Very high FT on 70mg/wk?

[JustPanicNoDisco]

I just got my blood results back. I have been lowering my testosterone dose significantly over time, as I was experiencing many side effects on higher doses, which I thought may have been in part due to the high T:E2 ratio (seemed it didn't rise proportionally).

I'm running 70mg of test cyp per week / 10mg ED. The following are my bloods at "trough":

https://imgur.com/oLPIoS5

test, total: 1021 ng/dL (range 250-1100 ng/dL)
test, free: 257.4 pg/mL (range 35-155) *HIGH*!
estradiol, ultrasensitive: 30 pg/mL (range <= 29 pg/mL)

It seems my metabolism of testosterone has changed wildly, considering in the past I was running 140 mg/wk (half my current dose) and my FT levels were about top of range, not nearly twice the top of the range!

In spite of e2 sensitive being "high" at 30 pg/mL, I have a ton of low e2 symptoms - numbness, apathy, lethargy, dead libido, lacking erection fullness/quality, dry skin/hair, etc.

I feel horrible right now. I'm thinking about trialing some low doses of estrogen if I can get a prescription in order to balance out the ratio. In the past, I crashed and the symptoms of low e2 never really rebounded, with ongoing symptoms similar to those of other guys, such as nurselyfe and lowe2 sucks.

I used dialysis, which I believe is considered the goal standard, according to @madman

Any advice on where to go from here? Anyone taken supplemental estrogen with good results? I've seen a few posts about it and talked to a couple others, but I don't want to mess myself up further.

**Edit**

I should add that even though my FT reads much higher on this small weekly dosage, my total T levels are slightly lower, and I feel like I have less testosterone in my body (before, I was putting on significant muscle / maintaining without even working out) + was getting quite a bit of back acne. Now, I've lost some muscle and acne has definitely lessened.

I'm not sure if this lab test is some anomaly / mistake or what...

I can't really afford to have more testing done at the moment (this was a package from Private MD Labs)

 

[eli]

Are you doing SubQ?

How long have you been on this protocol?

 

[Cataceous]

Did you happen to test SHBG? This can be used as a backup to calculate free testosterone and compare it to test results. Barring significant changes in underlying metabolism it's expected that average free testosterone should be roughly proportional to the dose rate.

I was just discussing OTC estradiol supplementation. I think it's worth considering given your lowish E2/T ratio. Low-and-slow, of course.

... Normal daily production [of estradiol] in men is said to be on the order of 50 mcg. In a test like this I might start at 10 mcg. Estradiol cream would be a convenient option, though you would need to find or make some that has a sufficiently low concentration. If the absorption rate of a topical is about 10% then you'd need to apply 100 mcg of estradiol in cream to absorb 10 mcg. You can get estradiol mixed with estriol on Amazon. But each pump of this product delivers 500 mcg of estradiol, five times more than a prudent starting dose.​

https://www.excelmale.com/forum/threads/is-“enclomiphene-citrate”-going-to-replace-hcg-in-the-usa.24887/post-219581

 

[Willyt]

and what was your dosing schedule on 140mg per week?

 

[bixt]

Was the 140mg a week also ED?

 

[JustPanicNoDisco]

Are you doing SubQ?

How long have you been on this protocol?

No, I’m doing daily shallow IM in quads. I switched from delts, as it seemed delts caused me more joint pain (odd, I know, but I’d been shooting there for a while, and I think the conversion to DHT may have been higher when injecting at that site, hence the obvious huge increase in joint popping / cracking without changing ester or dose.

 

[JustPanicNoDisco]

Are you doing SubQ?

How long have you been on this protocol?

Daily IM (shallow), quads. I’ve been on the protocol for a couple months.

 

[JustPanicNoDisco]

Did you happen to test SHBG? This can be used as a backup to calculate free testosterone and compare it to test results. Barring significant changes in underlying metabolism it's expected that average free testosterone should be roughly proportional to the dose rate.

I was just discussing OTC estradiol supplementation. I think it's worth considering given your lowish E2/T ratio. Low-and-slow, of course.

... Normal daily production [of estradiol] in men is said to be on the order of 50 mcg. In a test like this I might start at 10 mcg. Estradiol cream would be a convenient option, though you would need to find or make some that has a sufficiently low concentration. If the absorption rate of a topical is about 10% then you'd need to apply 100 mcg of estradiol in cream to absorb 10 mcg. You can get estradiol mixed with estriol on Amazon. But each pump of this product delivers 500 mcg of estradiol, five times more than a prudent starting dose.​

https://www.excelmale.com/forum/threads/is-“enclomiphene-citrate”-going-to-replace-hcg-in-the-usa.24887/post-219581

No, unfortunately I did not. I actually plugged in my results to an online calculator to assess SHBG (figuring it must be extremely low) after receiving these results. The calculators, however, are pretty useless, since units/volume and their associates ranges very wildly across technique. It would surely be interesting.

I know dialysis is the method always championed on this website, but science seems to believe the different test methods correlate very highly (r > 96).

Free testosterone by direct and calculated measurement versus equilibrium dialysis in a clinical population - PubMed

These results support the clinical use of both RIA and cFT as measures of FT. Due to numerical differences, each test requires its own set of reference values.

pubmed.ncbi.nlm.nih.gov

In the past I’ve used mostly calculated or LC/MS, I believe, which could potentially account for differences in results, but I still doubt it. Daily shots should keep SHBG higher, if anything.

As for estrogen supplementation, my concern is that it may cause (permanent or semi-permanent) changes to aromatase production. I don’t know exactly whats underpinning the lasting low E2 sides many experience after crashing their estrogen as serum numbers seem to rebound while symptoms remain. I just don’t want to take on unnecessary risk worsening this (but also cannot exactly live in this state)

I’m not sure if there is any literature that tests how exogenous estro influences aromatase expression.

I would definitely start slow. Thanks for the resource. Typing on mobile. Apologies for formatting / typos.

 

[JustPanicNoDisco]

and what was your dosing schedule on 140mg per week?

I went from daily to EOD and think I my joints, rashes, and other sides did improve on that schedule due, likely, to higher aromatization.

The reason I went back to daily shots is because I was running a propionate blend for a while.

 

[JustPanicNoDisco]

Was the 140mg a week also ED?

EOD, delts, as mentioned below.

 

[Systemlord]

In spite of e2 sensitive being "high" at 30 pg/mL, I have a ton of low e2 symptoms - numbness, apathy, lethargy, dead libido, lacking erection fullness/quality, dry skin/hair, etc.

The symptoms are likely not from your normal E2 levels, the symptoms are likely from too many androgens which can actually make you tired and sluggish.

Men on cycles report diminished sexual parameters, but returning to normal levels corrects things.

You need to bring the T dosage down to like 6-7mg daily. Also, when on daily injections, the difference between peak and tough will be indistinguishable as your hormones are virtually flat.

Anyone taken supplemental estrogen with good results?

If the person has low estrogen, the results are expected to be beneficial, that is for someone with "low estrogen" which you do not have.

 

[JustPanicNoDisco]

The symptoms are likely not from your normal E2 levels, the symptoms are likely from too many androgens which can actually make you tired and sluggish.

Men on cycles report diminished sexual parameters, but returning to normal levels corrects things.

You need to bring the T dosage down to like 6-7mg daily. Also, when on daily injections, the difference between peak and tough will be indistinguishable as your hormones are virtually flat.


If the person has low estrogen, the results are expected to be beneficial, that is for someone with "low estrogen" which you do not have.

Yes, but I crashed my estrogen (repeatedly, with DHT derivatives + PDE5is), and in spite of serum levels returning to normal, I still have all the symptoms of low e2 almost a year later. I did not have these symptoms when running high T before crashing my estrogen unknowingly.

My sexual function was non-existent on normal test levels to begin with (I was in the 700s with normal e2 when I started TRT) due to PSSD - Post-SSRI sexual dysfunction). SSRIs disrupt the endocrine system and cause a syndrome similar to that of PFS. When I was running androgens high and before crashing E2, erections and libido were much, much better than before starting (went from about 700s to ~1500)

Others have reported permanently low e2 symptoms after using AIs or crashing it to single digits/flooring it in other ways. Check out this thread:

low e2 symptoms didnt go away after crash

So long story short i crashed my e2 levels using anastrozole during anabolic steroids cycle. That was 1 year ago. Im on trt. I had awful symptoms when i crashed it and i discontinued anastrozole 1 year ago. Thing is symptoms still are there, I tried to up my T dosage, tried HCG in big doses...

www.excelmale.com

 

[Systemlord]

Yes, but I crashed my estrogen (repeatedly, with DHT derivatives + PDE5is), and in spite of serum levels returning to normal, I still have all the symptoms of low e2 almost a year later.

The only thing I can come up with is when you crashed your estrogen, the E2 receptors got atrophied when E2 went to zero and now normal E2 levels can't affect tissue. The same thing can happen when men are using DHT blockers have symptoms (post finasteride syndrome) despite normal hormone levels after discontinuing the drug.

 

[JustPanicNoDisco]

No one knows exactly what causes all these post-drug symptoms, but the prevailing school of thought seems to be over expression of receptors and subsequent methylation / silencing of the ARs/ERs. Anyway, I don’t want to derail this thread regarding theory. I’d like to first see if my receptors are fried or if fixing my skewed ratio helps. I know it helped @solothesensei. Every time he raised his test dose, he got low E2 issues (same as me) immediately, and only resolved the issues through use of exogenous estrogens.

 

[JustPanicNoDisco]

Did you happen to test SHBG? This can be used as a backup to calculate free testosterone and compare it to test results. Barring significant changes in underlying metabolism it's expected that average free testosterone should be roughly proportional to the dose rate.

I was just discussing OTC estradiol supplementation. I think it's worth considering given your lowish E2/T ratio. Low-and-slow, of course.

... Normal daily production [of estradiol] in men is said to be on the order of 50 mcg. In a test like this I might start at 10 mcg. Estradiol cream would be a convenient option, though you would need to find or make some that has a sufficiently low concentration. If the absorption rate of a topical is about 10% then you'd need to apply 100 mcg of estradiol in cream to absorb 10 mcg. You can get estradiol mixed with estriol on Amazon. But each pump of this product delivers 500 mcg of estradiol, five times more than a prudent starting dose.​

https://www.excelmale.com/forum/threads/is-“enclomiphene-citrate”-going-to-replace-hcg-in-the-usa.24887/post-219581

@Cataceous

I checked out that product from Amazon, and it appears it also contains 2mg estriol/E3 in addiction to the 500mcg of estradiol. Would this estriol pose any problems?

Volumetrically dosing the solution seems easy enough, so long as the volume/pump is consistent.

One other question - is this like test gel, where since the test is not attached to an ester, it's metabolized very quickly? And if so, how should it be dosed? Perhaps two 5 mcg doses per day?

 

[Cataceous]

@Cataceous

I checked out that product from Amazon, and it appears it also contains 2mg estriol/E3 in addiction to the 500mcg of estradiol. Would this estriol pose any problems?

Volumetrically dosing the solution seems easy enough, so long as the volume/pump is consistent.

One other question - is this like test gel, where since the test is not attached to an ester, it's metabolized very quickly? And if so, how should it be dosed? Perhaps two 5 mcg doses per day?

Estriol is said to have about 1/100th the potency of estradiol, which knocks it down to a relatively trivial 20 mcg estradiol-equivalent per dose. If it is really only increasing the effective dose by 4% then I'm thinking it's not likely to be a problem.

I'd expect the pharmacokinetics to be similar to what's seen with topical testosterone; there is no ester. Ideally the skin is acting as a reservoir, slowing absorption and making once-daily dosing possible. But two smaller doses would certainly produce more even levels. With topical estradiol I didn't seem to run into the absorption problems I encountered with topical testosterone—perhaps due to the much lower quantities involved.

 

[Charliebizz]

I know for me personally I feel horrible on daily’s. Even with good labs. And I’m also a low shbg guy. I’ve tried daily’s a few times over the years and they just don’t work well for me.

 

[JustPanicNoDisco]

I know for me personally I feel horrible on daily’s. Even with good labs. And I’m also a low shbg guy. I’ve tried daily’s a few times over the years and they just don’t work well for me.

I definitely felt much less anxiety and CNS stimulation when dosing EOD many months ago. The anxiety right now is unreal. What symptoms did you experience on daily injections?

I only chose daily injections because I was previously running a blend to mimic diurnal variation, just as cataceous and some other guys here have done.

I wanted to switch back to EOD, but I feared the large spikes in T would cause additional issues, and as such, I tried to smooth the transition by staying on daily shots.

Anyway, I am not sure what’s going on — what’s causing this unbearable anxiety, considering I’m running the lowest amount of test I’ve ever run. I am guessing symptoms are due to low E2 / high test:E2 ratio.

 

[JustPanicNoDisco]

Estriol is said to have about 1/100th the potency of estradiol, which knocks it down to a relatively trivial 20 mcg estradiol-equivalent per dose. If it is really only increasing the effective dose by 4% then I'm thinking it's not likely to be a problem.

I'd expect the pharmacokinetics to be similar to what's seen with topical testosterone; there is no ester. Ideally the skin is acting as a reservoir, slowing absorption and making once-daily dosing possible. But two smaller doses would certainly produce more even levels. With topical estradiol I didn't seem to run into the absorption problems I encountered with topical testosterone—perhaps due to the much lower quantities involved.

Thanks for the info!

 

[tareload]

No, unfortunately I did not. I actually plugged in my results to an online calculator to assess SHBG (figuring it must be extremely low) after receiving these results. The calculators, however, are pretty useless, since units/volume and their associates ranges very wildly across technique. It would surely be interesting.

I know dialysis is the method always championed on this website, but science seems to believe the different test methods correlate very highly (r > 96).

Good observation. However, try taking the direct RIA fT value and use an online calculator to estimate SHBG from TT and fT. Be careful with the unit conversions.

Or take direct RIA fT and divide by TT to get an estimate of % fT. Is this fraction reasonable given what we know about human physiology? What do you conclude?

Response from LabCorp About Their Incorrect Unit Usages For Their Free Testosterone - Direct - Test

I've been irked for a year by the apparent incorrect unit usage for the particular Free Testosterone test mentioned above. I periodically reach out to whatever relevant executive I can find. No luck for months until the below correspondence. In brief his explanation doesn't hold up in my view...

www.excelmale.com