Strange case at my clinic

[Vitamin_C]

Greetings, I have a TRT patient at my clinic and the fellow providers nor myself can figure this out. I have a patient who had a total Estrogen level of 20,240, with a TT of 420 and FT of 12. I had the other provider to run sensitive estradiol on him and he is pitifully low at 3.4, I had them stop the Arimidex he was on. The thing is, we sent him to get a mammo and he has gyno. We don't think he is being truthful about what he is using. Any ideas here? He's also been greater than 1500 TT on a few of our labs we have for him.

We sent him for imaging on the adrenals and there was no tumor. To do an MRI of the brain, we have to pull prolactin and a few other labs to show a reason why.

 

[swoops36]

None sensitive e2 of 20,250? With gyno and low ultra-sens e2? My guess would be Tren

 

[Vitamin_C]

None sensitive e2 of 20,250? With gyno and low ultra-sens e2? My guess would be Tren

His sensitive E2 was low at 3.4
It was his total estrogens that were 20k. I thought Tren doesn't aromatize that much other than through prolactin pathways but its pretty dry, don't really see it causing E2 problems.

 

[swoops36]

Tren doesn’t aromatics, but it shows up on an e2 test as crazy high, unless you use the ultra-sensitive version.

 

[swoops36]

His sensitive E2 was low at 3.4
It was his total estrogens that were 20k. I thought Tren doesn't aromatize that much other than through prolactin pathways but its pretty dry, don't really see it causing E2 problems.

It isn’t really e2, it just throws the test off

 

[Nelson Vergel]

Total estrogen is done by immunoassay. That test has interferences. Did you run it again ? It does not make sense.
He may be using a DHT analog anabolic like oxandrolone plus his T.

 

[sv1000]

He’s gonna have to be honest about what else he’s using whether it’s just diet anabolic‘s or supplements. You could take a holistic approach and do a full IGE IGG panel to also look for allergies. Which may sound a little much but it’s how I found out that I have a chromium deficiency.

 

[JimGainz]

I’ve seen this before. I have a feeling he was running some major gear or Test with an AI and then came off (probably right before your blood test so he didn’t trip any alarms). The compound was likely highly aromatizing so he Frankensteined his AI dose when he got itchy nips and gyno symptoms and is now still taking too much AI.
How bad is the Gyno? Does he need surgery? If not, some HCG and normal Test dose should get his E2 squared away along with Nolvadex perhaps. (I am no doctor by the way - just repeating what I’ve seen work and experienced).

how are his liver values? if they were elevated then sure enough he was popping some methylated orals that aromatize. How does he look - jacked or kind of normal. If normal than I would suspect higher doses of Testosterone.