E2 Management

[Vince Carter]

I have bloodwork in the next 10 days just speculating on where I'd go from here, if, my E2 is still elevated.

I'm following this self administered protocol:

75mg TCyp E3.5D
.250iu HcG EOD
.250mg Anastrozole EOD

My last b/w (condensed version) had my E2 @ 34 while on TCyp @ 105mg 1x Weekly, (NO HcG), .250 Anastrozole E3D. This is what prompted me to change to an EOD for Anastrozole and I concurrently switched to the stated increased dosing and added HcG. A lot has changed in dosing and medicines, its just rattling around in my head where I could possibly take E2 management while following what seems to be SOP on Anastrozole.

I just don't know where I'd take the AI dosing if I'm still elevated > 20 atleast.. .500mg/.5 tablet on Injection day....?

 

[Gene Devine]

Can you post your E2 lab exactly as it appears complete with reference range?

Was your E2 lab the "Sensitive" assay designed for men?

.25 mg of an AI EOD is a lot and can tank your E2 serum levels right quick so be careful.

 

[Vince Carter]

This was from Quest I'm unsure if it was sensitive:

"Estradiol, 34, < or = 39 pg.ml"

Other than when I know its been high, as high as 56 in the past I've felt angry, irritable, emotional, like PMS, never had an instance of Gyno, itchy nipples, but have felt bloated but thats rare. I've tried to listen to my body about E2 but I'm not able to interpret the results. I do have some mild to moderate ED symptoms, some of which Im linking to use of Prilosec which I stopped. Morning and nocturnal erections are rather rare..1-2x a week at best. I thinki I have ok desire and libido, the feeling of being horny though is low.

 

[Gene Devine]

This was from Quest I'm unsure if it was sensitive:

"Estradiol, 34, < or = 39 pg.ml"

Other than when I know its been high, as high as 56 in the past I've felt angry, irritable, emotional, like PMS, never had an instance of Gyno, itchy nipples, but have felt bloated but thats rare. I've tried to listen to my body about E2 but I'm not able to interpret the results. I do have some mild to moderate ED symptoms, some of which Im linking to use of Prilosec which I stopped. Morning and nocturnal erections are rather rare..1-2x a week at best. I thinki I have ok desire and libido, the feeling of being horny though is low.

Ok, on your next pull please make sure your Physician orders the "Sensitive" lab designed for men...this is VERY important.

If the E2 lab you have here is the standard default lab designed for women it tends to overestimate men's values so your 34 pg/ml may in fact be lower than this!

BTW, E2 serum levels of 34 pg/ml are not elevated in anyway so I an wondering if your symptoms are related to something else.

Get the "Sensitive" labs next pull Vince.

 

[Vince Carter]

I think this is/was the sensitive test from Quest; does this help you Gene?

Estradiol[h=4]Test Code[/b]4021

[h=4]CPT Code(s)[/b]82670
[h=4]Preferred Specimen(s)[/b]1 mL serum
[h=4]Minimum Volume[/b]0.5 mL
[h=4]Collection Instructions[/b]Note: For any patients for whom low estradiol levels are anticipated (e.g. males, pre-pubertal children and hypogonadal/post-menopausal females), the Quest Diagnostics Estradiol, Ultrasensitive, LC/MS/MS assay is recommended (test code 30289).

 

[Gene Devine]

I think this is/was the sensitive test from Quest; does this help you Gene?

Estradiol

Test Code

4021

CPT Code(s)

82670
Preferred Specimen(s)

1 mL serum
Minimum Volume

0.5 mL
Collection Instructions

Note: For any patients for whom low estradiol levels are anticipated (e.g. males, pre-pubertal children and hypogonadal/post-menopausal females), the Quest Diagnostics Estradiol, Ultrasensitive, LC/MS/MS assay is recommended (test code 30289).

No it's not; read the Note above. It says test code 30289 is recommended for hypogonadal men and post menopausal women because serum levels are low and this test is the one necessary.

 

[Vince Carter]

Clinic/physician says that the test I'm getting, so, at least it'll be consistent from one test to the next; no Ultrasensitive testing.

 

[Vettester Chris]

That lab just isn't sufficient. The measurement system and detection efficiency E2 sensitive assay is significantly more accurate than the standard assay, especially within the lower limits of the reference range. See if you can get the Labcorp test #140244 .. You can get it a la carte through places like privatemdlabs.com, or Jasen at the team at Defy Medical can probably get it for you.

 

[Gene Devine]

Clinic/physician says that the test I'm getting, so, at least it'll be consistent from one test to the next; no Ultrasensitive testing.

Consistent or not, it's the wrong E2 lab as noted directly on you lab.

The standard default E2 lab is designed for pre menopausal women.

Chris is correct, the lab you have to measure E2 tends to overestimate the value in men so you may be taking an AI when you shouldn't.

 

[Vince Carter]

Understood. EDIT: i was able to purchase the test with privatemdlabs using 140244 test number, I'll link up with LabCorp and get it done.

 

[Vince Carter]

Just as I educate myself are the terms "standard" and "sensitive" one in the same, its seems like they're interchanged in my research..I see references to get this test or get that test and then there's "ultrasensitive", which I'll be getting from LabCorp in 7 days based on your advice above.

 

[CoastWatcher]

It has been made clear to me that "standard" and "sensitive" are two different methods of determining E2 levels. There are some excellent stickies on the board, written by Nelson and Gene, that detail why the sensitive test is the one to rely on.

 

[Vince Carter]

I uploaded my test results here as an attachment. I'm still waiting on the LabCorp sensitive which is what I will base any Anastrozole decision on. I was at test time taking .25mg/EOD. I stopped Anastrozole after the LabCorp test so I've been off of it for about 96hrs now. The sensitive test I want to judge whether to restart and if so, how much.

My protocol:
75mg/.5ml E3.5D
.250iu EOD
.25mg Anastrozole

Dr is likely going to clear me to increase my TCyp dose to 90mg/.6ml or 105mg/.7ml (these are compounded vials at 150mg/ml)

I feel good, I'm not great or outstanding, I have room to move upward in my overall well being. My moods are ten times better and more stable, I'm making good gains in the gym. Still have some stubborn belly fat.

**We're aware that I need to make a therapeutic blood donation with the high Hemoglobin, etc.., I've been high all year.

 

[Gene Devine]

I uploaded my test results here as an attachment. I'm still waiting on the LabCorp sensitive which is what I will base any Anastrozole decision on. I was at test time taking .25mg/EOD. I stopped Anastrozole after the LabCorp test so I've been off of it for about 96hrs now. The sensitive test I want to judge whether to restart and if so, how much.

My protocol:
75mg/.5ml E3.5D
.250iu EOD
.25mg Anastrozole

Dr is likely going to clear me to increase my TCyp dose to 90mg/.6ml or 105mg/.7ml (these are compounded vials at 150mg/ml)

I feel good, I'm not great or outstanding, I have room to move upward in my overall well being. My moods are ten times better and more stable, I'm making good gains in the gym. Still have some stubborn belly fat.

**We're aware that I need to make a therapeutic blood donation with the high Hemoglobin, etc.., I've been high all year.

Vince, start a new thread as you are essentially hijacking this thread with your own personal case.

Once you do, Nelson, Chris and i will jump in on your blood work.

Thanks man,

G

 

[Vince Carter]

This is my own thread and it's on topic of estrogen management.

 

[Gene Devine]

This is my own thread and it's on topic of estrogen management.

Oh shit, sorry man.

I read so many damn threads they all start to blend in LOL!

Regarding your blood work; other than needing to give blood to get Hematocrit levels down, you're dialed in!

Keep in mind, the standard default E2 lab designed for women tends to overestimate E2 serum levels in men so the ultra sensitive may present with a lower value.

Give blood my healthy friend

 

[Vince Carter]

Yep I had to go back and look myself, the threads and forums seem to blend together easily!

I'll be back with the Sensitive labs!

 

[Vince Carter]

OK my LabCorp sensitive estradiol is: 19 (3-70pg/mL)

I would like a recommendation to restart Anastrozole, I am currently off of it, I wanted to stop and then restart after receiving the result and anticipation of increased TCyp dosing. My NEW dosing (I was cleared to go to .6 or .7mL, my choice) protocol effective immediately is going to be:

increase TCyp to: 97mg/.65mL E3.5D (150mg/mL vial)
No change: .250iu HcG EOD

I think .25mg the day after my injection is a place to re-start. I honestly thought my E2 was going to be in the basement but the tests said no.

Again my major complaint in my therpay as a whole is ED. I have some generic Sildenafil I've taken at 50mg which was a minor improvement going solo, and once with a partner was what I'd call a failure. No night erections, no morning wood, no spontaneous during the day although I believe the libido and desire is sufficiently present. Im using NO2 as a workout supplement and will try it paired with the Sildenafil.

 

[CoastWatcher]

OK my LabCorp sensitive estradiol is: 19 (3-70pg/mL)

You want to lower E2 when your reading is 19? You might be setting yourself up for more problems.

 

[Vince Carter]

no no...not lower it from 19, I just expected it to be lower is all. I'm wanting to let it rise and reduce my Anastrozole dose in an effort to see if my ED symptoms are low E2 related. Make more sense?