T Nation

Blood Results: High Estrogen, WTF?

Male, 19 years old, 140-150lbs, sufferer of anxiety and depressoin no history of steroid use. Please look over my results and give your opinion thanks.

(im not looking for anything regarding steroids, dont flame, simply want help)

WBC Count 3.8-10.8 thous/mcl 5.4
RBC 4.20-5.80 mill/mcl 5.33
Hgb 13.2-17.1 g/dl 16.1
Hematocrit 38.5-50% 47.1
MCV 80-100FL 88.4
MCH 27-33PG 30.1
MCHC 32-36vG/DL 34.1
RDW 11-15% 13
Platelets 140-400 thous/mcl 199
Platelet Sufficiency normal
ABS Neutrophils 1500-7800 cells/mcl 2260
ABS Lymphocytes 850-3900 cells/mcl 2590
ABS monocytes 200-950 cells/mcl 410
ABS eosinophils 15-500 cells/mcl 100
ABS basophils 0-200 cells/mcl 20
Total neutrophils 40-75% 42
Lymphocytes 15-50% 48
Monocytes 0-10% 8
Eosinophils 0-6% 2
Basophils 0-2% 0
RBC Morphology Normal
Sodium 135-146 mmol/l 143
potassium 3.8-5.1 mmol/l 4.6
chloride 98-110 mmol/l104
carbon dioxide 21-33 mmol/l 33
calcium 8.9-10.4 mg/dl 9.9
glucose 65-99 mg/dl 104
blood urea nitrogen 7-20 mg/dl 10
creatinine .50-1.30 mg/dl 1.18
BUN creatinine ratio 6-22 8.7
GFR estimate LOW: < OR=60 ml/min/1.73m2 >60
EGFR African american LOW: < OR=60 ml/min/1.73m2 >60
Alkaline Phosphatase 48-230 u/l 63
Aspartate Aminot 12-32 u/l 15
Alanine Aminotrans 8-46 u/l 11
Total Bilirubin .2-1.1 mg/dl .7
Direct Bilirubin LOW: < or=.2 mg/dl .2
Total Protien 6.3-8.2 g/dl 7.5
Albumin 3.6-5.1 g/dl 4.7
Globulin 2.1-3.5 g/dl 2.8
Albumin/globulin ratio 1-2.1 1.7
TSH (third generation) .50-4.30 mU/L 1.34
Estrogens total LOW: 130 or less (pg/ml) 198
Testosterone 241-827 (ng/dl) 657

Estrogen may be high but it says total estrogens. I don’t know if that is the same as E2. What lab was it done at? That may help others determine if it is meaningful. Glucose is high. I assume you were fasted. Are you on any meds for depression or other?

just started taking 10mg of prozac, .25mf of klonopin, 50mg of trazadone, 5htp, b vitamins, fishoils, multivitamin, and magnesium.

How long are you expecting to remain on this cocktail. From what I see looking up klonopin it is a potent benzo and recommended for short term use especially accompanying an SSRI like prozac. I assume you started this treatment since your blood was drawn and tested?

I don’t know too much on these matters, but others may. What specifically do you want to know? Are you curious if your hormonal balance is affecting your mood and anxiety?

I am curious about how you feel with the meds. How they affect you. Especially the prozac and trazadone. I have heard good things about traz.

prozac its terrible, kills your sex drive
klonopin, addictive, tolerance, not good
Trazadone, makes me sleep like a baby but has a hangover effect

Anxiety has been destroying my life, its getting to were i rarely go anywhere, i hardly go outside unless im dragged. And when that does im so nausiated and worked up. I just cant keep living like this.

Im just trying to get to the botom of things. And was wondering if this was the key to my anxiety issues.

I also have real bad acne, face, chest, shoulders, back and almost on my ass.

Reviewing the estrogen level again it does appear rather alarming. I had confused your reading and the test parameters on first glance.

Did you discuss it with your doctor. If indeed it is way out of whack, lowering it could indeed put you on a more even keel.

Those meds sound horrible. Are they helping you at all? How long have you been on them (as you said you just started, but have quite an opinion already)?

How long have these symptoms been present? Is it a recent development? Were you well adjusted before? If so, how long ago?

I am sorry to hear of all your suffering. Especially at the tender age. There are so many who experience some degree of these debilitating chemical/hormonal imbalances.

KSman of “The Over 35 Lifter” forum is quite knowledgeable on these matters. You may want to PM him. He is very generous with helping others.

I know he has repeatedly warned me of the de-emotionalizing and libido-stripping effects of SSRIs and mentioned that welbutrin is preferred in some instances since it does not diminish libido. It can have a manic effect however since it is in the amphetamine family. Wellbutrin and trazadone are both reputed to stimulate dopamine production which should improve mood assuming that you are suffering from low level dopamine in the first place. If that is the case you should feel better almost immediately after taking the traz (next morning). He hadn’t spoken of the “hangover effect”, but a friend who takes it mentioned she did not feel rested or clearheaded the morning after taking traz.

That said I do know of several people who seem to have their heads screwed on much better since they went on SSRIs like paxil. If it is the difference between contemplating suicide and being a little numbed out but functional; I’d take the latter. Of course a perfect solution would have you feeling great and extroverted with a gusto for being a full participant in life.

It sounds like just getting to where you are feeling ok would be a great first step.

I don’t know what would be the cause of the acne except your age and hormonal turmoil. Frequent showers, acne soaps, and such should help. You could see a dermatologist.

Godspeed and best of luck…

yea, im going to go back in a few weeks to get retested.

Im assuming i will be put on some kind of anti-aromatizer.

But my doctor really hates doing that stuff so i may half to find another doc, or self medicate with monthly blood tests.

yea ive had these symptoms for a long period of time. Acnes always been with me. Ive always had some form of anxiety with mild depression. I cant do welbutrin or anything that effects dopamine or noradrenaline. That will only increase my anxiety levels (dopamine converts to noradrenaline)

ksman is very knowledgable about these issues (not sure about the anxiety and depression meds, but surely your hormone levels and what they may mean)… hopefully he will have a peek at your post! Great guy, first hand knowledge… very helpful… maybe even PM him… I don’t think he will mind… Good luck and Godspeed!

Jet

Hey man,
Sorry about the dark days of winter. Shit will get better for you eventually.

Can’t help you on the estrogen reading (btw, odd that “LOW” is written there, when the reading is clearly above range… or am I just missing something fundamental?)

Prozac & 5HTP together could cause serotonin syndrome. I’d ditch the 5HTP if you’re sticking with prozac. I’ve seen 5HTP work (on my wife) by itself, incidentally, but some here at T-Nation have had problems with it. When you you add in an SSRI you’ve got a potentially nasty situation.

Finally, I’ve seen the effects of klonopin on my wife too. Everybody is different, but that shit turned her into a zombie. Long half life, IIRC, compared to most other benzos. I wouldn’t think that you’d want to be running that too long.

Anyway, just giving you my non-medical 2 cents for you to consider and discuss with your doctor perhaps. Hope things turn around soon.

Your blood work is fine. Your testosterone levels are too high for there to be any problems with your estradiol levels.

Unfortuneately depression/ anxiety alot of times comes hand in hand.

I am sure you have tried the talk therapies e.t.c., and tried mentally coping with your axiety attacks.

Clinical Deppression e.t.c is just another body malfunction - a lot like something like diabetes. It isn’t something for most people that you can make go away if you say for example focus on trying to be happy. It needs to be treated with medication.

The medications you have initiated are very powerfull and your body will become quite physically addicted to them.

Try to minimize your use of the benzos and sleeping meds if possible. Live without whatever medications you possibly can while still being able to comfortably cope.

Don’t be afraid to seek other expert opinions and empower yourself by doing research and knowing as much about your condition as you can.

Of course you will have to wait for the medication to kick in and decrease your deppression firt before you can even begin to help yourself in this manner.

[quote]The450Man wrote:
just started taking 10mg of prozac, .25mf of klonopin, 50mg of trazadone, 5htp, b vitamins, fishoils, multivitamin, and magnesium. [/quote]

IMO you could drop one out of the Clonazepam or Trazadone.

I hate Klonopin. It is a real shit benzo. I find its effects are seriously lacking, no real euphoria and its anti anxiety benefits arent as good as many others i have used. It is not particualrly sedative so why wouldnt he prescribe valium which has good effects in sedation and anxiety - where a night time dose would help sleep and assist anxiety during the following day.

Just a quarter milligram of Clonazepam a day will result in physical addiction BUT it will be mild. I also know that physical dependance to benzodiazepines is much more reliant on length of time on rather than dose. So be careful how long you stay on it… cycling is a good idea, not onto another benzo (as is common with long term addicts) but off totally, or cycling the trazadone and Klonopin - this should help to avoid addiction, but of course trazadone is nowhere near as effective for anxiety as a ‘real’ benzo.

The loss of libido caused by prozac is caused by an increase in prolactin. Cabergoline is used successfully in many cases i have read.

I would of course recommend that one never use the drugs you are on - but i know that i rely on certain drugs too - sometimes it is necessary to not stop the treatment due to sides (take prozac for example) but to find the best way you can learn to live with it for the long term.

B

Estrogen poisoning:

Note that some drugs and foods can increase estrogen levels.

Suggested reading: The Testosterone Syndrome, Eugene Shippen - Amason.com

Please list cholesterol levels.

Did you do a 12 hour fasting for this blood work? Glucose is too high if so.

Your electrolytes and hematocrit are getting up there. Dehydrated? Many do not drink enough water for a 12 fast lab.

If traz is leaving you feeling heavy in the morning, you are staying up to late and not getting enough Z time or are taking too much. The dopergenic effects of the traz can be helpful. You may also need [generic] Wellbutrin. Both are good for libido, energy, intiative, mood. Traz can be side effect free if dosed properly.

You need an E2 = estradiol test. If from Quest Diagnostics lab, must be ultra high sensitivity serum estradiol as rheir regular E2 test bottoms out at E2<32.

Elevated E can cause the problems that you have. However, your weight does not scream that out. Please report how you carry your fat and if you have any signs of gyno or carry fat on your upper torso.

Do not repeat total estrogen labs… not helpful.

Your high E is enough to kill someone with TT=1000. This estrogen poisoning [dominance] can ruin you life. You can reduce your estrogen levels with Arimidex/anastrozole. Your E levels now are repressing your HPTA, thus reducing your TT and FT levels. Reduce E levels and TT, FT should increase and SHBG will go down, increasing FT % fraction.

You can do some labs on your own if need be. PM me with any particulars that you are not comfortable discussing here.

You may need more dopamine. Wellbutrin and traz will do that, but some find Wellbutrin to much of a systemic stimulant. I find that dostinex/cabergoine provides the dopergenic benefits without the sense of been over stimulated… that can be exhausting in the long term. Cabergoline in contrast feels very natural and focused. It can also fix any prolactin issues that you may have.

Prolactin: If elevated, this can cause depression, loss of libido etc etc. You could get tested for that later if correcting E leaves you with some problems.

When you correct your E2 levels, your target should be 22pg/ml in a range of 0-54 pg/ml.

You do need to get off of the SSRIs. If you can feel better on dopergenic drugs, you will be in a much better state.

Estrogen poisoning:

Note that some drugs and foods can increase estrogen levels.

Suggested reading: The Testosterone Syndrome, Eugene Shippen - Amason.com

Please list cholesterol levels.

Did you do a 12 hour fasting for this blood work? Glucose is too high if so.

Your electrolytes and hematocrit are getting up there. Dehydrated? Many do not drink enough water for a 12 fast lab.

If traz is leaving you feeling heavy in the morning, you are staying up to late and not getting enough Z time or are taking too much. The dopergenic effects of the traz can be helpful. You may also need [generic] Wellbutrin. Both are good for libido, energy, intiative, mood. Traz can be side effect free if dosed properly.

You need an E2 = estradiol test. If from Quest Diagnostics lab, must be ultra high sensitivity serum estradiol as rheir regular E2 test bottoms out at E2<32.

Elevated E can cause the problems that you have. However, your weight does not scream that out. Please report how you carry your fat and if you have any signs of gyno or carry fat on your upper torso.

Do not repeat total estrogen labs… not helpful.

Your high E is enough to kill someone with TT=1000. This estrogen poisoning [dominance] can ruin you life. You can reduce your estrogen levels with Arimidex/anastrozole. Your E levels now are repressing your HPTA, thus reducing your TT and FT levels. Reduce E levels and TT, FT should increase and SHBG will go down, increasing FT % fraction.

You can do some labs on your own if need be. PM me with any particulars that you are not comfortable discussing here.

You may need more dopamine. Wellbutrin and traz will do that, but some find Wellbutrin to much of a systemic stimulant. I find that dostinex/cabergoine provides the dopergenic benefits without the sense of been over stimulated… that can be exhausting in the long term. Cabergoline in contrast feels very natural and focused. It can also fix any prolactin issues that you may have.

Prolactin: If elevated, this can cause depression, loss of libido etc etc. You could get tested for that later if correcting E leaves you with some problems.

When you correct your E2 levels, your target should be 22pg/ml in a range of 0-54 pg/ml.

You do need to get off of the SSRIs. If you can feel better on dopergenic drugs, you will be in a much better state.

Howdy,

I have had experiences with all of the drugs you have mentioned here (and many of the depressive and anxiety issues as well).
The first advice I could give you would be to ditch the 5-htp (especially if on prozac or another SSRI).

My short experience with 5-htp (about 7 years ago), put me in the worst panic attack I have ever experienced, before or since. I will never mess with this stuff again. In a nutshell, I could not leave my house, all I could do was sit in a cold dark room, and jump at every little noise. NOT GOOD STUFF AT ALL.

Klonopin, for me is good for a buzz, or MAJOR attack (if I don’t have to do anything productive). If I took it at work I would have to leave as it has a “zombification” effect on me.

Most of the time though, I am at work or in the middle of doing something important when I get an attack. I keep a bottle of low dose Ativan for these episodes, as I can still function like a normal human being while on it. I take this on an episode by episode basis (usually a few times a year).

As I’m sure that you already know, benzos are known for addiction potential, and need for higher doses if used continually.

Prozac as a drug is pretty lame. This was my first foray into SSRIs. At the time this stuff was fairly new, and everyone was precribing it as a wonder drug. These days we know better than this.

There are plenty of other drugs (even SSRIs) that WILL work better than this. Effexor works great for many, but has other sides associated with it that could make or break its usefulness. If (and I think you might have mentioned this), you are prone to issues with dopamine or norepinephrine (sp?), than this won’t be the drug for you.

It is also a BITCH to come off, with very strong withdrawl. I can remember literally counting grains every day in the XR caps to wean off. Not fun at all. If I knew then , what I know now (and if the drug was available), I would have started with LEXAPRO, and worked from there. Right now this seems to be working great.

The one thing that I do see missing from your drug cocktail is vitamin D-3. This stuff has done wonders for me. Some of the latest literature is saying that lots of the depression coming about very well may be attributed to vitamin D deficiancy.

My doctor suggested that I start with 4000iu per day of D-3 (which is about 4x what current RDI states). Of course as we all know, nutrition values as set by uncle sam are antequated and in need of an overhaul. The key is to use D-3 (found in natural foods and supplement stores). this has a profound effect over regular old “vitamin D”.

Regular vitamin D (D-2 I think, please correct me if I am wrong), did nothing for me. D-3 is a WONDER DRUG for me. Again If I had known about this when I was originally diagnosed, I would have started long ago.

Anyway, sorry for the short novel. But this is a subject very near and dear to my heart. Hang in there, once you find what works for you, quality of life WILL improve. The key is to just keep at it.

Peace,

If i may say 1 thing, in relation to your acne it may sound weird but dessicated liver is REALLY good at clearing out the toxins.

Around 30 of them a day will do wonders, as for the rest i know a small bit but i bow to KS Man’s knowledge really good stuff.

Hey 450man,

How did that name come about?

I see you’ve got some good feedback. What strikes me most is that your condition can be tamed and there are lots of good strategies listed above. Vitamin D-3 cannot be underestimated (as D3HT09 mentioned). 3000iu/d has helped me a lot on its own (especially in the dark months). Do you suffer from SAD? I have 5000iu D-3 caps as well (from lef.org), but 3x1000iu seems to be doing the trick for now. It kicks in after a few days.

I hear many good things about cabergoline too (as KSman pointed out). It lowers prolactin which has an inverse relationship with dopamine. I know you said too much dopamine can lead to ratcheted-up anxiety for you, but does that mean in your case it is preferable to have low dopamine levels?

KSman also knows his stuff about which labs will give you the E2 tests you require.

You can beat this kid!!

Just make sure the D3 is in LIQUID gel form NOT tablet…

I use caps (powder) and it works fine.