1. #1

    New guy here and New to TRT--looking for advice on raised estridol levels

    Hi,
    I hope this is in the right section.

    In December of 2016 I was 285lbs 5'11"
    Pre TRT Total Test level was 190 ng/dl with free test at 135 pg/ml

    Currently 47 years old 5'11" 227lbs. Been in the gym and meal prepping for 1 year and 3months

    I am prescribed 200 mg Test Cyp i taken- 100mg Sunday AM & 100 mg Wednesday PM
    HCG at a total of 1000ius a week taken on the Friday-5th(500iu) & Saturday-6th day(500iu)

    After 60day on TRT I took my first set of labs

    Labs from 90 days ago... (1st labs since beginning TRT)


    Total Test- 1067 ng/dl
    Free test- 198.5 pg/ml
    Estridol - 31.9 pg/ml
    Hemocrit- 45.3
    Hemglobin- 14.9g/dl
    RBC- 4.97
    PSA 0.7 ng/ml
    T3, Free- 3.7pg/ml

    Doc said free test is kind of high as is total test- I pointed out that testing day was only 1.5days after last injection on Wednesday pm so this was not my "trough" That seemed to satisfy him so we kept rolling with the same protocol.

    Labs from June 1st, 2018

    Total Test- 1071 ng/dl
    Free test- 232 pg/ml
    Estridol - 78 pg/ml
    Hemocrit- 47.3
    Hemglobin- 16.3 g/dl
    RBC- 5.23
    PSA 0.7 ng/ml
    T3, Free- 5.3 pg/m


    Had my appointment with my Dr on the 13th of June.
    He came in the room and said we have some issues... Which I already knew about the Estridol
    He proceeded to tell me that my total test was high and my free test is "way" too high as well as my estridol.
    I told him about my symptoms of not feeling good for the past 3-4 weeks along with mood swings and overall feeling of "blah" as well as minor swelling of my hands and feet.(i read somewhere that this could be a symptom of high estridol)

    I also informed him that my testicles were not responding to the HCG and we still shrunken a good bit.

    I then asked him if I needed an AI to reduce the estridol and he simply told me his recommendation was the following...
    Reduce testosterone to 150 mg per week, increase HCG to 2000ius 2x a week(total of 4000ius) ???
    and retest in 6-8 weeks and then decide if we need an AI.....

    My CONCERN.... I dont feel good and want to feel better. we didnt do labs on my trough day so I think the 200mg test is ok...but i am open to reducing to 150mg of test per week.
    I have read quite a bit on HCG and isn't this dose WAY to much... Wont this spike my estridol as well?
    My main concern is following these instructions and being miserable for another 1.5-2 mths?
    My question is does my Drs plan of action sound like best way to go? Or should we get estridol under control with an AI and then re-evaluate?

    Please give me some feedback on my situation...

    Thanks in Advance,
    Wayne

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  3. #2
    HCG dose is not outrageous, but could be too high for you. Yes, it can provoke higher E2, but your T dosage is most likely the primary culprit

    I think the main issue is you're on too much T plain and simple. Your TT anf FT are very high, Estradiol has followed and your HCT/HGB though OK by last labs are increasing and could easily be provoked to go too high.

    Generally speaking 200mg of T cyp a week though commonly prescribed by chop shop clinics is a very high dose. More conservative starting dose is half of that at 100mg/week. I would not hesitate to decrease dosage to 150mg/week as a first step, and reassess at 6 weeks. When adjusting testosterone dosage unfotunately you do have to be patient. It takes 40 days for new blood level to stabilize.

    Dosing frequency depends on Sex Hormone Binding Globulin-SHBG. You have not provided that lab number. have you had it evaluated?

  4. #3
    Im not sure. How would it be listed SBGH i am assuming? Probably not. He wasnt even going to do an estridol test until i mentioned it. ANd the bad thing is this is a large reputable doctor group. Its an edocrinology/ diabetes office.

    Should i ask him again for an AI to get the estridol in check sooner or is that not the right move?
    Thanks for your input.

  5. #4
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    Quote Originally Posted by 08RavenR1 View Post
    Im not sure. How would it be listed SBGH i am assuming? Probably not. He wasnt even going to do an estridol test until i mentioned it. ANd the bad thing is this is a large reputable doctor group. Its an edocrinology/ diabetes office.

    Should i ask him again for an AI to get the estridol in check sooner or is that not the right move?
    Thanks for your input.
    If your doc is not going to give you an AI you need to drop your injection dose to 120mg/wk.
    You are going to continue to feel like shit if you don't.

    Go to Nelsons blood testing site and get a real look at where you are.
    https://www.discountedlabs.com/trt-m...p-panel-option

    Not knowing your SHGB makes protocol suggestions a stab in the dark. That said most can't do more than 120mg/wk without and AI.
    Only if your SHGB is high to very high will you need more that 150.

    Good luck don't chase numbers like 200mg/wk it will only make you regret starting this TRT thing.

  6. #5
    Thanks....I thought 200mg was high when they started me on that much.... Then i started feeling great! But now I am beginning to see the bigger picture!
    So it wouldnt be bad to take an AI? Would that get the estridol in check faster? I am open to whatever will level things out the best.
    thanks again for the input...

  7. #6
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    Quote Originally Posted by 08RavenR1 View Post
    Thanks....I thought 200mg was high when they started me on that much.... Then i started feeling great! But now I am beginning to see the bigger picture!
    So it wouldnt be bad to take an AI? Would that get the estridol in check faster? I am open to whatever will level things out the best.
    thanks again for the input...
    Yes what you experienced in the beginning we call the honeymoon phase of TRT, that never comes back. Some think it your natural T and the injected T making you feel that way. I don't think that is it at all. More than likely your body has been starved of T so it has made tons of extra T receptors all over your body now you introduce and outside source of T and all of those extra receptors get happy and you feel like a million bucks however your body then senses all that T and does not make anywhere near as many new receptors so down you come.

    As for AI's. Many try to find the proper T dose and not use an AI and that works very well for low SHGB guys but not so much for guys that are high they need more T to get more Free T and that cause bad side effect like elevated E2, prolactin and all the crap that causes. Then you also have to worry about your blood HCT and do the donating thing. I could go on and on. Best to drop your dose and see how you feel in 40 days. If it turns out your SHGB is low then you might even need to go to 100mg/wk or even 80.

  8. #7
    I highly advise to everybody who has high estradiol and doesn't feel great at the moment to take their time and reduce their estradiol with more natural approach (splitting the dose, lowering the dose, reducing hcg or removing it, maybe avoiding food that can raise e2 etc) and avoid AI. Don't get me wrong AI works well with reducing estradiol and works right away but when you go too low on e2 or god forbid crash it you will not feel good you will feel even worse than you felt with low testosterone (and risk of long term damage to dopamine).

  9. #8
    Ok... Thanks for the input. I will struggle through 40 days..LOL....

  10. #9
    Thanks, I will do that. I will drop the dose as recommended by the doc and try the natural approach...Why did he prescribe me 4000ius of HCG per week? I am lost with that one...

  11. #10
    it's quite big dose of hcg i don't understand it either. about 1000 is enough on trt. you get most of the testosterone from taking testosterone there is no need for such high dose hcg especially considering risk of decencetizing yourself to it

  12. #11
    Quote Originally Posted by 08RavenR1 View Post
    Thanks, I will do that. I will drop the dose as recommended by the doc and try the natural approach...Why did he prescribe me 4000ius of HCG per week? I am lost with that one...
    Whoa. I saw and commented on the 500 twice a week.

    4000iu on top of 200mg of T? Has me wondering about your doc.

  13. #12
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    Quote Originally Posted by lowe2sucks View Post
    it's quite big dose of hcg i don't understand it either. about 1000 is enough on trt. you get most of the testosterone from taking testosterone there is no need for such high dose hcg especially considering risk of decencetizing yourself to it
    I agree with l2s 1000 is more than enough heck I prefer 800/wk that worked fine for me when I started and my balls were pulled up tight against my body from 6 months of T mono. I am currently test how low can I go with HCG before my balls start pulling back up into my body. I'm at 600/wk right now and my boys are swinging just fine.

  14. #13
    Ok...that makes me feel better...i thiuhjt 4000 was crazy....i will stick with my 500 2x a week...and inthink i am gonna search for another Dr! 👍👍👍

  15. #14
    Quote Originally Posted by 08RavenR1 View Post
    Ok...that makes me feel better...i thiuhjt 4000 was crazy....i will stick with my 500 2x a week...and inthink i am gonna search for another Dr! 
    That's a wise decision. We have to be our own advocate in this game. All the best.

    I am not a physician. Comments offered here are for discussion purposes only. Please consult your doctor before initiating, changing, or stopping any therapy.

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