Opinions on E2 blood draw timing

[SixHouse]

Switched to 150mg Cypionate weekly, broken up into MWF injections. Made a big difference in free and total testosterone when compared to 150mg weekly in only 2 injections.

My estradiol is high: 37.1 (8-35 reference range Labcorp sensitive) and I have all the physical symptoms to back up the high number - itchy nipples, ED/sexual issues etc. My happy range for e2 is somewhere around 23. That's when all the symptoms go away.

I started taking Anastrozole 0.125mg twice a week, 2 weeks ago. Still have symptoms but not going to add more Anastrozole until I get more blood work to see exactly where I am. I'm very sensitive to AI and if I go too far I can crash easily and want to die.

My question is, when should I have blood drawn to specifically test e2 when it's at the high point?

I take 0.125mg on Tue morning and Fri evening. It's not like testosterone where I want to test at the low point, but should my testosterone injection schedule affect when I test e2?

What day of the week should I have blood taken?

 

[Vince Carter]

I run E labs in the trough just like I do for T, though in those instances if I'm due for a dose of an AI, I do take it 2hrs prior to the labs. I think that is the best method.

For comparative reasons you should follow whatever method you've been following up til now. If you change it now then you can't compare the previous labs.

 

[SixHouse]

I run E labs in the trough just like I do for T, though in those instances if I'm due for a dose of an AI, I do take it 2hrs prior to the labs. I think that is the best method.

For comparative reasons you should follow whatever method you've been following up til now. If you change it now then you can't compare the previous labs.

Good point. My problem is that when I last tested I was more concerned with testosterone levels so I had blood taken on a Mon morning before injection (last injection was a Fri morning). So I was in the "trough" as far as testosterone goes. But logically, I'm thinking that if testosterone was at a low point then e2 was also not at a high point, and that's really what I need to see... just how high my e2 is/goes.

My fear is that, by dosing my AI based on a e2 number that might not be the absolute high, I risk not taking enough. I'm hypersensitive to e2 levels and the effects of AI so I really need to be careful and precise.

 

[Vince Carter]

E isn't managed from the high point. but do as you please

 

[SixHouse]

E isn't managed from the high point. but do as you please

When should it be managed? And please provide documentation if you have information other than personal opinion or things you read by forum users. It seems logical that since my concern is symptoms related to high e2 that I would need to know what my e2 high point is and when. Knowing its low point or mid range doesn't help me dose Anastrozole. I need to know how much AI to take.... based on the e2 high point. Does that make sense?

 

[jessie02]

I'm in the same boat as the OP. I'm on a Monday AM, Thursday PM injection schedule. 6 weeks into treatment and my E2 level at my trough (blood drawn at 0900 the day of my Thursday injection was 25 (I was 24 prior to treatment). How much higher can E2 be at peak T levels? I have not been on an AI since beginning treatment. Should E2 levels be tested maybe 24 hrs post injection? When T levels are at there peak?

 

[SixHouse]

I'm in the same boat as the OP. I'm on a Monday AM, Thursday PM injection schedule. 6 weeks into treatment and my E2 level at my trough (blood drawn at 0900 the day of my Thursday injection was 25 (I was 24 prior to treatment). How much higher can E2 be at peak T levels? I have not been on an AI since beginning treatment. Should E2 levels be tested maybe 24 hrs post injection? When T levels are at there peak?

Good questions. Seems to be much debate and little fact on this topic. Does e2 peak at a specific time after testosterone injection? Of course this is probably subjective like all things TRT, but an average would be nice. Adding Anastrozole complicates things further. When does the AI's effects on e2 levels peak? I'll probably have blood taken on Mon morning again so at least I'm comparing apples to apples, even if I'm not getting the accuracy I need to properly dose my Anastrozole.

 

[Vince]

Boy you're really chasing numbers now!

 

[MarkM]

I'm in the same boat as the OP. I'm on a Monday AM, Thursday PM injection schedule. 6 weeks into treatment and my E2 level at my trough (blood drawn at 0900 the day of my Thursday injection was 25 (I was 24 prior to treatment). How much higher can E2 be at peak T levels? I have not been on an AI since beginning treatment. Should E2 levels be tested maybe 24 hrs post injection? When T levels are at there peak?

If you want to be technical, if you are injecting Monday AM and Thursday PM you should be having blood work Monday AM prior to the injection or as late as possible on Thursday before lab closes, say 5pm, before the Thursday PM injections. A blood draw at 9AM Thursday morning, like you did, isn't really getting you a trough to be honest. Had you had your blood draw in the evening on Thursday, closer to your trough, your E2 would have been lower than 25.

 

[SixHouse]

Boy you're really chasing numbers now!

No, I'm chasing symptoms and correlating numbers, as it should be done.

 

[MarkM]

Switched to 150mg Cypionate weekly, broken up into MWF injections. Made a big difference in free and total testosterone when compared to 150mg weekly in only 2 injections.

My estradiol is high: 37.1 (8-35 reference range Labcorp sensitive) and I have all the physical symptoms to back up the high number - itchy nipples, ED/sexual issues etc. My happy range for e2 is somewhere around 23. That's when all the symptoms go away.

I started taking Anastrozole 0.125mg twice a week, 2 weeks ago. Still have symptoms but not going to add more Anastrozole until I get more blood work to see exactly where I am. I'm very sensitive to AI and if I go too far I can crash easily and want to die.

My question is, when should I have blood drawn to specifically test e2 when it's at the high point?

I take 0.125mg on Tue morning and Fri evening. It's not like testosterone where I want to test at the low point, but should my testosterone injection schedule affect when I test e2?

What day of the week should I have blood taken?

You are all concerned about when to do the blood work to determine how high your E2 gets.

Here's my opinion..............You're taking an AI anyway so you should want to see where it is at trough with the AI since you don't want to crash your E2 as you stated. Therefore, you should be concerned how low it goes with the AI and not how high because it does not crash when its high, it crashes when it is low. Pretty rational in my mind.

If you want to see just exactly how high your E2 gets, stop taking the AI, wait about two weeks to get it completely out of your system (half life of anatrozole is about 50 hrs, so 10 days would do it) and then test. That still won't tell you how much anastrozole you need to take. However, if you get an E2 while taking the 0.125 mg of anastrozole, based on the result you can try to decrease it just a little bit or increase it just a little bit.

Again, this is my opinion and I am not going to provide you a bunch of documentation. I am just giving you my experience and what information I have gained over 13 years of being on TRT.

 

[SixHouse]

You are all concerned about when to do the blood work to determine how high your E2 gets.

Here's my opinion..............You're taking an AI anyway so you should want to see where it is at trough with the AI since you don't want to crash your E2 as you stated. Therefore, you should be concerned how low it goes with the AI and not how high because it does not crash when its high, it crashes when it is low. Pretty rational in my mind.

If you want to see just exactly how high your E2 gets, stop taking the AI, wait about two weeks to get it completely out of your system (half life of anatrozole is about 50 hrs, so 10 days would do it) and then test. That still won't tell you how much anastrozole you need to take. However, if you get an E2 while taking the 0.125 mg of anastrozole, based on the result you can try to decrease it just a little bit or increase it just a little bit.

Again, this is my opinion and I am not going to provide you a bunch of documentation. I am just giving you my experience and what information I have gained over 13 years of being on TRT.

Thanks. I'm just a very logical thinker. We take AI because e2 is HIGH. In order to know how much to take we need to know how HIGH it is. If I always test e2 when it's NOT at its highest, I will be taking a non-optimal dose of AI. In other words I'm lowering my e2 when I never even knew how high it actually was. That, is not rational.

In 13 years I'm sure you have figured out what works for YOU. I assure you that same thing does not work for me. I've been doing this for quite a while myself, just still struggling with the final piece of the puzzle, which is e2 for me.

 

[MarkM]

Okay, then stop taking the AI and test your E2 without the AI. Just let it get out of your system. Won't that work for you and get you what you want?

 

[SixHouse]

Okay, then stop taking the AI and test your E2 without the AI. Just let it get out of your system. Won't that work for you and get you what you want?

Yup. I should have mentioned that the AI is new for me. So I know that without any AI my e2 levels are way too high for me (37, 38 etc). So that's where I normally am with NO ai. I've only been doing the Anastrozole for 2 weeks so now I want to see what effect it has had and I just want to be sure I test on the right day so when I add more I don't add too much. I think for now I'm just going to test on Mon like I did last time. I hope to at least see some lowering if e2.

 

[Vince Carter]

When should it be managed? And please provide documentation if you have information other than personal opinion or things you read by forum users. It seems logical that since my concern is symptoms related to high e2 that I would need to know what my e2 high point is and when. Knowing its low point or mid range doesn't help me dose Anastrozole. I need to know how much AI to take.... based on the e2 high point. Does that make sense?

If you need documentation print this thread out and hold it in your hand. You've come here with your opinionated viewpoint intent on doing what you want which is thinly veiled in to a "what should I do" question when your mind was made up before you made the thread, but you've got 3 of the most learned people you'll come across in TRT telling you that you're on the wrong path here.

 

[MarkM]

You are taking a small dose but it is pretty powerful. I expect you will see a decrease in your E2, but how much????

 

[SixHouse]

If you need documentation print this thread out and hold it in your hand. You've come here with your opinionated viewpoint intent on doing what you want which is thinly veiled in to a "what should I do" question, so log off and have things your way but you've got 3 of the most learned people you'll come across in TRT telling you that you're on the wrong path here.

Hardly. Think this through...

You inject testosterone because your level is LOW.
When you test your blood for testosterone you test at the LOW point.

You take an AI because your e2 is HIGH.
Ergo, you would only want to test your blood when e2 is at the HIGH point. Otherwise you are taking a powerful drug to LOWER your e2 when you don't even know how HIGH it is. See how that works?

You can't argue that. And just because you have been doing it WRONG doesn't mean what I'm saying is wrong. You just need to understand how it all works, which you clearly do not. But you probably THINK you figured out what works for YOU, so just keep doing it and you should be fine.

 

[Vince]

Why would you think 37.1 is a high number. It seems like after reading this thread you want the number to be higher so you can take an AI. So I recommend just take the AI and be done with it.

 

[SixHouse]

You are taking a small dose but it is pretty powerful. I expect you will see a decrease in your E2, but how much????

Yup exactly. It's powerful stuff, and I have crashed my e2 in the past with very low amounts so I'm just being extra careful. I'll post here when I get my results.

 

[SixHouse]

Why would you think 37.1 is a high number. It seems like after reading this thread you want the number to be higher so you can take an AI. So I recommend just take the AI and be done with it.

Why would I think 37.1 is high? LOL, uhm... well, because a) it's higher than the high end of the reference range, and b) I have many symptoms of high e2. How does that sound?