Blood Test Questions - Estrone Levels High

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drbenway

New Member
  • 52 yo male
  • 6'0" 246lbs
  • Started TRT in Early Nov (Total T of 182/Bio Av Test "normal at 109 ng/dL)
  • My Endo tests Estradiol and Estrone - the former is consistently (over 3 labs) <20 pg/ml and the latter has been persistently > 170 pg/ml)
  • SHBG is low (likely insulin resistance)
  • Take 40mg Pravastatin for lipids
  • Started with 40.5mg of Androgel in Nov/December labs showed no change in TT/BAT, doubled to 81mg at end of December
  • Latest labs are below
Questions/Comments:
  • I have worked very hard on my diet and exercise since the new year, cut drinking way down and weight is so stubborn to come off - anything here that people can see that provides a clue?
  • libido is better, not great
  • I feel much better than before TRT but not "great"
  • Endo feels my levels are fine, I'm concerned about Estrone levels and sub 20 Estradiol - should I be? He feels that Estrone is because of body weight previous tests showed DHEA Sulfate and Androstenedione normal

Thoughts?

Hemoglobin A1c

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Estradiol

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Estrone, Serum

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Cbc With Differential/Platelet

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Lipid Panel

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Comp. Metabolic Panel (14)

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Testost., Bioavailable W/Shbg

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Defy Medical TRT clinic doctor

CoastWatcher

Moderator
Welcome to Excelmale. Your doctor ordered the incorrect estradiol test - all men should rely on the sensitive test, LC, MS/MS. By ordering the standard test, used for women, you don't really know where your estradiol level sits. Why did he order, and why did you pay for estrone? It provides no actionable information for you or your doctor.
 

Sean Mosher

Member
Your Total T is 390 ng/DL, which frankly isn't really normal.
Very sub par for being on TRT.
And you definitely need the sensitive estradiol test.
What's your current protocol?
Definitely needs some adjustment IMO....
 

drbenway

New Member
Welcome to Excelmale. Your doctor ordered the incorrect estradiol test - all men should rely on the sensitive test, LC, MS/MS. By ordering the standard test, used for women, you don't really know where your estradiol level sits. Why did he order, and why did you pay for estrone? It provides no actionable information for you or your doctor.

Thanks for the reply.

I have no idea why he ordered the Estrone, nor do I understand whether I should be concerned with the level. Insurance paid for tests...

Weirdly he did order the sensitive test before starting TRT in November. The regular Estradiol test was 15.4 pg/mL

Estradiol, Free Serum

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drbenway

New Member
Your Total T is 390 ng/DL, which frankly isn't really normal.
Very sub par for being on TRT.
And you definitely need the sensitive estradiol test.
What's your current protocol?
Definitely needs some adjustment IMO....
2 packets of Androgel for a total of 81mg of T - all done per instructions. When I was on 40.5mg, my total T was 180.

Endo says "Total T doesn't matter, BAT is good and that's all that matters. Come back in 6 months"
 

CoastWatcher

Moderator
2 packets of Androgel for a total of 81mg of T - all done per instructions. When I was on 40.5mg, my total T was 180.

Endo says "Total T doesn't matter, BAT is good and that's all that matters. Come back in 6 months"

He orders a test of no value (estrone), he orders an incorrect test (the wrong estradiol measure), and he tells you that total testosterone doesn't matter. You are consulting a doctor who will not provide you with the direction you need to achieve TRT success.

Did he mention that a substantial number of men fail to achieve success with topical testosterone? It's an absorption issue, some guys - no matter how much topical is applied - do not boost their levels. That was true in my case and it happens many times. It an be fixed easily with a transition to injections.

I'd be astonished if anything changes between now and your next consultation. You deserve better care and that means probably finding another doctor. Don't wait six months.
 
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