Concerned my E2 is too low. Not on any TRT meds at all.

JCUSN · May 20, 2019

I was on TRT for about 18 months. Decided to stop and attempt a restart using toremifene. The restart was a success!

I haven’t had any injection or any SERM since October 2018.
My current labs are:
Total T: 694
E2: 12.8

I’m concerned that my E2 is too low. Is it actually too low? Is this cause for concern for osteoporosis, erectile dysfunction, or any other low E2 condition?

Systemlord · May 21, 2019

Generally I would say an E2 of 12.8 is very low when compared with your testosterone, symptoms or lack thereof will be a better indication.

Usually when E2 is low that is an indication Free T could also be low, we see it all the time. High SHBG is usually the cause of having higher Total T in relation to your Free T and E2 levels, in this instance Free T and E2 would be low.

Do you have any Free T labs and even better SHBG labs?

Vince · May 21, 2019

JCUSN said:
I was on TRT for about 18 months. Decided to stop and attempt a restart using toremifene. The restart was a success!

I haven’t had any injection or any SERM since October 2018.
My current labs are:
Total T: 694
E2: 12.8

I’m concerned that my E2 is too low. Is it actually too low? Is this cause for concern for osteoporosis, erectile dysfunction, or any other low E2 condition?

I wouldn't be concerned or even mess with your estrogen levels. Your overall testosterone is good and your body is making it. Do you really want to convert more of your testosterone into estrogen. Eat healthy, take the right supplements and live a healthy lifestyle. You'll be fine.

HealthMan · May 21, 2019

Agree with Vince. Also worth checking SHBG and Free T and Free E if you are really that concerned. Add DHEA if after testing levels are not optimal can help and will not shut you down again

Vince Carter · May 21, 2019

JCUSN said:
I was on TRT for about 18 months. Decided to stop and attempt a restart using toremifene. The restart was a success!

I haven’t had any injection or any SERM since October 2018.
My current labs are:
Total T: 694
E2: 12.8

I’m concerned that my E2 is too low. Is it actually too low? Is this cause for concern for osteoporosis, erectile dysfunction, or any other low E2 condition?

This is worry about a number on a page and given there's no complaints other than a lab test, I would not give it another thought.

JCUSN · May 21, 2019

Systemlord said:
Generally I would say an E2 of 12.8 is very low when compared with your testosterone, symptoms or lack thereof will be a better indication.

Usually when E2 is low that is an indication Free T could also be low, we see it all the time. High SHBG is usually the cause of having higher Total T in relation to your Free T and E2 levels, in this instance Free T and E2 would be low.

Do you have any Free T labs and even better SHBG labs?

You are totally spot on.

Looking at my SHBG, it's at 72!
My free T is at 84.99 pg/mL. I don't know if that's high or low.

Is this pretty bad? Should I consider TRT again?

As far as symptoms, about 2 weeks ago I started to feel totally DRAINED. My energy levels have slowly declined. Additionally, it's like overnight I developed a bit of anxiety/depression. I've also recently been unable to shed my stomach fat. I typically am VERY lean and with very tight and visible six-pack, but that has begun to dwindle away.

JCUSN · May 21, 2019

I also have thyroid labs if that matters at all:

Thyroxine 6.5 mcg/dL
Triiodothyronine Uptake 28 %
Thyroxine Free Index 1.8

Thyrotropin1.910 mcIU/mL

JCUSN · May 21, 2019

HealthMan said:
Agree with Vince. Also worth checking SHBG and Free T and Free E if you are really that concerned. Add DHEA if after testing levels are not optimal can help and will not shut you down again

Added those numbers in above post. Thanks!

Vince · May 21, 2019

JCUSN said:
I also have thyroid labs if that matters at all:

Thyroxine 6.5 mcg/dL
Triiodothyronine Uptake 28 %
Thyroxine Free Index 1.8

Thyrotropin1.910 mcIU/mL

Why don't you just post your complete Labs along with all the ranges.

JCUSN · May 21, 2019

Vince said:
Why don't you just post your complete Labs along with all the ranges.

BASIC METABOLIC PANEL:
Urea Nitrogen26 mg/dL
Higher Than Normal(9-20)

Carbon Dioxide26 mmol/L
(22-30)

Chloride104.0 mmol/L
(98-107)

Creatinine0.9 mg/dL
(.66-1.25)

Glucose91 mg/dL
(74-106)

Potassium3.80 mmol/L
(3.5-5.1)

Sodium143 mmol/L
(137-145)

Calcium9.3 mg/dL
(8.4-10.2)

Anion Gap13 mmol/L
(8-16)

GFR Calculated Non-Black110.3 mL/min
(60->=60)

GFR Calculated Black127.5 mL/min
(60->=60)

LIPIDS:
Cholesterol232 mg/dL
Higher Than Normal(0-200)

Triglyceride69 mg/dL
(0-150)

HDL Cholesterol47 mg/dL
(40-60)

LDL Cholesterol171 mg/dL
Higher Than Normal(0-129)

VLDL Cholesterol14 mg/dL
(2-49)

Cholesterol/HDL Cholesterol4.97

Lutropin 3.65 mIU/mL
(1.7-8.6)

Prostate Specific Ag 1.020 ng/mL
(0.014-4.00)

Testosterone689.00 ng/dL
(249-836)

Sex Hormone Binding Globulin69.93 nmol/L
Higher Than Normal(8-48)

Testosterone Free/Total84.99 pg/mL
(35-155)

Albumin5.0 g/dL
(3.5-5.2)

Thyroxine6.5 mcg/dL
4.5-12.0

Triiodothyronine Uptake28 %
24-39

Thyroxine Free Index1.8
1.2-4.9

Thyrotropin1.910 mcIU/mL
(0.27-4.2)

Vitamin D, 25-Hydroxy53.6 ng/mL
(29-100)

Vitamin B12 (Cobalamins)703.7 pg/mL
(232-1245)

at15 · May 25, 2019

if you feel good and have no negative symptoms your fine in my opinion, let the body lie where it wants.

Vince · May 25, 2019

JCUSN said:
BASIC METABOLIC PANEL:
Urea Nitrogen26 mg/dL
Higher Than Normal(9-20)

Carbon Dioxide26 mmol/L
(22-30)

Chloride104.0 mmol/L
(98-107)

Creatinine0.9 mg/dL
(.66-1.25)

Glucose91 mg/dL
(74-106)

Potassium3.80 mmol/L
(3.5-5.1)

Sodium143 mmol/L
(137-145)

Calcium9.3 mg/dL
(8.4-10.2)

Anion Gap13 mmol/L
(8-16)

GFR Calculated Non-Black110.3 mL/min
(60->=60)

GFR Calculated Black127.5 mL/min
(60->=60)

LIPIDS:
Cholesterol232 mg/dL
Higher Than Normal(0-200)

Triglyceride69 mg/dL
(0-150)

HDL Cholesterol47 mg/dL
(40-60)

LDL Cholesterol171 mg/dL
Higher Than Normal(0-129)

VLDL Cholesterol14 mg/dL
(2-49)

Cholesterol/HDL Cholesterol4.97

Lutropin 3.65 mIU/mL
(1.7-8.6)

Prostate Specific Ag 1.020 ng/mL
(0.014-4.00)

Testosterone689.00 ng/dL
(249-836)

Sex Hormone Binding Globulin69.93 nmol/L
Higher Than Normal(8-48)

Testosterone Free/Total84.99 pg/mL
(35-155)

Albumin5.0 g/dL
(3.5-5.2)

Thyroxine6.5 mcg/dL
4.5-12.0

Triiodothyronine Uptake28 %
24-39

Thyroxine Free Index1.8
1.2-4.9

Thyrotropin1.910 mcIU/mL
(0.27-4.2)

Vitamin D, 25-Hydroxy53.6 ng/mL
(29-100)

Vitamin B12 (Cobalamins)703.7 pg/mL
(232-1245)

Are you being treated for your hypothyroidism?

Vince · May 25, 2019

Hypothyroid In Men: What Are Underactive Thyroid Symptoms? | Men’s Health

He thought his testosterone levels were to blame, but tests for T checked out just fine. It was another test that showed the answer—it was a thyroid problem.