Gilberts Syndrome and High E2 on TRT Causing Issues

Hi all,

My E2 is creeping up and along symptoms of depression and anxiety that are unknown to me.

I felt super the first 3 months (TT around 550 and E2 25) but slowly developing the before mentioned symptoms (currently TT 500, fT 11 and E2 61).

About 5 years ago I was on 12.5mg Clomiphene eod for 6 months resulting in TT 560 and E2 22 and felt the best I ever did.

I have Gilberts syndrome which is caused by a polymorphism in the UGT1A1 enzyme, the enzyme also mainly responsible for estradiol metabolism and clearance.
Interestingly, steroid hormones in turn negatively impact the UGT1A1 activily which explains my further elevated bilirubin levels lately.

Does anyone else have Gilberts syndrome and a hard time to control E2 and symptoms of anxiety, irritability and depression?

Physical changes on TRT like muscle gain and increase in strenght are impressive but i really struggle with the emotional sides.

More info on estrogen metabolism can be found here

Respectfully, I am not asking for advice on the injection frequency (although I might consider this to control E2) nor on advice regarding the optimal fT levels.

What are your bilirubin levels?

Why are you against raising your testosterone levels and see how it goes? Sounds like the easiest thing to try. (Yes I read the ā€œdonā€™t comment on testosteroneā€ but youā€™re in the testosterone forum)

Total bilirubin Increased from around 2 pre TRT to now 4.1 mg/dL.

E2 is a metabolite of T, the more T the higher E2 will be. E2 us already high so I donā€™t know how putting more T in the system would decrease E2.
Daily might be worth to try.

Besides, physically the TRT experience is there, put on 4 kg of muscle mass in about 4 months, libido and erections are top, regenarate faster etc.

Maybe itā€™s also unrelated to E2, put my intention is to find out if also other men with Gilbertā€™s share my experience with high E2.

I have the gilberts gene, it was found out by complete accident when my skin started turning yellow on a daily protocol. Gilbertā€™s symptoms are yellow skin and eyes, thatā€™s it. I donā€™t have trouble controlling E2 when on a daily protocol.

My bilirubin levels pre-TRT was 2.5 mg/dL, it is the same on TRT.

Thanks for tge feedback.

Did you develop polycythemia on dialy shots? Maybe with different dose? A publication suggests that the injection frequency rather than the dose predicts thd risk for dev polycythemia. Some members here and on excelmale seem to confirm this.

I think its both, dosage and frequency, but as i developed high HCT on a kow dose of 3x25mg I am afraid that daiky coukd excarbate this problem.

No, my HCT was only 46% on 7mg daily. The problem I have on a daily protocol at 10mg is potassium is crushed quickly, I really thought I was a dead man. My HCT is actually higher on EOD protocols with similar numbers because I have to use more T to account for the decline between injections.

Du you have an idea why your K crashed on daily?

@johann77
Is your urine dark orange?

In the mornings yes.

No change in liver enzymes. Only non conjugated bilirubin increased.

@johann77
My bilirubin was 1.3 (1.2 range) at last check. You think itā€™s something to worry about?

No. In Gilberts total bilirubin is typically somewhere between 1.5 and 5 mg/dl. Its not considered a disease but a ā€˜natural variantā€™. Actually studies have shown that high levels of bilirubin are associated with a lower risk for cardiovascular events.

If the liver enzymes are fine than there is nothing to worry about. But liver enzymes can also artificially be increased due to heavy lifting as these enzymes are also released by skeletal muscle.

1 Like

My liver enzymes are improved on TRT as seen in testing right before stopping and a week later, there was clearly a slight difference and may be why bilirubin is slightly lower on TRT. This was only seen when on the daily protocol as well as an increase in SHBG which has never been seen at 22 off TRT or on other protocols.

I can only imagine if I had given the daily protocol more time, I would have seen SHBG increase even more. I had only been 7mg daily for four and a half weeks.

howā€™s your A1C? Orange urine sounds like a sugar issue.

Hey @hardartery

Sugar levels are under control. Actually improved on T.

On daily I shall go. What the heck, I give if a try and see what happens.

Thanks guys!