Updated labs, very low E2

[davidrn]

I am seeing my rheumatologist in a week, (have RA) and got a few labs to bring in, also wanted to see how my TT and FT levels were looking. I have very low SHBG (10-15 usually) and so my FT is always high. My regimen has changed a bit over the years, currently my goal is to decrease my FT, it is usually about 15-25% above normal limits. Over the past few months, I have been taking 10mg of T cyp 3 x week (M-W-F) and use a small amount of T cream on the testicles 4 days a week. HcG is 20mg three x wk, I also take DHEA 25mg and Pregnenolone 50mg 3 x wk with the T Cyp.
So, I have been having some serious ankle pain, and was confused about that. Now I understand, my CRP was 1.2, so inflammation is not the problem. However my E2 was 5 (<29) and now I know what is going on. (I believe the low E2 is causing the joint pain?) my TT was 491 and FT is 118 ( 35.0-155.0 pg/mL ) this is the lowest FT I have gotten, so i am happy that I can get it down, my DHT last time was <100 but I am wondering if the testicle cream is causing less E2? (with almost doubling my DHT over a year ago, although still in the 80-95 range). I need to increase my E2, any opinion? I am thinking I may need more DHEA? or more doses ? Any thoughts on what I should do?

 

[swoops36]

I am seeing my rheumatologist in a week, (have RA) and got a few labs to bring in, also wanted to see how my TT and FT levels were looking. I have very low SHBG (10-15 usually) and so my FT is always high. My regimen has changed a bit over the years, currently my goal is to decrease my FT, it is usually about 15-25% above normal limits. Over the past few months, I have been taking 10mg of T cyp 3 x week (M-W-F) and use a small amount of T cream on the testicles 4 days a week. HcG is 20mg three x wk, I also take DHEA 25mg and Pregnenolone 50mg 3 x wk with the T Cyp.
So, I have been having some serious ankle pain, and was confused about that. Now I understand, my CRP was 1.2, so inflammation is not the problem. However my E2 was 5 (<29) and now I know what is going on. (I believe the low E2 is causing the joint pain?) my TT was 491 and FT is 118 ( 35.0-155.0 pg/mL ) this is the lowest FT I have gotten, so i am happy that I can get it down, my DHT last time was <100 but I am wondering if the testicle cream is causing less E2? (with almost doubling my DHT over a year ago, although still in the 80-95 range). I need to increase my E2, any opinion? I am thinking I may need more DHEA? or more doses ? Any thoughts on what I should do?

You’re not taking much test, and your TT is low, FT is low, SHBG wasn’t checked but you can calculate it from what you have. You can raise your e2 just by increasing either your injected test dose or add more cream.

edit: I forgot to ask, why do you want your FT lower? Most guys feel good in the 20-30ng range. Do you feel worse with higher FT?

 

[swoops36]

I am seeing my rheumatologist in a week, (have RA) and got a few labs to bring in, also wanted to see how my TT and FT levels were looking. I have very low SHBG (10-15 usually) and so my FT is always high. My regimen has changed a bit over the years, currently my goal is to decrease my FT, it is usually about 15-25% above normal limits. Over the past few months, I have been taking 10mg of T cyp 3 x week (M-W-F) and use a small amount of T cream on the testicles 4 days a week. HcG is 20mg three x wk, I also take DHEA 25mg and Pregnenolone 50mg 3 x wk with the T Cyp.
So, I have been having some serious ankle pain, and was confused about that. Now I understand, my CRP was 1.2, so inflammation is not the problem. However my E2 was 5 (<29) and now I know what is going on. (I believe the low E2 is causing the joint pain?) my TT was 491 and FT is 118 ( 35.0-155.0 pg/mL ) this is the lowest FT I have gotten, so i am happy that I can get it down, my DHT last time was <100 but I am wondering if the testicle cream is causing less E2? (with almost doubling my DHT over a year ago, although still in the 80-95 range). I need to increase my E2, any opinion? I am thinking I may need more DHEA? or more doses ? Any thoughts on what I should do?

You’re SHBG is about 25nmol, which isn’t really that low. Taking more androgens would lower it a bit, however

 

[davidrn]

Thanks for your thoughts. I wish I had my SHBG ever get as high as 25, unfortunately, it is always around 12-15. (sometimes slightly off that, but not by much). My FT is all I am watching now, until I cut my T cyp even more (I was taking 20mg 3 x wk, with a TT between 850- 1100, and a very high FT , always above the upper limit. My next labs are for my T MD, and will include SHBG, but we don't test that more than one or two times a year, it has varied so little. I have an autoimmune disease, which may be more responsible for the low SHBG. I will more than likely increase the T cyp slightly, heading back up to maybe 12mg x 3 for the next test. My TT is low, but if FT is 50% over the limit, does your TT really matter? I am using joint pain at this time to decide what will help. I am planning on a 3 day experiment of Flax oil to see how it effects my joints. The good thing is morning wood is very strong, so maybe the E2 was lraedy on its way up since testing last week.

 

[swoops36]

Thanks for your thoughts. I wish I had my SHBG ever get as high as 25, unfortunately, it is always around 12-15. (sometimes slightly off that, but not by much). My FT is all I am watching now, until I cut my T cyp even more (I was taking 20mg 3 x wk, with a TT between 850- 1100, and a very high FT , always above the upper limit. My next labs are for my T MD, and will include SHBG, but we don't test that more than one or two times a year, it has varied so little. I have an autoimmune disease, which may be more responsible for the low SHBG. I will more than likely increase the T cyp slightly, heading back up to maybe 12mg x 3 for the next test. My TT is low, but if FT is 50% over the limit, does your TT really matter? I am using joint pain at this time to decide what will help. I am planning on a 3 day experiment of Flax oil to see how it effects my joints. The good thing is morning wood is very strong, so maybe the E2 was lraedy on its way up since testing last week.

Right now, with your TT 491ng, FT 11.8ng, assuming Albumin 4.3, your SHBG is 25nmol. Your FT isn’t 50% over the limit.

At any rate, raising your dose of T sounds like the right move. Good luck to ya

 

[davidrn]

You read my FT wrong, " my TT was 491 and FT is 118 ( 35.0-155.0 pg/mL ) this is the lowest FT I have gotten " . Lowest level of FT in years since I started TRT, you were close on Albumin, its 4.5 (3.6 - 5.1) . Estimates may work for some, but I have other underlying health issues, and have never had a SHBG over 20. (regardless of my protocol) . I don't agree that I need a higher TT.

 

[swoops36]

You read my FT wrong, " my TT was 491 and FT is 118 ( 35.0-155.0 pg/mL ) this is the lowest FT I have gotten " . Lowest level of FT in years since I started TRT, you were close on Albumin, its 4.5 (3.6 - 5.1) . Estimates may work for some, but I have other underlying health issues, and have never had a SHBG over 20. (regardless of my protocol) . I don't agree that I need a higher TT.

No i read it right, the units you are using are different. 118pg/mL is 11.8ng/dL. That’s what you use to calculate the SHBG value. You may have an underlying condition, but the math doesn’t lie. Anyway, you’ll get it sorted out I’m sure.

edit

 

[Tman]

You read my FT wrong, " my TT was 491 and FT is 118 ( 35.0-155.0 pg/mL ) this is the lowest FT I have gotten " . Lowest level of FT in years since I started TRT, you were close on Albumin, its 4.5 (3.6 - 5.1) . Estimates may work for some, but I have other underlying health issues, and have never had a SHBG over 20. (regardless of my protocol) . I don't agree that I need a higher TT.

...but do you feel better?

 

[davidrn]

I feel like the TRT was working well, but....the joint pain confused me, I thought it was the RA, but then when I got my E2 test results, I realized the ankle pain was related to the low E2. I just need to adjust my TRT protocol slightly, so my e2 goes back to the usual 25 (or so). I will more than likely increase my T Cyp to 12mg x 3, and continue the T cream 4 x wk, that should bring my FT up fairly close to the lab normal range. Last FT were 15.8, 18.1, and 19.0, all last year were above lab limit, and my TRT MD wanted me to attempt to deal with the low SHBG by dropping my FT. I may have gone to low, and the DHT was 95 last test, may be slightly higher, although I am dosing the same with the T Cream, just decreased the T cyp from 60mg/wk down to its current 30mg (total) wk. I understood that (higher) DHT can keep E2 down naturally. Libido has been good, and nocturnal erections are frequent and strong.
The only variable I was unsure of was Hcg, I take 20 units 3 x wk, I am unsure if going up to 25 x 3/wk would be beneficial.