switch to 1x week injection to increase estrogen?

thanks

2

You could use a higher dose of T then FT–>E2 will increase.
FT may be low from elevated SHBG which creates non-bioavailable SHBG+T that also reduces FT.

When SHBG is elevate with more SHBG, TT numbers are inflated with more SHBG+T then TT overstates your T status. You need FT lab work. In this case one needs to ignore the fact that TT is ~upper limit as this is not a normal situation.

TSH number looks good, but by itself if often an inadequate picture of thyroid status. Most guys who come here have some degree of low thyroid function -aka not optimal. You need to eval overall thyroid function via oral body temperatures - see below.

Most thyroid problems seem to be from not using iodized salt. Progression over the years can be from hypo to nodules to possible cancer to hypo etc.

Body temps can be your thyroid med dosing guide.

Thyroid hormone fT3 is the only active thyroid hormone and should be tested. There is no known receptor for T4.

Labs:
TSH
fT3
fT4 - [not T3, T4 or indexes etc.
DHEA-S
TT - total T
FT - free T
E2
SHBG

If you get your FT increase, you will have more facial hair growth.

How is stress, pain and injury a part of your life? This can increase rT3, reverse T3, that blocks some fT3 at T receptors. See the sticky.

Stick with injections twice a week.

Perhaps more SHBG reduces FT reduces FT–>E2.

3

Any supplements? Do you eat a lot of cruciferous vegetables?

4

Thanks @KSman for the response - i really appreciate your time and consideration.

I see my GP again next week and will ask for better labs but i will likely have to go across the line to washington as our MSP limits what can be tested. i had a shbg test a few years ago and it was 40.9 10.0-70.0 nmol/L

I don’t use salt with iodine but also take a multivitamin with selenium and iodine- i also take a kelp supplement so hopefully that is helping the thyroid.

testing my body temperature while on synthroid .25mcg were 95.9 at 0700 and 97.2 at 1500

Stress is an interesting one - yes very stressful at times and shft work too. But no stress once i have left work- but i work 12 hour shifts - 2 days 2 nights- so i have found this to be an issue and am trying to address adrenal aspects considering my sleep is just improving on TRT and 20 years of shift work and stress have impacted things.

I have chronic pain from a car accident 7 years ago which ended my running and long distance cycling and which had me on non opioid pain killers for a long time - and now i try to just stay active and avoid the medications. Since being on TRT my activity level has gone up, which has resulted in more back pain but i am not taking pain meds.

I had been on anti depressants for a long time too but stopped them a year or 2 ago.

I will ask for better labs, and to increase the t dose. thank you

5

Hi @anon10035199 Yes, to suppliments

Vitamin d 2000Iu daily
multi with selenium 55mcg and iodine .15mg
Kelp (at least till it runs out)

not a lot of cruciferous veggies

6

With the recent labs
TT 26nmol/l (8.4-28.8)
and estradial is 57 pmol/l (<157) - 15.5 pg/ml

Estradial has dropped from 134 pmol.l to 64 pmol/l to 57 pmol/l

as i asked for an increased dose of Testosterone as an attempt tp raise my Estradial to around the 20-22 area. hoping that excess would aromatase but my Dr had me decrease my dose form 50 ml test c every 3.5 days 50 ml test c every 4 days.

I know it is not all about the higher tt numbers but is decreasing the dose the right move? I feel the effects of low Estradial and recognize my e2 has decreased since being on trt.

7

Wrong move, what was your doctors reasoning for lowering the dosage? Estrogen might be low because free T is low, SHBG is probably higher than a few years ago. I don’t expect your doctor to monitor or understand the SHBG relevance, get out of the sick care model and seek a true (professional) hormone specialist or else you’ll live with substandard levels for life. Years old SHBG labs are basically useless now.

Most doctors are unaware we have men walking around with 1000-1200 ng/dL levels naturally.

If SHBG is high stop eating veggies, in other words remove veggies from your diet as this will increase SHBG. While veggies are generally good for most people, there just not good for everyone. Low SHBG men would do well on a veggie diet, high SHBG men not so much.

8

you need Free t lab to make an informed decision about increasing/lowering test.

9

I think the idea is that when my TT was low i had higher Estradial - as my TT has gone up, my E2 has gone gown. So by reducing my T dose my Estradial should go up.

Being in Canada i am grateful to have the Test Cup prescription anyways. No HCG and forutnaltey no need for an AI. Don’t want to de a difficult patient.

I will give it the month my GP has asked for and will post labs in May. If i feel better with a higher Dose and lower Estrogen i will try to return to the higher dose.

Also i think this works out to going from 100mg/week to something like 87.5mg/week (but in 2 50mg shots) so not s significant decrease.

Will post labs in a month

10

Interesting results - So in order to raise my Estrogen, my dr effectively reduced my Test cyp from 50ml every 3.5 days to 50 ml every 4 days.

New labs show my testosterone has dropped (logically) to 24.1nmol/L (8.4-28.8) from 26 and my
Estradial which had been at 57 pmol/l (< 157) increased to 83 pmol/l (<157)

So so that puts my Estradial in a good place but i dont feel any better,

Here are the rest of my current labs and i would appreciate some comments re cortisol and DHEA. Should i be supplementing as i have a naturopath who is willing to prescribe DHEA or cortisol - but i wanted to do some research before hand.

2018/may/05

Estradiol 83 <157 pmol/L
Testosterone 24.1 (8.4-28.8) nmol/L
DHEA Sulphate 6.3 <15.0umol/L
AM Cortisol 246 (125-536) nmol/L

Our government labs wont do the SHBG or bio available or free t tests as i am “within range”

11

They couldn’t know if free T is in range without knowing your SHBG level, they have no clue. Whoever runs things and makes the rules within the state healthcare is so clueless. Someday they will figure it out, just not today.

1 Like
13

Why would lowering test reduce e2?

14

Reduced aromatization, less test to aromatize.

15

I wrote that wrong I meant to say why would lowering test increase e2?