Am I eligible to TRT considering the following...?

[Zibernet]

Hello everyone,

First off, the number bits:
- TT: 480 (240-870)
- FT: 10 (8-40)
- e2: 15 (11-44)

After 2 months taking a B-vitamin complex:
- TT: 860 (240-870)
- FT: 11 (8-40)
- e2: 15 (11-44)

TT doubled, but FT and e2 are still low

Other bloods of interest:

- complete liver panel is normal except for slightly above range bilirubin
- 25 OHD is slightly below normal in spite of plenty of sunshine with no blocker.
Vitamin D supplementation gives me liver pain and makes me feel off.


The symptoms:

- flat muscles, even after a workout. The last pump I got was maybe 5 years ago.
- little to no sweating
- no emotions, flat.
- almost no energy to workout
- sluggish and no desire to do anything
- no libido in spite of great erections and good ability to perform
- vivid dreams
- dry skin

Other avenues I have explored:

- negative to candidiasis, parasites or SIBO
- liver function is normal except for high bilirubin
- systemic inflammation is low thanks to a "Ray Peat / carnivore" kind of diet. When I was eating "clean", I was all puffy and gut was inflammed.


I still feel awefull eventhough my TT is at 840 thanks to B vitamins.
I have all the symptoms of low e2.

Would a compounded testosterone cream help?


@Nelson Vergel your input would be immensely valuable to me.

 

[Systemlord]

TT doubled, but FT and e2 are still low

Your SHBG increased your Total T (inert) and is why your Free T barely increased. Your Free T is converted to estradiol so if your Free T is low and it's not surprising to see estradiol low as well.

The Free T is what matters, I once remember a guy with a natural Total T level at 1995 ng/dL and had a Free T extremely low because his SHBG was 248 nmol/L.

While you may not qualify for TRT using your insurance, that doesn't mean you can't get TRT from a doctor running a cash business.

Would a compounded testosterone cream help?

T-cream doesn't effect SHBG much at all, so injections is a better choice if you want to increase Free T substantially.

complete liver panel is normal except for slightly above range bilirubin

I have elevated bilirubin levels with normal liver enzymes and was diagnosed with Gilbert's syndrome, a gene defect.

I wouldn't be too concerned about elevated bilirubin.

 

[Zibernet]

Your SHBG increased your Total T (inert) and is why your Free T barely increased. Your Free T is converted to estradiol so if your Free T is low and it's not surprising to see estradiol low as well.

The Free T is what matters, I once remember a guy with a natural Total T level at 1995 ng/dL and had a Free T extremely low because his SHBG was 248 nmol/L.

While you may not qualify for TRT using your insurance, that doesn't mean you can't get TRT from a doctor running a cash business.




T-cream doesn't effect SHBG much at all, so injections is a better choice if you want to increase Free T substantially.



I have elevated bilirubin levels with normal liver enzymes and was diagnosed with Gilbert's syndrome, a gene defect.

I wouldn't be too concerned about elevated bilirubin.

Thank you Lord.

Indeed I'm driven to think my free T should be the main concern and driver for action, along that low e2 that make me feel aweful.
Previous use of Aromasin may be the culprit, but that's another debate.

I can procure 20% compounded cream from a pharmacy, but only UGL vials, so I'd rather go the transdermal route.

Are my levels warranting even a self treatment?
Will my organs be healthier with higher free T and e2?
I read liver can suffer from low e2.

My IGF-1 and recovery are quite low, maybe due to low e2.

 

[Cataceous]

Is this you? If not it's a remarkably similar situation, with B vitamins ostensibly increasing total testosterone but not free testosterone. Low estradiol too.

B Vitamins Doubled My Total Testosterone Levels

As many of you already know, I attribute a lot of importance to hormones, and I've played quite a bit with them. I have been off testosterone since the 6th of June this year. When natural, my natural testosterone levels has always hovered around 500ng/dl. It was 480ng/dl before I ever used...

raypeatforum.com

The thing about topical testosterone is that you can end up with a lot of DHT, which itself may reduce and oppose estradiol. This may not be ideal if your aromatization is low to begin with.

 

[Zibernet]

Is this you? If not it's a remarkably similar situation, with B vitamins ostensibly increasing total testosterone but not free testosterone. Low estradiol too.

B Vitamins Doubled My Total Testosterone Levels

As many of you already know, I attribute a lot of importance to hormones, and I've played quite a bit with them. I have been off testosterone since the 6th of June this year. When natural, my natural testosterone levels has always hovered around 500ng/dl. It was 480ng/dl before I ever used...

raypeatforum.com

The thing about topical testosterone is that you can end up with a lot of DHT, which itself may reduce and oppose estradiol. This may not be ideal if your aromatization is low to begin with.

Thank you.
Would you then recommend the cream be applied to the belly instead of the genitals for lesser DHT conversion ?

 

[Cataceous]

...
Would you then recommend the cream be applied to the belly instead of the genitals for lesser DHT conversion ?

I suppose this could help marginally. However, if you're going with TRT then you won't be concerned about suppressing natural production. Therefore the simplest solution is to add estradiol to your protocol as needed to resolve symptoms and attain normal levels. Ideally this is under a doctor's supervision, but if not it's easy enough to get estradiol cream on Amazon, or estradiol valerate at places like AllDayChemist.

 

[snkloverpgh]

That e2 really doesn't seem so low but everyone is different. I have had e2 from 17 (using 1/8 tab adex e3.5 days) to 35 (using no adex) and I couldn't tell any difference. This was with trough TT ranging from 770 to mid 900s and FT of 25-30. I've even had e2 as low at 4 when I was using primobolan alongside my TRT and I couldn't tell the difference. If your free test goes up your e2 pretty much has to.

 

[Zibernet]

That e2 really doesn't seem so low but everyone is different. I have had e2 from 17 (using 1/8 tab adex e3.5 days) to 35 (using no adex) and I couldn't tell any difference. This was with trough TT ranging from 770 to mid 900s and FT of 25-30. I've even had e2 as low at 4 when I was using primobolan alongside my TRT and I couldn't tell the difference. If your free test goes up your e2 pretty much has to.

Numbers are one thing, DHT from scrotal application antagonizing e2 too much is another one.

 

[Cooper]

I thought transdermal raised E2 more than injections

 

[Zibernet]

I thought transdermal raised E2 more than injections

Yes it does

 

[SkyWarn]

I have elevated bilirubin levels with normal liver enzymes and was diagnosed with Gilbert's syndrome, a gene defect.

I wouldn't be too concerned about elevated bilirubin.

Old post but I was searching threads regarding elevated bilirubin. My labs just came back with total bilirubin at 1.6 - Freaked me out a little. Checking my eyes for jaundice every day now. My bilirubin normally runs 1.0 to 1.3
Other liver enzymes normal.
ALT 22
AST 22
Platelets 230
Albumin 4.6
How high was your bilirubin?

 

[Systemlord]

How high was your bilirubin?

My bilirubin was as high as 2.9, but has been some time since I bothered testing it. My skin and eyes starts to turn yellow approaching 2.9. My liver enzymes are 17 last time I checked.

You have nothing to worry about.

 

[SkyWarn]

My bilirubin was as high as 2.9, but has been some time since I bothered testing it. My skin and eyes starts to turn yellow approaching 2.9. My liver enzymes are 17 last time I checked.

You have nothing to worry about.

When I was in my 20s (I'm 57 now) I went in for a physical. The Doc calls me and says he wants me to go for a CT scan of my liver. He says my bilirubin is very high and he wants to make sure I don't have a tumor. CT was normal and he concluded I prob have Gilberts. I was drinking (quite a bit) almost every day back then. So I always wondered if it was Gilberts or the daily vodka inflaming my liver. Perhaps the alcohol aggravated the Gilberts.