Estrogen out of control Please help

[Fiddler]

Nelson Vergel, just ordered your book through Amazon. Should be here next week.
I am 4 months in to TRT with a dose of .5 cc Test C 200mg weekly ( so 100mg Test C).
Base numbers were Free Test at 65, E2 at 33 before any treatment.
After 4 months and testing in between with both numbers climbing steadily, Free Test has risen to 210 but unfortunately E2 has risen to 141! Yep high enough for a womans normal estrogen and that is after being on avodart for 8 weeks.
I also had a blood panel for my CDL and normal yearly physical with my GP and although he didn't give me actual numbers he said my Hematocrits were too high and he was concerned.
I will follow up on this next week but I am concerned, am I in big trouble here?
Sex drive and performance were great for the first month but have gotten bad in the last month. Easy to get aroused but not able to stay that way.
Any help appreciated, my HRT Doc recommended Stinging nettles and Chrysin to try to lower the E2

 

[Nelson Vergel]

Have your doctor run the E2 test again but make sure it is using the ultrasensitive test. Unless you have a lot of fat, liver dysfunction or other metabolic issues, 100 mg per week of T cypionate should not cause an E2 over 100 pg/mL

 

[Fiddler]

I am 5'8" and 205 and fairly active but no specific excercise except working a physical job.
No doubt I am 25 lbs. overweight but I am also pretty muscular. 31 inch waist and 44 inch chest 17 inch flexed bicep.
Only excess fat is belly and flank.
E2 was 33 first test pre HRT, 56 second test, 88 third and, and 141 this one roughly 6 weeks apart each test.
I will ask for an ultrasensitive test next time.
Bad thing is I live in a smaller town and the only person for Hormones is a Great lady but she specializes in womens health.
She is perplexed as to why my tests show such a drastic conversion of Test to E2.
Thanks

 

[Nelson Vergel]

By the way, be careful with the DHT blocker avodart. It may have the same negative effects on erectile function as Proscar (Propecia).

If you are having prostatic hyperplasia that makes you go pee frequently, try using an alpha blocker instead since they have actually be shown to improve ED.

 

[Gene Devine]

I am 5'8" and 205 and fairly active but no specific excercise except working a physical job.
No doubt I am 25 lbs. overweight but I am also pretty muscular. 31 inch waist and 44 inch chest 17 inch flexed bicep.
Only excess fat is belly and flank.
E2 was 33 first test pre HRT, 56 second test, 88 third and, and 141 this one roughly 6 weeks apart each test.
I will ask for an ultrasensitive test next time.
Bad thing is I live in a smaller town and the only person for Hormones is a Great lady but she specializes in womens health.
She is perplexed as to why my tests show such a drastic conversion of Test to E2.
Thanks

Why is she perplexed why your E2 is so high?

Testosterone converts to either DHT or Estrogen in the pathway.

You are clearly estrogen dominant and you need to bring it down.

The only way to do that is lower your Testosterone dose or start taking an aromatase inhibitor like Anastrozole.

If she starts you on this you may want to front load with 2 mg per week for 3 weeks than cut back to 1 mg per week and get tested in 6 weeks.

The best time to take an AI is 24 hours after each Testosterone injection.

With your body fat this is really no surprise to be honest.

Most well trained TRT Doc's monitor estrogen very closely for just this reason.

 

[Fiddler]

LOL.... Well I am glad my "Fat" doesn't surprise you Gene.
I am trying to get back to fit and am seeking help with it.
With regards to her being perplexed I guess you would have to ask her but I suspect I am not as obviously "Fat" as the numbers may seem. I feel I am 25 over but in fact most people are shocked that I weigh what I do..
I really do appreciate the input though.
She did cut down my Test dose to 80 mg weekly and due to insurance not paying for the Avodart switched me to Finasteride which insurance will pay for.
Bad thing is now I hear that Finasteride can cause some ED issues and sure enough been on it a week and having some BPH type symptoms of frequent urination, discomfort and some failure to maintain good erections, so not sure if it is the high Estrogen or the Finasteride or both.
End of the day I will see about the Aromatase Inhibitor you suggest and get more input as needed.
If I start the Anastrozole in your experience will I need the Finasteride? She seemed to think the BPH symptoms were related to the high Estrogen levels.

 

[Gene Devine]

I didn't mean to be disrespectful Fiddler re your body fat.

The fact is that the aromatase enzyme increases as we age and proliferates in body fat so it's a double whammy if you know what I mean.

It points to your increased E2 levels.

I have a paper I written on E2 and Management and will start a thread in the Testosterone forum...make sure to read it.

In fact, copy it and print it out for your Doc as she needs to understand how E2 follows T.

 

[Fiddler]

Thanks Gene, I appreciate the expertise you guys offer on this site and the FB page.
It is a little overwhelming as some of the info can get a little "Heady" as in tough for a newcomer to follow, but obviously compiled out of years of study by you guys.
I will get up to speed as I learn more, and this is something I am realizing, I need to be educated on myself to make sure those that are prescribing treatment for me are spot on as to their recommendations.
I have never really had any health issues in my 53 years so I admit I am a little inexperienced in Doctor/Patient interaction to do with a long term treatment scenario such as this is going to be.
In the past it was maybe strep throat and take this anti-biotic for a week and call me if you don't feel better.
I just got my blood panel for my CBC's and they are:
Hematocrit 59.8
HGB 20.8
Red blood cells 6.49
So all are elevated.
Dose of test has gone down from 100mg weekly to 80mg weekly to see if it will adjust those and maybe get the Estrogen down also.
I am going to put some real effort into cleaning up my diet to lose the excess fatty tissue which hopefully will help also.
My GP told me that no one will let me donate blood with those levels, so now I will have to maybe get a scrip for a Theraupeutic Phlebotomy I guess if those numbers are dangerously high.
I am a little frustrated and was contemplating quitting the T but I do feel so much better on it.
Maybe it is just the Estrogen talking.....
I think my GP is a little cranky that I am seeing the Hormone Doc as he said I should consult her on the blood levels that he sent over.