Man with Estradiol, DHT, Free T Way High

[Axlerod]

Hi all,
Long-time reader and big fan of the site. Big thanks to you @Nelson Vergel for all the info, the willingness to share, care and effort put into this and other forums). My background: very fit, lean 175lbs, 6'1", 58 work out hard (lift 3 - 4x per week; sprint 2-3x per week; yoga 3 times per week). Practice Time Restricted Feeding 17/7); fast 48 hours every six months; supplement with protein 180 gm / day, eat low-ish carb diet, .

I've been on TRT for 27 months, and for 20 of those using weekly injections of test cypionate 200 mg. Labs always good, no AI. 7 months ago switched to cream (compounded 150 mg/ml; applying 1ML 2x per day); and my Dr. upped this to 175 mg/ml 2ml/day about 3 months ago. Have been feeling really great and everything all good (energy focus, libido, etc.)

I just got my labs back and most results were well within range and consistent with previous blood draws. But a few results were very OUT of range, and got me quite concerned. These were:

• AST = 61 U/L (was 31 on 7/19; note that I have been eating a high protein diet for the past 7 yrs; bilirubin was 1.2 mg/dL)
• DHT =243 ng/dL (!!! - note I take 1 mg Finasteride daily; previously 14 on 7/19)
• Estradiol, ultrasensitive = 78 pg/mL (previously 9 on 7/19)
• Testosterone, total = 1977 ng/dL (previously 1034 on 7/19)
• Testosterone, Free = 395.4 pg/mL (previously 84.3 on 7/19)
• LDL = 114 mg/dL

A few other results of potential interest (all within range) are:

• IGF-1 (LC/MS) = 117 ng/mL
• SHBG = 57 nmol/L
• PSA total = 0.5 ng/mL
• DHEA sulfate = 107 mcg/dL
• Hematocrit -46.4%

Any guidance would be very much appreciated.

Thanks!

 

[bochinit]

Drop the dose.

 

[Axlerod]

Agree that's the next action, and have already cut it by half. Any thoughts on what the high AST might indicate? Am I right that the high E2 and DHT are simply a function of conversion due to higher serum levels of T? Should I be concerned about the high E2 or DHT levels?

 

[bochinit]

You said you're feeling well, so there's no problem and are not necessary if you feel your best at this point.

 

[UCFguy01]

If you feel good and you don't have high blood pressure or any other health indicators looking poor, keep doing what you're doing.

 

[Axlerod]

If you feel good and you don't have high blood pressure or any other health indicators looking poor, keep doing what you're doing.

Thanks for your comment and perspective.
My BP is great, all my other CBC work is all good. Feel good, having great workouts (pushing new highs), BF is now 8%, libido is wonderful, morning wood 5-6 days out of 7, sleeping well, mood is upbeat. Have noticed more rapid growth of beard, some new body hair, and unfortunately, accelerated hair shedding. No other side effects that I can tell.

Gotta say, the very high E2, DHT and AST freaked me out... since no nipple tenderness or soreness, no intention of taking an AI given all I've read on the subject.

One question: I take B complex multi vitamin and vitamin D supplements - could this have impacted any test results (I was fasted for 14 hours when I took it).

 

[sammmy]

Are your 'previous' levels from 7/19 on 150 mg/mL cream?
If yes, the concentration increase 150 -> 175 does not explain the doubling and tripling of testosterone levels.

Do not apply the cream on testicles - leads to ultra-high levels.

I don't know what typical concentration of testosterone creams are but 150mg/mL = 15% ! The well known AndroGel is 1.67%, so your cream concentration is 10 times that.

 

[Systemlord]

IGF-1 (LC/MS) = 117 ng/mL

This value is below average for a guy your age, peptides will likely increase your natural levels.

 

[SSHSSA74]

Thanks for your comment and perspective.
My BP is great, all my other CBC work is all good. Feel good, having great workouts (pushing new highs), BF is now 8%, libido is wonderful, morning wood 5-6 days out of 7, sleeping well, mood is upbeat. Have noticed more rapid growth of beard, some new body hair, and unfortunately, accelerated hair shedding. No other side effects that I can tell.

Gotta say, the very high E2, DHT and AST freaked me out... since no nipple tenderness or soreness, no intention of taking an AI given all I've read on the subject.

One question: I take B complex multi vitamin and vitamin D supplements - could this have impacted any test results (I was fasted for 14 hours when I took it).

You said you cut your dose in half, then said you feel great and listed all the ways you feel great. Is this post about feeling great with the full dose you first stated or after cutting it in half?

 

[Axlerod]

You said you cut your dose in half, then said you feel great and listed all the ways you feel great. Is this post about feeling great with the full dose you first stated or after cutting it in half?

I cut my dose in half AFTER receiving my lab work, which was just a few days ago. I described how I was feeling prior to receiving my blood results, i.e. on full dose (which was pretty awesome, TBH)

While some of the replies have suggested that I continue with what I'm doing and not to worry, what I'm concerned about is the side effects or long term negative health effects of such high E2, T or DHT, and what the high AST might indicate. This is the reason why I've lowered my dose by half. I'd appreciate any thoughts on this. If I really shouldn't be concerned, then I likely will go back given how I was feeling and the impact it was having on my workouts.

 

[Axlerod]

T

This value is below average for a guy your age, peptides will likely increase your natural levels.

Thanks for you input. Apologies for the newbie question, but what peptides do you recommend?

 

[SSHSSA74]

I cut my dose in half AFTER receiving my lab work, which was just a few days ago. I described how I was feeling prior to receiving my blood results, i.e. on full dose (which was pretty awesome, TBH)

While some of the replies have suggested that I continue with what I'm doing and not to worry, what I'm concerned about is the side effects or long term negative health effects of such high E2, T or DHT, and what the high AST might indicate. This is the reason why I've lowered my dose by half. I'd appreciate any thoughts on this. If I really shouldn't be concerned, then I likely will go back given how I was feeling and the impact it was having on my workouts.

Thank you.
If it were me, and I was feeling so good, I'd keep it up as long as I felt that way. But that is me. I'm not a medical professional so maybe you should talk it over with one you trust.
Thanks for the reply.

 

[SSHSSA74]

Hi all,
Long-time reader and big fan of the site and Nelson (thanks upfront for the info, willingness to share, care and effort in this and other forums). My background: very fit, lean 175lbs, 6'1", 58 work out hard (lift 3 - 4x per week; sprint 2-3x per week; yoga 3 times per week). Practice Time Restricted Feeding 17/7); fast 48 hours every six months; supplement with protein 180 gm / day, eat low-ish carb diet, .

I've been on TRT for 27 months, and for 20 of those using weekly injections of test cypionate 200 mg. Labs always good, no AI. 7 months ago switched to cream (compounded 150 mg/ml; applying 1ML 2x per day); and my Dr. upped this to 175 mg/ml 2ml/day about 3 months ago. Have been feeling really great and everything all good (energy focus, libido, etc.)

I just got my labs back and most results were well within range and consistent with previous blood draws. But a few results were very OUT of range, and got me quite concerned. These were:

• AST = 61 U/L (was 31 on 7/19; note that I have been eating a high protein diet for the past 7 yrs; bilirubin was 1.2 mg/dL)
• DHT =243 ng/dL (!!! - note I take 1 mg Finasteride daily; previously 14 on 7/19)
• Estradiol, ultrasensitive = 78 pg/mL (previously 9 on 7/19)
• Testosterone, total = 1977 ng/dL (previously 1034 on 7/19)
• Testosterone, Free = 395.4 pg/mL (previously 84.3 on 7/19)
• LDL = 114 mg/dL

A few other results of potential interest (all within range) are:

• IGF-1 (LC/MS) = 117 ng/mL
• SHBG = 57 nmol/L
• PSA total = 0.5 ng/mL
• DHEA sulfate = 107 mcg/dL
• Hematocrit -46.4%

Any guidance would be very much appreciated.

Thanks!

One more question. how many hours apart are/were you dosing when you were at 175mg/ml twice per day?

 

[SSHSSA74]

One more question. how many hours apart are/were you dosing when you were at 175mg/ml twice per day?

And.... when did you get tested? Meaning before Taking your dose in the morning? Or in between first and second dose is on the day you got tested?

 

[SSHSSA74]

And.... when did you get tested? Meaning before Taking your dose in the morning? Or in between first and second doses on the day you got tested?

 

[Axlerod]

Are your 'previous' levels from 7/19 on 150 mg/mL cream?
If yes, the concentration increase 150 -> 175 does not explain the doubling and tripling of testosterone levels.

Do not apply the cream on testicles - leads to ultra-high levels.

I don't know what typical concentration of testosterone creams are but 150mg/mL = 15% ! The well known AndroGel is 1.67%, so your cream concentration is 10 times that.

The data from 7/19 was test cypionate 200 mg injected 1x/week, blood drawn 80 hours post last injection (about half way through the week). So, the values do not reflect the cream. Pharmacy instructions said to apply to upper shoulders/thighs, but Dr. said apply to scrotum due to thinness of the skin and better absorption.

Thanks for doing the math and putting the concentration in perspective. Somewhat eye opening....

 

[Axlerod]

And.... when did you get tested? Meaning before Taking your dose in the morning? Or in between first and second dose is on the day you got tested?

I was applying 2x per day, 1 ml each time (so 350 mg/day), typically at 9 am & 10 pm. I got tested 24 hours after my last application (i.e. applied at 9 am on a Sunday, tested at 8:30 am on a Monday), as that's what my Dr. recommended. So, the levels would have been even higher had I applied 12 hours previously...

 

[SSHSSA74]

I was applying 2x per day, 1 ml each time (so 350 mg/day), typically at 9 am & 10 pm. I got tested 24 hours after my last application (i.e. applied at 9 am on a Sunday, tested at 8:30 am on a Monday), as that's what my Dr. recommended. So, the levels would have been even higher had I applied 12 hours previously...

Got it. Thanks for all you replies. And where on your body were you applying the T cream?

 

[Axlerod]

Got it. Thanks for all you replies. And where on your body were you applying the T cream?

Scrotal application.

 

[SSHSSA74]

Scrotal application.

Got it. Thanks