T Nation

34 Yr Old With Low T... Hit Me Out of Nowhere!

300mg a week should he be worried about estrogen levels? lol

hak, you really need to be self injecting twice a week. What you are doing is really wrong.

Your E2=32 was tested when in the two week roller coaster? You cannot manage E2 when it is moving.

Where is your hematocrit?

Your doctor is an idiot.

uhmmm… yeah…

plus he was already at 32 which is 150% of ideal (22).

Interesting… Yeh my E2 was 32 the 13th day of my cycle (So I was getting a shot the next day)… I did get a refferal to an endocrinologist, so maybe I’ll go see them and go for the 2nd opinion.

Fyi – Not doing 300mg per week, doing it every other week.

What do you guys think about my idea regarding the Iron and Vitamin D? The Iron level scared me more than anything, because high Iron can cause a higher rate of risk for liver cancer, and can definitely cause the abdominal pain I was feeling earlier this year, and your testes to shut down. Thoughts?

I was thinking once I get the iron down, (And my VitD Up) and if I can detoxify my liver – I might be able to get off of injecting T all together?

I have found that serum iron levels can vary a lot. I have been over limit and under limit. RBC is a good proxy and ferritin is really the measure that you need. Serum iron can indicate that you need to look deeper, but perhaps should not be used to trigger any drastic changes. You need CBC lab results… which are really very basic and should have been done already.

You need to self inject twice a week. Making this change could have a big effect on your quality of life [QOL]. Then see where your TT, FT and E2 settle. Do the lab work 1/2 way between injections. You want an endo to give you a second opinion about what? How can an endo state anything about lab results that are a snap shot of a two week roller coaster? You need to have an understanding and determination/option about what you need. You need to manage your own health care. Thinking that docs will do the right thing is a very bad approach.

Update:

Summary for those who haven’t seen my other posts: I was diagnosed with low T a few months ago and my PCP put me on T-Shots every 2 weeks immediately. That helped initially, but I started to wonder things like “WHY am I having these problems as a healthy 34 year old male?” and “Why did the T stop having much of an effect on my sexual performance after a few months?” – I noticed low T and poor sexual performance after dealing with digestive issues and a bizarre skin rash on my face for about a year before the ED, etc started.

So I’ve been seeing an Endo now, and she just went over the following labs with me. Let me know what you think about these numbers, because a couple of them freaked me out, but she had a different take:

LIPID PANEL
Cholesterol Total 178 (100-199)
Trigylcerides 385 (0-149) VERY HIGH
HDL Cholesterol 28 >39
VLDL Cholesterol 77 (5-40)
LDL Cholesterol 73 (0-99)
LH <.2 (1.7-8.6)
FSH .3 (1.5-12.4)
Vitamin D, 25 Hydroxy 18.4 (32-100)
Estradiol 47.7 (7.6-42.6) ** Note, this was taken on day 13 after receiving 300 of T shot
Free Testosterone (Direct) 17.4 (8.7-25.1)
TSH 2.38 (.45-4.5)
T4 .94 (.82-1.77)
Calcium Serum 8.9 (8.7-10.2)
Ferritin 49 (30-400)
Lyme Disease <.91 (Negative)

What the doctor said: She said I probably still feel crappy because of my very low Vitamin D… She wrote me a scrip for a big dose to take twice a week for 2 months, and then we will meet again. She said this could be the result of digestive problems I’ve been dealing with for about a year now. She also said there was no evidence of testicular damage, and my low T was most likely coming from either my Thyroid of Pituitary — but she saw no reason to image those or be concerned of anything like Cancer, etc. She said this all could very well be the result of STRESS… Before our next meeting, she’s going to have me do a midnight SALV Cortisol test also. She asked me to switch to the Patch to see if that gives me a better even dose, and better QOL…

My Main Concern: I told her that I thought my Estradiol level was WAY HIGH… I said I had heard from many guys in this group that this could be the cause of my unhappyness on T, and that I should be placed on some kind of blocker. She said that she has seen no evidence of that, and those blockers have “MAJOR SIDE EFFECTS”… She further went on to say that E2 being high when on T is normal, because that is how the body is supposed to work – Balancing T with E… Do we have any actual medical journal articles here to back up that this is not the case? Something I can send her to open her eyes?

Thanks guys…

p.s. –

At this point I’m kind of wondering if I shouldn’t step myself down on the T, because it’s currently day 15 since I’ve had a shot, and I don’t feel too bad. Actually wondering if letting my E2 levels drop naturally, reducing my stress levels, and trying to treat things naturally would be a way to go?

I’m concerned that being on the T for a few months has caused my Triglycerides to go out of control (Although they were high before, they are even higher now…) I’ve had a swollen liver in the past couple years that seems to come and go, and don’t want my Tri’s to agrivate liver problems again.

Please post waking body temp.
Eval supplements and table salt for iodine.
Is your thyroid large?

Get E2 down ASAP if you stay on TRT. Go underground if need be.

You do not have CBC or hematocrit data. But your low ferritin suggest inadequate iron intake or iron losses from a gut disease. Low ferritin lowers the effectiveness of what fT3 that you have.

Low HDL is consistent with inadequate b-vitamins as well as other nutrients. Get a high potency B-vit and vitamin product which might be two tablets per day. If you have gut problems, your B-12 will be low.

Your LH/FSH levels are zero, as expected on TRT, no need to test again. Also thus no evidence of an FSH secreting testicular cancer.

Thannks for the response KSMAN – You are a respected authority here, and I appreciate your ideas & input more than you know!

I’ve read the sticky on E2, and am wondering why my Endo has no clue that higher E2 levels are a problem. Is this just a theory by some guys here, or is this something that’s been proven in a medical journal somewhere?

What are these “MAJOR side effects” she’s talking about, if I take something to block the E2? How do you suggest I safely bring down this level?

To get waking body temp, I guess I take my temp 1st thing in the morning? I can do that… My thyroid is not large, as she felt it twice now and says it feels normal. I do have a CBC, which I will post as I dig it out shortly. I have not had any blood in my stool or anything to suggest I’m bleeding out my Iron, but who knows… I have given about 25 vials of blood in the last 12 months – could that have anything to do with my low iron? haha

Thanks!

I was just looking online, and it seems like the #1 ingredient in a lot of the natural T blockers is Zinc… Is it pretty effect just to take lots of Zinc for this purpose?

[quote]hakrjak wrote:
I was just looking online, and it seems like the #1 ingredient in a lot of the natural T blockers is Zinc… Is it pretty effect just to take lots of Zinc for this purpose?[/quote]

T blocker, or E2 blocker (T->E2 aromatization, specifically)?

To control E2, you need anastrozole. Either convince your doc to prescribe you some (brand name: Arimidex, also a generic version out there now for slightly less $) or go through an underground lab and buy it as a “research chemical”. Former option is preferred over the latter due to potency concerns.

If you read the protocol for injections sticky and the estrogen sticky you would know:
-estrogens park in T receptors, blocking access to testosterone - like a competitive drugs
-elevated E2 leads to mood problems, depression, social withdrawal, intolerance, confusion, noise sensitivity

  • & diminished libido, even if TT and FT are top of ranges
  • & fat gain or inability to loose fat, or reduced fat loss response to TRT
    -low dose anastrozole/Arimidex is used to modulate E2 levels, not zero them out
    -optimal E2 level is near 22pg/ml in terms of fat loss, energy, mood and libido response, within “normal”
    -E2 in the 30’s [pg/ml] or higher causes problems
    -elevated E2 is associated with arterial disease, insulin resistance, diabetes and prostate enlargement/cancer
    -the ratio of FT or bio-T to E2 determines ones outcomes
    -lower E2 levels can lead to estrogen dominance when T levels are also low
    -TRT, improving T:E2 ratios, improves insulin sensitivity and endothelial function
    -reducing E2 when on TRT can also have the above effects
    -TRT can only deliver partial benefits if E2 is not managed

@ HAKR – Hey, I am about 6 weeks into TRT myself. Listen closely to KSMAN - he’s a wealth of info…and correct. I was doing 1x per week shots of 250mg and it was great at first - then things started getting bad by day 5. So per KSMAN, I talked to my dr and moved to every 3-4 days (1/2) less each injection so, 2x per week. This worked wonders. Totally even keel now.

Also, I am on anastrozolone and you absolutely cannot discount that. I am also using HcG daily now (started at 3x per week) and I feel as if I have been totally rejuvenated. The main things are your goals of cousre and labs.

Your in the right spot for info, feedback, etc.

Thanks guys - What I’m looking for is a scientific article or something I can provide to my Endo to get her to prescribe me the E2 blocker. She seemed dead set against it, so obviously she is misinformed.

Do you guys have any documentation you can reco that I provide her with? I’m thinking New England Journal of Medicine articles, JAMA articles, etc? Has our own Dr. O participated in any studies or publications that I can supply her?

I’m married to a Dr. (Not of Medicine, Neuropsychology), so I know how these people think, and what you need to convince them.

Thanks much KSMan – I read the stickies, I promise :slight_smile: – Just was looking for some clarification.

Thanks in advance,

  • Hakrjak

Docs: “you can’t fix stupid”, only solution is often a new doc.

Yeh it’s wierd that my PCP seemed to know about E2 – Maybe I’ll go back to him and see if he wants to write it… You’d think the endo would know more, but apparently not.

Is she blowing smoke about side effects?

Just found this on Wikipedia – doesn’t sound like many side effects at all:

Usage in men
While officially indicated for women, this drug has proven effective in the off-label use of reducing estrogens (in particular and more importantly, estradiol) in men.[citation needed] Excess estradiol in men can cause benign prostatic hyperplasia, gynecomastia, and symptoms of hypogonadism.[citation needed] Some athletes and body builders will also use anastrozole as a part of their steroid cycle to reduce and prevent symptoms of excess estrogens; in particular, gynecomastia and water retention.[citation needed] Study data currently suggest that dosages of 0.5 mg to 1 mg a day reduce serum estradiol by about 50% in men, which differs from the typical reduction in postmenopausal women.[citation needed] However the reduction may be different for men with grossly elevated estradiol (clinical data are currently lacking).[citation needed]

[quote]hakrjak wrote:
Just found this on Wikipedia – doesn’t sound like many side effects at all:

Usage in men
While officially indicated for women, this drug has proven effective in the off-label use of reducing estrogens (in particular and more importantly, estradiol) in men.[citation needed] Excess estradiol in men can cause benign prostatic hyperplasia, gynecomastia, and symptoms of hypogonadism.[citation needed] Some athletes and body builders will also use anastrozole as a part of their steroid cycle to reduce and prevent symptoms of excess estrogens; in particular, gynecomastia and water retention.[citation needed] Study data currently suggest that dosages of 0.5 mg to 1 mg a day reduce serum estradiol by about 50% in men, which differs from the typical reduction in postmenopausal women.[citation needed] However the reduction may be different for men with grossly elevated estradiol (clinical data are currently lacking).[citation needed]

[/quote]

If you want your doctor to take you seriously, dont bring her a wikipedia article without any citations whatsoever.

Research is out there though, just gotta dig.

When anastrozole is used to take E2 to an optimal level, you get optimal results. If anastrozole is not prescribed properly and E2 goes too low, you get the expected problems. Simple.

We sometimes see docs prescribe Arimidex for guys with the 1mg/day dose commonly used for female breast cancer patients. That really displays deep ignorance.

You may find better use with this:

Thanks VTBalla! That’s what I was looking for…

Funny thing — I had my last T shot 3 weeks ago tomorrow (Because my Endo switched me to the patch, and I haven’t been able to get it approved by insurance yet – so I’ve been going without) – and I have started to feel better. I don’t know if it’s the 50,000 IU of Vitamin D I took 3 days ago, or just the fact that my E2 levels have dropped naturally because it’s been awhile since I’ve taken a shot – but last night I had great sex with no issues, and I’ve been working out every day for the last few days with lots of energy.

If things keep up like this, I may not even start using the patches once they are approved!? Then again, I could just have so much T in my system, it’s taking awhile to wear off? I’ll post updates in the future…

Thanks guys!!

  • Hakrjak