Discountedlabs free estrogen test results in

[stx359]

I typically run a sensitive estrogen in the 50's on my labs. My SHBG is also in the 50's. I have been on TRT for about 15 months and the numbers are pretty consistent. I do all the stuff that people caution will spike estrogen: 80 mg test cyp every 3.5 days, 400 IU HCG M W F and DHEA 25 mg twice a day. I do worry that my estrogen is too high even though I do not have symptoms so I ordered the free estrogen test through discounted labs and it came in as follows:

Serum Estradiol MS - 49 (Range 8 - 35)
Free estradiol percent - 2.2 (Range 1.7 - 5.4)
Free serum estradiol - 1.1 (Range 0.2 - 1.5)

So even though my sensitive estrogen is sky high my free estrogen is dead normal, which I suppose should be expected for someone with high SHBG. It begs the question - is total serum estradiol even relevant? I see a lot of advice offered on here for guys with elevated or only slightly elevated E2. We have a kind of vernacular on here and a way that things are discussed. i wonder if free E2 should not become a more often discussed factor especially when people are considering managing E2 when they might not need to. Also, who do we talk to at discounted labs to make free E2 a part of the male hormone panels?

 

[Systemlord]

So even though my sensitive estrogen is sky high my free estrogen is dead normal

Interesting results, thank you for sharing. The opposite will be true for low SHBG men, normal estrogen and sky high free estrogen. I'll take some of that SHBG.

 

[Vince]

Some men do not have to use an AI if their estrogen levels are running 60 or under.

 

[Vince Carter]

Thats me that is going that direction, like Free T, should be Free E that is being tested and monitored, along with LC/MS/MS but possibly even supplanting that test entirely.
For your SHBG its entirely plausible that your Free E is "normal" because the SHBG binds to E just like it does to T. So you run what most would call a high LC/MS/MS number but the truth lies in the Free E.

Im trying to change the pattern of thinking on this, considering the SHBG when making comments on the LC/MS/MS being high, or low.

 

[Weasel]

I like it VC. Makes perfect sense to me.

Although, me being low shbg (20-25ish) I still feel better with a higher e2 level. I'm terrified of crash my e2 again, Which was pure hell. I do still feel very flat though. but at least not like I'm dying.

 

[stx359]

Here is the embarrassing and potentially catastrophic part. I feel like I have everything dialed in but for my sexual function which if I had to rate I would say is at 90%, lack of sensitivity being my main concern. After addressing everything else the only thing left seemed to be my "high" estrogen. I actually had my doctor write an order for anastrozole 0.25 mg twice a week which I picked up. I was a week in and had just taken my third capsule when the test results came in. Naturally I am stopping but I can only imagine what I could have done to my free E2 had I not ordered this test. I wonder if those three capsules are going to bottom me out.

Perhaps at 49 with all of the injuries I have heaped on my body over the years 90% is a number I should be content with.

 

[Vince Carter]

I think it would be prudent to continue I'd like to see where you end up if the Free E came down a bit more. Remember this is the low point you're seeing. I complain of the same things you mentioned there...my libido and interest in sex are very high but closing the gap on the physical erection, and the sensitivity is what I'm after.
The Free E range is really up in the air as far as what's good and what's too low, time will tell on that but sure to be a hot topic like 21-30 is still a very questionable level and that was established on the Roche ECLIA test, not the LC/MS/MS.

 

[Vince Carter]

I did mean to say that I think .25mg twice per week is too much in your situation, maybe .125mg once per week as a trial?

 

[stx359]

Thanks Vince. Actually those free estrogen numbers are BEFORE I started the anastrozole so they are the high water mark not the low one.

Concur on the dose.

It would be nice to see a lot more discussion on here of free estrogen. I am questioning whether total E2 is even relevant.

 

[MarkM]

Thats me that is going that direction, like Free T, should be Free E that is being tested and monitored, along with LC/MS/MS but possibly even supplanting that test entirely.
For your SHBG its entirely plausible that your Free E is "normal" because the SHBG binds to E just like it does to T. So you run what most would call a high LC/MS/MS number but the truth lies in the Free E.

Im trying to change the pattern of thinking on this, considering the SHBG when making comments on the LC/MS/MS being high, or low.

I'd prefer adding a Free Estradiol test to the current Estradiol Sensitive test that DiscountedLabs.com offers verse supplanting/replacing the Estradiol Sensitive test altogether. That way we see both and can better ascertain what correlations there may or may not be to the other hormones we typically measure. It would be a learning curve for me and having both, at least for my personal use, would help me better understand.

 

[Vince Carter]

I run all three...my insurance picks up the cost but moreso I like seeing Estrradiol/Sensitive/Free all from the same blood draw. My E is bad enough if you've followed my journey with it I run a higher sensitive E than ECLIA...just for curiosity sake.

 

[MarkM]

I run all three...my insurance picks up the cost but moreso I like seeing Estrradiol/Sensitive/Free all from the same blood draw. My E is bad enough if you've followed my journey with it I run a higher sensitive E than ECLIA...just for curiosity sake.

I have noticed you run all three and that your non-sensitive E2 is lower than your Sensitive E2. SO makes sense you would do that.

The Free Estradiol test is at a price point that for many, makes it unaffordable. It would be nice to see a panel with includes all three, like you test, that was more affordable for the average person. With so many paying out of pocket for TRT it just an expense that many can't afford or will bypass that particular test, even if they need it, because they can't afford another $100 plus just for the Free Estradiol test.

 

[Vince Carter]

Youre right at $108 I usually have to make sure that I say something like if you can afford it...I'd have to think twice and three times about paying that.

 

[Nelson Vergel]

It begs the question - is total serum estradiol even relevant? I see a lot of advice offered on here for guys with elevated or only slightly elevated E2. We have a kind of vernacular on here and a way that things are discussed. I wonder if free E2 should not become a more often discussed factor especially when people are considering managing E2 when they might not need to. Also, who do we talk to at discounted labs to make free E2 a part of the male hormone panels?

Excellent question. Free E2 should be THE factor to monitor. However, there are no studies looking into this variable. None.

 

[DragonBits]

I have seen studies that indicate free E2 can be calculated much the same way free T can be calculated if you know your SHBG and albumin levels.

Though I have not seen an actual free E2 calculator.

If free E2 was made a part of the male hormone panel then it would increase the cost of the panel, maybe not by $108, but significantly increase the cost nonetheless, I would guess by at least $80. And the cost does depend on volume of blood tests ordered, so that factor is hard to estimate. If fewer men ordered the panel due to cost, it might make the whole panel more expensive.

I mentally factor in my SHBG + symptoms when looking at E2, then consider how high my TT was, then think about how fast E2 might drop naturally. Not scientific at all, just a swag.

If free E2 was very cheap or insurance covered it all, sure I would go ahead and test that plus all other hormones.

Though I agree with the basic premise, it's all about free E2/bioavailable E2 when thinking about how to react to high E2.