Low or high E2: what to do?

[DRay]

Hey fellas,

Need some input. I've been on TRT therapy for over a year now. My current TRT protocol is as follows

Test Cyp 200mg/wk E3D injection
HCG 500iu/wk E3D injection
Arimidex 1mg E3D

I have been experiencing symptoms for quite some time now (fatigue, the need to sleep, bloating, water retention in the abdomen and face, puffy and sensitive nipples, feeling flat, no pump in the gym, joint clicking and minor aching) these symptoms I ignored for the most part until witnessing a friend of mine on AAS tank his E2 by excessive arimidex use. Please note I have no issues with sex drive or erections both morning wood or on command. I was convinced I too had low E2 as I am aware 1mg Adex E3D is a very high dose for most on TRT. I had bloodwork done this week:

Total test 1713
Free test 448
Bioavailable 914
Estradiol 36 Test range is < 39
DHT 94
SHGB 22


I was shocked to see what appears that my E2 is on the high side. This was the normal quest estradiol test and not the sensitive. The symptoms I described can be both symptoms of high or low. I will note that about two months ago I changed my dosing of arimidex from 1mg E3D to .5 E3D and i felt phenomenal. Lean, no bloating, dense and firm muscle, energy was great. I changed my dosing due to unable to fill prescription right away. Once filled I returned to normal dose of 1mg E3D. Now I'm back to original symptoms. So I'm thinking "ok so my E2 was low nd I need to decrease dose of arimidex" but then I see my test results and I am thrown for a loop.

Do I have low E2 like I think or is it high E2 like the test says? Could it be another issue other than E2 imbalance causing the symptoms?

Thanks

 

[johndoesmith]

Hey fellas,

Need some input. I've been on TRT therapy for over a year now. My current TRT protocol is as follows

Test Cyp 200mg/wk E3D injection
HCG 500iu/wk E3D injection
Arimidex 1mg E3D

I have been experiencing symptoms for quite some time now (fatigue, the need to sleep, bloating, water retention in the abdomen and face, puffy and sensitive nipples, feeling flat, no pump in the gym, joint clicking and minor aching) these symptoms I ignored for the most part until witnessing a friend of mine on AAS tank his E2 by excessive arimidex use. Please note I have no issues with sex drive or erections both morning wood or on command. I was convinced I too had low E2 as I am aware 1mg Adex E3D is a very high dose for most on TRT. I had bloodwork done this week:

Total test 1713
Free test 448
Bioavailable 914
Estradiol 36 Test range is < 39
DHT 94
SHGB 22


I was shocked to see what appears that my E2 is on the high side. This was the normal quest estradiol test and not the sensitive. The symptoms I described can be both symptoms of high or low. I will note that about two months ago I changed my dosing of arimidex from 1mg E3D to .5 E3D and i felt phenomenal. Lean, no bloating, dense and firm muscle, energy was great. I changed my dosing due to unable to fill prescription right away. Once filled I returned to normal dose of 1mg E3D. Now I'm back to original symptoms. So I'm thinking "ok so my E2 was low nd I need to decrease dose of arimidex" but then I see my test results and I am thrown for a loop.

Do I have low E2 like I think or is it high E2 like the test says? Could it be another issue other than E2 imbalance causing the symptoms?

Thanks

Your symptoms are almost exclusively associated with high E2, except for joint clicking.

Honestly, instead of tweaking your AI, have you considered reducing your testosterone dose? You are way above range, and it's possible that you do not need AI at a more normal dose.

When were these taken relative to injection?

 

[Zooka15]

Your total T is way to high. You might want to consider lowering you T dose to control estrogen if you think that is the issue. Your Doc is OK with those levels?

 

[Zooka15]

Also I think the less than 39 is the quest standard E2 lab, you need the sensitive, Im guessing you might be low e2.

 

[lowe2sucks]

im 80% sure its low e2 symptoms you experiencing.. the fact that your e2 is on high end of range doesnt really mean its high because your T is so high way above range that one would expect higher E numbers to go together with that. lower your AI and you will see. the bloat in the face does happen with low e2 too.

 

[DRay]

These labs were taken the day after injection.

I'm aware that my total is high. My Doc is aware as well. Keep in mind I am 25 years old. Is my doesage ar 200mg/week really that high? Or could it be my bodies response given my age plus I am also on HCG weekly as well.

My gut says it's low E2. I don't know that I trust the standard quest estradiol test.

 

[CoastWatcher]

Has your current protocol been adjusted, either up or down, any element, in the year you've been following it? Your levels are all elevated and may well, as has been pointed out, be dealt with by altering your dose of testosterone.mWhen did you last run a CBC and what were your hematocrit and hemoglobin values?

 

[DRay]

Has your current protocol been adjusted, either up or down, any element, in the year you've been following it? Your levels are all elevated and may well, as has been pointed out, be dealt with by altering your dose of testosterone.mWhen did you last run a CBC and what were your hematocrit and hemoglobin values?

There has been no change to my protocol in the last year.

I just completed a CBC with this bloodwork
Hemoglobin 16.8
Hematocrit 50.0

 

[CoastWatcher]

With the incorrect estradiol lab you can't firmly draw any conclusions. Your total testosterone level is supraphysiological, no matter what you age is, because you are at the vey upper end of testosterone dosing for TRT. It is the experience of many that an AiI can be eliminated, or pulled back, with smaller more frequent doses of testosterone, while still achieving healthy overall levels of testosterone.

 

[Vince Carter]

200mg E3D is that a typo? With that dosage I bet you do need 1mg E3D. But none the less as pointed out you do need the E test for males, (ultra) sensitive with the LC/MS/MS methodology. You could feel low E2 though because their so far apart in the ratio of T divided by E where something ideal could be 14-20. I would retest and of note also you're testing wrong, you should be having bloods right before your next injection, not the day after.

 

[DRay]

200mg E3D is that a typo? With that dosage I bet you do need 1mg E3D. But none the less as pointed out you do need the E test for males, (ultra) sensitive with the LC/MS/MS methodology. You could feel low E2 though because their so far apart in the ratio of T divided by E where something ideal could be 14-20. I would retest and of note also you're testing wrong, you should be having bloods right before your next injection, not the day after.

200mg/wk is my doseage sorry for the typo. I'm beginning to think my ratio is so far off that even though my E2 levels are within range or even high, that I'm still experiencing low E2 sides. Thanks for the advice on the ultra sensitive test and when to get bloods done. Will do

 

[DRay]

With the incorrect estradiol lab you can't firmly draw any conclusions. Your total testosterone level is supraphysiological, no matter what you age is, because you are at the vey upper end of testosterone dosing for TRT. It is the experience of many that an AiI can be eliminated, or pulled back, with smaller more frequent doses of testosterone, while still achieving healthy overall levels of testosterone.

So let's say I lower my TRT doesage and get my T to E ratio better suited, I would still have to back off my 1mg arimidex doesage correct? It's my understanding that lowering T will lower E, therefore lowering E inadvertently with that AI dose will further plummet my levels.

Let's also say that I don't adjust my doseage but back off my AI to allow E2 to climb to a better level and get ratio in check and symptoms subside.

The question I'm getting at is that either way, whether lowering T dose or keeping the same, I will still have to back off of my AI dose. Am I correct in thinking that?

 

[CoastWatcher]

So let's say I lower my TRT doesage and get my T to E ratio better suited, I would still have to back off my 1mg arimidex doesage correct? It's my understanding that lowering T will lower E, therefore lowering E inadvertently with that AI dose will further plummet my levels.

Let's also say that I don't adjust my doseage but back off my AI to allow E2 to climb to a better level and get ratio in check and symptoms subside.

The question I'm getting at is that either way, whether lowering T dose or keeping the same, I will still have to back off of my AI dose. Am I correct in thinking that?

It is likely, and I would think it would be hoped for, that with a lower testosterone dose your estradiol will drop. E follows T in all respects, both up and down. If you don't lower your testosterone doseage a higher estradiol level may be possible p, but why run supraphysiological levels of either hormone? In doing so you open yourself to other health problems.

Bring testosterone into line, and see where your estradiol settles when measured with the appropriate test.

 

[DRay]

So I met with my Doc today. I told him my symptoms and concerns about either low or high E2. He agreed that 1mg E3D of arimidex is too high and that we should back down to .5 mg E3D. He also suggested I back down my HCG from 250iu E3D to only 250iu per week.

Here is my main concern...he prescribed me finasteride due to my DHT levels (94 on a <79 scale). He stated that my high DHT levels is what is causing my symptoms. He prescribed .5mg E3D. I was on Fina before for high DHT although that time I was taking 1mg E3D. This caused erection problems and I immediately stopped taking. Needless to say I'm scared to take again and I've never heard or read any literature stating that higher DHT levels a) causes those symptoms and b) negatively impacts your health outside of hair loss. Can anyone advise?

 

[CoastWatcher]

A lot of your issues can be traced back to your steep testosterone dose. But you seem fixed on maintaining it at the current level. So be it.

Under no circumstances would I take finasteride. My own doctor refuses to prescribe it under any circumstances as she believes men who take it put their health at real risk.

 

[hva]

I've yet to read anything positive regarding finasteride in the TRT universe.

 

[DRay]

A lot of your issues can be traced back to your steep testosterone dose. But you seem fixed on maintaining it at the current level. So be it.

Under no circumstances would I take finasteride. My own doctor refuses to prescribe it under any circumstances as she believes men who take it put their health at real risk.

I have not been ignoring your advice on lowering T dose, just trying to get any and all advice possible. My Doc suggested that I switch my dosing from E3D to E4D due to my T being so steep. I can't imagine it would make as big an impact as lowering the weekly dose. I will not be taking finasteride. Period.

I appreciate your advice. Thank you for your help.

 

[Zooka15]

Like Coastwatcher stated and others , you need to lower your T levels....You are not benefiting from having it that high. Of course you can see you have symptoms. You are in for a long road if this is how you and your doc are managing your TRT.

 

[Nelson Vergel]

I would stop the HCG and reduce the T dose to 100 mg/week to see if you retain less water.

What is your height, weight and neck size? What is your hematocrit? Do you snore?

Focusing on only one variable (the "evil" estradiol) leads nowhere in most guys.


I encourage everyone on ExcelMale to first answer any questions with more questions. I hardly see on here that someone actually lists all factors involved in fatigue, water retention and other issues.

 

[DRay]

I would stop the HCG and reduce the T dose to 100 mg/week to see if you retain less water.

What is your height, weight and neck size? What is your hematocrit? Do you snore?

Focusing on only one variable (the "evil" estradiol) leads nowhere in most guys.



I encourage everyone on ExcelMale to first answer any questions with more questions. I hardly see on here that someone actually lists all factors involved in fatigue, water retention and other issues.

I am 6'1 205lb. Unsure of neck size. Yes I do snore badly. Hematocrit is 50%

I've cut back arimidex to .5mg E3D and HCG to 250iu once per week. My next move is lowering T dose. Would you suggest doing each protocol change one at a time to observe change?