Do I Need TRT, E2 Low?

Pharma / TRT Testosterone Replacement
1

38 yrs old
5’8" tall
33" waist
170 lbs
Not hairy (back) but not hairless (chest).
Not much fat, but no 6-pack either.
Few years back I started getting rashes during summer time. No diagnosis was ever reached, but corticosteroids clear it up. That is my only prolonged Rx use. And what lead me down this road.
Probably not the best diet, but I don’t eat much sweets. Get plenty of meats, eggs, breads, and some veggies.
Don’t workout and never have. I work outdoor, physical labor though and always have.
Testes ache right now. Dull ache. Not a chronic condition though. Don’t get many fevers.
Morning wood is few and far between, but used to be consistent every morning.

I have taken oral temperatures upon waking and have the lowest I’ve seen is 97.6. I was using sea salt, but went back to iodine salt after reading here.

About 5 years ago I started getting a skin rash on foot, leg, and back of arm during summers. Doctors gave me topicals that clear it up with consistent use. Last fall I was really annoyed and had blood work done to look for anything.

Triglycerides - 67 (<150 MG/DL)
Cholesterol - 172 (<200 MG/DL)
LDL/HDL Ratio - 1.33 (<3.55 Ratio)
Hemoglobin A1c - 5.1 (4.0-5.6 %)
Albumin - 4.9 (3.5-5.2 G/DL)
Calcium - 9.9 (8.5-10.5 MG/DL)
Chloride - 104 (97-110 MEQ/L)
Creatine - 0.82 (0.8-1.4 MG/DL)
Glucose - 88 (70-99 MG/DL)
Potassium - 4.5 (3.5-5.3 MEQ/L)
Protein, Total - 7.0 (6.1-8.3 G/DL)
Sodium - 146 (133-146 MEQ/L)
Alkaline Phosphatase - 42 (46-118 U/L) LOW

I was told I’m health and normal. I later looked into Alkaline Phosphatase and found that could be a indicator of hashimoto syndrome which is an autoimmune disorder. Thought maybe it could explain my skin rash.

This spring I went to a Urologist to see about a vasectomy. I asked to test for Testosterone while I was there to see if hasimoto was attacking my thyroid. I could be wrong on all of this stuff, but my rash was starting again and I figured, why not check.

Testosterone - 310 NG/DL (300-1080)

Doc wanted to give me a shot of test depot biweekly, 200mg.

I left and went to my GP for more blood work.

This was one month later:
WBC - 8.0 (3.4-10.8x10e3/uL)
RBC - 4.88 (4.14 - 5.80 x 10e6/uL)
Hemoglobin - 15.3 (12.6-17.7 g/dL)
Hemocrit - 44.8 (37.5-51%)

TSH - 1.150 (0.450-4.500 uIU/mL)
Thyroxine (T4) - 7.8 (4.5-12 ug/dL)
T3 Uptake - 28 (24-39%)
Free Thyroxine Index - 2.2 (1.2-4.9)

Estradiol - <5.0 L (7.6-42.6 pg/mL) LOW

LH - 8.6 (1.7-8.6 mIU/mL)
FSH - 4.4 (1.5-12.4 mIU/mL)

Testoterone, Serum - 552 (348-1197 ng/dL)
Free Testosterone(Direct) - 12.3 (8.7-25.1 pg/mL)

PSA Serum 1.3 (0.0-4.0 ng/mL)

Questions:

Could low estradiol cause skin rashes, (maybe dry skin)?
Could low estradiol prevent morning wood? Currently, my erections are use it or lose it.
Why such a difference on T levels?
I don’t want to take a life long series of shots, but want my rash gone and dick back.
Also, in the small towns I frequent, doctors are few. But I read here that biweekly shots is no good, so… If I were to take the shots home and split it up myself, I should be good. But what is the difference in Test Depot vs Test Cyp?

My GP says, “TRT is overused and you’re normal anyway.”

I’ve been searching for examples of men with low E2, but can only find information regarding women or men on TRT that have crashed their E2 with an AI.

Hello and Thanks,
Nate

2

Also, I noticed that my LH is high, but my T and E2 is not. Thoughts? Is that a sign of primary?

Nate

3

Thought I’d add that my Urologist says, "no need to test for Estrogens. HCG is for fertility problems.)

Nate

4

Just went to urologist for another blood test. I’ll post the results when I get them. Doesn’t matter much though since I can’t interprete the results well, my doctors aren’t much help, and I don’t have much doctor selection.

5

Found out that test Depot=test cyp. One question answered.

6

Was that lab with Labcorp?
I have seen a lot of lab failures there where fault lows are reported.
Test again to confirm.

Injecting is not a problem once you get past the aversion and feel the benefits. You are encouraged to self-inject T twice a week with #29 1/2" 0.5ml insulin syringes, subq, not IM.

Cyp vs Eth, no real difference. Cyp is mostly the ‘generic’ in USA, eth more common elsewhere.

As T esters are absorbed from the oil, the ester groups are removed and you get bio-identical T, so the ester does not matter as you get T in the end.

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years.

7

I’ll have to ask my GP what lab they use. The report is on the doctors letterhead and I have no way to tell what lab actually did the test.

I got more blood drawn today at the urologist, I’m not sure what he’s testing for, but last time it was TT only and he said he doesn’t test for E2 (even when on TRT.)

Thanks,
Nate

8

Your GP likely won’t be able to help you, he sounds ridiculous and clearly don’t know squat, sounds irrational.

9

OK… The latest blood work is in.

Unfortunately, all that was tested for is:
Prolactin - 7.8 NG/ML (4.0-15.2)
TSH - 0.734 UIU/ML (0.4-4.1)

Also… In my only E2 lab work (posted above), the lab was indeed LabCorp and the bill they sent says “Estradiol” and no more than that–it probably was NOT sensitive.

I would still like to know if anything can be deduced from my previous lab work or have I simply been spending a lot of money to donate blood?

TSH??? went from 1.15 to 0.734 in a month. Meaning? I’ve read that Free T3 is the important thing.

What can I draw from the past results?
TSH - 1.150 (0.450-4.500 uIU/mL)
Thyroxine (T4) - 7.8 (4.5-12 ug/dL)
T3 Uptake - 28 (24-39%)
Free Thyroxine Index - 2.2 (1.2-4.9)

Am I primary? Does borderline high LH with lower TT and FT indicate primary?
LH - 8.6 (1.7-8.6 mIU/mL)
FSH - 4.4 (1.5-12.4 mIU/mL)

Can the E2 blood work indicate anything? It was unreadable, but NOT sensitive. It seems that in most cases E2 is overestimated without sensitive testing. Does that mean mine is nonexistent, or inconclusive?
Estradiol - <5.0 L (7.6-42.6 pg/mL) LOW

I started TRT this week. Rx is 200mg every 2 weeks. I’m taking 100mg/week in 2 doses, self-administered. Been 3 days and my dick is back; placebo? I have no AI or HCG. Skin rash is not different, in fact it seems to be worsening.

10

Having your dick back might not be placebo . It took me the same time to had it back. Sometimes it still goes off but i’m only 1 month into treatment .

Look at this study