Managing Low SHBG and E2, High Free T

[Xerxes]

HI All,
I was posting here back at the end of the summer when I was really having a hard time with my TRT. I thought I had high e2 and a non-sensitive test had shown I was high (not sure if that is totally accurate).

Since then, I have been injecting 40mg on Mon, Wed, Fri (down from 80 mg on Mon and Thursday). I have also been using 1/8MG of arimidex the day after injections when I am having (my) high e2 symptoms. I know we're all different, do I say MY symptoms (i.e. anxiety, insomnia, loss of morning wood and libido, ed stuff). I've also been taking ferritin every other day b/c my ferritin #s had been very low.

I haven't posted very much b/c I had been feeling pretty good, frankly.

Luckily I've had some of the best weeks of my TRT experience on this protocol (although, I've had some bad weeks too).

I just got new numbers from my uro b/c I needed a new prescription and he wrote me a script for 3 months of my T-Cyp and arimidex. He is letting me dose arimidex by symptom (a la Phil over at ATM forum).

My new numbers are:
TOT T 949 (high) 249-836
SHBG 16 range 10-57 (low in my opinion) I had tested at 24 in May and I think 21 or so in Aug.
Free T 288 HIGH 30-150
E2 (ultra sensitive test this time) - 14.5 range 7-49

So I guess my question is how do I avoid going too low on the e2 but keep it in line with my low SHBG. I want to get to the good weeks and days more often than the down weeks and days. I have laid off the arimidex b/c my e2 numbers were low end of normal and I do not want to go low.

I was thinking of adding oral DHEA b/c my numbers in Aug were 168 (low side of range I can't remember). I had held off on this b/c I was fearful of the E2 rising from it.

Any advice about adding the DHEA now that I have the arimidex to help with e2 symptoms?

Any advice from guys who have lowish SHBG. I know it's a tough nut to crack.

Should I reduce my T dose b/c my total and free T are above limit?

Any advice would be helpful.

Thanks again

 

[Vince Carter]

Im low SHBG and this what I'd do glancing over your post:

inject EOD not just M/W/F. I tried that and had some slight improvement by going EOD. Just keep splitting up your weekly dosage, I use 50-55mg EOD. I'd suggest with a reading of 14 that you stop taking AI. High Free T is not a problem and a direct result of your low SHBG. I would not call your TT high, its under 1000.

 

[Vitamin_C]

How are you feeling?

 

[Jk78]

...I would not call your TT high, its under 1000.

Why are the ranges all over the place for these test sometimes? I understand there are different units of measurement, but this top end range is 836, I've seen some over 1,200.

In other words, if he got tested at a different lab with a top end of 1,100 would he still be at 949 and his doctor saying that's perfect or would it have come back at 1,250 & doc still wanting to lower it?

 

[Xerxes]

How are you feeling?

I've been feeling pretty good since early September (with some bad days here and there). I was not at first taking the arimidex all the time, in fact quite infrequently. Now I've been taking 1/8mg the day after my shots (3x a week) for about 2-3 weeks and have been feeling very good. Good morning wood and libido, which are some of my most annoying symptoms when they are not good.

I am just nervous about going low b/c my e2 number was 14.5 on ultra-sensitive test.

If I don't get my morning wood or if my libido seems low, I fear I'm going too low. But I don;t want to overreact and stop using the arimidex if it's working.

I guess I just have to continue to do what works and stop the armidex when low e2 symptoms present themselves, which from my research seem to be frequent urination, ED (much like high), lethargy, etc. Is there any distinct way to tell high e2 from low e2? I've done lots of reading and it looks like the symptoms are almost identical. Any insight from more seasoned vets?

I'm just grateful that I've some really steady and good days and week (again there were bad days and weeks in there too over the 7 weeks), but I've felt like a normal person for the first time in 2 years, so I want to figure out how to harness that and make it steady.

Thanks!!

 

[CoastWatcher]

Remind me, how high did your estradiol get prior to Anastrozole being prescribed?

 

[Xerxes]

40 for non sensitive assay. But my thinking is need lower E2 numbers than normal bc of my low SHBG (16). I assume I have a lot of fee E2 floating around like o do free T

 

[CoastWatcher]

40 for non sensitive assay. But my thinking is need lower E2 numbers than normal bc of my low SHBG (16). I assume I have a lot of fee E2 floating around like o do free T

Well, you seem to have a solid relationship with the Doctor you're working with to bring your protocol into line, and that is, in many ways, half the battle. But, 40 on a non-sensitive assay is of no clinical significance. I would keep a close eye on my labs, correlate it with how you are feeling, and withdraw the AI. You are running a low, low estradiol value as of the last test. You could well be surprised at how well you feel with a higher E2 value. You can always pick Anastrozole back up.

 

[Vince Carter]

Why are the ranges all over the place for these test sometimes? I understand there are different units of measurement, but this top end range is 836, I've seen some over 1,200.

In other words, if he got tested at a different lab with a top end of 1,100 would he still be at 949 and his doctor saying that's perfect or would it have come back at 1,250 & doc still wanting to lower it?

Labcorp and Quest have different tests and methodologies, even within their own labs. There is not one test that they all use.

 

[Vince Carter]

You should never take an AI as a given or required part of a protocol and def never use it to treat a number on a test. You should only use it if experiencing negative side effects of high E2 and then only in very very small amounts. 40 on a standard test, the test may say its "high" but it's not, and I don't think the free E2 and low SHBG, I know where you're going with it, I read it in Crislers book. My opinion there is that it just makes E2 tougher to manage. I do that by NOT managing it, I let it be while looking for things like itchy nipples, etc

 

[CoastWatcher]

As I noted, and Vince Carter amplified, there is no reason to take an AI on the basis of a number. Take some time and search for the multiple posts on the Forum dealing with estradiol ratios. The typical hard and fast rule (keep your estradiol between 20 and 30 at all costs) is being questioned. Higher total testosterone values can, and likely should, sustain higher estradiol levels. I feel at my best with E2 in the mid 30s to mid 40s. The key is learning to attend to how I feel and to support those subjective feelings with lab work. Consider setting the Anastrozole aside.

 

[Xerxes]

I really only use the arimidex (v low 1/8 mg dose) when my morning wood is gone, my sleeping gets weird and my anxiety ramps up. I know my numbers don't really show it, but the addition of Adex has been something that has actually been quite positive in the symptoms that were frustrating me with my TRT. I guess that I just don't want to over do it while maintaining the positive effects. I just have to monitor and be judicious in how I use the Adex.

 

[a_crossfitter]

Do you take the AI before bedtime, in the morning, or with the T injection?