E2 Levels Question

Pharma TRT
1

Hello everyone,

I’ve been reading this forum for months but only registered now. My doctor started me TRT on May 1, right before we did the first injection we did some blood work.

Estradiol (<162) 109.00 pmol/L
Testosterone Total (8.4 - 28.8) 2.30 nmol/L
Testosterone Boiavailable (3.6 - 11.2) 2.40 nmol/L
Testosterone Free (196 - 636) 93.00 nmol/L

I was placed on 150mg E Test per week, injected twice at 75 mg, I opted to do 3 weekly injections at 50 mg M/W/F, I was also placed on 500iu, 3 times a week totaling 1500iu. No anastrozole (Arimidex). By the second week of May I had gained almost 12 pounds of water, so I dropped my dose of HCG back to 300iu 3 times a week totaling 900 iu/week. The doctor had asked me to keep a log of how I felt. Below is the log I provided

I seem to be responding slowly to the T and HCG injections, but I seem to also be a high aromatizer of testosterone, one week after starting injections I had gained 12 lbs of water, acne started and my nipples became extremely hard and sensitive. I had early morning erections as well. Reducing hCG and splitting the T dose to 3 injections a week has helped with the nipples, but no change for acne or water retention, nor has there been any return of morning erections, by the beginning of the 3rd week I have been having some slight joint pain (mostly elbow and shoulder)

On May 29 we did some more blood work and the results are below, please note that the blood work was done about 12 hours after the Monday evening injections.

Estradiol (<162) 306.00 pmol/L
Testosterone Total (8.4 - 28.8) 28.60 nmol/L
Testosterone Boi (3.6 - 11.2) 21.40 nmol/L
Testosterone Free (196 - 636) 915.00 nmol/L

additional info: Before getting the results back my doctor had a change of heart and pumped my E test to 250 mg per week, considering the numbers I had when we started we figured the initial dose of 150 was too low and based on my log. The doctor is doing his best to help me out since he is a family friend, I had seen two family doctors, 3 Endos and 2 Urologists and I was getting extremely frustrated. I had been asking for TRT and HCG for 3 years, but no one is willing prescribe HCG and I was concerned about fertility. I’m 44 years, 6ft, 240 pounds, and I’m about 50 pounds over weight which is probably not helping with the E2 conversion. The doctor gave me a script for anastrozole 1mg, we thought i would start at 0.25 a week and go with how i feel, but considering that my E2 is at 309 (almost tripled within 28 days), we had that discussion and he gave me the script before the E2 test came out, we knew I would need some sort of E2 inhibitor just not how much, which is my question to you guys?

2

It’s imperative that you test your SHBG, this is how doctors determine dosing and injection frequency. Low SHBG requires two or more injections a week, midrange SHBG two injection a week, very high SHBG one large injection a week.

You started out on very high doses of both testosterone and HCG, you need to start low and go slow. This isn’t a sprint, it’s a marathon. Start out at 50mg twice weekly and HCG 250iu two times a week taken together with test and .5mg AI taken at T injection time.

Do this until you get your SHBG labs. It takes 6 weeks for blood levels to stabilize after making a change to your dosage andor injection frequency, if you make a small change in the middle of a new protocol you reset the time it takes to reach a stable state, then its another 6 weeks.

You’re not going to feel like magic in between the 6 weeks, it doesn’t matter what dose you’re on you’re not going to feel well.

3

Hi there thank you for the quick reply, I don’t know why i didn’t post my SHBG, my SHBG has been low for years. It was tested 6 times in the year prior to starting TRT on May 1st. The results were always in the range of 10-14.2, the lab range is 10-70, after 1 month of TRT (150 E test and 900 HCG per week) my SHBG is 15 on May 29

4

I didn’t expect your SHBG to be that low, in that case you need 8 -10 mg daily. Inject using insulin syringes subQ on love handles. There are lots of guys with low SHBG below 15 who seem to have trouble resolving all symptoms, you need to find out why SHBG is low.

Again low thyroid function would be a cause for low SHBG, thyroid meds increase SHBG. Diabetes and metabolic disorder or another cause.

5

sorry I seem to be short changing you with the info, I’m very Hypothyroid, I’m currently on daily 200 mcg of synthroid, I used to be 225 but my TSH went down to 0.09, and between my thyroid and T, I can gain weight just looking at food so I’m considered pre-diabetic, but I’m bringing the numbers for diabetes under control but too slowly for my liking. My body is very sensitive, on 200mcg of synthroid my TSH went up to 3, but on 225 it went down to 0.09, but i attribute that to Ramadan, I was on 225 mcg but we changed to 200mcg in late april, due to the fact that in the summer months in Canada we end up fasting almost 18 hours a day, I dont have the usual windows to take my thyroid med on empty stomach and keeping it empty for a couple of hours before eating, usually I take my synthroid at 4 am and then have breakfast at 7 am. In Ramadan i take my pill at 8:45PM and eat 15 minutes later. Muslims are not permitted fast if its affecting a medical condition, I’m just too hesitant to make that call.

As of last month I’m no longer within pre-diabetic range, but I’m still too high. My Hematology results have been saying for close to a year I’m border LOW on MCV and MCH, and borderline High on RDW. Same thing for Cholesterol. I think all of these are due to my high weight issue.

I haven’t exercised in almost 2 years, I was working crazy hours and spent extended periods of time in the hospital with my ailing father. Last February my father passed away and in late April I quit my second job and switched my primary job to a less time demanding primary source of income so I could focus on my health, so I will be going to the gym at 3 times a week starting mid June, hopefully with my thyroid and T levels rising I will actually be able to burn some of the fat and have more motivation