Could this be low E2?

[RickB]

About a month ago I got my second Pfizer covid shot. I felt a little sick for about four days. I recovered, but I noticed a few days later that my joints don't feel right. I googled and saw a lot of cases of this being a lingering effect from the vax, so I figured there's not really much I could do but wait for it to go away.

Then it hit me that I better rule out low E2 just in case. I won't get to the lab for a few days, so I thought I'd try to get some opinions here. My protocol for months has been 85mg cypionate and 6.25 Exemestane E3.5 days, and my numbers were always coming back very good, with E2 in the mid 20's. I haven't had blood work done since early June, but I don't see any reason why they should be different now.

The half life of Exemestane being so short, I can't imagine there's any way my E2 should be lower than it had been. The additional time since my last labs should mean higher T and therefore higher E2 if anything. Can anyone think of any way my E2 could've gotten lower? It's not a huge deal because I will get labs done in a few days, but if anyone knows any reasons that E2 could drop after an extended time sticking with a protocol, please let me know.

 

[Vince]

E2 in the mid-20s is somewhat low. Have you ever tried not using an AI?

As I'm sure you know, higher E2 levels are better for your joints, better for your libido and better for building muscle.

 

[swolg8r]

I would drop the exemestane and try to find a balance using just test.

 

[Systemlord]

Can anyone think of any way my E2 could've gotten lower?

I have seen cases where men had been on AI's for months, even years and had steady E2 and one day they find it in the single digits.

The worst thing that can happen is your body adapts to what the Exemestane is trying to do, which is kill off aromatase to the point where your body stops making more.

I have heard of this happening and it's a living hell from what I hear.

 

[swolg8r]

That’s what I’m dealing with currently. Like lowe2guy and nurselyfe. It’s a living hell. Exemestane was created to stop the production of estrogen for women who have cancer brought on by their estrogen levels. The med is literally made to be used to destroy estrogen levels permanently. I’m of the opinion that if your trt dosage requires the usage of such a toxic medication, you’re doing it wrong.

 

[RickB]

E2 in the mid-20s is somewhat low. Have you ever tried not using an AI?

As I'm sure you know, higher E2 levels are better for your joints, better for your libido and better for building muscle.

Good point. A lot of people say its a good number, and it felt good for me, but it makes sense that the more time spent at a number, the more thorough the effects will be. I could've felt fine at 25 for several weeks, while it was slowly taking its toll on me. If that's the case, my next labs might not shed much light. I can be at 25 still and be suffering from low E2. Very good point.

 

[RickB]

I would drop the exemestane and try to find a balance using just test.

I tried that and just couldn't get it right, but I might have to try again.

 

[swolg8r]

I tried that and just couldn't get it right, but I might have to try again.

What were your bloods on 170mg cyp per week? To me, that is a lot of test per week. There’s a user in here who just found his sweet spot doing 52mg once every 7 days. Not saying this is going to be the case for you but Sometimes less is more.

 

[madman]

About a month ago I got my second Pfizer covid shot. I felt a little sick for about four days. I recovered, but I noticed a few days later that my joints don't feel right. I googled and saw a lot of cases of this being a lingering effect from the vax, so I figured there's not really much I could do but wait for it to go away.

Then it hit me that I better rule out low E2 just in case. I won't get to the lab for a few days, so I thought I'd try to get some opinions here. My protocol for months has been 85mg cypionate and 6.25 Exemestane E3.5 days, and my numbers were always coming back very good, with E2 in the mid 20's. I haven't had blood work done since early June, but I don't see any reason why they should be different now.

The half life of Exemestane being so short, I can't imagine there's any way my E2 should be lower than it had been. The additional time since my last labs should mean higher T and therefore higher E2 if anything. Can anyone think of any way my E2 could've gotten lower? It's not a huge deal because I will get labs done in a few days, but if anyone knows any reasons that E2 could drop after an extended time sticking with a protocol, please let me know.

What factors could influence total T result?

I was taking 200mg cypionate every Thursday morning. I got tested Thursday at absolute trough and was 1361. I did not pin that day, and instead waited until Saturday morning. I got tested the next Friday afternoon and was >1500. While those second bloods were drawn about 16 before my new...

www.excelmale.com

You were on that piss poor 200 mg T/week protocol previously which would easily have your TT, FT, and estradiol sky-high.

Unfortunately, you never tested TT/FT or estradiol using the most accurate assays.

As you can clearly see when looking over the thread your trough TT was absurdly high which would easily have your FT very high even if you have high/highish SHBG.

Let alone your estradiol would have been high if you were not trying to manage it with an AI.

You stated in this thread that you are running a slightly lower weekly dose of 170 mg T/week (85 mg every 3.5 days) which is still a fair dose and I would bet you are still hitting a high trough TT and more importantly trough FT on such protocol (dose of T/injection frequency).

Put money on it you easily have room to lower your weekly dose let alone drop the AI.

Post your labs when you get them trough TT, FT, and estradiol let alone RBCs/hemoglobin/hematocrit.

Hope you finally tested your FT using an accurate assay especially if you have altered SHBG.

From what I remember your SHBG was high!

 

[madman]

About a month ago I got my second Pfizer covid shot. I felt a little sick for about four days. I recovered, but I noticed a few days later that my joints don't feel right. I googled and saw a lot of cases of this being a lingering effect from the vax, so I figured there's not really much I could do but wait for it to go away.

Then it hit me that I better rule out low E2 just in case. I won't get to the lab for a few days, so I thought I'd try to get some opinions here. My protocol for months has been 85mg cypionate and 6.25 Exemestane E3.5 days, and my numbers were always coming back very good, with E2 in the mid 20's. I haven't had blood work done since early June, but I don't see any reason why they should be different now.

The half life of Exemestane being so short, I can't imagine there's any way my E2 should be lower than it had been. The additional time since my last labs should mean higher T and therefore higher E2 if anything. Can anyone think of any way my E2 could've gotten lower? It's not a huge deal because I will get labs done in a few days, but if anyone knows any reasons that E2 could drop after an extended time sticking with a protocol, please let me know.

Huge mistake driving your estradiol too low!

Have no clue where it sits as of now seeing as you have not had blood work done yet.

As I have stated numerous times on the forum:

Keep in mind that the metabolites estradiol and DHT are needed in healthy amounts to experience the full spectrum of testosterones beneficial effects on (cardiovascular health, brain health, libido, erectile function, bone health, tendon health, immune system, lipids, and body composition).

*Natural testosterone is viewed as the best androgen for substitution in hypogonadal men. The reason behind the selection is that testosterone can be converted to DHT and E2, thus developing the full spectrum of testosterone activities in long-term substitution

 

[RickB]

What were your bloods on 170mg cyp per week? To me, that is a lot of test per week. There’s a user in here who just found his sweet spot doing 52mg once every 7 days. Not saying this is going to be the case for you but Sometimes less is more.

Through Marek Health, I have been going to LabCorp and using the same assays that my uro uses. My plan was to stabilize my free and E2 around 25 and then get the equilibrium dialysis assays done a couple of months later (unless I was feeling really good). By late May weekly bloods were coming back all in the range I was looking for. And sexually I have been better than ever, so I wasn't even giving much thought to bothering to do the gold standard tests.

My second vax shot was actually 6/21, and I noticed the joint pain maybe around 7/1. So now I want to of course get bloods. And in this case it makes sense to stick with the standard assays. If I do the gold standards I'll have nothing to compare them to. When I get my results, I'll post them and maybe schedule the gold standards for next week.

This post was as much a reply to madman as it was a reply to swolg8r. I knew that madman would be upset about the assays and would claim my free is probably sky high. But while I do appreciate his stance on the assays, I am not 100% sold that the equilibrium dialysis ones are better. I still plan to do them, but I really want to stick with comparing apples to apples, instead of starting in on the oranges.

 

[madman]

Through Marek Health, I have been going to LabCorp and using the same assays that my uro uses. My plan was to stabilize my free and E2 around 25 and then get the equilibrium dialysis assays done a couple of months later (unless I was feeling really good). By late May weekly bloods were coming back all in the range I was looking for. And sexually I have been better than ever, so I wasn't even giving much thought to bothering to do the gold standard tests.

My second vax shot was actually 6/21, and I noticed the joint pain maybe around 7/1. So now I want to of course get bloods. And in this case it makes sense to stick with the standard assays. If I do the gold standards I'll have nothing to compare them to. When I get my results, I'll post them and maybe schedule the gold standards for next week.

This post was as much a reply to madman as it was a reply to swolg8r. I knew that madman would be upset about the assays and would claim my free is probably sky high. But while I do appreciate his stance on the assays, I am not 100% sold that the equilibrium dialysis ones are better. I still plan to do them, but I really want to stick with comparing apples to apples, instead of starting in on the oranges.

Wrong assays to rely on when it comes to testing free testosterone, especially in cases of altered SHBG!

140103: Testosterone, Free, Direct With Total Testosterone | Labcorp

Labcorp test details for Testosterone, Free, Direct With Total Testosterone

www.labcorp.com

144980: Testosterone, Free, Direct | Labcorp

Labcorp test details for Testosterone, Free, Direct

www.labcorp.com

Get back to me on where your trough FT level truly sits when you have it tested numerous times using the same lab (Labcorp)/same assay (most accurate).

070038: Testosterone, Free, Equilibrium Ultrafiltration With Total Testosterone, LC/MS-MS | Labcorp

Labcorp test details for Testosterone, Free, Equilibrium Ultrafiltration With Total Testosterone, LC/MS-MS

www.labcorp.com

Even if you are hitting a trough TT 1000-1200 ng/dL you can rest assured that your trough FT is going to be healthy let alone high even if you have highish/high SHBG!

 

[RickB]

Someone shoot me now...

 

[swolg8r]

Someone shoot me now...


View attachment 23576

Ok so there you go now you know why you’re having issues. That dose is way too high for you.

 

[RickB]

Ok so there you go now you know why you’re having issues. That dose is way too high for you.

I don't know what to make of these results. I've got crazy high total and E2, with average free.

I think I can rule out my protocol having anything to do with my joint pain, so that's a positive. And like I had said, sexually I've been good, which was my whole reason for trt in the first place.

But like you said the other day, and many others have said, I think I am better off trying to get off the AI. I mean, my E2 was fine a few weeks ago and now it's 164. If I stick with AI's, I'm never going to get dialed in.

I've tried lower doses and more frequent dosing and no AI's before, and my free hardly ever reached 15. But since it's not high now anyway, I might as well try again.

 

[Gman86]

So ur E2 went from mid 20’s to 164 while on the same exact protocol? Only change is that u received the vaccine?

U don’t test ur SHBG? I think it’s safe to assume it’s very high, but jc

 

[RickB]

So ur E2 went from mid 20’s to 164 while on the same exact protocol? Only change is that u received the vaccine?

U don’t test ur SHBG? I think it’s safe to assume it’s very high, but jc

Even though I was talking about the vaccine and trying to figure out if it or low E2 might be causing my joint pain, until you posted I didn't even consider that the vax may have affected my hormones. Who knows. I wouldn't be surpirsed.

I'm paying out of pocket for bloods except for when seeing the uro once every 4 months, and SHBG is a little pricey.

As far as protocol, I looked back more closely and most lab results were when I was on 180mg E7D and 6.25 exemestane E3.5D. The results stayed the same when I switched to current protocol, but maybe time took its toll. But it still doesn't make sense, because if anything, my E2 should be lower not higher. I'm splitting my dosage and taking the same amount of Exemestane, so higher E2 is super weird,

 

[madman]

I don't know what to make of these results. I've got crazy high total and E2, with average free.

I think I can rule out my protocol having anything to do with my joint pain, so that's a positive. And like I had said, sexually I've been good, which was my whole reason for trt in the first place.

But like you said the other day, and many others have said, I think I am better off trying to get off the AI. I mean, my E2 was fine a few weeks ago and now it's 164. If I stick with AI's, I'm never going to get dialed in.

I've tried lower doses and more frequent dosing and no AI's before, and my free hardly ever reached 15. But since it's not high now anyway, I might as well try again.

Again it's an inaccurate assay and should not be used!

No way you are hitting an average FT with a TT 1500+ ng/dL even with highish/high SHBG.

You are hitting an absurdly high TT 1500+ ng/dL which means your FT is going to be high/absurdly high even if you have highish/high SHBG.

For the last time, you need to have your FT tested using the most accurate assays Equilibrium Dialysis or Ultrafiltration, especially in cases of ALTERED SHBG!

Even then you did not use the most accurate assay for TT (LC-MS/MS) otherwise you would have known where your TT level truly sat as the analytical measurement range 1.0 ng/dL - 2,000+ ng/dL.


Method Used for Total Testosterone:

– Liquid chromatography-tandem mass spectrometry (LC-MS/MS)- No upper or lower limit

– Analytical sensitivity: 1.0 ng/dL

– Analytical specificity: no cross-reactivity with other steroid compounds or supplements like biotin/

– Analytical Measurement Range: 1.0 ng/dL to 2,000+ ng/dL




You had it tested using the standard immunoassay which caps out at 1500 ng/dL.

For all, we know your TT 1600, 1700, 1800....who the F**K knows!

You clearly have no clue what you are doing.

Man up and have your blood work done using the most accurate assays (TT/FT/estradiol).

Same sob story here.

You are going to be chasing your tail until the cows come home!

What factors could influence total T result?

I was taking 200mg cypionate every Thursday morning. I got tested Thursday at absolute trough and was 1361. I did not pin that day, and instead waited until Saturday morning. I got tested the next Friday afternoon and was >1500. While those second bloods were drawn about 16 before my new...

www.excelmale.com

 

[madman]

I don't know what to make of these results. I've got crazy high total and E2, with average free.

I think I can rule out my protocol having anything to do with my joint pain, so that's a positive. And like I had said, sexually I've been good, which was my whole reason for trt in the first place.

But like you said the other day, and many others have said, I think I am better off trying to get off the AI. I mean, my E2 was fine a few weeks ago and now it's 164. If I stick with AI's, I'm never going to get dialed in.

I've tried lower doses and more frequent dosing and no AI's before, and my free hardly ever reached 15. But since it's not high now anyway, I might as well try again.

070038: Testosterone, Free, Equilibrium Ultrafiltration With Total Testosterone, LC/MS-MS | Labcorp

Labcorp test details for Testosterone, Free, Equilibrium Ultrafiltration With Total Testosterone, LC/MS-MS

www.labcorp.com

 

[RickB]

Again it's an inaccurate assay and should not be used!

No way you are hitting an average FT with a TT 1500+ ng/dL even with highish/high SHBG.

You are hitting an absurdly high TT 1500+ ng/dL which means your FT is going to be high/absurdly high even if you have highish/high SHBG.

For the last time, you need to have your FT tested using the most accurate assays Equilibrium Dialysis or Ultrafiltration, especially in cases of ALTERED SHBG!

Even then you did not use the most accurate assay for TT (LC-MS/MS) otherwise you would have known where your TT level truly sat as the analytical measurement range 1.0 ng/dL - 2,000+ ng/dL.


Method Used for Total Testosterone:

– Liquid chromatography-tandem mass spectrometry (LC-MS/MS)- No upper or lower limit

– Analytical sensitivity: 1.0 ng/dL

– Analytical specificity: no cross-reactivity with other steroid compounds or supplements like biotin/

– Analytical Measurement Range: 1.0 ng/dL to 2,000+ ng/dL




You had it tested using the standard immunoassay which caps out at 1500 ng/dL.

For all, we know your TT 1600, 1700, 1800....who the F**K knows!

You clearly have no clue what you are doing.

Man up and have your blood work done using the most accurate assays (TT/FT/estradiol).

Same sob story here.

You are going to be chasing your tail until the cows come home!

What factors could influence total T result?

I was taking 200mg cypionate every Thursday morning. I got tested Thursday at absolute trough and was 1361. I did not pin that day, and instead waited until Saturday morning. I got tested the next Friday afternoon and was >1500. While those second bloods were drawn about 16 before my new...

www.excelmale.com

One question about the FT assay I'm using. Is it simply giving me a less accurate reading than ED or ultra, or is it randomly inaccurate? What I mean is this - I've been assuming that even though the assay is not perfect, it is proportionately correct to itself one reading to the next, meaning I can compare them from week to week.

For instance if I'm at 18 one week and then at 24 two weeks later, I was assuming my FT did go up roughly 33% (give or take). That's why I kept using that assay for the time being.

If you're telling me that they are so inaccurate that my lower reading could've been actually higher than my higher reading, as if there is just no rhyme or reason to the results, then I definitely have been wasting my time and money.