Crazy that it took your E to get that low to feel good. I think I have finally figured out why I have been dealing with constant headaches, brain fog and feeling mediocre the past 6 months on TRT. My E non-sensitive (didn't know any better) prior to starting TRT was 5. I've contemplated quitting TRT quite a few times because I mostly felt worse on it and couldn't figure out why as labs looked ok E wise. Going to try and maintain a little lower E and see how I feel.
With low SHBG youre on what I think is the right track, by the numbers, you can look crashed E, when you're not and that's due to the Free Estrogen you have. Notice your Free T is over range, you can likewise expect Free Estrogen to be in a similar position. I've been working towards E mirroring the SHBG number, maybe a little less, or at least LC/MS/MS being under 20.
I am honestly doing the best I have been on TRT with my LC/MS/MS in the single digits, I think 6 was my last test, and SHBG was 12. Free Estradiol 0.18, lab range is <0.45, I'm doing Cyp @ 16mg/D which has been placing my Free T at the lab range.
I also have to use Exemestane/Aromasin @ 12.5mg EOD. I had been using Anastrozole @ .25mg EOD which just wasn't quite enough so I worked with my Dr to try a different approach and its been this that has done better for me with E.
Predict estradiol, DHT, and free testosterone levels based on total testosterone
This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.
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A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.
Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.
The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.
Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.
DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038