First, I'd like to say that this board has been an amazing resource for me and no doubt many others in their quest to understand the incredibly complicated world of hormone replacement therapy. Without boring you with too much information, I'm 45, I've been on TRT for about 8 years, all under the guidance of an endocrinologist who, upon looking back, had really not much of a clue about TRT. In fact, after doing my own research, mostly over the last couple of years, I've been the one directing him on proper protocol. My Total Test, Free test, etc, are all spot on, Free Test being 142.8 (range 35.0-155.0). This is on a self directed, but supervised switch to 20mg Sub-Q Test-Cyp EOD. I have always had very, very low SHBG, in the low teens, barely in the "normal' range. I require very low doses of test to get good numbers, which is common with low SHBG, as all of you know. Prior to Sub-Q, I was on about 80-90 mg per week, one shot, IM. Numbers were good, but still had ED issues.
Cutting to the chase, until recently, he was very dismissive of my desire to routinely test for Estradiol and only once a few years ago (2013) he ran Quest's regular Estradiol test.....the one that says in the lab report that it shouldn't be used for men. It returned a 24, which tells us very little, likely. In my quest to really get a handle on my ED symptoms and some mood inconsistency, I began researching lots about Estradiol and the important role it plays in overall health and, especially, in the bedroom for guys on TRT. Viagra gets the job done nicely, but I'd like to not need it for good wood!
After switching to my new Sub-Q protocol for a couple of months, we ran my labs and included the proper ultrasensitive Estradiol test. Numbers were good as far as Test, Free Test, etc, and Estradiol was spot on at 27.4. Unless there was a lab error, estradiol shouldn't be causing my problems, right? Well, this got me thinking. If low SHBG can cause rather modest total testosterone levels (mine) to lead to rather high normal FREE test levels, can't it also be the case that a rather good "total" Estradiol level might also lead to very high FREE Estradiol number? In other words, even with the correct lab test, does a "good" Estradiol number really mean anything with someone who has very low SHBG. Wouldn't it be undercounting the actual amount of Estradiol that might be creating the problem? I know I can't be the first person to think about this, so I would very much like to hear from the TRT veterans here. Thanks!
Cutting to the chase, until recently, he was very dismissive of my desire to routinely test for Estradiol and only once a few years ago (2013) he ran Quest's regular Estradiol test.....the one that says in the lab report that it shouldn't be used for men. It returned a 24, which tells us very little, likely. In my quest to really get a handle on my ED symptoms and some mood inconsistency, I began researching lots about Estradiol and the important role it plays in overall health and, especially, in the bedroom for guys on TRT. Viagra gets the job done nicely, but I'd like to not need it for good wood!
After switching to my new Sub-Q protocol for a couple of months, we ran my labs and included the proper ultrasensitive Estradiol test. Numbers were good as far as Test, Free Test, etc, and Estradiol was spot on at 27.4. Unless there was a lab error, estradiol shouldn't be causing my problems, right? Well, this got me thinking. If low SHBG can cause rather modest total testosterone levels (mine) to lead to rather high normal FREE test levels, can't it also be the case that a rather good "total" Estradiol level might also lead to very high FREE Estradiol number? In other words, even with the correct lab test, does a "good" Estradiol number really mean anything with someone who has very low SHBG. Wouldn't it be undercounting the actual amount of Estradiol that might be creating the problem? I know I can't be the first person to think about this, so I would very much like to hear from the TRT veterans here. Thanks!
