High E2 low T

[sreacher]

Hi,

I recently received testosterone and estradiol blood tests (nothing else). These were:

Testosterone - 356 ng/dl
Estradiol - 44 pg/ml - this was flagged as being outside the normal range. The test was a standard Estradiol test from medichecks.com not the recommended ultra sensitive test (I am in the UK).

I know that high E2 is not necessarily a problem. However, the E2 level seems to be very abnormal given my testosterone level. What could cause the high E2 levels?

I am fairly lean 175lbs at 6ft, have a fairly active lifestyle (lifting weights and playing sports). No excessive alcohol consumption. No liver problems. I haven't done any sort of testosterone replacement.

 

[CoastWatcher]

Welcome to Excelmale. Two things come to mind in regard to your estradiol value: lab error or another example of the unreliability of the standard estradiol test when used by men.

You had these tests run because...? What caused you to have your testosterone checked? Was there a reason other labs were not run?

Are you in London? When I was there in August I read if the Doctor's Laboratory on Wimpole Street supposedly offering andrology labs as a speciality. I doubt, however they yet provide access to the LC, MS/MS test.

 

[sreacher]

Welcome to Excelmale. Two things come to mind in regard to your estradiol value: lab error or another example of the unreliability of the standard estradiol test when used by men.

You had these tests run because...? What caused you to have your testosterone checked? Was there a reason other labs were not run?

Are you in London? When I was there in August I read if the Doctor's Laboratory on Wimpole Street supposedly offering andrology labs as a speciality. I doubt, however they yet provide access to the LC, MS/MS test.

I was interested to see my testosterone values. I was expecting the T value to be fairly low for a number of reasons - fairly weak sex drive (no morning erections), very disappointing long term strength gains in the gym, and often feeling tired despite appearing to sleep well in the night.

I only ran the simple tests for reasons of cost - I was hoping the results would be more normal and not really warrant any further investigation. I realize now this is a bad idea because the cost of a full set of hormone tests is only another 30-50 pounds. I'm not in London but I can get a test from medichecks for LH, FSH, SHBG, DHEA etc.

Is the normal E2 test really that inaccurate for higher values of E2? I don't think I can get the sensitive test easily in the UK. If my measured value is not inaccurate, am I correct in thinking that it is potentially a serious problem?

I am planning to tell my GP but I'm not sure the best way of presenting it to him. I don't think there is any medical guidance on the monitoring and treatment of high E2 or low T/E2 ratios in the absence of clear associated symptoms like gynecomastia, so he is quite likely to tell me that there is no problem to investigate.

 

[Vince]

You definitely have low testosterone, you could try to treat E2 by symptoms if you have any. A good zinc supplement and Cialis will help.

 

[CoastWatcher]

I was interested to see my testosterone values. I was expecting the T value to be fairly low for a number of reasons - fairly weak sex drive (no morning erections), very disappointing long term strength gains in the gym, and often feeling tired despite appearing to sleep well in the night.

I only ran the simple tests for reasons of cost - I was hoping the results would be more normal and not really warrant any further investigation. I realize now this is a bad idea because the cost of a full set of hormone tests is only another 30-50 pounds. I'm not in London but I can get a test from medichecks for LH, FSH, SHBG, DHEA etc.

Is the normal E2 test really that inaccurate for higher values of E2? I don't think I can get the sensitive test easily in the UK. If my measured value is not inaccurate, am I correct in thinking that it is potentially a serious problem?

I am planning to tell my GP but I'm not sure the best way of presenting it to him. I don't think there is any medical guidance on the monitoring and treatment of high E2 or low T/E2 ratios in the absence of clear associated symptoms like gynecomastia, so he is quite likely to tell me that there is no problem to investigate.

Congratulations - you recognized you had a medical problem and proceeded to take charge of your own health. That is something that all of us here at Excelmale realize as critical. Now it's time to dig deeper. If you are going to self-test, in anticipation of a discussion with your doctor, you need to run, at a minimum, the tests you indicated in your post along with the following: Free Testosterone, CBC, a full thyroid evaluation (TSH, t3, t4, rt3, antibodies), DHT, PSA, Prolactin.

I would also test your CRP levels. The standard estradiol test can see those levels and report it it as estradiol.

Are you taking any other medications/supplements? Your age, weight, past history of steroid use? Head injury?

I understand that you'll not find the sensitive test in the UK. If your doctor refuses to engage with you on the subject of e2 management, are you willing to go outside the NHS and consult a private physician?

So, repeat the testosterone and flawed estradiol test, add to them the other tests referenced, and let us know how you proceed.

We're you joined us and look forward to hearing more.

 

[sreacher]

Congratulations - you recognized you had a medical problem and proceeded to take charge of your own health. That is something that all of us here at Excelmale realize as critical. Now it's time to dig deeper. If you are going to self-test, in anticipation of a discussion with your doctor, you need to run, at a minimum, the tests you indicated in your post along with the following: Free Testosterone, CBC, a full thyroid evaluation (TSH, t3, t4, rt3, antibodies), DHT, PSA, Prolactin.

I would also test your CRP levels. The standard estradiol test can see those levels and report it it as estradiol.

Are you taking any other medications/supplements? Your age, weight, past history of steroid use? Head injury?

I understand that you'll not find the sensitive test in the UK. If your doctor refuses to engage with you on the subject of e2 management, are you willing to go outside the NHS and consult a private physician?

So, repeat the testosterone and flawed estradiol test, add to them the other tests referenced, and let us know how you proceed.

We're you joined us and look forward to hearing more.

Thanks for the advice. I will get a full set of tests done. I am not currently on any medication (I have taken Proton pump inhibitors in the past), 27 years old, 175 lbs at 6ft. No steroid use or previous head injury.

 

[CoastWatcher]

Thanks for the advice. I will get a full set of tests done. I am not currently on any medication (I have taken Proton pump inhibitors in the past), 27 years old, 175 lbs at 6ft. No steroid use or previous head injury.

Proton pump inhibitors can, and do, hammer nitric oxide in a lot of men. That, in turn can result in erectile issues. How long were you on them?

 

[sreacher]

Proton pump inhibitors can, and do, hammer nitric oxide in a lot of men. That, in turn can result in erectile issues. How long were you on them?

I have taken PPIs for around 1-2 months on 3 separate occasions when symptoms were bad. There was a gap of at least 6 months between each time they were taken. I haven't used them for over a year.