Labs Check; How Do You Control Estrogen?

Hey,

Asking for labs check. 37yo male, 207lb; dad, husband, etc. Lifting for 10+ years; I lift four days a week and run, ride my bike or murph in Z2 two days a week. Currently bulking at ~600 kcal surplus per day; not on creatine at the time. I was struggling with knee lesions for ~12 months when an ortho tested my test (along with a lot of other labs); tested was 267 ng/dl in August. Dr suggested start 200 mg/week of test cyp. I didn’t know I had low T symptoms (mainly low late day energy) until going on TRT took care of them; it’s made a big difference. After 8 weeks I was at 800 ng/dl Dr. upped me to 225 mg/week to try and push estrogen up for cartilage healing. I’ve been on it ~14 weeks with daily injections. Its honestly so hard to see the fine numbers on the syringe that I’m pretty sure I was over injecting. I ordered labs myself last week (LabCorp) and now my test and estradiol are concerningly high. I’m switching to every other day injections so I can tell what I’m injecting better and reducing back to 200 mg a week. I wanted legit srs thoughts on the following.

Currently concerns:
-how do I reduce estrogen?
-TRT increased by blood pressure by 10 mmHG systoliclly
-high ALT/AST

CBC
WBC 4.7
RBC 5.23
Hemogolbin 15.3
Hematocrit 47.7
MCV 91
MCH 29.3
MCHC 32.3
RDW 11.9
Platelets 215

CMP
Glucose 98
BUN 17
Creatinine 1.11
eGFR 88
BUN/Creatinine Ratio 15
Sodium 137
Potassium 4.8
Chloride 100
CO2 25
Calcium 9.9
Protein 6.6
Albumin 4.7
Globulin 1.9
A/G Ratio 2.5 HIGH (1.2-2.2)
Bilirubin .6
Alkaline Phosphatase 76
AST 56 HIGH (0-40)
ALT 51 HIGH (0-44)

Thyroid
TSH 1.57 (.45-4.5)
Thyroxine 5.3 (4.5-12)
T3 Update 25 (24-39)
Free Thyroxine Index 1.3 (1.2-4.9)

Test
Total >1500 ng/dl HIGH (264-915)
Free 26.8 pg/ml HIGH (8.7-25.1)

Others
Estradiol 93.3 pg/ml HIGH (7.6-42.6)
Hemoglobin A1C 5.4 (4.8-5.6)
APO-B 98 (<90)
GGT 15 (0-65)
Iron 85 (38-169)
Ferritin 37 (30-400)

I 100% forgot to order a lipid panel….

If you read this far, thank you.

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The ranges for estrogen are not for men on TRT. Men on TRT with estrogen over 42.5 report less problems with erections and higher libido. If you’re going to run very high testosterone, you need appropriate levels of estrogen to function normally.

Makes sense. What about thyroid function; does it seem low?

You’re taking more than the amount of Testosterone you likely need hence above range T levels and E2 levels. Lower your dose to lower your E2 otherwise if you feel fine don’t do anything.

I def have some gyno under my right nip. What E2 is too high?

Optimal E2 is different for everybody. Sometimes tenderness and puffiness happens around the nips with new hormonal swings. Often times it subsides on its own. If the lumps are more firm it would be time to take it serious and lower E2 or take a SERM.

It’s one lump, just behind the nip. Nips have been tender off and on since starting TRT. Should I take a AI?

I am in no way medical / doctor but I would think an aromatase inhibitor like anastrozole would be beneficial and I would start asap. Get your Dr to prescribe it or another equivalent solution as gyno isn’t something you want to mess with

I thought the same and already messaged him

If e2 is elevated, yes

So Nolvadex blocks E2 receptors in breast tissue. Talk to your doc about that and/or a combination of AI and Serm until E2 is under control.

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Talked to dr. Does anastrazole at 1mg m-w-f sound about right? Any sides I should be expecting?

Nope. Not even remotely close. It’s very strong. Depending on your e2 levels, I would suggest .25mg once or twice per week to start with.

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Good to know. It sounded very strong based on what I’ve read elsewhere in this forum, but I genuinely didn’t know

I would agree with @swoops39. I’m not giving medical advice but would simply go back to your doc with your concerns. Thats enough AI to quickly flip flop your condition from high to low E2. If it were me, I would baby step the AI and add a SERM to block the gyno as I mentioned.

Thank you and @swoops39 . I’ll start at .5 totally weekly mg. I guess I’ll redo labs in another ~8 weeks and see what it does.

Ive just been put on anastrozole and its a 1/4 of a tab once a week. Maybe start there also. My estrogen is quite high so hopefully this dose brings it down to desired levels. Not crash it

Thanks @antelope . I get the vib that my Dr googled ai when I asked for it. I’ll start slow

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@blshaw @GAINSBYIG @antelope @swoops39 @systemlord what time of day should I dose or does it even matter?

I do weekly TRT shots and take AI within 24 hours of my shot