Hypopituitary, testosterone and estradiol.

[ratbag]

Thank you Nelson and your team for making this site possible for all of us on TRT. Getting good info is so hard and there is so much conflicting information about all this!

I'm in Canada and I had a head injury at the age of 9. I was only diagnosed as being hypopit in my early 50's (I'm 56 now) and it took a lot of reading on my behalf to inform my MD so that we could arrive at this diagnosis. All my hormone levels were low or bottom of range. I felt like I was dying. In fact I remember thinking it was just a matter of time. Now I'm on every hormone possible and it's been quite an education to get it working right.

I've been hanging out at Phils yahoo site and Datbtrue and others like Meso, & allthingsmale after Phil had set it up. My TRT protocol is 75mg Test-Cyp E3D using arimidex to keep my E2 in check and I follow Phil's RSW method to help determine where I am with that. It works well and my life has turned around completely. My MD is quite approachable so he's open to good ideas. I was taking HCG but recently stopped that (did that ever spike my E2) I was on 3.5mg arimidex daily for that and now without HCg I'm down to 1/4mg EOD. That HCG puts me on the E2 roller coaster. Peter

 

[Nelson Vergel]

I respect Phil but I am not in agreement with his estradiol opinions. I believe you and most guys are overtreating with anastrozole. You may want to read this and ask me questions about it.

Thread: Role of Estradiol in Men and Its Management

 

[Gene Devine]

Read the works of Dr. Mark Gordon in Southern California.

He specializes in head trauma and low hormone levels.

http://www.millenniumhealthcenters.com/

 

[ratbag]

That link doesn't appear to work nelson, looking around the site now.

 

[pmgamer18]

Hi Peter,

And what are you saying Nelson that we are driving down E2 to low I don't keep my E2 levels to low yet one needs to gage E2 by what there SHBG is if your low on this you need to keep your E2 lower. I don't buy that study out saying higher E2 helps with libido and it's from the UK you can't even get Dr.'s to test or treat high E2 in then UK.

But we all need to remember one thing what works for one is not the law or the best for everyone. You need to read some of the post by Roy at the Yahoo forum he was 80 yrs. old and on TRT through the VA and still active with his wife on sex but needed to us a penis pump and ring to have sex. He found me at Yahoo and he got the VA to test his E2 and he was very high. He did what I do and got his normal sex life back it was good for 5 yrs until his wife took ill and could not have sex anymore now that is just one of many stories of men that over came ED getting there E2 down.

 

[Nelson Vergel]

ratbag

Try it again https://www.excelmale.com/forum/thr...trozole-(Arimidex)-What-Every-Man-Should-Know

and another recent thread https://www.excelmale.com/forum/thr...-Boosts-Libido-in-Men-on-Testosterone-Therapy

 

[ratbag]

It wasn't long ago on several big trt sites that the ultrasensitive E2 test was considered totally unreliable. When the sensitive tests first came out as I remember. In fact I can dig up posts about it. At the same time the symptoms were matching the regular E2 test. Nelson you are now saying the sensitive test is working properly. I wasn't aware of this. I don't think anyone is arguing what low E2 does to us long term. This issue is about lab test reliability. Also in Canada we don't get the sensitive E2 test, it just isn't available.

 

[Nelson Vergel]

What I am saying is that not a single study has determined what E2 is too high when it comes to sex drive, etc. We know the low side of the range (under 10 pg/mL) may predispose someone to issues. The balance of T versus E2 matters more than the absolute E2 value. Someone with 1000 ng/dL of TT with an E2 of 60 pg/mL (T/E2 of 17) may be be better off than someone with a TT of 550 ng/mL with an E2 of 60 pg/mL (T/E2 of 9). I would not give the first one anastrozole and may give the second one low dose anastrozole. Both have the same E2.

There is a reason for T to be the precursor of E. Like all hormones, balance is more important than absolute numbers.

We have very limited data on T/E2 ratios but I am pushing for more studies now or re evaluation of old data that can be re-analyzed. I know I will have a lot of push back but hey, new ideas are always rejected.

 

[ratbag]

Thanks for fixing that link... all good info. I follow what your saying. Not sure I'd want to inject daily if I can help it. But obviously makes sense for those on gel. I'm hypopit so before TRT I was high, over range E2. Had all the symptoms, crying watching tv, tears burning etc. But with injection E3D and some arimidex, I could dose so that I had really good RSW and that I think is still a good indicator. I've gone too low on E2 and too high and you get to know the symptoms which is helpful for sure. My dilemma is that Canada doesn't do the ultra sensitive tests. But I can tell you one thing... over range E2 isn't fun, you feel all the high E2 symptoms. BTW, when did the ultra sensitive test start working? Peter

 

[pmgamer18]

Gee what is going on with this forum I spent a lot of time replying to this
thread only to send my post find it's gone.



So I don't have time for this but men need to read these links. If you
think your going to feel better with higher E2 levels go luck.

https://www.lef.org/magazine/mag2008/nov2008_Dangers-of-Excess-Estrogen-in-the-Aging-Male_01.htm



In this link it is put out by Lef and it's a copy in this it states a ton
of info about how bad high levels of E2 are for men. And that levels of E2
should be between 10 to 30 pg/ml.

http://www.griffinmedical.com/male_hormone_modulation_therapy.html

=====================================

Estrogen
Estrogen (measured as estradiol) should be in the mid- to
lower-normal range. If estradiol levels are in the upper one-third of the normal
reference range, or above the normal reference range, this excessive level of
estrogen should be reduced. Labcorp lists a reference range of between 3-70
picogram/mL for estradiol while Quest states a reference range of between 10-50.
For optimal health, estradiol should be in the range of 10-30 picogram/mL for a
man of any age.

 

[Nelson Vergel]

PMGAMER18 No one deleted your post. Do you have a copy of it?

Yes, we have seen the LEF.org article that started it all.

As I reviewed here, I am not disputing the importance of keeping estradiol above 10 pg/mL since E2 levels under that value have been associated with low bone density, higher fat mass, higher cardiovascular risks and lower sex drive.

There is one study in men with heart disease that linked higher stroke risks with E2 above 35 pg/mL.

There is not a single study published that shows lower sex drive or erectile function with levels over 35 pg/mL. None. That does not mean there is no effect but it means that there are no data. Hopefully Lipshultz will shine a light on this when his complete review is published. No need to get defensive about this statement (unless you can show a published reference that I may have missed).

Publishing estradiol data without taking into consideration men's corresponding T levels is misleading.

I would speculate that higher estradiol in men with low T is detrimental in many aspects. But there is no indication that the same is true for men with high testosterone. I think that is what the studies should be looking at.

Should all men on TRT be given anastrozole? I don't think so unless they monitor their E2 via ultrasensitive testing and its range is 15-35 pg/mL

By the way, none of the studies referenced by LEF (or me) used the ultrasensitive test.

A clinic I consult with will be doing a study comparing the two estradiol tests in men with TT under and above 500 ng/dL. I will keep you informed about it soon.

 

[pmgamer18]

Hi Nelson get reply,



I am not being defensive it just worries me when I see people saying levels
of 60 pg/ml are fine for men when most men I have talked to have a big problem
with levels over 30.



I am not by any way the last word on E2 but if your search back at MESO
when Dr. John aka SWALE was running the forum there for "Men's Health" I was one
of the first men that started posting men need to check there E2 levels if they
are having problems on TRT with there sex life.



I went on TRT at age 27 my first test showed my TT 120 yet I never had ED
or problems having sex the problem was feeling like having it.



So I told men make it a point to have sex once you get started all is
good.



But after about 20 yrs on TRT I started having some bad ED and problems
reaching an orgasm. I stated having bad rash's on my body. I started feeling
some anxiety and later bad Panic Attacks even BPH and feeling very hot with a
lot of sweating and trouble sleeping.



All this went away when I got my E2 down to about 20 it's hard for me to
post long posts. When I was in a coma from my Open Heart Bypass Surgery I had a
Stroke. So when I type I need to read this over my mind get a head of me and
some time when I read them back I don't even know what I was saying.



I told the guys at the forum I should quit and everyone got upset so hear I
am so bear with me.



I don't know what happened to the post I sent but it never showed up.
There is a problem at some forum when you go from on site to the other keeping
both open when you come back your posting it gone. This has happened a few
times here all ready.



So now I type my reply in my Email so if I lose it I still have a copy this
can be my new laptop doing this I am looking into this.



I don't feel all men on TRT need to take E2 meds most of them do well with
out them it's about ones age and health. I even get me that tell me there Dr.'s
tell them to lose weight and it will come down I have yet to see this
happen.



As for the Ultra Sensitive Estradiol test at Quest labs forget about it in
most states it dose not work right and I can't understand for the life of me how
Quest can send a man a result of <3 pg/ml to so many men and charge them for
it. I can't see how a man can walk around with a level this low. Yet they keep
pushing this test on men when it not any good does not work being a retired
Quietly Control Engineer that works with numbers I can tell you if it's not
fixed by now after 6 yrs of this it's time to scrap it.



Even LabCorp came out with a Sensitive Estradiol test and is doing the same
thing telling men there E2 is <7 I feel it's about calibration there testing
equip needs to have quietly checks so they know the process is not off and
working right.



I don't trust most Study's even double blind ones just look at the way the
Drug Co.'s got Statin Drugs approved by the FDA yet there are thousands of
people in pain and crippled from using them like me. For every Dr. out there
saying Statin Drugs can save your life from a heart attack there are 2x's more
saying this is not true. Yet the FDA keeps Statin Drugs on the market it's all
about the money.



I base most of what I know from talking to men and seeing what happens to
them and what they go through. I try to tell men find out why your T levels are
low and if it can be fixed your levels will come back up it's too bad Dr.'s
don't do this and a lot of men are on TRT for life because after you on TRT over
8 weeks your shut down for life.

 

[Nelson Vergel]

pmgamer18

Thanks for the update, man. I will keep you informed about what else I find out about the study when I have a meeting with the author.

Here it is:

 

[pmgamer18]

Nelson,



I can't tell you what to do but I stopped reading crap like this yrs ago in
Europe you can't get Dr.'s to even test Estrogens let alone Estradiol. And when
you do get one they will not treat it.



I don't waste my time reading black and white studies which are
prefabricated to get a desired out come. Look at the last testosterone study
prime example.


Everyday the News Medea talks about a new study saying this or that is bad
for you when just the week before they were talking about a study saying how
good it was for you.



The word study is being used to get people att. and them study's are not
Doubled Blind FDA Approved Study's.



I find it upsetting study's out are telling men they need higher levels of
E2 from reading this stuff. I can't tell you how many men I have talked to that
there life was a living He** due to having levels of E2 just over 30 pg/ml let
alone 60.



And they were not on TRT others with lower SHBG levels are very sick with
levels over 15 pg/ml.



I don't know of any men doing great with a level of E2 on TRT over 30
pg/ml.



Now about T to E2 ranges just more crap we tired this at MESO, The Yahoo
and Dr. John's new forum most of the men that had there levels in the range felt
bad. It is a poor way to try to get leveled. It's just more cookie cutter
recipes.



I get most of my info from real life helping and talking to
men.

I don't believe everything I hear and only hafe of what I see I guess this comes from being an Engineer for so many yrs and hearing all the bull from vendors.

pmgamer18

Thanks for the update, man. I will keep you informed about what else I find out about the study when I have a meeting with the author.

Here it is:

 

[HarryCat]

Thanks for posting that Nelson, I for one am still interested in learning about the latest research. Yes I agree with all that has been said about how studies are biased and skewed and data is selective etc. etc. but if you take all that into account you can still sometimes glean useful information. This study looked 423 men which is more than I'll ever be able to get to meet and find out about their experience on TRT.

I don't know how many men pmgamer18 has talked to who have had trouble with high Estrogen but his sample is probably just as biased as anything ever published in a research study.

 

[pmgamer18]

In the study they talk about the Estradiol in the units of ng/dl I can't find Estradiol mesured in units of ng/dl we need to see apples to apples here what are the units in pg/ml or in pmol/l. So are they talking about Estradiol and what is TST.
HarryCat I am not saying I am the last word on this all I am saying is don't take what you read as the rule a lot of what is out there can do more harm then good so take what you can from them and use them.

 

[tmckenzie]

Well, I am far from an expert and I know I am not worth a toot if my e levels are not tanked. Test a month ago, was feeling pretty good, e on sensitive assay was less than three. Dr told me to cut back on arimidex, I am know feeling like crap, so my e must be back in normal territory. It was mentioned above that men with lower sgbh levels need lower e levels. First I have heard this, does anybody have any links to more info? My level is always low. Last reading was 15.

 

[pmgamer18]

Hi tmekenzie,

I see this all the time on the sensitive estradiol labs both from Quest and Labcorp labs they just don't work right I can't believe your that low how could you live this low <3 is not possable even for women on it nothing I read about women on Arimidex show low levels like this and this is what they want.

You will not find any links about low SHBG and needing lower levels of E2 this came from Dr. John Crisler at http://www.allthingsmale.com/forum/forumdisplay.php?2-All-Things-Male.

As for your e2 levels I would redo the test doing the reg. E2 test not the sensitive one if it is ture your this low your damaging your body.

Well, I am far from an expert and I know I am not worth a toot if my e levels are not tanked. Test a month ago, was feeling pretty good, e on sensitive assay was less than three. Dr told me to cut back on arimidex, I am know feeling like crap, so my e must be back in normal territory. It was mentioned above that men with lower sgbh levels need lower e levels. First I have heard this, does anybody have any links to more info? My level is always low. Last reading was 15.

 

[HarryCat]

I see this all the time on the sensitive estradiol labs both from Quest and Labcorp labs they just don't work right I can't believe your that low how could you live this low <3 is not possable even for women on it nothing I read about women on Arimidex show low levels like this and this is what they want.

From this website: "Doses of 1 mg and higher resulted in suppression of mean serum concentrations of estradiol to the lower limit of detection (3.7 pmol/L)."

So yes, in fact, even in women, Arimidex can reduce serum estrogen below detectable levels.

pmgamer18 where are you getting your information?

 

[pmgamer18]

What can I say do you live in the UK and if you do I see why your reading this the <3 is pg/ml = .82 pmol/L 3.7 pmol/L is = to 14 pg/ml not less then 3 pg/ml. I don't need this do your home work before you ask me where I am getting my information.

I was only posting to keep it real and help men don't do well with levels of E2 over 30 pg/ml.

From this website: "Doses of 1 mg and higher resulted in suppression of mean serum concentrations of estradiol to the lower limit of detection (3.7 pmol/L)."

So yes, in fact, even in women, Arimidex can reduce serum estrogen below detectable levels.

pmgamer18 where are you getting your information?