Sky High E2 on Three Milligrams of Anastrozole Per Week

[geezerjude]

Gentlemen,
I need help with estradiol. Way too high - 239 pg/ml
Currently taking 3-1mg pills per week of Anastrozole.
Injecting 50mg of testosterone twice a week. (Total test=1041ng/dl( (Free test=188.4pg/ml)
Injecting 250iu's of HCG twice a week.

There is a pattern of high estrogen. Have incrementally lowered testosterone doses and HCG doses. Incrementally increased Anastrozole dosage too. Same result. Estradiol keeps increasing.

I have a follow up next Friday with my Urologist next Friday. He is very concerned about my consistently high estradiol. I would like to hear how others have dealt with this issue. Would like to show up to my appointment armed with information and solutions instead of just sitting there...

Would it be useful to post some blood work?
How is the best way to do that?
I have access to them from my Urologists patient portal and through MyQuest.

Thanks.

 

[CoastWatcher]

Gentlemen,
I need help with estradiol. Way too high - 119 pg/ml
Currently taking 3-1mg pills per week of Anastrozole.
Injecting 50mg of testosterone twice a week. (Total test=1041ng/dl( (Free test=188.4pg/ml)
Injecting 250iu's of HCG twice a week.

There is a pattern of high estrogen. Have incrementally lowered testosterone doses and HCG doses. Incrementally increased Anastrozole dosage too. Same result. Estradiol keeps increasing.

I have a follow up next Friday with my Urologist next Friday. He is very concerned about my consistently high estradiol. I would like to hear how others have dealt with this issue. Would like to show up to my appointment armed with information and solutions instead of just sitting there...

Would it be useful to post some blood work?
How is the best way to do that?
I have access to them from my Urologists patient portal and through MyQuest.

Thanks.

That is high estradiol under any circumstance. However, for accuracy, was that value obtained with the sensitive/ultra sensitive (LC, MS/MS) lab test? It's the only one that men can rely one to provide an accurate read for e2. Can you post the associated ranges for your results?

But...

You are taking three milligrams on anastrozole per week??? Something seems very, very strange.

 

[geezerjude]

ESTRADIOL

[COLOR=#FFFFFF !important]239 H[/COLOR]​

< OR = 39 (pg/mL)

239

Reference range established on post-pubertal patient
population. No pre-pubertal reference range
established using this assay. For any patients for
whom low Estradiol levels are anticipated (e.g. males,
pre-pubertal children and hypogonadal/post-menopausal
females), the Quest Diagnostics Nichols Institute
Estradiol, Ultrasensitive, LCMSMS assay is recommended
(order code 30289).

Please note: patients being treated with the drug
fulvestrant (Faslodex(R)) have demonstrated significant
interference in immunoassay methods for estradiol
measurement. The cross reactivity could lead to falsely
elevated estradiol test results leading to an
inappropriate clinical assessment of estrogen status.
Quest Diagnostics order code 30289-Estradiol,
Ultrasensitive LC/MS/MS demonstrates negligible cross
reactivity with fulvestrant. Show Less


I copied this from MyQuest.

 

[CoastWatcher]

You are on a standard protocol, 50mg twice weekly with a reasonable HCG dose. You note that this is an ongoing problem, which would eliminate the possibility of lab error? Your estradiol has climbed since you began treatment? At that level, what sort of subjective response to your protocol are you having?

 

[geezerjude]

Morning erections occur with regularity. Libido is very high. Easily aroused and easy to achieve orgasm. I take generic cialis 3 times a week. 20's.
My strength in the gym has decreased. Lowered testosterone dosage and age, 50, most likely the factor there.
Blood pressure is slightly elevated.
Weight 245 pounds, 5' 11" tall. 42" belly measured with soft tape measure.
Lift weights, following a Jim Wendler 5/3/1 routine, 3 days a week.
Cardio done twice a week. Long walks or Concept 2 rower & elliptical sessions.

 

[geezerjude]

No negative moods. No anxiety.

 

[geezerjude]

Very concerned with why my estradiol has shot up over the years....
Used to weigh 270. Estradiol was lower.

 

[Vince]

It sounds like you're feeling really good even with the high estradiol levels. I believe with no symptoms of high estrogen it should not be a big concern.

 

[geezerjude]

It sounds like you're feeling really good even with the high estradiol levels. I believe with no symptoms of high estrogen it should not be a big concern.

Any other blood tests I should take to be sure?
What other testable factors are influenced by high estrogen?
I have good insurance that will pay for the blood work..

 

[Vince]

None that I can think of, maybe others will chime. I would continue losing weight and exercising, hopefully you will make progress in lowering your estradiol levels.

 

[CoastWatcher]

When was your last CBC run?

 

[geezerjude]

When was your last CBC run?

That is coming up. Moved. Need a new Primary Care Physician. Probably going to use MedStar. Very close to my home. It has been 2 years.

 

[geezerjude]

When was your last CBC run?

Anything special I should ask them to test for?

 

[Vince]

Anything special I should ask them to test for?

Blood Tests Needed Before and During Testosterone Replacement Therapy
https://www.excelmale.com/forum/sho...e-and-During-Testosterone-Replacement-Therapy

 

[johndoesmith]

Gentlemen,
I need help with estradiol. Way too high - 239 pg/ml
Currently taking 3-1mg pills per week of Anastrozole.
Injecting 50mg of testosterone twice a week. (Total test=1041ng/dl( (Free test=188.4pg/ml)
Injecting 250iu's of HCG twice a week.

There is a pattern of high estrogen. Have incrementally lowered testosterone doses and HCG doses. Incrementally increased Anastrozole dosage too. Same result. Estradiol keeps increasing.

I have a follow up next Friday with my Urologist next Friday. He is very concerned about my consistently high estradiol. I would like to hear how others have dealt with this issue. Would like to show up to my appointment armed with information and solutions instead of just sitting there...

Would it be useful to post some blood work?
How is the best way to do that?
I have access to them from my Urologists patient portal and through MyQuest.

Thanks.

Can you post the full lab results with ranges?

I think it's an interference issue, the standard E2 test can misread AIs as E2. Without ranges, we don't know which test you have.

You don't have any symptoms at an E2 level many times over what I've ever seen in a man. It just doesn't add up.

 

[Vince Carter]

I never got that high, just 88(!) but couldn't find a reason why, switched to daily injections, I eliminated DHEA, elimiated Pregnenolone, eliminated HCG (for a month)...still high at every turn though AI did work for me.
Perhaps rather than an aromatase inhibitor you try one of the suicide types I think they're called SERM? Rather than inhibiting the aromatase, you can outright kill the Estrogen with a SERM. I think that's how it works.

 

[johndoesmith]

I never got that high, just 88(!) but couldn't find a reason why, switched to daily injections, I eliminated DHEA, elimiated Pregnenolone, eliminated HCG (for a month)...still high at every turn though AI did work for me.
Perhaps rather than an aromatase inhibitor you try one of the suicide types I think they're called SERM? Rather than inhibiting the aromatase, you can outright kill the Estrogen with a SERM. I think that's how it works.

SERM = clomid or tamoxifen.

You're referring to a suicidal aromatase inhibitor. Aromasin for example.

 

[geezerjude]

ESTRADIOL
< OR = 39 pg/mL
Reference range established on post-pubertal patient
population. No pre-pubertal reference range
established using this assay. For any patients for
whom low Estradiol levels are anticipated (e.g. males,
pre-pubertal children and hypogonadal/post-menopausal
females), the Quest Diagnostics Nichols Institute
Estradiol, Ultrasensitive, LCMSMS assay is recommended
(order code 30289).

Please note: patients being treated with the drug
fulvestrant (Faslodex(R)) have demonstrated significant
interference in immunoassay methods for estradiol
measurement. The cross reactivity could lead to falsely
elevated estradiol test results leading to an
inappropriate clinical assessment of estrogen status.
Quest Diagnostics order code 30289-Estradiol,
Ultrasensitive LC/MS/MS demonstrates negligible cross
reactivity with fulvestrant. Show Less

239
239

​

< OR = 39




Does this tell us if I had the ultra sensitive estradiol test?
I sent a message to my urologist asking if he ordered a standard E2 test or sensitive/ultra sensitive test.
Awaiting his reply.
One reply I received on this forum suggests the test MAY be reading the AI's in my blood, Anastrozole, as E2. I could see how that would correlate. We kept steadily increasing my dosage to lower my E2.

 

[johndoesmith]

ESTRADIOL
< OR = 39 pg/mL
Reference range established on post-pubertal patient
population. No pre-pubertal reference range
established using this assay. For any patients for
whom low Estradiol levels are anticipated (e.g. males,
pre-pubertal children and hypogonadal/post-menopausal
females), the Quest Diagnostics Nichols Institute
Estradiol, Ultrasensitive, LCMSMS assay is recommended
(order code 30289).

Please note: patients being treated with the drug
fulvestrant (Faslodex(R)) have demonstrated significant
interference in immunoassay methods for estradiol
measurement. The cross reactivity could lead to falsely
elevated estradiol test results leading to an
inappropriate clinical assessment of estrogen status.
Quest Diagnostics order code 30289-Estradiol,
Ultrasensitive LC/MS/MS demonstrates negligible cross
reactivity with fulvestrant. Show Less

239
239

​

< OR = 39




Does this tell us if I had the ultra sensitive estradiol test?
I sent a message to my urologist asking if he ordered a standard E2 test or sensitive/ultra sensitive test.
Awaiting his reply.
One reply I received on this forum suggests the test MAY be reading the AI's in my blood, Anastrozole, as E2. I could see how that would correlate. We kept steadily increasing my dosage to lower my E2.

That is the standard test, if you look at what you posted, it even suggests that you should get the sensitive test.

You don't have any symptoms, correct? That would lead me to believe it's a lab error or anastrozole's interference with the assay.

 

[geezerjude]

That is the standard test, if you look at what you posted, it even suggests that you should get the sensitive test.

You don't have any symptoms, correct? That would lead me to believe it's a lab error or anastrozole's interference with the assay.

Thanks for clarifying. I will ask him to order the sensitive test. Appreciate the feedback everyone!