Estradiol: Why You Should Care

Pharma TRT
421

Counting drops: The drops per ml are higher for glass droppers than plastic - surface tension effects.

Saliva testosterone: That is considered free T in tissues. Serum TT is largely SHBG bound T. This is limited to the blood steam. So only one result. I do not know why they call it total. Anyone have further info on this to link to?

When you talk to your doc, your symptoms should be part of the discussion of your response. Don’t rave about feeling good and strong libido if you are wanting to switch to injectables. Transdermal T creates short lived increases in FT, so saliva T will vary as well. I think that you are better to use the T gel the day before and then not use the day of the test. I don’t know how low T would go in your case even if levels were decent.

E3=E2? Edit your post to correct if needed.

422

Test Units ABN Results Reference Range
Estrone (E1)---------ug/24hr----Low-------1.5--------3-12.0 ug/24hr

Estradiol (E2)-------ug/24hr----None------Detected—0 - 7

Estriol (E3)---------ug/24hr--------------3.6--------1 - 16

Total Estrogens------ug/24hr--------------5.1--------4 - 22

Testosterone---------ug/24hr----Low-------9.5--------45-85

Dihydrostestosterone ug/24hr--------------2.9--------0 -13

Androstanediol-------ug/24hr--------------48---------48 -578

Androstenedione------ug/24hr-------None Detected-----0-50

DHEA ----------------ug/24hr--------------621--------5 -1476

Androstenetriol(5-AT-ug/24hr--------------230--------42 -710

Androstenrone(AN)----ug/24hr--------------935--------798 - 4705

11b-OH androsterone(OHAN)-ug/24hr-Low-----433--------461 - 1692

Etiocholanolone(ET)-ug/24hr---------------1174-------689 - 3252

11b-OH Etiocholanolone (OHET)-ug/24hr-----449--------134 - 1186

Progesterone--------ug/24hr None Detected None Detected (note normally not detectable in urine)

Pregnanediol (PD)—ug/24hr---------------168--------32 - 501

5-Pregnenetriol-----ug/24hr---------------132--------28 - 1062

Cortisone (E)-------ug/24hr------Low------84---------92 - 366

THE ----------------ug/24hr------Low------1229-------1365 - 5788

THB-----------------ug/24hr---------------47---------32 - 238

5a-THB--------------ug/24hr------Low------111--------135 - 588

THA-----------------ug/24hr------Low------20---------52 - 277

Cortisol------------ug/24hr---------------40---------35 - 168

THF-----------------ug/24hr------Low------682--------942 - 2800

5a-THF--------------ug/24hr------Low------301--------796 - 2456

So now that I have these numbers, I have to figure out what they mean.

First thing is that I don’t think I have any obvious symptoms other than falling asleep every day after lunch. Iâ??ve had this problem since high school and never been able to figure out why. Iâ??ve been sleeping in my car or at my office or where ever I had to ever since. I had a glucose tolerance test done that was fine. I had some kind of blood work done 10 years ago that was inconclusive (I donâ??t know what they looked for). I had a sleep study done. I donâ??t have sleep apnea. They put me on methylphenidate ( Ritalin) 5mg three times a day. Itâ??s been great but only treats the symptoms. Other wise Iâ??ve been healthy and stay in great shape but have never been able to get in any better shape. Iâ??ve always been on the thin side and never been able to gain mussel mass by weight training. I begain hearing about testing for low testosterone several years ago. I’m now thinking my sleeping problem may be related to the low Testosterone

I had the first blood test done to investigate the possibility of low testosterone about 18 months ago and I was in the 300s. Not low enough to take action at the time. Just a couple of months ago I had a second test done and it was in the 200s. This was low enough to get my doctor to perscribe the androgel

I got on Androgel 5mg per day and thought I felt better and might have been gaining some mussel strength but nothing definite. I did notice an increase in libido about a month ago but that faded.

I started reading this line and had the 24hr urine test and now have more information than I know what to do with. Iâ??ve given my doctor a lot of information from this thread and other studies and expect to get prescribed testosterone cyponate, hCG and amirdex as has been discussed here.

I have asked the lab to also run the T3 and T4 thyroid panel. Those tests are not in yet.

I would like to understand what all of these levels are telling me. I donâ??t think my doctor is going to understand it much better than I do.

Iâ??ve considered a new doctor or the anti-aging clinics but would rather try to understand it myself first so I can better judge what my doctor is recommending. The doctors are probably more conservative than I might like and the anti ageing clinics try to sell you like a used car salesman.

Thanks for the help so far and any advice

423

GeoBob: How to you react to stress, injuries or illnesses? Do these events lay you low? Are there times where you do not have the energy to get out of bed? Do you have an energy drop later on in the morning and late afternoon? Do you drink a lot of coffee sweat snacks? Salt cravings? How fast do cuts and bruises heal?

I am wondering about adrenal fatigue. Cortisol and cortisone are low for this 24 average.

This may need its own thread or we take this to PM… not on topic for this sticky.

Your E2 is not there. Are you taking anything that would lower your E2?
Your T levels suggest that you are not a transdermal absorber. That in turn raises the possibility of hypogonadism as non absorption is a symptom of hypothyroidism. So more T gel might not get the job done. Injections might be needed.

424

Iâ??ll start a new thread if you think it will keep things more organized

Regarding the symptoms you suggested, no I donâ??t have any problems with stress. I do drink coffee in the morning and later in the day Iâ??ll have a cup. Not much sugar, no salt craving, no problem healing.

I met with my doctor Friday. We discussed the low cortisol and cortisone and the symptoms of Addisons disease. She called an endocrinologist and we got a recommendation on additional test to run. She wanted to make sure there are not problems with my pituitary function. My thyroid tests came back from Rhein and they were apparently fine so the reason for low Testosterone absorption is still question.

I gave a blood sample Saturday morning after fasting over night, they are running 1g2f (?) for pituitary function, LH, FSH, Estrodiol, cortisone, testosterone total and free and I forgot what else. I used the andogel Friday afternoon but not Saturday before the blood draw.

Iâ??m curious how long the daily androgel Testosterone levels remains elevated. The Rhien Labs instruction was to not use anything 24 hour before and during the sample collection so maybe thatâ??s why their number was so low. I also think there number represents a free value.

Regarding the non-detect E2 level, that just make no sense. I have not been using any AI before the sample collection. I did start have the collection and may have taken 1mg over the following week and then stopped after receiving the test results.

Iâ??m also curious why the Androstenedione was non-detect. It appears to be a precursor for Testosterone. Would being on Androgel suppress this hormone.

425

TRT, that is effective, shuts down the testes and associated hormone levels would drop. When on TRT, you are not concerned about how well the testes are working when on TRT.

That test may be good for getting a picture of things before TRT. But stopping transdermal T that far before the saliva testing might be making the result useless for TRT dose evaluation and adjustment.

Addisons disease is clear cut, rare and easily diagnosed. Adrenal antique is not. Many?most doctors will not know what to do in terms of diagnosis or treatment; most of which becomes lifestyle issues.

426

Thanks again for the advice KSman, so any thoughts on why the estrodiol might have been so low. I’ll look up Adrenal antipue and see what I can find. Also you mentioned the saliva test but I did a urine test and just recently, a blood test. I’m not sure it matter what test your doing, I suspect if the T levels drop that rapidly, your not going to see them unless you draw blood 3 or 4 hours after application. I suspect this is the case other wise I don’t think they would be having you apply it daily

427

When T is very low, E can be too as there is little T to feed T–>E aromatization.

With saliva tests one still need a 12 hour fasting blood draw for CBC, chemistry and cholesterol. If cholesterol is too low, all hormones will be lower. SHBG, PSA, CRP and Homocysteine require blood work.

428

Have not got my most recent blood work back but I did look up Adrenal Fatigue and I’m now thinking that I probably do have the low energy problem. Why else would I need ritalin and coffee all day to funtion.

I’ll have to check my last cholesterol numbers but I’m sure they were not high. I don’t recall them being abnormaly low either. I also manage to eat anything and never have gained any wieght

429

[quote]GeoBob wrote:
Have not got my most recent blood work back but I did look up Adrenal Fatigue and I’m now thinking that I probably do have the low energy problem. Why else would I need ritalin and coffee all day to funtion.

I’ll have to check my last cholesterol numbers but I’m sure they were not high. I don’t recall them being abnormaly low either. I also manage to eat anything and never have gained any wieght[/quote]

I told you about adrenal insufficiency from the start to get checked out as well as your thyroid. Yes BOB i am all over the place Several of guys from here has come to see us and are very happy with progress.

430

One can find many references stated that the larger T spikes from infrequent injections cause E2 spikes that lead to higher SHBG levels that then lower FT as a fraction of TT.

Note that for a given level of T production or delivery by injection or transdermal, increases in SHBG will increase TT numbers while lowering FT. So one can have more TT by increasing SHBG while getting less beneficial effects from testosterone. That sort of shows how TT is a bit of a bogus indicator of one’s T status.

And we know that more frequent injections do not create such high SHBG numbers etc. That is not the point of this post.

It is always good to see a relationship such as this showing up in another context.

I have been reading a good book on female HRT. That book explains that oral estradiol pills are largely dose degraded with liver first past metabolism. To compensate, the doses are then made larger. When the estrogen is absorbed, the liver sees a high spike of E2, not the serum E2 level, but the much higher E2 level in the portal vein that transports absorbed materials from the gut to the liver. The liver creates SHBG levels that are greatly increased. These high SHBG levels aborb E1 estrone and E3 estriol creating relative deficiencies of free E1 and free E2. That is a problem as women then have less protective estriol to protect them from the effects of the other estrogens. And as we know, women taking oral E2 will then have lower testosterone and diminished sex drive. For non menopausal women, taking oral estrogens also represses there HPOA, LH levels fall and the ovaries are making less T. So T production in the ovaries drops and what is left is subjected to increased SHBG binding. This explains how birth control pills can lower a woman’s sex drive. It is also known that for some women, when they stop taking the pill, their SHBG levels do not recover well and their FT levels do not recover. Libido is never the same. After the very high estrogen levels of pregnancy, the same results on libido and FT can occur.

As with the diminished T production and FT, the less E1, E2 and E3 are produced in the HPOA repressed ovaries and more is bound.

The take home lesson for women is that HRT needs to be transdermal to avoid the SHBG problems or oral dosing and that E replacement needs to include compounded E1, E2 and E3, not E2 alone. The need for progesterone with E replacement is very important and another story. There are also very compelling reasons why women should not use fake estrogens or fake progesterone chemicals [progestins].

431

Just an update, I’ll fill all of you in on the details later, got my test cyp and tried a 100mg does last week. Seemed to feel beter but not definet. started the Armidex also. Last labs show Total T was still low on the Androgel and E2 was 40. This week I tried 50mg on monday and I’ll do another 50 on friday.

The Armidex may now be catching up and lowering my E2 because I feel much better. Not falling a sleep in the middle of the day. No morning stiffness and very few mussel cramps. Guys I think I may have found a solution to a problem that I have had since I was 18 years old. Thanks, I’ll fill in some lab details later. Got a lot of energy and I plenty to get done.

432

Where can I get liquid adex thanks.

433

The little bottle I have has a pump that I believe I accuatly measured out as two pumps = .25 ml so every other day I take a two pumps. I’ll be getting lab data later this month and see where it’s go me. My last test was up around 40. After a week or two now, I feel right (I think) I know the mussel cramps I was getting have gone away. I’m sure that’s telling me something.

434

For anyone interested here are my lab results for 7/29/09
It was a blood test run by York Hospital Clinical Lab with LH, Prolactin, Estradiol, Total Test and Free test performed by Central Pa Alliance Lab. Not sure what test proceedures were done so I’ll have to try and get that info. I don’t know how accurate their results are but at least it’s the same lab that I had two other previous test run from. Some of the results are consistant with the urin test from Rhien but the Estradiol is completely reversed.

The tests we ran were recommended by an endchronologist after reviewing my Rhien lab results

Total Testosterone 296 ng/dL (260 - 1000) range
Free Testosterone 78 pg/mL (50 - 210)

Estradiol 41.3 pg/mL (up to 56 )

FSH 2.8 mIU/mL (1 - 12)

Prolactin 8.5 ng/mL (3 - 13)

LH 1.8 mIU/mL (1 - 9)

TSH 1.54uIU/mL (.3 - 5)

Free T4 .9 ng/dL (.6 - 1.6)

Cortisol 13.7 ug/dL (10 - 25) for 8:00 AM

IGF-1 161 ng/mL (86 - 220)

My doctor and I reviewed the results and I believe the consulting Endochronologist looked them over and decided the the Cortisol levels were representative of a normal condition. It was a concern from results of the Urine test done by Rhien. I believe the T4 level also indicated a normal Thyroid function.

The Low Total Testosterone levels even while on the Androgel was a suprise, the Estrodiol level was also a suprise since the previous test was non-detect. Like I said, I think I was experiencing symptoms consistent with high levels (I have to check that again). In either case, these result prompted my doctor to perscribe the Test cyp as I ask. She still has not perscribed the hCG or Armidex. I was not about to spend 6 weeks waisting time on the injectible Test just have my Estradiol levels go through the roof. I’ve been using the Armidex I purchased from a resurch chemical company as suggested here and after a couple of weeks now I feel good. I’d noticed my day time energy levels getting better for the first week but then I went to working nights 7:00pm to 7:00am so it’s a little difficult to determine but so far I’m not having much trouble staying up. I also have not needed the or been taking the Ritaln (Methylphendidate)to stay awake. Not sure yet if my nuts are shrinking but I think it’s a given that I need to find a doct to perscribe the hCG. Thats my next step. Thanks to all those who have help me so far. I’d have never made it this far with out the information provided here and else where for those of you that post to other lines. Like I said I’ve been falling a sleep in the afternoon ever since high school. It was a problem in collage with classes, at work with every job I’ve had and in my personel life. I really think I may have been suffering from low test ever since high school.

435

Low T and high E2? Welcome to Androgel! Glad to hear you’re off that crap. As for HCG you may want to save yourself 15 doctor visits and just “buy it for your pet hamster” online. It’s readily available.

436

GeoBob,

You labs show that (like me), your body is really good at converting T to E. And that conversion is happening in the fat under your skin. Rub T on your skin, and voila! It gets “aromatized” (converted by the enzyme aromatase) to Estrogen.

Please read the advice here from the guys, especially KSman and KDB.

You’re welcome to PM me as well.

BD

437

GeoBob, Your thyroid may be lab normal range, but it looks sub optimal. And as poor transdermal T absorption is also a symptom of hypothyroidism, you should do a low dose thyroid med trial. If you feel better, that is diagnostic enough to keep using it. If you do not feel any benefit, that is a cheap diagnostic results. Lab ranges include levels that are ‘sub clinical’ hypothyroidism.

Many who know will recommend Armour thyroid. Most docs prescribe the synthesized T4 that the drug reps tell them to use.

Most with adrenal fatigue are in normal range and have a terrible QOL. There are diagnostic codes for very low adrenals levels, but that needs to be below lab normal range which includes the levels of adrenal fatigue. So if they cannot diagnose you with Addison’s disease, you are shit out of luck. Most doctors have no understanding of adrenal fatigue. If they don’t have a diagnostic code, they cannot treat it as your insurance will not work and they thus cannot prescribe an cortisol. I found a good book on this: “Adrenal Fatigue - The 21st Century Syndrome” James L. Wilson

You need to look at symptoms that are consistent with adrenals and would also need a 4 sample saliva cortisol test. AM cortisol is your peak level and you can easily have levels that are low later in the day.

In both cases, lab ranges have absolutely no bearing on the needs of your individual body and its current state of aging and metabolic change.

Having T, thyroid and adrenal problems all at once is unusual, but certainly not rare. T and thyroid problems are often seen together.

Do not let your QOL be boxed in by dumb docs and lab normal ranges. You need to manage your own heath care. This will require ‘doctor management’ by you.

438

Once again, thanks for the great info:

I’ll get the book.

KSMan, will I be able to find the Armour thyroid on line as resurch chemical like the Armidex or a suppliment, or do I need to get a doctor to perscibe.

Regarding the cortisol test I’m assuming that will also require a doctors lab request. If the insurance company won’t pay, do you have any idea how much the tests cost and how it’s administered. (i.e. can I order the test kit and then just send the salive samples off to a lab. And, as with the Thyroid problem, is this something I can evaluate with a low dose cortisole test. Also which issue would you recommend addressing first. The symptoms seem to overlap so I’d assume I should evaluate them one at a time.

As for hCG, I’ll look for it on line but if anyone else has had experience with purchasing on line I’d appreciate the recommendations. This is the first that I have heard about aquiring if with out a perscription. As I have mentioned previously, I requested the persciption for both the Armidex and hCG but my doctor was not ready to write them yet.

439

I have been off this board for a while seeing if my TRT treatment protocol is working.

Current situation is as follows: 48 years old, blood work last week:

E2 = 51

TT = 597

SHBG = 31.3

I am current on 120 subcu T cyp divided in 2 doses, 25 units HCG 2 x weekly, 20 mg Danzol 5x weekly.

I finally got my doctor to prescribe arimidex and now have a bottle of 1 mg tablets. He started out prescribing .2 mg 2x weekly. I am guessing this is way too little. Since the pills are hard to divide, I should have enough to take a bit more. My thought is to go with .25 mg 2x weekly, or do you think more makes sense given my levels?

Thanks for all thoughts. The E2 problem has been my biggest challenge with all of this so far.

440

My doctor started me off on Arimadex (1mg 2x a week). After my most recent blood work showed nearly negligible levels of estradiol (apparently not good), she recommended I reduce the AI to 1mg 1x a week, which I will be starting this week. For what its worth, I think .2mg 2x a week is not enough, but I’m no doc.