Do you have any relatable low E2 symptoms? Your E2 is below range, but obviously existent. Your FT, calculated with albumin/SHBG, is pretty low too. As you said, everything else looks pretty good.
Ya, I never really considered low estrogen.
With that being said some of the symptoms of low T and low E are similar.
Low libido
Irritability
Cognitive issues
Fatigue
Low drive
Etc.
I have them all
Can you confirm they didnāt test FT? I didnāt see it. By calculation its low and it should be with labwork too. Your first tests you provided it wasnāt but based on these results its not clinically low, but low enough I think TRT is something to consider. Admittedly, I didnāt think TRT was a great option based on your initial labs, but these are not as good factoring in the FT you body uses.
TRT will bring up your FT and E2 thereby likely alleviating your symptoms. The fact that youāre so lean may be a contributing factor as well. Just because youāre muscular doesnāt mean you couldnāt have low T/FT, you would just be a genetic outlier.
I had to do a āTriple checkā on those reports. I was looking for FT numbers as well. I donāt know why they wouldnāt have included that.
Considering the fact that the first tests were taken in mid Sept. and Iāve been lean bulking ever since. I thought the numbers may have improved some. I just sent a message asking why FT was not included.
Outside of that. I have another Endo appt. in mid December. # Waiting!
Testosterone converts to estrogen via aromatase, which is where you get the majority of your estrogen. If youāre suboptimal on Free T levels, itās not uncommon to see estrogen low as well.
However in your case, the likely cause is low levels of aromatase enzymes in the body.
How is this typically treated?
TRT or hCG, since you need more testosterone to convert to estrogen. Both of these options will suppress the HPTA, and therefore natural production.
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Hereās the latest and hopefully last round of test results before my Endo. appointment on Fri. Total test and free test look like they are falling Estradiol and Bioavailable are still low. Curious as to whatās going to happen with the Doctor.
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Iād be interested to know how your free test was measured. Often it is done with calculations, sometimes the lab will use Direct, but the most accurate method is Equilibrium Dialysis.
FT is the best measurement to go by, when combined with Low T symptoms.
FWIW, your levels are better than mine were at 27 so that should be promising 
Ya, not sure how they came up with that number. I just ran the numbers through an online calc and it came out wonky.
Also, my Estradiol total was ā21ā normal ranges are supposed to be
27-52 pg/ml. I canāt make much sense out of it.
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Well? My endo appointment finally came and went. He said my test and estrogen was low and started me on TRT. Iām supposed to Inject 50 mg of Test Cyp. (1/2 mL) intramuscularly ONCE A WEEK as instructed.
Seems dreadfully low but i guess weāll see what happens. I have a follow up with him in 3 months.
Can you not go to a menās clinic? TRT by Endo is almost always poorly prescribed. I think @BrickHead get good treatment by an Endo but that seems rare.
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I havenāt started taking it yet. I should be able to pick up my Rx today and inject tonight. I guess Iām trying my best to stay positive in thinking this is just a starting point with my Endo.
He wants me to pull blood work and come back in 3 months to reevaluate.
I guess my thought process was to try it out and if in 3-4 wks I start to feel shitty. I would call in for blood to be taken early and they try to talk him into raising the dose prior to the scheduled 3 Mo. appointment.
I guess Iām not sure if heās being āsafeā or ādumbā
from what I gather he does have other TRT patients, and Iād be surprised if those guys are dialed in at such a small dose.
Thoughts?
My Rx says Testosterone Cyp.
100mg/ml - 10ml
Not sure how long thats supposed to last me before refill
Its so low its not likely to even get you back to your baseline levels. 100mg is a safe approach, 50mg is nonsense
20 weeks. You take 1/2ml /wk per this doc which again is too little.
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Soā¦ Should a run it as directed and potentially tank my levels even worse in order to prove the point that the dosage is too low?
Then advocate for a greater dose?
I would think that after showing proof (Labs) of low level that he wouldnāt agree and raise my dosage.
orā¦ raise the dose myself and miss my injection for a week or so, before my next appointment. In order to show low levels?
This admitedly sounds kinda dumb as Iām typing 
The Endocrine Society recommends 75-100 mg per week or 200 mg every two weeks, not 50 mg per week! The truth is many endocrinologistās and urologistās just arenāt interested in TRT. Itās not a passion, theyāre into other stuff.
Everyone here knows how this is going to end, and itās not positive.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5182226/
The Endocrine Society Clinical Practice Guidelines for testosterone therapy suggest an alternative of either 75 to 100 mg IM weekly or 150 to 200 mg IM every 2 weeks
Itās not common for doctors to ignore guidelines.
Youāre not going get tested for at least six weeks, and in the meantime, you going to feel like dog shit.
If you up the dosage, youāre going to run out of your prescription and then when you go to fill it, theyāre not going to fill it because itās too early.
Stop wasting time, find another doctor right now!