90 day labs....HIGH E....what now???

[BigBamBoo]

Hi Folks.
Just received my 90 blood work results back from Defy.

Looking at it the high E jumps out at me.

I am a high SHBG guy, so the nice doctor I spoke with on my initial consultation said he would like to see my E2 around 30-40.


I would have random high E issues once in awhile. These are sore nipples, but that only happens once in awhile and only lasts a day or so.
Delayed orgasm had to finish sometimes.
And some acne, nothing bad and only random.

Also, I was having bloating issues, and believed it was the HCG. I lowered my HCG down from .5ml twice a week to .35ml twice a week and the bloating went away and I lost 7+ lbs in two weeks after lowering it.

My T dose is .4ml twice a week (200mg/ml Test Cyp).

I am currently not taking a AI. And would really like to NOT start the AI.

I got a consultation scheduled with a Defy doctor, but it is not until the 12th of July!?!?

Thinking of lowering my T dose down to .30-.35ml and see if I feel any different.

Input greatly apricated.

 

[CoastWatcher]

You lower your dose testosterone now, prior to the consultation with Defy, and what will you and the medical team discuss? Will you draw labs again before you have your conversation? Say you drop the dose by X%...and feel good/worse/no change. Not enough time will have passed for serum levels to balance and the discussion becomes a "best guess fest."

 

[BigBamBoo]

You are correct. But having to wait almost a month for a follow up is a bit annoying. And now knowing that I have elevated E, it just makes things a bit harder to just sit on.

 

[Vince Carter]

You lower your dose testosterone now, prior to the consultation with Defy, and what will you and the medical team discuss? Will you draw labs again before you have your conversation? Say you drop the dose by X%...and feel good/worse/no change. Not enough time will have passed for serum levels to balance and the discussion becomes a "best guess fest."

Great post...you have a consult coming discuss it with them and I would directly discuss with them to avoid an AI reducing the Cyp dose to bring your Free T down closer to the lab range would be more preferrable to an AI.

 

[Vince Carter]

You are correct. But having to wait almost a month for a follow up is a bit annoying. And now knowing that I have elevated E, it just makes things a bit harder to just sit on.

You're really not being hurt in any way by waiting another month. I know the wait times are lengthy, have you asked for the very next available provider? If you've asked for a certain provider on that end you may be waiting that whole month. If you can take the next available maybe you get seen quicker.

 

[CoastWatcher]

You are correct. But having to wait almost a month for a follow up is a bit annoying. And now knowing that I have elevated E, it just makes things a bit harder to just sit on.

Believe me, I get it. But the adage that we're running a marathon, not a sprint, contains a great deal of truth. Watching the calendar crawl along three years ago when I was waiting for a protocol adjustment was a challenge. But it was worth it as my doctor (I'm not a Defy patient) and I were on the same page. Some discomfort now means a lot less confusion later.

 

[BigBamBoo]

Good advice. Yes, I asked to speak to the Dr I originally consulted with. I think I will call and ask for the first available Dr.Thanks again gents

 

[BigBamBoo]

Well..have a appointment for next week with a PA. Hoping it goes well as my wife is a Defy patient and has not had good luck with anyone but the doctors there.

Will post up what they say.

 

[S1W]

Well..have a appointment for next week with a PA. Hoping it goes well as my wife is a Defy patient and has not had good luck with anyone but the doctors there.

Will post up what they say.

Please do - looking forward to hearing what they advise you to do. Good luck!

 

[BigBamBoo]

Me too. Pretty much only two choices that I can see. Lower the T dose or take the AI. I REALLY do not want to take a AI, so will lean towards lowering the T a bit.

will post up when I know more.

 

[1Draw]

BigBam I would have them look at your thyroid numbers. Your T4 is low and RT3 slightly above optimal. See this link
https://www.restartmed.com/normal-thyroid-levels/

You may need to see a Dr instead one of their PA’s to get proper treatment. EOD shots for me helps keep my HCT and E2 in line.

 

[BigBamBoo]

BigBam I would have them look at your thyroid numbers. Your T4 is low and RT3 slightly above optimal. See this link
https://www.restartmed.com/normal-thyroid-levels/

You may need to see a Dr instead one of their PA's to get proper treatment. EOD shots for me helps keep my HCT and E2 in line.

Thank you for the info. I doubt they will say much about my thyroid as it was even less than optimal at my first labs and the doctor said he was not concerned. So?

It gets frustrating having to be the one to hunt down the info and then ask for advice when I am the one paying THEM for treatment...

 

[FeelingLost]

Thank you for the info. I doubt they will say much about my thyroid as it was even less than optimal at my first labs and the doctor said he was not concerned. So?

It gets frustrating having to be the one to hunt down the info and then ask for advice when I am the one paying THEM for treatment...

I'll be it is way harder to get ones thyroid up and running perfect than it is to tweak someones T to perfection.

 

[1Draw]

Thank you for the info. I doubt they will say much about my thyroid as it was even less than optimal at my first labs and the doctor said he was not concerned. So?

It gets frustrating having to be the one to hunt down the info and then ask for advice when I am the one paying THEM for treatment...

Agree but, they are no different than a normal PCP. You have to be an advocate for your own health first. Biggest question is how do you feel? I had an old MD tell me one time he didn't care about blood test but, how I felt. I thought that was so unusual and so right on! How you feel should be the main point of any consult.....

 

[Deleted member 16042]

It gets frustrating having to be the one to hunt down the info and then ask for advice when I am the one paying THEM for treatment...

LOL! Yes it is frustrating. I think it is safe to say we are all in agreement on this. Welcome to the real world!

And BTW, after i started injections I had levels very close to yours in those labs, including high E2. That was last November. It's been three more reductions in dosage since then and it seems I have found bottom. It is likely I'll have to bump back up. They started me on 150mg/weel dosed E3D, now down to 84mg/week. It can be a long haul man. It can indeed be difficult to remain patient at times

You're in good company, MANY of us have been through this and are still working on it.

 

[FeelingLost]

Agree but, they are no different than a normal PCP. You have to be an advocate for your own health first. Biggest question is how do you feel? I had an old MD tell me one time he didn't care about blood test but, how I felt. I thought that was so unusual and so right on! How you feel should be the main point of any consult.....

I can't feel when my blood pressure is 180/95
I can't feel when my blood sugar is at 160
I could not feel when my A1C was 6.4

How one feels only go so far. I want to see data. Its the engineer in me.

 

[BigBamBoo]

Agree but, they are no different than a normal PCP. You have to be an advocate for your own health first. Biggest question is how do you feel? I had an old MD tell me one time he didn't care about blood test but, how I felt. I thought that was so unusual and so right on! How you feel should be the main point of any consult.....

Outside of low ejaculation volume and strength...I don't feel bad. Don't feel great...definitely room for improvement. But not suffering.

LOL! Yes it is frustrating. I think it is safe to say we are all in agreement on this. Welcome to the real world!

And BTW, after i started injections I had levels very close to yours in those labs, including high E2. That was last November. It's been three more reductions in dosage since then and it seems I have found bottom. It is likely I'll have to bump back up. They started me on 150mg/weel dosed E3D, now down to 84mg/week. It can be a long haul man. It can indeed be difficult to remain patient at times

You're in good company, MANY of us have been through this and are still working on it.

Well shoot....man I was hoping you were going to tell me everything is going to be fine ya just have to do X. LOL.

Sigh...I went into this knowing it was for the long haul, but was hoping for a “quick fix”.

Thank you all for the replies.

 

[BigBamBoo]

I'll be it is way harder to get ones thyroid up and running perfect than it is to tweak someones T to perfection.

I can't feel when my blood pressure is 180/95
I can't feel when my blood sugar is at 160
I could not feel when my A1C was 6.4

How one feels only go so far. I want to see data. Its the engineer in me.

Yes and yes....

 

[BigBamBoo]

Had my consultation with the Defy PA. Basically told me everything looked good and to lower my T dose from .40ml (80mg) to .30-.35ml (60-70mg) based on how I feel and to lower E2.
Said the ratio of E2:T was not that bad based on my high SHBG. Said free E2 was probably fine and that I would not want to go too low.

No AI recommended at this time.

When I questioned the high SHBG, the reply was that some just have high SHBG and based on my labs, no worries about my liver.

Follow up appointment in 6 months.