Lab work - Androgel 1.62% - E2 Low - FOG!

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Hello - I am a 59 year old male and have applied 2 pumps of Androgel every morning for the last 3+ years. For the most part I've had good energy, strength, endurance & libido. I hit the gym 5 or 6 days per week for 1 - 1 1/2 hours and lift heavy (enjoying every minute). And then came last week!
You name it - it hit the fan! Foggy, mood swings, vacant trouser syndrome, anxiety, depressed every which way. After scouring this incredible forum I figured my E2 was sky high and had blood work done ASAP. The (attached) results are not terrible but the E2 (not "sensitive") is surprisingly LOW at 15.0 pg/ml. In 3 years the doc has never tested E2 and it was done at my request. Unfortunately, I don't think he ordered the correct test since these results seem to bottom out at 15. Before seeing the lab results I was (stupidly) ready to start taking DIM every day but now think a minimum of 15 mg DHEA everyday is in order. Is this a prudent choice to attempt for a month?

Doe's anyone have some sage advice that may help fix the new found doldrums I'm experiencing? My wife can live with the "vacant trouser syndrome" for a while longer but I need to get the rest of the story back in line. My head seems to weigh as much as a bowling ball.

Thank you in advance for any help!!! Cliff

 

[CoastWatcher]

Welcome to Excelmale. We hope you'll be an active member.

The prudent choice, the one you asked for our thoughts on, would be to do nothing at all in regard to your estradiol until you have the appropriate test run (the sensitive, LC, MS/MS test); www.discountedlabs.com can provide you with an efficient way to get that result. But...don't stop there. You are proposing to travel on the hormone highway and simply tossing hormones into the mix in the absence of a complete lab workup may lead you into a blind alley. What about your DHEA? Where does it sit? Just as importantly, what about your thyroid - tsh, ft3, ft4, rt3? Have you checked SHBG and glucose/a1c recently?

The more information you have, the better you'll be as an advocate for your own health.

 

[Scenmed]

Welcome to Excelmale. We hope you'll be an active member.

The prudent choice, the one you asked for our thoughts on, would be to do nothing at all in regard to your estradiol until you have the appropriate test run (the sensitive, LC, MS/MS test); can provide you with an efficient way to get that result. But...don't stop there. You are proposing to travel on the hormone highway and simply tossing hormones into the mix in the absence of a complete lab workup may lead you into a blind alley. What about your DHEA? Where does it sit? Just as importantly, what about your thyroid - tsh, ft3, ft4, rt3? Have you checked SHBG and glucose/a1c recently?

The more information you have, the better you'll be as an advocate for your own health.

Thanks for the quick reply!

btw: (TSH w/ reflex(?) is 1.59 ulU/ml)

I plan on having the lab work (re)done for DHEA-S, ft3,ft4,rt3 and "sensitive" E2 as soon as the next paycheck rolls in. This time it's on my nickel and unsupported by my doc. SHBG will come later. Is the glucose/a1c different than the 95mg/dl glucose reading I included in the image? Need advice soon!

Thanks - Cliff
***just got a forum message saying a post count of 4 or greater is needed before images will upload. Since I only have 2 posts I'm wondering if the lab work images uploaded at all with my first post***

 

[Vince]

Welcome to ExcelMale. You may wish to consider injections, it's a much easier way to control your testosterone levels.

 

[CoastWatcher]

Your lab results posted. I missed the TSH, and apologize for overlooking it. I did see your glucose, but feel the a1c results paint a somewhat more comprehensive picture.

Did you have comprehensive thyroid testing done prior to the start of TRT?

 

[Vince Carter]

Normally but not in every guy every time the sensitive test will be lower than any other E test and low E can be just as bad as high E with slightly different symptoms.

The more curious part is this all of a sudden...think back...any new supplements? Diet? Think about ANY changes that may have occurred in those areas.

I would run those full panel of Thyroid stuff, just to have baseline as your TSH of 1.5 isn't indicative of a problem.

Speaking to your Glucose and A1C above, as well as your Creatinine and AST/ALT (liver tests) those are always best to have a CBC/CMP on a 8-10-12hr fast. Gym activity can and does typically show up in elevated Creatinine and Liver falsely so what I do is never do those tests unless I'm off about 72hrs from the gym. Assuming you didn't know to fast, etc etc

 

[Vince Carter]

Also looking at your Total and Free T numbers, since you're on topicals, apply it and have your blood drawn 1-2hrs later if at all possible but always apply then test in the AM, I was wondering how you've had some larger swings in your numbers above like suddenly very consistent then 871 then back down...

 

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Vince - Agreed. For now I'm trying to get the E2 higher and topical may help with that.

Thank you!

 

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CoastWatcher - No thyroid testing whatsoever was requested by my doc at the start of TRT.

Thank you!

 

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Vince Carter - No new supplements or diet changes. I'm wondering if Low E2 can somehow deplete serotonin levels and trigger many of my symptoms. Perhaps I'm overthinking this...

I'll request the full Thyroid panel at this Tuesday's visit w/ doc.

I agree that the gym can alter lab results. In fact, the highest T reading I ever got was when I raced from the gym to a doctors appointment and they drew blood within 30 minutes of a 2 hour Oly lifting session. Granted it was not a smart move but I'm learning the basics of TRT everyday. Will fast in the future.

Thank you!

 

[lowe2sucks]

Vince Carter - No new supplements or diet changes. I'm wondering if Low E2 can somehow deplete serotonin levels and trigger many of my symptoms. Perhaps I'm overthinking this...

I'll request the full Thyroid panel at this Tuesday's visit w/ doc.

I agree that the gym can alter lab results. In fact, the highest T reading I ever got was when I raced from the gym to a doctors appointment and they drew blood within 30 minutes of a 2 hour Oly lifting session. Granted it was not a smart move but I'm learning the basics of TRT everyday. Will fast in the future.

Thank you!

it definitely can! e2 is very important for serotonin and maybe even dopamine

 

[Scenmed]

it definitely can! e2 is very important for serotonin and maybe even dopamine

lowe2sucks - Have you experienced E2 <18 pg/ml? If so, what steps have you taken to raise your levels? I came across several articles by Megan Geitz regarding hormones and the nervous system that support the Estradiol/Serotonin connection. It has me wondering if the hot weather just getting underway here in Minnesota is sufficient to wreak havoc on my well being. I take a very small dose of Zoloft (12.5 mg) every other night and it may be even less effective as ambient temps rise into the 80's. Confusing stuff!

Thanks for the reply!

 

[lowe2sucks]

yeah when e2 is very low you feel like low serotonin yeah have noticed it everytime i was in low low zone. when it raises again to your optimal level you are good to go again. for last half a year I take DHEA I don't know how much it helps but i believe it does. And too much testosterone made me feel low e2 symptoms even without low e2 labs I don't know why.. my aromatase is very low I don't ever have high e2 problems (probably due to anastrozole overuse in the past)

 

[Scenmed]

Would you mind sharing your dosage of DHEA and do you test your DHEA-S? I suppose one could say they were fortunate to not have high E2 on a regular basis due to the many health concerns that come with that. Nevertheless, low E2 sucks is right albeit with many but fewer health concerns at age 59.

Thanks!

 

[lowe2sucks]

well low e2 has even more health concerns that high and in my opinion in way more dangerous that high e2. When I first started DHEA I didn't test my levels but just added in in order to raise e2 faster. Now I am monitoring my levels and using whatever dose it takes to be in upper end range. Basically when I wasn't using DHEA my low e2 symptoms were not improving but they didn't go away right after adding DHEA so I can't say if that was the reason.
I would do standard dose 20-25mgs once or twice a day (depending on your DHEA-S)

 

[Scenmed]

well low e2 has even more health concerns that high and in my opinion in way more dangerous that high e2. When I first started DHEA I didn't test my levels but just added in in order to raise e2 faster. Now I am monitoring my levels and using whatever dose it takes to be in upper end range. Basically when I wasn't using DHEA my low e2 symptoms were not improving but they didn't go away right after adding DHEA so I can't say if that was the reason.
I would do standard dose 20-25mgs once or twice a day (depending on your DHEA-S)

Much appreciate your input. Did you introduce other supps during the same time period as DHEA?

 

[lowe2sucks]

Much appreciate your input. Did you introduce other supps during the same time period as DHEA?

not really but I stopped pregnenolone at that time because I ran out