T Nation

30y/o Lifter. Low T/Raging Estrogen


#1

30 years old never run anabolics or experimental shit…
symptoms
– test. atrophy
– nipple pain
– depression
– not low, no sex drive
– ed problems
most symptoms of low t… many of high e.
5’9 168 22%bf
weightlifting in my background USUALLY a part of my routine in life through my 20s until now. sparse eyebrows cant grow a beard… above symptoms are all current and new and with these levels life is difficult im out of the gym and in a rut.

my training came to a halt with nutrition perfect… etc… i became suspect of a problem. low energy depression… no major health problems (gi here and there not bad). nutrition is good. testicular atrophy (urologist ruled out non hormonal causes)…

primary doc and urologist both are talking t in patch/gel. both are talking of something to control estrogen as well… my primary ive discussed this more with but they both dislike my idea of arimidex.

primary is recommending a specially compounded testosterone patch/gel with a combined estrogen controller that i cant recall the name of, i havent heard of it ever in the trt world or fitness i think it started with a c ill get the name… as a naturopath he said he likes it and it can be compounded with the test.

i have a great gym and great private trainer took a while to find a guy who formerly competed as a bodybuilder and trains people to fairly successfully nowadays as well as guys like myself. ive considered testosterone injections for gym performance. doc who has used both gel and inj thinks the gel is much steadier as far as releasing over time… i thought injections were the way to go… when done well. especially for the purpose of adding lean mass.

photos of lab (ignore high white blood cell… the testosterone and estrogen as reflected in this lab over a period of time reflect very similar numbers)

urology on the 11th endo on the same day. primary wants to introduce trt and est. control now from a compounding pharmacy.

i want to use this time to figure out the cause, but also i want to see total testosterone top of high normal and free high and think my docs will help with that… if i can achieve this is it sustaible for durations much longer than 16 weeks even? first cycle want it to be right… or replacement whatever.

any input greatly appreciated. cortisol normal not high at all in the last 3 studies.

total t ranges typically 520-635
free t usually around 100-110

low ferritin keeps.coming up across labs… first one where iron total amd binding capacity have ever been out of range. hormones dont seem to change with this either.

why the fuck would my est be almost 300 regularly??? i dont eat like shit. im not a diabetic. im not unhealthy otherwise.

what do i do about estrogen and thoughts on testosterone patch/topical here by these docs? theyre willing to give vials and syringes too…

no gyno… swab hormone panel done over time coming back with results soon.


#2

serum E2=246pg/ml is a balance of T–>E2 aromatization[production] and E2 clearance by the liver. Liver markers AST/ALT may have some expected elevation from training. If FT [not tested] is low, then FT–>E2 is assumed low. Back to liver. Some medications, Rx and OTC can interfere with E2 clearance. With really strange labs, labs should be repeated to confirm.

Serum iron levels are highly changeable and thus should not dictate anything in isolation.

TSH is near 1.0, great.
tT4 is above mid-range
fT3 is well above mid-range
need your history of using iodized salt
need your oral body temperatures - see below
With strong fT3 and if body temperatures are low, suspect elevate rT3 blocking fT3 and adrenal fatigue. However TSH=0.99 does not fit that pattern.

White blood cells may be indication of fighting an infection.

“High iron binding capacity levels typically indicate low levels of iron in the blood.” - see the problem?

RBC - midrange
hemoglobin - midrange
ferritin - low

Any large muscle bruising/injury.

Ferritin shows iron deficiency or iron losses. Mens’ bodies horde iron and when iron is low, we suspect a GI bleed and an occult blood test can rule that in/out, testing for blood in your poop.

Any digestive issues or food sensitives?

Your LH/FSH and thus T will be low because E2 is high.
Lower E2 and things will change.
Should find and fix cause
and should start anastrozole .75mg twice a week ASAP.

Transdermals are a bad idea when training and sweating. If you do TRT, it should be self-injected T with anastrozole to get near E2=22pg/ml and 250iu hCG SC EOD to preserve testes and fertility.

Also test , AM cortisol and DHEA-S [an adrenal hormone].

“Sex-hormone Producing Tumor. Sex-hormone producing adrenal tumors are rare tumors that make too much androgen (i.e. testosterone), estrogen, or both. These tumors are found in 2 out of every million people and can be either benign (adenomas) or malignant (adrenocortical cancer).”

Nolvadex might be useful to block some E2 effects, 10mg/day.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.


#3

5 months ago hospitalization rhabdomyolisis from yes serious bruising and damage to muscle tissue. since then ive been out of the gym but even then had these same types of lab nums.

iron deficient from diet. extensive gi history. UC/GERD/IBS i avoid all food allergies. iodized salt has been in my routine diet for a while… i am making sure to get iodine. extensive looking no gi bleed… we cant figure out the ferritin/iron… suspected anemia from b12 absorption issue i have b12 and amino acids ived weekly… maybe 40 CTs with contrast in my life hope none of that threw off my thyroid. temps i will relog but those came in fine. i sweat badly and over a hundred times a day am running chills even if im in a hot shower.

as to my liver history of alcoholism 20-24 no cirrhosis been told fatty liver. meds:lyrica clonazepam atenelol adderall

thyroid has been thoroughly investigated. maybe 9 months ago doc put me on straight compounded t3 that worsened sympyoms so i stopped t3… he sees symptoms of hypothyroid or did. serious trouble sleeping.

ill start arimidex right away i want to watch t go up hopefully as estrogen is controlled… good on the hcg ill do that as well it was my other thought. i wont start exogenous t. until i see estrogen where it belongs and watch testosterone normalize… ill proceed with exo. test. after i figure out why this is going on… im set up with a flexible primary and urologist on the 11th… i feel like shit is that typical of a number like 270?
where do i start investigating the actusl problem what typreof doc what tests i am willing to go to any doc in or out of network i want to figure it out quickly… im watching my nuts recede… worried about fertility.

will post new labs with what you asked… really appreciate the reply.


#4

by the way i dont have these in front of me… cortisol averaged over time am and it didnt come in high at all at any point doc said. will retest dheas he also stated from memory that has been solid also…

digestive issues lifelong from 3mo. 2 surgeries for gerd. gi has been exploring crohns… allergies… bleeds… everything checks back alright.

sleep has become near impossible lately


#5

GERD meds can lead to multiple mineral deficiencies. Sounds like you are up on such issues.

Muscle damage can be what has led to some of your blood results as muscle is absorbed and rebuilt. Recovery really needs more T.

Consider a bone density scan. E2 is good for bones, T is needed to support the collagen matrix that the minerals deposit on. So you should be good re those factors. Mineral deficiencies also a factor. Serum calcium never tells you anything. Calcium is vital for functioning of nerves and your body will demineralize bone to support serum calcium levels.

Magnesium deficient? Signs are leg/foot cramps or being able to tense up a muscle and have it lock up. This site’s Biotest store sells ‘ZMA’.

Clonazepam might be impairing liver clearance of estrogens by competing for the same enzyme pathways that clear estrogens.


Metabolism Liver CYP3A4
May also decrease clearance of some other meds making doses effectively higher than intended.


– such lists are never complete