Conflicting Test Results: HRT Question

Training Over 35 Lifter
1

Started reading the Estradiol forum thread a long time ago and decided to follow through on the advice of getting a blood work-up done while I was relatively younger in order to record what my baseline was at 30 years old (which I am now) so that I would have that information for later in life.

My first test came out mostly fine except for high Estradiol:
Test 906 ng/dl (high)
Free Test 20.5 pg/ml (normal)
Estradiol 56 pg/ml (high)
Everything else across the board was well within or near the healthy ranges.

Doctor mentioned the high Estradiol and suggested instead of taking anything to address it I get a follow up blood test to see where things stood a couple of months later. Well, I didn’t want to waste two months time so I added Rez-V into my supplement regimen.

Got my latest results back today and they look like they came from a different person!

Test 411
Free T 9.0
Estradiol 39
Again, everything else in or near to normal range.

The only consistent abnormality from the two tests were that my white blood cell counts were slightly low (3.6 x10E3/ul for both tests).

Based on the latest results the clinic wrote me a prescription for Testosterone that I’m to rub on 5cc twice a day for the 1st week and then .75 cc twice a day for the 2nd - 4th weeks.

This through me off a little. With the two test results being so different is it wise to base treatment on just this latest result? Or am I fretting about nothing here and should just enjoy the benefits of the additional testosterone and see where things stand a month later when I get another set of blood tests?

The differences in my situation between the first test and second test…

Fasted all night before and then worked out the morning before the first test;
Was dieting for fat loss during first test (low-carb, lower calories).

Fasted the night before but didn’t work out the morning before the 2nd test;
Supplemented Rez-V for the two months before the 2nd test;
Supplemented Receptor Max for about a month before the 2nd test;
Was dieting normally for 2nd test (carb cycled, maintenance or higher than maintenance calories).

Long post, sorry for that. I really look forward to any input you guys can offer!

Thanks,

Greg

2

Your labs are all over the map. Personally I would drop all of the supplements, wait a couple of weeks, and then run a 24 hour urine panel. That will give you a clear picture of your daily values. You have two snap shots of hormones that are VASTLY different. One high and one low. One of the labs is probably crap but which one? Time for more labs.

E2 does look like a consistent problem but that’s easy to fix on it’s own if you aren’t in need of TRT.

3

What brent said. It’s better to stay away from the supplements and stay as consistant with diet and exercise while you’re getting the bloodwork done. It takes awhile for things to fall into place so the less changes/variables involved the better.

4

Thanks for the responses, they’re much appreciated. I’ve spent last evening and this morning scouring through the forums trying to read more about the process and I definitely agree with your thoughts.

One of the suggestions that the doctor had was that I get tested for Mono. They weren’t specific about this but said that some of my results might be explained by that. This was really odd to me, I don’t think I’ve ever experienced any symptoms that I’d associate with Mono! Still, I scheduled an appt with my primary physician for Friday…

I agree with Brentf that in both tests, my E2 seemed a bit high. It seems logical to me that if this is the case wouldn’t it have been a more conservative (and far more practical approach) for the physician to recommend a solution for that instead of the TRT?

I’ll ask the physician if they offer the 24 hour urine panel analysis.

Following the advice given I’m off of the Rez-V (as of this morning) and Receptormax (as of last week). I assume it is still fine to include Flameout, Leucine, BCAA’s, Surge, Met Drive, and Vit C in my diet?

Last question, and maybe I’m going to sound like a total arse asking this… I now have the Testosterone oil that they prescribed to me. Would it be detrimental if I used it at their recommended doses, so long as I included the proper use of an AI with it? From everything I’ve read, it seems like if this is properly done there are a great deal of beneficial effects to be gained from this?

5

How do you feel? Are you having any of the symptoms of low T/high E?

I would definitely NOT use the T prescribed to you unless you know you need it. If you have high normal ranges of T, the exogenous T will only shut down your natural production and replace it… it’s not meant to SUPPLEMENT your levels, it’s meant to REPLACE what your body is not making on its own.

I would do as suggested and see if you can get your doc to order a 24 hour urine test. It will take the daily fluctuations of levels out of the equation.

6

Don’t touch the T they prescribed until you know exactly what’s going on. Tell your Dr you want to run a Rhein Consulting Laboratories 24 hour urine panel. No harm in doing it and it’s fairly cheap. That should tell you which one of your previous labs are accurate.

7

I do not understand why serum hormone tests are been avoided.

ggarrett, what are the symptoms that made you walk this road? Any other health problems? What OTC or Rx drugs… some can cause these problems. Any occupational risks? When did this all start and did you have any accidents or blows to the head that preceded that?

PM me if some info is more than you care to post.

Any thyroid test data?

8

Again, many thanks to all of you who replied! As was suggested I’ve haven’t touched the Testosterone, and I’ve stopped taking the ReceptorMax and Rez-V for the moment.

Honestly, I think I feel great. I don’t have problems sleeping, good energy levels, I feel that my recovery from workouts and exercise is good (though I guess if it weren’t good I’d only have my perception of how I am now to gauge this), I’m almost never sick. I don’t exhibit any of the low T symptoms…

My purpose in getting the blood tests done to begin with was 100% solely based on the recommendations of people like Happydog and KSman that having this information when you are younger, and presumably have healthy hormone levels, will be beneficial later in life so that when/if reduced T happens, you have a baseline for comparison of where you where when healthy. I wasn’t seeking TRT or anything else.

After the first set of results, everything looked great. Testosterone High, Free T high, everything else healthy. The only exception was the high Estradiol. The doc suggested that if I wanted to get a proper baseline it would be better to have a second blood test. His logic being that it would be better to have two points of data on the timeline, rather than just a single snapshot from a single point and time. Seemed reasonable. You know the rest after the second blood test…

KSman, the thyroid results from the first test were as follows:
TSH: 0.875 uIU/mL
T4, Free: 1.64 ng/dL

This information was not provided on my second set of results…

I am interested in seeing what can be done about the Estradiol levels. Which was why I started taking the Rez-V to begin with. And I perceived an affect after taking the Rez-V. My erections were more easily attained and firmer, and recovery from exercise seemed to improve somewhat.

My gym performance during this time has been great. I just finished Waterbury’s 10x10 program and went from 200lbs @ 14% BF to 197lbs @ 7.5% BF in 14 weeks. Took my first serum test about a month into the program, and my last test with about a month left of the program.

I figure at this point my best course of action would be to get another test (perhaps the urine panel), and go from there…

Thanks so much for your input guys! I look forward to hearing any other thoughts or advice you might want to share.

Greg

9

So I went to my primary care physician and got another serum test ordered. This time I haven’t taken either Receptormax or Rez-V for about 2-3 weeks. Though I kept up with everything else (Surge Recovery and WOF, Met Drive, Creatine, Leucine, ZMA, and Vit C).

The results of this one are much more in line with my 2nd test than my first.

Test, Serum 556 ng/dL Range: 241-827
Test, Free 9.5 pg/mL Range: 8.7-25.1
Estradiol 33 pg/mL Range: 0-53

Thyroid
TSH 1.163 uIU/ML Range: 0.450-4.5
T4, Free 1.21 ng/dL Range: 0.61-1.76

The other thing my primary care physician pointed out was that my white blood cell count was low in every test (3.6, 3.6, and 3.2 x10e3/uL respectively). They don’t think this is a big deal since it’s been consistent…

So my question goes back to the original post. Is there any call for me to consider using the testosterone that I was prescribed from the first clinic? If so, shouldn’t I also be using an AI with it, particularly considering the Estradiol levels are still on the higher side? Or are my levels fine and using the test will only be to my detriment?

My primary care physician gave me a slip to get a urinalysis done as well which I received today. I’ll probably get that done next week…

Again, thanks for all your help to this point. I really look forward to hearing your thoughts here.

Greg

10

At least you do not seem hyperthyroid this time.

Please edit your post above with lab ranges.

You might feel better with E2 lower still.

11

In my opinion, there is two ways at looking at your situation. You could fill your script and get on HRT now. This will allow you to never really experience the downfalls of truly having really low T levels.

Or you could not get on HRT and closely monitor your levels from now on. This is what I would do if I was in your situation. Unfortunately, my levels were so low when I began that it was effecting my health and every day life. Your levels don’t appear to be all that low (you should post ranges for your numbers) and you aren’t experiencing any of the symptoms either. I might catch some shit for saying so, but there are many HRT patients that feel better in the middle of the “healthy” range than at the top of the range.

HRT is a life long commitment and should not be taken lightly. It takes quite a while for most to fine tune their individual protocol. It can be extremely frustrating while you are trying to do this. So much so that people claim to feel worse than before they started and end up giving up on HRT all together. Just something to think about…

I would get the urine test done and monitor your levels by testing every six months or so.

12

Caged and KSMan, thank so much again! I edited my previous post as suggested.

Caged your advice seems really practical and makes a lot of sense to me. I really am not feeling any sort of symptoms or having problems that would drive me towards going down the HRT road just yet. Particularly considering the time and cost committments it may not be worth the benefit at this point. I’ve got a baseline and know how I feel with these levels. Should things change for the worse in the future I have a good pool of data to work from.

KSman, I am interested in exploring ways to lower the E2 numbers as you mentioned. My hope was that supplementing the Rez-V would take care of that, and while I was on the supplement I perceived some general benefits.

I’ll read back through the prior posts here and on the Estradiol Why you Should Care sticky to help me determine the best course of action in this regard. Any extra advice or sage wisdom you care to offer in that regard is definitely appreciated!

Thanks,

Greg

13

Your FT is quite low. This suggests that SHBG is a problem. Elevated E increases SHBG and SHBG also tends to increase with age. That increase may be also from less T and more E that is typical with age. Those effects are inter linked.

Using anastrozole to achieve serum E2=22pg/ml should lower SHBG. Less E should allow for more LH and T while lower SHBG could allow for a higher %FT of a higher TT level. Worth a try.

What are your cholesterol numbers?
Serum glucose good?

Some drugs, OTC and Rx, and some supplements [foods] or grapefruit can increase E levels. PM me with your supplements and meds.

14

KSMan,

I keep seeing “E2=22pg/ml” as the target for E2. What is the significance of ‘22’ vs. ‘18’ or ‘20’ or ‘24’ or ‘26’ etc. In other words, just a few points either way?

15

Thanks KSman. I sent you a PM with the details on my supplementation and diet.

As for the other numbers you asked about.

Cholesterol:

HDL 65 mg/dL Range: >39
LDL 106 mg/dL Range: 0-99
T. Chol/HDL Ration 2.7 Range: 0-5

Glucose, Serum 90 mg/dL Range: 65-99

I know the LDL is a little high, but from what I’ve heard from my Primary Care Physician, along with the Men’s Clinic doctor, the higher HDL number offsets the high LDL.

Thanks!