Raising E2 without TRT?

Pharma TRT
1

My dad (56) was having some low T (suspected) symptoms and so just had some blood work done expecting, due to his age, to have low T.

Bloodwork came back and actually all the hormones were good, middle upper end of the range, except for e2 which was crashed.

Low e2 explains all the symptoms, but I can’t figure out how you’d raise e2 without injecting more T?

Seems unnecessary to start TRT with good levels in everything else?

Lab results below, not on any medication. Any ideas or info would be much appreciated.

Proteins
Albumin 44.9 g/L (Range: 35 - 50)
SHBG 43.6 nmol/L (Range: 20.6 - 76.7)

Hormones
FSH 4.05 IU/L (Range: 1.5 - 12.4)
LH 4.03 IU/L (Range: 1.7 - 8.6)
Oestradiol X <18.4 pmol/L (Range: 41 - 159)
Testosterone 19.9 nmol/L (Range: 6.68 - 25.7)
Free Testosterone - Calc. 0.353 nmol/L (Range: 0.16 - 0.47)
Free Androgen Index 45.64 Ratio (Range: 24 - 104)
Prolactin 257 mU/L (Range: 86 - 324)

Adrenal Hormones
DHEA Sulphate 6.380 umol/L (Range: 1.4 - 8.01)

2

@increasemyt @anon18050987 sorry to tag you in, but you guys seem to know what you are talking about. Anything you know of that can help or ideas on what is going on?

3

He could try some dhea

4

What supplements is he taking?

5

There are a lot of foods and supplements available. Or, he could simply take estradiol, 1-2mg per day should do it.

6

His DHEA levels were fine, would this still be beneficial?

7

Nothing other than general health stuff like vit d3, zma and omega 3

8

Supplementing with a little DHEA could bring the estrogen levels up a tad. I don’t think it could hurt.

9

We had another member on here who found out vit d supps were lowering his e2. Not sure how much you are taking.

Also zinc can reduce e2. Not sure about omega 3. Things that increase liver efficiency may reduce e2.

May be worth to stop some supps and retake labs.

10

Can you elaborate on the symptoms?

High prolactin can cause a host of issues.

11

Mostly joint pain and slow recovery. I assume there are more but there’s only so much that passes in a father son relationship ha.

Is this high enough to be ‘high’, I only ask because it’s ‘in range’ for whatever that’s worth, and if so, how to lower it?

12

His Total T levels are good, but what of the free portion of testosterone? His SHBG is on the higher end, Free T is expected to be suboptimal.

Free T calculated is just that, it’s based on an calculation or assumption everyone is the same, Free androgen index has his free hormones on the below midrange and we also see E2 very low.

This isn’t the first time I have seen men with symptoms with below Free T midrange, in fact I see it all the time. As men age their receptors become more insensitive needing more hormones, his receptors are not as sensitive as they were when he was 21, they are older and not as efficient as they used to be.

We know there is a variability in the stickiness of SHBG from person to person, so these calculated methods make the assumption everyone is the same. There is only one way to correct the low estrogen situation which is caused by low Free T, TRT.

This screams low testosterone, again the free portion of testosterone and not the inactive portion.

13

I think @NH_Watts had trouble with supplements crashing his E2. Forgive me if it wasn’t you.

14

So your reccomendation would be to increase e2 via increasing T, probably via self administered TRT? (Can’t see UK TRT docs prescribing with T in range).

15

Not me, it was @alphagunner. He is on hiatus but he crashed it with regular supplements. Very sensitive.

16

We all know those ranges are bullshit. Certainly not “optimal”. Cabergoline or Pramipexole are the 2 anti prolactin drugs I’m aware of.

17

Correct, doctors in UK are still in the stone age of hormone medicine. It’s not much better here in the states because doctors still believe TRT causes prostate cancer, heart attacks and strokes.

18

And just to clarify here, because I really don’t know anything about this stuff, you think that lowering prolactin could help increase e2, which is the goal here?

19

No, I mentioned it due to your first statement (above) and that high prolactin creates impacts on erection quality and thought it could be related to the symptoms you mentioned

20

OK thanks. Yea its a confusing situation to be honest, he had the blood test because he thought he had low T symptoms.

The results came back showing only low e2 as the obvious problem and, in hindsight, better explains the symptoms. So really getting e2 up without resorting to anything too drastic is the current goal.

In a perfect situation there would be a way to raise e2, see if it resolved symptoms, and then only if not, look into other options like TRT.