New Member With Some Old Lab Results and Continuing Symptoms

New Member w/Old Labs and Cont. Symptoms - Low E

Hi all,

First off I am super excited to have found this forum. It appears there is quite the collection of helpful and knowledgeable members here and that is great. In the past I have been unsuccessful in finding help, and I am realizing now I can't continue to put this off and sacrifice my quality of life and goals.

Ok, first off a little lifestyle context (I'll try not to be too long winded). I am 27, Male, 5'11'', weigh between 190-220lbs (currently 195). I became overweight as a kid and continued to ignore my health until midway through college. Between then and now (7 years or so), I have tried many different diets, lots of workout routines from running 5 miles every day to just lifting. After not ever achieving the true results I want (to be rid of my gyno, this is what sparked it all) despite others telling me "You look great" "You have improved so much" I have settled into a weightlifting routine of 45-90min 5-6 days per week for the past 4 years (I rarely miss). I run and mountain bike for fun now that I realize it wasn't helping me achieve my true desired goal. My diet is fairly mixed with emphasis on lean meats and vegetables. Not to be cliche, but I enjoy the "healthy" more and more. I have been on EC stack on and off over the past few years. My Mother is on thyroid medication, and my Father is on anti-depressants, that is all I know of in my family.

So to the reason I am here asking for your opinion and help. In 2015 I was amidst doing one of my crazy diets (I think I was doing intermittent fasting & macro tracking with low carb). I really started to feel tired to the core. I literally remember just not wanting to interact with other humans. The thought of smiling hurt. This scared me since it is not who I want to be. I listened to Robb Wolf at the time and decided maybe my hormones were not helping me since he talks about hormones often (no thanks to my diet I'm sure). So I ordered the following lab tests at labcorp:





After receiving my results I made an appointment with a doctor here in Charlotte to review my results. At my appointment he asked me why I was there. I told him I wanted to review my labs and that I was constantly super tired (I realize now I did not impress the severity of my issues at that time). We went through everything line by line, he told me everything looked good. I questioned him on the low Estradiol and he said I have a good level of testosterone and Estradiol wasn't something I had to worry about. I left thinking I basically had to suck it up and these were the cards I was dealt. At the time I was unable to find much online on low estrogen in men. I remember looking through PubMed and there was only one study. Google searches did not really provide any solid information on it either.

Fast forward to today, and not a whole lot has changed. My body composition has not changed at all despite having a consistent good diet and workout often with good intensity. However the worst part of it all is I feel terrible. I don't like talking with people, I have literally zero libido, and rarely get AM wood. My sleep is poor - I become tired around 7pm and by the time I am in bed (9-10pm) I am unable to sleep, sometimes I lay in bed for hours before falling asleep. I have brain fog. I often feel emotional and get anxiety. My joints pop and click allot while working out. The most recent symptom that triggered me looking into hormones again was my hands and feet are ALWAYS cold. Does not matter when or where, they just never seem to be able to get warm. My skin is also really dry. I do find I feel significantly better in the summer, and I take vitamin D 10,000IU's per day but do not notice any effects. This peaked my interest in my old labs since I measured a few thyroid markers (but not enough).

I figure my first step is going to be getting labs done. I was looking at the Pre TRT male wellness panel on discount labs. I would think a solid baseline with most of the extra added tests would be useful to see? Perhaps also adding in thyroid antibodies and a cortisol test? I am definitely looking into contacting defy also but figure the labs are first and foremost.

I apologize for the long post. It is difficult to sum up! Please let me know if you need me to be more specific about any of my story.

Any insight you could provide would be great to hear. I would love to hear any speculation as to why my E2 is so low? It was a huge relief to hear others state how terrible they felt with low E. Let me state for the record I have not taken any HRT up to this point in my life.

Thank you!

Walker

Oh wow, you're in the right place here.

I'm sorry to hear you're suffering low E2, what's even worse is that your total test isn't that bad. This will make it much harder to receive treatment. It's also a shame LH and fsh weren't measured.

Do you ever feel you piss a lot, thirsty all the time, have anhedonia, and maybe get hot flashes that itch?

I truly understand what you're going through, and I find low E2 to be an 8th amendment violation of cruel and unusual punishment.

It's essential that you get follow up testing because the wrong E2 test was used, you need the sensitive test, LH, FSH, total and free testosterone, and SHBG.

Your free test is most likely a lab error. Any doctor who denies low E2 is a problem is doing you a favor, they're telling you to run as fast as possible, as any treatment under them will be awful.

johndoesmith said:

Oh wow, you're in the right place here.

I'm sorry to hear you're suffering low E2, what's even worse is that your total test isn't that bad. This will make it much harder to receive treatment. It's also a shame LH and fsh weren't measured.

Do you ever feel you piss a lot, thirsty all the time, have anhedonia, and maybe get hot flashes that itch?

I truly understand what you're going through, and I find low E2 to be an 8th amendment violation of cruel and unusual punishment.

It's essential that you get follow up testing because the wrong E2 test was used, you need the sensitive test, LH, FSH, total and free testosterone, and SHBG.

Your free test is most likely a lab error. Any doctor who denies low E2 is a problem is doing you a favor, they're telling you to run as fast as possible, as any treatment under them will be awful.

Click to expand...

Great Post, John.

Vince Carter said:

Great Post, John.

Click to expand...

Thank you Vince.

"Fast forward to today, and not a whole lot has changed. My body composition has not changed at all despite having a consistent good diet and workout often with good intensity. However the worst part of it all is I feel terrible. I don't like talking with people, I have literally zero libido, and rarely get AM wood. My sleep is poor - I become tired around 7pm and by the time I am in bed (9-10pm) I am unable to sleep, sometimes I lay in bed for hours before falling asleep. I have brain fog. I often feel emotional and get anxiety. My joints pop and click allot while working out. The most recent symptom that triggered me looking into hormones again was my hands and feet are ALWAYS cold. Does not matter when or where, they just never seem to be able to get warm. My skin is also really dry. I do find I feel significantly better in the summer, and I take vitamin D 10,000IU's per day but do not notice any effects. This peaked my interest in my old labs since I measured a few thyroid markers (but not enough). "


Welcome to ExcelMale.com, buddy.

After reading your post, I suggest/ask the following:

1- What supplement or medication are you taking that may be lowering your estradiol?

2- Have you explore the possibility that you may have sleep apnea? Have you been told you snore a lot? What is your neck size? Do you eat late at night and/or consume alcohol close to bedtime?

3- Your cold hands and feet: Have you tested your TSH, free T3 and free T4?

4- Your kidney and liver functions are great. So is your HDL (the highest I have ever seen!)

I would get the PCT panel plus the Thyroid Panel (cheaper than the pre TRT panel and more appropriate for you)



http://www.discountedlabs.com/post-pct-panel/

http://www.discountedlabs.com/thyroid-panel-tsh-free-t3-free-t4/

Thanks for the quick feedback fellas!

johndoesmith said:

Do you ever feel you piss a lot, thirsty all the time, have anhedonia, and maybe get hot flashes that itch?

Click to expand...

I do feel thirsty allot, and often have dry mouth. I do drink allot of water. As far as anhedonia (this being the first time I have heard of this condition), I would say it pretty accurately describes how I feel about most things when I am at my worst (this time of year). It does seem during the summer for example this is greatly alleviated along with some of my other symptoms. It has been a source of confusion for me since it seems to come and go, and I have not found the reason for it (yet). I do find that often my head and body will be hot, but my feet and hands are always cold which is odd and annoying when trying to sleep since I want to warm my limbs, but don't need covers over my body haha.

johndoesmith said:

I truly understand what you're going through, and I find low E2 to be an 8th amendment violation of cruel and unusual punishment.

Click to expand...

Thanks for that, good to know I am not the only one! I hope to get to the bottom of this and improve!

johndoesmith said:

It's essential that you get follow up testing because the wrong E2 test was used, you need the sensitive test, LH, FSH, total and free testosterone, and SHBG.

Click to expand...

I will be sure and get these tested.

johndoesmith said:

Your free test is most likely a lab error. Any doctor who denies low E2 is a problem is doing you a favor, they're telling you to run as fast as possible, as any treatment under them will be awful.

Click to expand...

It's scary to think he is still working with patients daily. I looked it up and he charged me $150 for the 30min we talked. :/

Nelson Vergel said:

1- What supplement or medication are you taking that may be lowering your estradiol?

Click to expand...

It is hard to know exactly what I was taking back 2 years ago when these labs were collected. Like I mentioned, I was most definitely on EC stack (200mg C 25mg E X3/day). Other than that I only do multivitamin, D3, MCT oil, and protein shakes (not really anymore I try to stick to solid foods). I don't like the idea of ever being on medication...and want(ed) to believe I was pretty healthy.

Nelson Vergel said:

2- Have you explore the possibility that you may have sleep apnea? Have you been told you snore a lot? What is your neck size? Do you eat late at night and/or consume alcohol close to bedtime?

Click to expand...

I have had some people say I snore a little but rarely. I sleep alone 99% of the time though. My neck circumference is 15.5''. I try to eat around 6pm and sleep by 10pm. I have cut way back on my Alcohol in past 3 years. Prob 0-5 drinks per week avg.

Nelson Vergel said:

3- Your cold hands and feet: Have you tested your TSH, free T3 and free T4?

Click to expand...

TSH was 2.63 (ref .45-4.5 iu/ml) on my old labs. I will be sure and get the above tested with my next labs.

Nelson Vergel said:

4- Your kidney and liver functions are great. So is your HDL (the highest I have ever seen!)

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Hey at least something is working properly! I was doing a pretty high fat/low carb diet at that time. I have adjusted to a more mixed diet with a bit more carbohydrate (oats, occasional bread..etc).

Nelson Vergel said:

I would get the PCT panel plus the Thyroid Panel (cheaper than the pre TRT panel and more appropriate for you)

Click to expand...

So you find allot of the preTRT items unneeded, ok. Would your philosophy be to get the basics first, and add more specific testing if any of the initial markers come back out of optimal range? This makes sense. The engineer in me wants to order every possible test and leave nothing to chance, but we are talking over $1k in tests and that is a tough pill to swallow!

So here is the current recommended testing:
E2 Sensitive
Free T
Total T
LH
FSH
SHBG

TSH
Free T3
Free T4

Vitamin D

Anything else that would be needed initially?

If you would prefer a different response format going forward let me know, I realize this is allot of text to go through. Your help is appreciated more than you can know! Thanks for your time guys!

Walker

WalkerClark said:

Thanks for the quick feedback fellas!

I do feel thirsty allot, and often have dry mouth. I do drink allot of water. As far as anhedonia (this being the first time I have heard of this condition), I would say it pretty accurately describes how I feel about most things when I am at my worst (this time of year). It does seem during the summer for example this is greatly alleviated along with some of my other symptoms. It has been a source of confusion for me since it seems to come and go, and I have not found the reason for it (yet). I do find that often my head and body will be hot, but my feet and hands are always cold which is odd and annoying when trying to sleep since I want to warm my limbs, but don't need covers over my body haha.
Thanks for that, good to know I am not the only one! I hope to get to the bottom of this and improve!
I will be sure and get these tested.
It's scary to think he is still working with patients daily. I looked it up and he charged me $150 for the 30min we talked. :/
It is hard to know exactly what I was taking back 2 years ago when these labs were collected. Like I mentioned, I was most definitely on EC stack (200mg C 25mg E X3/day). Other than that I only do multivitamin, D3, MCT oil, and protein shakes (not really anymore I try to stick to solid foods). I don't like the idea of ever being on medication...and want(ed) to believe I was pretty healthy.
I have had some people say I snore a little but rarely. I sleep alone 99% of the time though. My neck circumference is 15.5''. I try to eat around 6pm and sleep by 10pm. I have cut way back on my Alcohol in past 3 years. Prob 0-5 drinks per week avg.
TSH was 2.63 (ref .45-4.5 iu/ml) on my old labs. I will be sure and get the above tested with my next labs.
Hey at least something is working properly! I was doing a pretty high fat/low carb diet at that time. I have adjusted to a more mixed diet with a bit more carbohydrate (oats, occasional bread..etc).
So you find allot of the preTRT items unneeded, ok. Would your philosophy be to get the basics first, and add more specific testing if any of the initial markers come back out of optimal range? This makes sense. The engineer in me wants to order every possible test and leave nothing to chance, but we are talking over $1k in tests and that is a tough pill to swallow!

So here is the current recommended testing:
E2 Sensitive
Free T
Total T
LH
FSH
SHBG

TSH
Free T3
Free T4

Vitamin D

Anything else that would be needed initially?

If you would prefer a different response format going forward let me know, I realize this is allot of text to go through. Your help is appreciated more than you can know! Thanks for your time guys!

Walker

Click to expand...

In addition to the tests you list, I certainly would add a CBC and PSA.

I do feel thirsty allot, and often have dry mouth. I do drink allot of water. As far as anhedonia (this being the first time I have heard of this condition), I would say it pretty accurately describes how I feel about most things when I am at my worst (this time of year).

Click to expand...

Sounds about right. I'd wake up so damned thirsty I couldn't really brush my teeth, needed to go downstairs and get a 911 priority level glass of water. Although I honestly didn't realize this wasn't normal until it went away, if you asked me this before TRT I woulda said "huh?".

It does seem during the summer for example this is greatly alleviated along with some of my other symptoms. It has been a source of confusion for me since it seems to come and go, and I have not found the reason for it (yet).

Click to expand...

Which symptoms?

I don't think you answered the hot flashes one, not important, but it's a curiosity of mine.

It's scary to think he is still working with patients daily. I looked it up and he charged me $150 for the 30min we talked. :/

Click to expand...

I've had worse, not in terms of money, but in terms of a doctor confusing "iatrogenic" and "idiopathic" even when I told him he was wrong. He was on the news recently, for attacking an athlete at a pro sports stadium.

Another one who borderline sexually assaulted me. This was one condescending prick.

It is hard to know exactly what I was taking back 2 years ago when these labs were collected. Like I mentioned, I was most definitely on EC stack (200mg C 25mg E X3/day). Other than that I only do multivitamin, D3, MCT oil, and protein shakes (not really anymore I try to stick to solid foods). I don't like the idea of ever being on medication...and want(ed) to believe I was pretty healthy.

Click to expand...

Did you ever smoke cigarettes or consume nicotine in anyway? I don't think you would, you seem to health conscious.

So you find allot of the preTRT items unneeded, ok. Would your philosophy be to get the basics first, and add more specific testing if any of the initial markers come back out of optimal range? This makes sense. The engineer in me wants to order every possible test and leave nothing to chance, but we are talking over $1k in tests and that is a tough pill to swallow!

Click to expand...

This makes sense, and your list you have is pretty decent. Coastwatcher suggested some labs that are pretty critical as well.

Do you have health insurance that covers labs? You can consider Defy medical. They are the best around(IMO) for TRT related issues and they can give you a script for labs and hopefully your insurance will cover it, then you can satisfy the engineer in you.

If you would prefer a different response format going forward let me know, I realize this is allot of text to go through. Your help is appreciated more than you can know! Thanks for your time guys!

Click to expand...

I think it works well. You're one of the few OPs who ACTUALLY tries to answer all questions asked of him. Anything you do is fine with me, in my book.

"Fast forward to today, and not a whole lot has changed. My body composition has not changed at all despite having a consistent good diet and workout often with good intensity. However the worst part of it all is I feel terrible. I don't like talking with people, I have literally zero libido, and rarely get AM wood. My sleep is poor - I become tired around 7pm and by the time I am in bed (9-10pm) I am unable to sleep, sometimes I lay in bed for hours before falling asleep. I have brain fog. I often feel emotional and get anxiety. My joints pop and click allot while working out. The most recent symptom that triggered me looking into hormones again was my hands and feet are ALWAYS cold. Does not matter when or where, they just never seem to be able to get warm. My skin is also really dry. I do find I feel significantly better in the summer, and I take vitamin D 10,000IU's per day but do not notice any effects. This peaked my interest in my old labs since I measured a few thyroid markers (but not enough). "

First, your FREE testosterone is awesome and your E is LOW. People dream of having this, so I'm not sure what is the problem with this at all. It looks to me like your main issue is feeling tired all the time. My question then to you is, is this tiredness something that happened as a result of the diet change? Could it be possible that without a 'fuel' source of complex carbs or fats that your body is tired most of the time when you apply exercise and the workouts that you do?

Second, like you, I have been doing Intermittent Fasting every day for the past month at least (16/8, sometimes 18/6). I've been on a strict ketogenic diet for past 86 days and mostly paleo for the prior 3 years (minus a year of bulking) before that, so I just want to add in here that I also get cold hands and cold feet which I have right now as I type this. I know for me, the cold hands/cold feet happens to me when I eat no carbs and sometimes if I don't eat enough fat. Since you're not doing keto, you're likely not getting enough of the 'fuel source' that being complex carbs or fat. Today for example I am eating pretty much just vegetables and some red meat, but if I was eating breakfast (eggs, bacon, cheese) I can guarantee you the 'fat' for fuel would ensure I didn't have cold hands or feet. Just something to think about.

Third, I recently upped my Vitamin D which was 'deficient' to an 82 in a month which my doctor said was not possible to test for, but he was wrong. But like you Vitamin D didn't do much to make me feel any different, so I just wanted to say that. If your Vitamin D is in the normal range which would be something like 80-100, then it's not something you need to worry about, in my opinion.

Fourth, You mention "your joints pop and click alot while working out". Mine do too if I haven't properly recovered them. Do you know about trigger point therapy? Similiar to what people do with a foam roller for their legs where trigger points are, you can do the same with a lacross ball for your other muscles in the upper back like your triceps (which you could also do on a foam roller). I encourage you to google this, because what is happening when you hear that clicking noise is that your tendon is clicking over the bone because of muscle weakness due to tightness. You need to increase your mobility in your muscles during downtime. A trigger point is simply where muscle fibers get twisted and pinch nerves that refer pain to other places in the body. This happens a lot more in people that are active like in a gym where you are constantly ripping fibers.

Fifth, I think as I mentioned above, that you need to address why your sleep is poor and you feel tired all the time. This could be a combination of not eating enough 'fuel' for your body, or some other underlying condition. You should get a metabolic panel done on your body to identify if any organs are having issues (like kidneys). I also, like you have trouble falling asleep at night. One thing that helps me is having fat before bed (a healthy fat you can try is almond butter - I have a peanut allergy so peanuts do not work for me). But without that, I also have the same issue as you do here, so it may not be an integrated source of the main issue.

Finally, I have not posted myself on this board with my own issues yet, but I think I will, because I also suffer from low libido and ED and despite my continuous bloodwork no one has been able to help me with my issues in years. I have not given up yet, but I want to say that hormones are a complex system and is not properly understood by doctors completely. There are things that science has not yet figured out. I look at your results as amazing because I have LOW free T and can not get that to rise. Yet with your HIGH free T and LOW E you are also having issues with libido and morning wood, just like me. I look forward to hearing back from you on your results from future labs and hope my answers provided you some comfort in some of the other areas.

My remaining question to you is: Are you natural or do you take TRT?

Cheers,
Bdawg

PS - You mentioned anxiety so I will just throw this in there for you. On a recent hunt for information (tonight actually), I came across this for anxiety: Gaia Herbs Ashwagandha. Take a look into it.

Here is a website I was using for examining medical studies and claims for herbs like the above:
examine.com/supplements/Ashwagandha/

Bdawg said:

"Fast forward to today, and not a whole lot has changed. My body composition has not changed at all despite having a consistent good diet and workout often with good intensity. However the worst part of it all is I feel terrible. I don't like talking with people, I have literally zero libido, and rarely get AM wood. My sleep is poor - I become tired around 7pm and by the time I am in bed (9-10pm) I am unable to sleep, sometimes I lay in bed for hours before falling asleep. I have brain fog. I often feel emotional and get anxiety. My joints pop and click allot while working out. The most recent symptom that triggered me looking into hormones again was my hands and feet are ALWAYS cold. Does not matter when or where, they just never seem to be able to get warm. My skin is also really dry. I do find I feel significantly better in the summer, and I take vitamin D 10,000IU's per day but do not notice any effects. This peaked my interest in my old labs since I measured a few thyroid markers (but not enough). "

First, your FREE testosterone is awesome and your E is LOW. People dream of having this, so I'm not sure what is the problem with this at all. It looks to me like your main issue is feeling tired all the time. My question then to you is, is this tiredness something that happened as a result of the diet change? Could it be possible that without a 'fuel' source of complex carbs or fats that your body is tired most of the time when you apply exercise and the workouts that you do?

Second, like you, I have been doing Intermittent Fasting every day for the past month at least (16/8, sometimes 18/6). I've been on a strict ketogenic diet for past 86 days and mostly paleo for the prior 3 years (minus a year of bulking) before that, so I just want to add in here that I also get cold hands and cold feet which I have right now as I type this. I know for me, the cold hands/cold feet happens to me when I eat no carbs and sometimes if I don't eat enough fat. Since you're not doing keto, you're likely not getting enough of the 'fuel source' that being complex carbs or fat. Today for example I am eating pretty much just vegetables and some red meat, but if I was eating breakfast (eggs, bacon, cheese) I can guarantee you the 'fat' for fuel would ensure I didn't have cold hands or feet. Just something to think about.

Third, I recently upped my Vitamin D which was 'deficient' to an 82 in a month which my doctor said was not possible to test for, but he was wrong. But like you Vitamin D didn't do much to make me feel any different, so I just wanted to say that. If your Vitamin D is in the normal range which would be something like 80-100, then it's not something you need to worry about, in my opinion.

Fourth, You mention "your joints pop and click alot while working out". Mine do too if I haven't properly recovered them. Do you know about trigger point therapy? Similiar to what people do with a foam roller for their legs where trigger points are, you can do the same with a lacross ball for your other muscles in the upper back like your triceps (which you could also do on a foam roller). I encourage you to google this, because what is happening when you hear that clicking noise is that your tendon is clicking over the bone because of muscle weakness due to tightness. You need to increase your mobility in your muscles during downtime. A trigger point is simply where muscle fibers get twisted and pinch nerves that refer pain to other places in the body. This happens a lot more in people that are active like in a gym where you are constantly ripping fibers.

Fifth, I think as I mentioned above, that you need to address why your sleep is poor and you feel tired all the time. This could be a combination of not eating enough 'fuel' for your body, or some other underlying condition. You should get a metabolic panel done on your body to identify if any organs are having issues (like kidneys). I also, like you have trouble falling asleep at night. One thing that helps me is having fat before bed (a healthy fat you can try is almond butter - I have a peanut allergy so peanuts do not work for me). But without that, I also have the same issue as you do here, so it may not be an integrated source of the main issue.

Finally, I have not posted myself on this board with my own issues yet, but I think I will, because I also suffer from low libido and ED and despite my continuous bloodwork no one has been able to help me with my issues in years. I have not given up yet, but I want to say that hormones are a complex system and is not properly understood by doctors completely. There are things that science has not yet figured out. I look at your results as amazing because I have LOW free T and can not get that to rise. Yet with your HIGH free T and LOW E you are also having issues with libido and morning wood, just like me. I look forward to hearing back from you on your results from future labs and hope my answers provided you some comfort in some of the other areas.

My remaining question to you is: Are you natural or do you take TRT?

Cheers,
Bdawg

Click to expand...

No. Low E2 is not only an absolutely miserable condition, but it's deleterious to health and sexual function. I wouldn't wish it on my worst enemy. It is not "the goal" to lower estradiol as low as possible as estradiol is an essential hormone. Anyone who believes otherwise is simply misinformed when it comes to hormones. People do not "dream" of having low E2. I have nightmares.

OP has a hormone deficiency that no lifestyle factor you recommend will ever fix. No amount of weight loss, eating more "fuel" or "trigger point therapy" or "eat fat before bed" will ever fix this.

Your thinking low E2 is fine is leading me to believe your problem is low E2.

In the groups that received testosterone, inhibition of estrogen synthesis (cohort 2), as compared with intact estrogen synthesis (cohort 1), was associated with significant increases in the percentage of body fat (P<0.001), subcutaneous-fat area (P<0.001), and intraabdominal-fat area (P = 0.002) and with significant decreases in sexual desire (P<0.001) and erectile function (P = 0.022); these findings provide additional evidence of an independent effect of estradiol on these measures.

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4142768/

Elderly men with low serum testosterone and estradiol have increased risk of mortality, and subjects with low values of both testosterone and estradiol have the highest risk of mortality

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. https://www.ncbi.nlm.nih.gov/pubmed/19401373

Among 501 men with chronic HF, 171 deaths (34%) occurred during the 3-year follow-up. Compared with quintile 3, men in the lowest and highest estradiol quintiles had increased mortality (adjusted hazard ratio

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, 4.17; 95% confidence interval [CI], 2.33-7.45 and HR, 2.33; 95% CI, 1.30-4.18; respectively; P < .001). These 2 quintiles had different clinical characteristics (quintile 1: increased serum total testosterone, decreased serum DHEA-S, advanced NYHA class, impaired renal function, and decreased total fat tissue mass; and quintile 5: increased serum bilirubin and liver enzymes, and decreased serum sodium; all P < .05 vs quintile 3). For increasing estradiol quintiles, 3-year survival rates adjusted for clinical variables and androgens were


> quintile 1, < 12.90 pg/mL; 3 Year Survival Rate: 44.6%
> quintile 2, 12.90-21.79 pg/mL; 3 Year Survival Rate: 65.8 %
> quintile 3, 21.80-30.11 pg/mL; 3 Year Survival Rate: 82. 4%
> quintile 4, 30.12-37.39 pg/mL; 3 Year Survival Rate: 79.0 %
> and quintile 5, > or = 37.40 pg/mL. 3 Year Survival Rate: 63.6 %

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http://press.endocrine.org/doi/full/10.1210/jc.2012-3861

Estrogen appears to play an important role in determining bone mineral density in men, but it remains unclear whether estrogen primarily determines peak bone mass or also affects bone loss in elderly men. Thus, we assessed longitudinal rates of change in bone mineral density in young (22&#8211;39 yr; n = 88) vs. elderly (60&#8211;90 yr; n = 130) men and related these to circulating total and bioavailable estrogen and testosterone levels. In young men bone mineral density increased significantly over 4 yr at the mid-radius and ulna and at the total hip (by 0.32&#8211;0.43%/yr), whereas it decreased in the elderly men at the forearm sites (by 0.49&#8211;0.66%/yr), but did not change at the total hip. The rate of increase in bone mineral density at the forearm sites in the young men was significantly correlated to serum total and bioavailable estradiol and estrone levels (r = 0.22&#8211;0.35), but not with total or bioavailable testosterone levels. In the elderly men the rates of bone loss at the forearm sites were most closely associated with serum bioavailable estradiol levels (r = 0.29&#8211;0.33) rather than bioavailable testosterone levels. Moreover, elderly men with bioavailable estradiol levels below the median [40 pmol/liter (11 pg/ml)] had significantly higher rates of bone loss and levels of bone resorption markers than men with bioavailable estradiol levels above 40 pmol/liter. These data thus indicate that estrogen plays a key role both in the acquisition of peak bone mass in young men and in bone loss in elderly men. Moreover, our findings suggest that age-related decreases in bioavailable estradiol levels to below 40 pmol/liter may well be the major cause of bone loss in elderly men. This subset of men is perhaps most likely to benefit from preventive therapy.

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https://www.ncbi.nlm.nih.gov/pubmed/11502778



Take a large dose of AI and let me know how you feel.

Johndoesmith,

Thank you for your post, I'm pretty sure the studies you sited apply directly to myself and yes I agree I don't wish it on anyone either. Your response seemed rather hostile rather than helpful. I was rather addressing some of the other things described in the young man's post. Unlike the OP, I have low T, low free T and low E and am on TRT. Hence my responses to try to assist the OP based on my experiences. Do you have any other helpful advice?

Thanks,
Bdawg

Bdawg said:

Johndoesmith,

Thank you for your post, I'm pretty sure the studies you sited apply directly to myself and yes I agree I don't wish it on anyone either. Your response seemed rather hostile rather than helpful. I was rather addressing some of the other things described in the young man's post. Unlike the OP, I have low T, low free T and low E and am on TRT. Hence my responses to try to assist the OP based on my experiences. Do you have any other helpful advice?

Thanks,
Bdawg

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Yeah I admit it was rather hostile. I apologize for that, I just cannot stand when people suggest lifestyle improvements when a person's problem is not going to be helped by that, such as OP, or a guy with 150ng/dl total test. No exercise is going to fix that.

It happens man, TRT doesn't fix everything, you still get angry or whatever.

If you have labs, I'd recommend you starting your own thread. I'd be happy to take a look but I don't want to take over OPs thread anymore.

JohnDoesmith,

Thanks for following up bud. I said I might in my post, but obviously didn't hijack this one. My reasoning is from my perspective of having low T, low free T and low E, I was always under the impression that having High Free T would resolve my issue. Now that we are talking, maybe low E is the issue all along. I mean obviously, if doctors gave me more T, then perhaps my free T and E would rise. Right? What then would you recommend to bring low E up to a higher level?

And back to my overall point, most of the things I suggested do matter and will help the OP because they have made sense to me who also has low E. They may not address your whole response on focusing on E, but I'm not convinced that the OP's post is all based on E, that's an assumption you came to. For example, I recently have cut my horrible body fat which has always been there no matter what to almost 12% in just 3 months by doing things that go against what everyone says and while having low t, low free t, and low e. So I think I am qualified to respond to this post and I would very much like to see some more discussion on this topic. I'll post in a separate thread later. Thanks for your time tonight.

Cheers,
Bdawg

Bdawg said:

JohnDoesmith,

Thanks for following up bud. I said I might in my post, but obviously didn't hijack this one. My reasoning is from my perspective of having low T, low free T and low E, I was always under the impression that having High Free T would resolve my issue. Now that we are talking, maybe low E is the issue all along. I mean obviously, if doctors gave me more T, then perhaps my free T and E would rise. Right? What then would you recommend to bring low E up to a higher level?

And back to my overall point, most of the things I suggested do matter and will help the OP because they have made sense to me who also has low E. They may not address your whole response on focusing on E, but I'm not convinced that the OP's post is all based on E, that's an assumption you came to. For example, I recently have cut my horrible body fat which has always been there no matter what to almost 12% in just 3 months by doing things that go against what everyone says and while having low t, low free t, and low e. So I think I am qualified to respond to this post and I would very much like to see some more discussion on this topic. I'll post in a separate thread later. Thanks for your time tonight.

Cheers,
Bdawg

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I think you've misunderstood me on a few things.

High free test(which OP doesn't have, that's very clearly a lab error) doesn't resolve the lack of estradiol ALONE, it must aromatize into estradiol in which case, yes it would resolve the low E2, but high free test with low E2 will not negate the problems of low E2. They are separate hormones, and estradiol is in fact responsible for a lot of testosterone's actions, specifically in the brain.

More test = more E2. Assuming you're not the 9th man on the planet with documented aromatase deficiency.

If OP's problems are all caused by low E2, which it seems they are, then no, lifestyle factors will do absolutely nothing for most of them. Yes, you can lose fat with terrible hormones, but that's not what OP was complaining about. He's complaining mostly about mental effects.

johndoesmith said:

Sounds about right. I'd wake up so damned thirsty I couldn't really brush my teeth, needed to go downstairs and get a 911 priority level glass of water. Although I honestly didn't realize this wasn't normal until it went away, if you asked me this before TRT I woulda said "huh?".

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I keep a glass of water next to bed. First thing is to chug that sucker 100% before I even get out of bed haha.

johndoesmith said:

Which symptoms?
I don't think you answered the hot flashes one, not important, but it's a curiosity of mine.

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I was referring to anhedonia. I find that unless I am really cutting calories I just feel more depressed/not happy at all. When my calories get lower (sub 2200) for a few months the intense tiredness comes in and it is brutal. This will barely give me weight loss (sub 1lb/wk). I figure there has to be some connection between calories and hormones but I don't feel it is a normal per say. I never considered I actually had hot flashes, but I do often get really hot in my ears and body, but I usually am more frustrated with my cold feet!

johndoesmith said:

Did you ever smoke cigarettes or consume nicotine in anyway? I don't think you would, you seem to health conscious.

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I smoke the occasional cigar (1-5 per year) for special occasions. Nothing more then that.

johndoesmith said:

Do you have health insurance that covers labs? You can consider Defy medical. They are the best around(IMO) for TRT related issues and they can give you a script for labs and hopefully your insurance will cover it, then you can satisfy the engineer in you.

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I have BCBS of NC. I read through the plan and it states in-network lab testing is paid complete. But it is a bit unclear (this is under "specialist" category). I need to call them Tuesday and find out if they will pay for it. Labcorp is listed as a in-network independent lab. I am ready to pull the trigger on this testing and see where I am at!!

johndoesmith said:

I think it works well. You're one of the few OPs who ACTUALLY tries to answer all questions asked of him. Anything you do is fine with me, in my book.

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Thanks for the feedback. I realize this method of diagnosis can be very confusing, so anything I can do to make it easiest!

Bdawg said:

My remaining question to you is: Are you natural or do you take TRT?
Cheers,
Bdawg

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Bdawg, thank you for writing and giving your advice/experience! Over the past few years my main struggle has been to loose weight and see if I can get my gyno (undiagnosed) down or perhaps get lucky and see it was just fat! The symptoms that brought me to this board have surfaced throughout the past few years (at least from what I can tell). I have spent the years trying to monitor and tweak my diet to help alleviate my anxiety and depression and cannot create a correlation (yet). Don't get me wrong, I am not denying nutrition plays a huge role in how we function! I cook 99% of my own meals and I enjoy trying to become as healthy and strong as I can. I want to get a complete picture of what all is unbalanced with my hormones now that I know low E is a source of me not feeling well at all. I really want to find out why I have low E in the first place before starting any sort of therapy. To answer your question, no I have never taken TRT (natty bro!).

johndoesmith said:

If OP's problems are all caused by low E2, which it seems they are, then no, lifestyle factors will do absolutely nothing for most of them. Yes, you can lose fat with terrible hormones, but that's not what OP was complaining about. He's complaining mostly about mental effects.

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I do hope correcting my low E will turn this all around. But I do wonder why I have low E in the first place. Just so you know I am still actively trying to loose body fat and increase muscle mass (it has become a passion and I enjoy it). However with very consistent effort I have seen very little to no progress (which is ok, because I enjoy it anyway). Obviously you understand the mental effects I am experiencing far outweigh how I look though, so this is a complete priority. This is effecting my lifelong goals, friendships, and career in a severe way.

Any advice on where I can do some research on Estrodiol production in men?

Thank you!
Walker

I keep a glass of water next to bed. First thing is to chug that sucker 100% before I even get out of bed haha.

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Haha I should have thought of that. Really, I just hate the feel of my mouth when I wake up, and the thought of water before brushing my teeth is disgusting to me.

I was referring to anhedonia. I find that unless I am really cutting calories I just feel more depressed/not happy at all. When my calories get lower (sub 2200) for a few months the intense tiredness comes in and it is brutal. This will barely give me weight loss (sub 1lb/wk). I figure there has to be some connection between calories and hormones but I don't feel it is a normal per say. I never considered I actually had hot flashes, but I do often get really hot in my ears and body, but I usually am more frustrated with my cold feet!

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So wait, you feel better when cutting calories? That's odd.

There absolutely is a connection between calories and hormones. Testosterone will decrease, SHBG will generally increase, and I'm sure there are impacts on other hormones such as thyroid and adrenal hormones in caloric restriction.

I smoke the occasional cigar (1-5 per year) for special occasions. Nothing more then that.

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That won't have any long term effect. Nicotine is an aromatase inhibitor.

I have BCBS of NC. I read through the plan and it states in-network lab testing is paid complete. But it is a bit unclear (this is under "specialist" category). I need to call them Tuesday and find out if they will pay for it. Labcorp is listed as a in-network independent lab. I am ready to pull the trigger on this testing and see where I am at!!

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You'll have to call them and ask if they will cover lab orders from an "out of state out of network" doctor. It's important to specify not that they cover this doctor but orders they make for labs.

Thanks for the feedback. I realize this method of diagnosis can be very confusing, so anything I can do to make it easiest!

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Of course you know this is not a diagnosis and except for Dr Saya we are not physicians, and even if anyone is, there's no doctor that would diagnose over the internet.

This is entirely my opinion and experience. Take it as you will.

I do hope correcting my low E will turn this all around. But I do wonder why I have low E in the first place. Just so you know I am still actively trying to loose body fat and increase muscle mass (it has become a passion and I enjoy it). However with very consistent effort I have seen very little to no progress (which is ok, because I enjoy it anyway). Obviously you understand the mental effects I am experiencing far outweigh how I look though, so this is a complete priority. This is effecting my lifelong goals, friendships, and career in a severe way.

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I do think it will turn things around for you.

Why one has low E2 will depend on many things. Who's the doctor that ordered these tests? They seem to understand hormones well, but left out tests that even a doctor who doesn't understand hormones well will usually order like LH, FSH, and SHBG.

If LH and FSH were ran, it'd tell you if you're secondary or primary. While you're not testosterone deficient you are certainly estradiol deficient which has nearly all of the same symptoms but IMO with more long term risks.

Contrary to popular belief, low E2 will cause increased body fat, whereas most think only high E2 will do so. It's possible low E2 is holding you back directly, but I think it may be more indirect, from depression, fatigue, and joint pain.

Any advice on where I can do some research on Estrodiol production in men?

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Google is where you should start. Wikipedia. Pubmed is great also, but rather advanced, so if you don't mind jargon and such it'll be very informative.