Blood Work - Low E2/Low T?

[Joey786]

Hello excelmale members. In the last few months I've had two blood draws through discounted labs. I'm 27. I train 4 days per week. I had bilateral varicocelectomy about 6 months ago.
2/29/16
Total test 373ng/dl 348-1197
Free test 14.9 pg/ml 9.3-26.5
Free t4 1.41ng/dl .82-1.77
Free t3 2.9pg/ml 2.0-4.4
Tsh 3.05uIU/ml .45-4.5
Estradiol sensitive 16.1 pg/ml 8.0-35

After this test I started 50mcg t4 and 10mcg t3 per my Drs orders.
4/16/16
Total test 373ng/dl 348-1197
Free test 12.7pg/ml 9.3-26.5
Free t4 1.15ng/dl .82-1.77
Free t3 3.0pg/ml 2.0-4.4
Tsh 1.07uIU/ml .45-4.5
Estradiol sensitive 16.6pg/ml 8.0-35
I have fatigue, muscle weakness, low sex drive, hot flashes/flushing,brain fog, memory loss,dry skin, poor confidence, fat gain. The worst symptom is the memory loss. I swear I have the memory of a 90 year old man. I'm scared about having dementia or Alzheimer's in my later years. When I speak I have difficulty choosing the right words to say. I forget how to do basic things. My dr said my memory is bad because of low thyroid but I believe my estrogen is too low. Can you be put on trt because of low estradiol? My free test is ok but I believe low estradiol is causing my symptoms. Also, I am not ripped. I have a bit of a belly. 6'2" 187lbs. So the low estradiol is not caused by extremely low body fat levels. I have an appointment with my dr next week but I'd like to know what ya'all think. Thanks excelmale members

 

[socks]

Based on research and personal experience, ALL of your symptoms speak to your testosterone level being VERY low, especially for you age and workout habits. You aren't likely to resolve any of those symptoms until you hit 600+ total-t.

TRUST ME, I feel terrible even at 500ng/dl with 13.5pg/ml of free-t (age 27-30). This is definitely not an estrogen issue for you at this point. You're in the 5th percentile for your age group. As such, you need to find a Doc who actually knows how to treat guys like you so primebody or defy medical would be a smart place to start.



I cannot comment on your thyroid levels as I'm not knowledgeable in that area.

 

[Joey786]

Thanks for the input socks. My dr is open to all options. Hopefully we can come up with an appropriate treatment plan.

 

[Nelson Vergel]

Joey

How is your sleep? What other meds or over the counter stuff are you taking?

 

[Joey786]

My sleep is fine. I get 7 to 8 hours per night. When I wake up i feel tried and groggy. The only medication Im taking is 50 mcg t4 and 10 mcg t3. No supplements or over the counter medicines. I cant wait for my appointment with my dr next week! Im really struggling. Im so tired.

 

[ecdysone]

Thanks for the input socks. My dr is open to all options. Hopefully we can come up with an appropriate treatment plan.

Your free test is fine, so this is obviously not the problem. You're right, hopefully your Dr. has some germane ideas, otherwise visit here again, and maybe others can give you some useful input.

 

[Joey786]

So my dr and I discussed trt and we decided to commence therapy. He wants me to inject 100mg/wk broken up into shots every day. This seems a bit over kill to me but I will listen to his orders. He says by injecting everyday my levels will be very constant and my E2 will not spike. So my protocol as of now is 100mg/wk test cyp, 50 mcg t4, 10 mcg t3.

 

[CoastWatcher]

So my dr and I discussed trt and we decided to commence therapy. He wants me to inject 100mg/wk broken up into shots every day. This seems a bit over kill to me but I will listen to his orders. He says by injecting everyday my levels will be very constant and my E2 will not spike. So my protocol as of now is 100mg/wk test cyp, 50 mcg t4, 10 mcg t3.

I inject daily -16mg of testosterone every morning. We have many members here who inject EOD - and are happy with that protocol. Your doctor is savvy enough to realize that control of E2 levels via protocol adjustment is a worthwhile goal. So many members come arrive here with doctors clueless about estradiol, they ignore it, or hammer it with an AI. You have every reason to be hopeful.

Can you offer any thoughts on the thyroid plan?

 

[Joey786]

I inject daily -16mg of testosterone every morning. We have many members here who inject EOD - and are happy with that protocol. Your doctor is savvy enough to realize that control of E2 levels via protocol adjustment is a worthwhile goal. So many members come arrive here with doctors clueless about estradiol, they ignore it, or hammer it with an AI. You have every reason to be hopeful.

Can you offer any thoughts on the thyroid plan?

Before I started HRT my tsh was 3.05 uIU/ml (.45-4.5). My dr believes in keeping tsh about 1 uIU/ml. He told me that by starting thyroid replacement my testosterone would likely increase. Apparently hypothyroidism in men is associated with low testosterone. Unfortunately my testosterone did not increase after starting thyroid replacement. In fact my free testosterone went down 2.2 pg/ml. We then decided to start testosterone replacement because I was still very symptomatic. I am continuing to take the thyroid medication because dr believes trt works much better with optimal thyroid levels. CoastWatcher, what are your test levels on everyday injections?

 

[CoastWatcher]

CoastWatcher, what are your test levels on everyday injections?

Total testosterone between 935 and 970. Free in the mid-teens. Estradiol sensitive 27-31.

 

[Joey786]

Coastwatcher, your numbers look great. I just don't know if I'm going to be able to stick myself everyday. Lots of holes.

 

[CoastWatcher]

Coastwatcher, your numbers look great. I just don't know if I'm going to be able to stick myself everyday. Lots of holes.

Get through the first week on an EOD protocol, or a daily protocol, and you'll have it down to a few minutes every morning. When you start to really feel better it's amazing how little thought you give to the needle.

 

[Joey786]

So i had my follow up appointment with my doctor and we decided to start therapy as I stated earlier. It was a telephone appointment and my doctor said he would email me my treatment plan along with prescription. My appointment was 4/28. Its now 7/3 and my doctor still hasn't emailed me my treatment plan or prescription. I've been going to this doctor for years and have never had a problem but this is ridiculous. I have called the office many times and the receptionist says dr has been really busy and hasn't finished writing my treatment plan. If a dr dropped a patient that dr would have to legally inform the patient correct? Or can the doctor just ignore the patient until the patient decides to find another doc? There is no reason the dr would do this besides not caring about my well being. I've followed his treatment plans, I've never been late paying for services. I feel like telling you guys who he is. Hes well known.

 

[CoastWatcher]

So i had my follow up appointment with my doctor and we decided to start therapy as I stated earlier. It was a telephone appointment and my doctor said he would email me my treatment plan along with prescription. My appointment was 4/28. Its now 7/3 and my doctor still hasn't emailed me my treatment plan or prescription. I've been going to this doctor for years and have never had a problem but this is ridiculous. I have called the office many times and the receptionist says dr has been really busy and hasn't finished writing my treatment plan. If a dr dropped a patient that dr would have to legally inform the patient correct? Or can the doctor just ignore the patient until the patient decides to find another doc? There is no reason the dr would do this besides not caring about my well being. I've followed his treatment plans, I've never been late paying for services. I feel like telling you guys who he is. Hes well known.

Regardless of the legal aspects, if any, the ethical situation is far worse. Frankly, I believe it's time for you to find a new provider. You simply deserve better. Much better.

 

[Joey786]

The first year with this doc I had a problem refilling a prescription so i called the docs office for help. The receptionist told me to grow up and that she wouldn't be able to hold my hand any more. I had another run in with her recently. She accused me of not paying my bills on time. I told her repeatedly that I've never been late. We go back and forth, yes you have, no I haven't. Then she says oh Im sorry I thought you were someone else. Theres an Indian guy that sounds just like you who doesnt pay his bills on time. WTF Im not Indian and I dont have an accent of any kind. Born and raised in California. The way this office is set up you cant talk to the doc unless you have an appointment. All other business is handled through the receptionist. For all I know the doc could have finished the treatment plan and given it to the receptionist who hasn't sent it out because she hates me. This doc is supposed to be one of the best too. I've heard guys debating whether to go to Crisler or this guy.

 

[CoastWatcher]

The first year with this doc I had a problem refilling a prescription so i called the docs office for help. The receptionist told me to grow up and that she wouldn't be able to hold my hand any more. I had another run in with her recently. She accused me of not paying my bills on time. I told her repeatedly that I've never been late. We go back and forth, yes you have, no I haven't. Then she says oh Im sorry I thought you were someone else. Theres an Indian guy that sounds just like you who doesnt pay his bills on time. WTF Im not Indian and I dont have an accent of any kind. Born and raised in California. The way this office is set up you cant talk to the doc unless you have an appointment. All other business is handled through the receptionist. For all I know the doc could have finished the treatment plan and given it to the receptionist who hasn't sent it out because she hates me. This doc is supposed to be one of the best too. I've heard guys debating whether to go to Crisler or this guy.

Dr. Crisler and Dr. Saya (Dr. Saya is the medical director) both practice out of Defy Medical. Why are you waiting? Seriously...you don't need that.