Newest labs without AI for 6 weeks

[Mitch]

Good morning

6 weeks ago I ran my labs because something felt “off” a couple months into reinstating trt.

My labcorp test results showed by estrogen sensitive at 8.5, my protocol was 50mg test cyp 2x a week and 1/4 anastrozle with injection.

A few weeks ago I ran another e2 test (4weeks off AI) and I was at an 18.9

Last week I ran another panel and I am at 26.4 on labcorp sensitive (8-35 range)

Total Test 901.3 (264-906)
Free Test 17.7 (8.7-25)
Dihydrotestostrone 60 (30-85)
Dhea s 189. (102.6-416.3)

Everything else on the panel was on normal range including thyroid.. what I did forget to add to my testing was shbg because I am an idiot..

I have an appt with my doc next week, I am sure he’s going to try to get me back on anastrozle, you guys think that’s necessary? Should I wait another month and see if e2 jumps again? Or do you think my e2 will stay around this level after 6-7 weeks with no AI or other protocol changes?

 

[Vince Carter]

So what was "OFF"...you're too vague...and how do you feel now? Improvement?

 

[Mitch]

So what was "OFF"...you're too vague...and how do you feel now? Improvement?

Sorry, haven’t had coffee yet this morning, i know details are important... Off meant, some soft erections, brain fog, didn’t feel like i was even on trt in the gym, bedroom or daily life... I was also pretty anxious.. today wood is strong, fog is way better, gym life is really improved too...

 

[Vince Carter]

Good to hear that...my only curiosity and you mentioned is the SHBG absence.

 

[Mitch]

Yeah, i thought I added that to my cart, apparently not.. I looked through my old emails to see what it has been in the past... it’s always been within range middle or a little higher within the ranges. Doesn’t exactly help me today.

Good to hear that...my only curiosity and you mentioned is the SHBG absence.

 

[Systemlord]

Sorry, haven’t had coffee yet this morning, i know details are important... Off meant, some soft erections, brain fog, didn’t feel like i was even on trt in the gym, bedroom or daily life... I was also pretty anxious.. today wood is strong, fog is way better, gym life is really improved too...

All of those symptoms you mention are inline with all of my symptoms while taking anastrozole. The labs you have posted are perfect, I would kill to have those levels. Don't be overly concerned with having E2 above the ranges as long as there are no symptoms.

In the future if you wanted to lower estrogen, injecting smaller multiple doses per week (3-4x) would see estrogen decrease even without the use of anastrozole. I'm an AI over-responder and inject T every 2 days to keep estrogen lower and better managed.

Estrogen is an important hormone and is needed for a great many things, like thick strong bones, brain health, libido and sexual function as well.

Given your Total T and Free T levels, your SHBG has got to be on the higher end of normal and is prefered as long as Free T levels are optimal.

 

[Mitch]

All of those symptoms you mention are inline with all of my symptoms while taking anastrozole. The labs you have posted are perfect, I would kill to have those levels. Don't be overly concerned with having E2 above the ranges as long as there are no symptoms.

In the future if you wanted to lower estrogen, injecting smaller multiple doses per week (3-4x) would see estrogen decrease even without the use of anastrozole. I'm an AI over-responder and inject T every 2 days to keep estrogen lower and better managed.

Estrogen is an important hormone and is needed for a great many things, like thick strong bones, brain health, libido and sexual function as well.

Given your Total T and Free T levels, your SHBG has got to be on the higher end of normal and is prefered as long as Free T levels are optimal.

Thanks for the insight, my shbg was always on the higher side of the range, like 60-75% of the range.

I was going to talk to my doctor about more frequent injections and even possibly lowering my weekly test intake, 900 total is cool, but I would rather control my e2 without an AI and have a little lower test levels. I have never had high estrogen, I know everyone is different but what are tell tale signs?

 

[Mitch]

So everything is improved and you concluded that you should change the protocol based on a lab test? Did I read this correctly?

I want to avoid AI at any cost, slight concern about estrogen getting too high... just looking for other people’s feed back, because I know the doc will suggest an AI, because that’s what docs do...

 

[Deleted member 16042]

I have an appt with my doc next week, I am sure he’s going to try to get me back on anastrozle, you guys think that’s necessary?

Normal healthy young men with good hormone levels have E2 in the mid to upper 20's... Your E2 is in near perfect range by the numbers. Why in the world would any doctor want you on an AI with E2 in the mid 20's? If your doc wants to drop your E2 from mid 20's you should find another doc.

 

[Mitch]

Normal healthy young men with good hormone levels have E2 in the mid to upper 20's... Your E2 is in near perfect range by the numbers. Why in the world would any doctor want you on an AI with E2 in the mid 20's? If your doc wants to drop your E2 from mid 20's you should find another doc.

Yes, but mine has gone up 6 in the last two weeks, I would like it to stay in the range it’s in. My question is, typically does it continue to increase of eventually stop going up.

 

[Deleted member 16042]

Healthy range is upper 20's, and many guys do just fine MUCH higher. If you don;t have symptoms don't suppress estrogen. If you think estrogen is bad for men you have homework to do. It is extremely important to have adequate E2. You said yours was at 8... that is a recipe for bone loss and increased risk of cardiovascular disease and overall mortality.

It can get more complicated depending on SHBG, your personal metabolism, aromatization, clearance of E2 and your free E2 levels, but in general it is hazardous to try to keep E2 in the lower "normal range". I personally fear ever going below mid 20's for overall health.

If you increase testosterone dosage or reduce or eliminate anastrozole, it is normal for E2 to go up.

I am sorry I don;t have time right now to provide links, it's dinner time. There are many good references on this forum about this. search on Nelson Vergel's articles about estrogen and estradiol.

 

[Mitch]

Healthy range is upper 20's, and many guys do just fine MUCH higher. If you don;t have symptoms don't suppress estrogen. If you think estrogen is bad for men you have homework to do. It is extremely important to have adequate E2. You said yours was at 8... that is a recipe for bone loss and increased risk of cardiovascular disease and overall mortality.

I am aware that mid to upper 20s is great, it’s where I want to be, my concern is going higher, only because I have never been this high. Would love to keep it where it’s at, I definitely don’t wanna go down below 20s

 

[CoastWatcher]

I am aware that mid to upper 20s is great, it’s where I want to be, my concern is going higher, only because I have never been this high. Would love to keep it where it’s at, I definitely don’t wanna go down below 20s

It’s very easy to add an AI and lower your estradiol...perhaps too easy. It’s far harder to raise e2 levels once they have been sent to the basement and the patient is spending time in hormone hell.

Be patient and mark time. I have never used an AI; I adjusted a climbing e2 level by manipulating my protocol. Don’t worry - if the time comes, you can deal with an estradiol level that is out of line.

 

[Vince]

Your testosterone panel looks very good. I see no reason to make any further adjustments. Why don't you post your complete thyroid panel. It would be interesting to see it.

 

[SkiDaddy]

Mitch
Don't worry so much about a Number, TRT protocol is good when you feel good. Don't do what a lot of people do, change something because you see a # that don't match everyone else, we all are different and need to adjust for you not everyone else. I agree with Vince why make a change when you feel good, wait it out and see.

 

[Deleted member 16042]

I am aware that mid to upper 20s is great, it’s where I want to be, my concern is going higher, only because I have never been this high. Would love to keep it where it’s at, I definitely don’t wanna go down below 20s

Personally, I would not want to start an AI just because I think I might overshoot a number. I'd rather see if I feel fine if my E2 goes above the 20's. It is VERY common that men do just fine in the 30's and higher. I personally disagree however that letting E2 soar to very high levels is healthy and fine due to my own experiences with high E2. I do get intolerable symptoms from high E2.

I am happy to see you want to keep it above 20. I would be much more concerned with pushing E2 too low than seeing how I do if it got high. I personally do not believe in prophylactic use of AI without symptoms.

 

[Mitch]

Your testosterone panel looks very good. I see no reason to make any further adjustments. Why don't you post your complete thyroid panel. It would be interesting to see it.

TSH 1.840 (0.450-4.5) uiu/ml
T4 free 1.660 (0.82-1.77) ng/dL
T3 free 3.2 (2.0-4.4) pg/ml

 

[MarcoFL]

TSH 1.840 (0.450-4.5) uiu/ml
T4 free 1.660 (0.82-1.77) ng/dL
T3 free 3.2 (2.0-4.4) pg/ml

With a FT4 that high I would want to know what your RT3 runs.

 

[Mitch]

With a FT4 that high I would want to know what your RT3 runs.

With a FT4 that high I would want to know what your RT3 runs.

I have so much to learn, being in the high normal range of free t4 isn’t ok? What could it mean?

 

[Systemlord]

I have so much to learn, being in the high normal range of free t4 isn’t ok? What could it mean?

You want T4 midrange, Free T4 midrange, Free T3 midrange or higher and Reverse T3 <15 ng/dL.