Is My E2 High Enough for Symptoms? Could I benefit from small dose AI?

[LakeGuy81]

Symptoms: Little to zero libido, somewhat decreased erection strength, anxiety.

Dosage: Just switched from 100mg T/week via IM to 20mg/day via Sub Q. Have only been Sub Q for 7 days. HCG dose is 500IU 3 times per week. No AI prescribed.

Summary: My doc says "Estradiol is good for men" and that his practice doesn't believe in prescribing AI's, but he told me he would experiment with it if I insist. He also didn't order any sensitive E2 tests, and won't, because he believes E2 is good, not bad. My T levels seem high, where is my libido? Could it be E2 even at these levels? Could too much HCG be causing some of this? I've went from 22 (pre TRT) to 38-40 on E2, labs below. NT=Not Tested

Date	5/9/17	7/20/17	8/29/17	12/14/17	3/14/18
Lab	LabCorp	LabCorp	Vibrant	LabCorp	Quest
Weight	213 lbs	213 lbs	213 lbs	215lbs	220lbs
T Dose	Pre-TRT	100mg/week	100mg/week	100mg/week	150mg/week
Total T	292 ng/dl	745 ng/ml	851 ng/dl	641 ng/dl	863 ng/dl
Range	348-1197	264-916	348-1379	264-916	250-1100
Free T	NT	NT	21.8	NT	196.8 pg/ml
Range	NT	NT	9.00-30.00	NT	35.0-155.0
Estradiol	22.0 pg/ml	33.8 pg/ml	40.2 pg/ml	33.5 pg/ml	38
Range	7.6-42.6	7.6-42.6	25.8-60.7	7.6-42.6	<=39
SHBG	24.5 nmol/L	24.1 nmol/L	21.9 nmol/L	22.1 nmol/L	NT
Range	16.5-55.9	16.5-55.9	16.5-55.9	16.5-55.9	NT

 

[Saul]

The the sensative E2 test with DiscountedLabs. Also, wait until your levels stablize. 7 days after change is too soon.

Doctors are smart, but often have poor logic. Why get the Estradiol test but not the right one? Why prescribe an AI if don't know E2?

 

[Vince Carter]

One thing in particular try and stick with one lab, they're not all the same. For comparability I stick only with one lab for everything. What I see is your SHBG being right at ~22ish is that 38 may be to high an E2, for you. This could mean that liek your Free T being over range, you could (probably) have Free Estrogen that is elevated (a never tested thing). It's my own theory that maybe for SHBG values liek yours a dose reduction in Cyp to get your Free T not over the lab range, could help with the E and any Free E that is roaming around. A low(er) SHBG guy may need to run E values closer to 20 but would be more advisable to do that through a Cyp dose change than with an AI.

 

[LakeGuy81]

One thing in particular try and stick with one lab, they're not all the same. For comparability I stick only with one lab for everything. What I see is your SHBG being right at ~22ish is that 38 may be to high an E2, for you. This could mean that liek your Free T being over range, you could (probably) have Free Estrogen that is elevated (a never tested thing). It's my own theory that maybe for SHBG values liek yours a dose reduction in Cyp to get your Free T not over the lab range, could help with the E and any Free E that is roaming around. A low(er) SHBG guy may need to run E values closer to 20 but would be more advisable to do that through a Cyp dose change than with an AI.

Great response, thanks so much! Can you speak to my 500IU HCG 3/week dose? Would I be wise to trim that down as well if E2 is a concern? If so, what’s a better dosage for HCG?

 

[Vince Carter]

That's upper limit for trt more common is 500 twice per week, or less. Could be an E issue but it's not really very likely.

 

[blackebob]

Every time I get the wrong E test Quest labs puts a litlle note in with the result that says its the wrong test for men. You need to dig around and find that info to show your Dr, or pm me and I will email you a copy of mine to show your Dr.

 

[blackebob]

https://www.excelmale.com/forum/showthread.php?9469-Quest-Ultra-Sensitive-Estradiol-Test

 

[blackebob]

. This could mean that liek your Free T being over range, you could (probably) have Free Estrogen that is elevated (a never tested thing). .

Why isnt it ever tested? Quest has a lab code for it, 36169. It says in the description it is the ls/ms/ms. It also states that estradiol should be less than than 29, same as on the ultra sensitive test. The free E should be.45 pg/ml. Is free E something that would be nice to know, and I wonder if this test would cover both free and sensitive?

 

[Vince Carter]

I Mean that we the community aren't testing Free Estrodial when we probably should, especially for the low SHBG guy where were know Free T is very high = high Free E. I've pulled it a few times for some more insight to my E problems and I'm way over the lab range. I tend to pull a trifecta with my testing: LC/MS/MS UltraSensitive, Free Estradiol, and Estradiol, serum. I like to see all three on the same blood draw.