thanks systemlord. im almost expecting this to be a first step in the process especially by the way he phrased how the treatment will need to be changed along the way to get me to feeling how i want to. Being in Ontario im not certain if there is a certain protocol that he has to follow before settling in the the best course of action? ie cannot suggest injections until the gel is tried and shown not effective enough?
Hi everyone. my 2 month appt with endocrinologist is coming up so had blood work done a few days ago.
Should mention on two 5 gram packets of androgel a day, applied at night. was feeling great about 3 weeks in, a lot of symptoms alleviated. That did not last overly long, symptoms came back almost worse than they were before. I assumed it was just my natural T production shutting down and not enough replacement testosterone, and then i got the blood results?
Free Test HI 864 range 196-636pmol/L
Estradiol Hi 241 range < 162 pmol/L
everything else was normal range. (no test for shgb as i see regularly mentioned here)
Could my overall feeling of crapiness be as simple as the high estrogen?
And also is that normal for free T to be that high on the prescribed dosage i am taking, i was expecting the tests to come back even lower T levels than my original which resulted with me being placed on TRT.
any input is appreciated on what to expect ( or what i should ask to happen my next appt)
thanks
Yes, having a very high FT can be a reason for high estrogen considering FT is converted to estrogen. High estrogen can feel a lot like low testosterone. You just need to lower your dosage and retest in 6-8 weeks.
You have low SHBG because FT is very high and TT is in range, someone with middle range SHBG wouldnāt have FT over the top of the ranges. When my TT was 697 I had FT over the ranges (29.6 6.8-21.5 pg/mL) because I have low SHBG.
Thanks Systemlord. Would that mean that having low SHBG is a good thing then? Always up for some good news if that is the case, since I always had the feeling my body would be stubborn to TRT treatment.
Also I get really flushed and warm skin about half the time when i put on Androgel? Iām going to mention this to Endo. But again curious if this is something to be overly concerned about?
No itās not a good thing, you might think having a lot of FT is a good thing, but the problem low SHBG men seem to have is excess hormones which cause symptoms. There are a lot of diseases associated with low SHBG.
The low SHBG men seem to be having the most difficult time on TRT, usually itās self induced because some refuse daily injections which is whatās usually needed.
This is a sign the dosage is too high, this may be high estrogen. I have the same symptoms when my dosage was excessive. You can control things better on daily injections, especially is you are over responding to androgel.
I find enanthate to be best for a daily protocol versus cypionate, cypionate is best when not injecting daily. This is of course my own experience and may not be true for everyone, but I have encountered other who make made similar comments.
Thanks. Not exactly sure what the doctor will suggest. I just know at about that 3 week mark is how i would like to feel everyday. Just have to figure out how to stay in that zone.
Interesting. So, is there a way to gauge what FT is optimal based on oneās SHBG? Trial and error is of course going to work based on the individual, but wondering if thereās any numerical correlation.
If not, I guess the only way is to try a protocol and slowly bump up or bump down for a set period of time, til the body syncs up. Then, stick with whatever you felt best at.
Just curious, would spreading out the dose of Androgel lessen its estrogen effect/conversion? i.e. one packet at night, one in the morning instead of both packets at once?
appreciate any insight given!
I will say most low SHBG men will do very well with TT about midrange and am seeing a trend of low SHBG and high free estrogen percentage. Take me for example, a TT at 417 will see estrogen at 28, but have been at around 100 ng/dL for seven months and estrogen has got to be close to single digits and I donāt feel low estrogen symptoms.
I donāt think this will change things much, over time I would expect levels to accumulate.
Have you noticed any trends with how mid SHBG men do well on for TT? I would think 800-1200?
Saga continues. Most recent visit with Dr. and he does not see an issue with my elevated estrogen levels, brushed off any symptoms that i may believe are associated to it. thinks people only want anti estrogen meds prescribed to increase testosterone that would normally be converted to estrogen. Suggested i keep doing prescribed treatment and thinks things will āfind there levelā eventually? Next visit isnāt for over 6 months away.
Iāve cut back on dosage as systemlord suggested, but aside from ordering some sort of AI off of internet is there something that can be taken to limit estrogen conversion? I have read conflicting things about Boron usage, and am working on losing fat as i am aware that also speeds up the estrogen conversion.
Again any insight is more than appreciated.
Did the MCV value improve after starting testosterone? I am kind of in the same boat and I havenāt started TRT yet.
Reduce dose will reduce conversion.
You could also look to improve metabolism and excretion of estrogen. How is your diet? Do you drink a lot of beer? Do you eat broccoli? Warm lemon water and pure cranberry juice also help detox the liver helping to clear estrogen. DIM is also helpful in estrogen metabolism.
it was at 84 this time around. i apologize i only listed the results that were out of normal range.
That is great. Did you supplement iron during this time?
No, no real supplements except for tumeric, and vitamin d, and no real change in diet during time period as well. oddly enough i wasnāt even concerned with this # until you mentioned it as it was seen as ānormalā
ok thanks. And don not touch alcohol, diet is average, not to strict but not horrible either. Iāve found the more motivated i feel to workout, the better the diet gets. this is why Iām trying to see if lowering estrogen would help with these feelings. will read up on DIM.