I'm a 32 y/o male undergoing testosterone replacement therapy. I'm currently taking 100mg testosterone enanthate / week through IM injections. My followup lab work last month showed that my total and free testosterone were in pretty good shape, but my estradiol was WAY out of alignment. In fact, when I asked my doc about my estradiol levels, which she thought was normal at first (I was @ 124), I commented that it must be a different unit of measure than what I had read about because it wasn't anywhere close to what I had expected.
She went out for a few minutes to do some quick research and then realized what she thought was normal was actually the ovulating woman range - or some other high-hormone stage of the female menstrual cycle. The actual normal range for men (according to the lab report) was <54 pg/ml. Given the ideal range talked about in these forums is 20-30 pg/ml, that puts me about 4-6 times above what I should be.
At this point, my doctor admitted this is beyond her expertise and I should probably see either a urologist or endocrinologist. While I applaud her recognizing this, I'm afraid the specialists may not be any more knowledgeable than she is and I know they won't be as understanding, patient and flexible as she has been.
So I've asked about her continuing to treat me using the protocols outlined in this forum for the short term until I find a suitable doctor and can afford to possibly get a little worse while a new doctor tries whatever the new therapy might be. I've suggested using an aromatase inhibitor (arimedix), with smaller and more frequent injections.
What I'd like to know from all of you:
Is arimedix a recognized approach in the traditional medical community?
While I wait for my doctor to respond to my proposal, what can I do to help lower my Estradiol? (I have cut my dose in half and injected 2x per week, added a zinc supplement, and added 500mg saw palmetto supplement as of yesterday)
Is 500mg saw palmetto, appropriate?
Would Testosterone cypionate be better for aromatase than enanthate?
What's up with the enanthate limited availability and "permanent back-order"???
Is an estradiol level of 124 ridiculously high? Would this level mean my body is very prone to creating aromatase and converts an abnormal amount of T to E? Could this be why my T was low to begin with? (Yes, I know proper tests before I started TRT could help answer that questions... but it's too late now).
If I decided to scrap everything, go cold turkey to reset my body... how long would it take to return to it's natural state so I could perform that LH tests? Or could a MRI be helpful without having to go back to that point?
To anyone who replies...
Thank you for your help. -
- I don't have my lab work in front of me, so this is what I remember right now. Sorry.
2/2010 10/2010 1/2011 Range
Estradiol 124 <56 pg/ml
Total Testosterone 295 602 *160-726 ng/dL
*(test method changed between October and January tests)
Testosterone Free 90 143 50-210 pg/ml
Vitamin D 35 33 >30 ng/ml
Vitamin B12 185 283 >=181 pg/ml
Recent Tests (Jan 2011)
CBC Value Range & Units
HCHC 33.2 31-35 GM/DL
RDW-SD 39.5 37-52.3 fl
Abs immature gran ct: .02 0-0.06 ku/l
HCT 52.1 % 38.5-53%
Immature gran: .3 %
* MPV 9.7 9.9-12.6 FL
HGB 17.3 13-17 gm/dl
MCH 28.1 27-33 PG
* RBC 6.15 4.3-5.9 M/UL
RDW-CV 12.8 11-16
WBC 6.9 4-11KU/L
PLATELET 222 140-400 KU/L
MCV 85 83-99 FL
LIPID PANEL Value Range & Units
Triglyceride 178 <149 mg/dl
HDL Cholesterol 35 >41 mg/dl
Cholesterol 215 <199 mg/dl
Chol/HDL Ratio 6.14 2.00-6.09
LDL Cholesterol interpretation 144 <100 mg/dl
Other Value Range & Units
Calcium 9.7 8.5-10.4 mg/dl
alk phos 67 40-110 iu/l
CO2 31 22-32 mmol/l
Chloride * 100 101-111 mmol/l
Total Protein 6.9 6-8 gm/dl
Albumin Lvl 4.3 3.5-4.8 gm/dl
Potassium 4.1 3.5-5.3 mmol/l
Anion Gap 7 3-11 mmol/l
Sodium 138 136-144 mmol/l
Glucose Fasting 93 70-99 mg/dl
Total Bilirubin .8 .3-1.2 mg/dl
Creatinine .88 .64-1.27 mg/dl
ALT 22 10-60 iu/l
BUN 11 8-20 mg/dl
AST 23 10-42 iu/l
TSH 1.56 .3-5.00 uIU/ml
Vit B1 17 9-44 NMOL/L
Other - Misc. Stuff
I've also had an assortment of other health issues, which may have some relevance so IÃ¢??ll mention them below in-case you all see some relationship:
2000 - Started gaining weight (I used to be very scrawny, but strong for size) @ age 20 by 26 I was 180 lbs (from 125).
2007 - "adhd-pi" all my life - started treating with adderall/straterra in 2007 - I lost 30lbs dropping to 150 lbs some improvement in energy and concentration
February 10 - Vitamin D deficient, treated with (50,000ui 1x/week for 6 weeks) - felt much better (more energy, better mood/motivation/memory, clearer thoughts) dropped the adderall/straterra. I started gaining some weight - but expected that since I had my appetite back. After the Vit D supplements were gone (while still taking OTC supplements), all the good effects fell away and I slowly grew more weak and tired.
Oct 10 -Lymes disease discovered, treated with antibiotics for 6 weeks, seems to be gone.
Oct 10 -Sleep Apnea discovered central and obstructive apnea with 7 events/hour average.
Oct 10 - B12 Deficient discovered, started b12 OTC supplements
Oct 10 - Testosterone borderline deficient discovered - started TRT IM injections
Jan 11 - Vitamin D dropped slightly from Oct (35 -> 33), despite heavy OTC vit d supplementation
Jan 11 - Cholesterol High (HDL low), B12 up some
Jan 11 - Estradiol 124 pg/ml (range <54)