T Nation

Blood Work Question: High Ratio of Estrogen to Testosterone


#1

Ok a little background:

Back in January I had blood work done in anticipation of my first cycle. I assumed the blood work would be fine, and began before getting the results back from the lab (stupid i know). Here are the results from January:

FSH 18.8 (1.6-8.0)
LH 9.2 (1.5-9.3)
Testosterone, total 343 (247-827)

So clearly something was wrong, met with a urologist who said to have my blood drawn again once the AAS cleared my system.

I went ahead and finished the 12 week cycle (500mg/wk T-Cyp, 300mg/wk deca, .25mg arimidex every other day). Nolvadex PCT for 4 weeks.
Last pin at the end of March.

So a few weeks ago I went to have more blood work. Results were better but still not what I wanted. Also had them add estrogen (specifically asked for Estradiol, lab results are for Total Serum Estrogen...)

Estrogen, total, serum 110 (130 OR LESS)
FSH 14 (1.6-8.0)
LH 6 (1.5-9.3)
Prolactin 12.0 (2-18)
Testosterone 467 (250-1100)
Free testosterone 74.7 (35.0-155.0)

Ok so it is clear that something is wrong. The doctor said that everything is fine, with the exception to my FSH that would indicated some issues with fertility. Since I am not trying to conceive (i'm single and young) he said to come back and see him if i wanted to do fertility tests when i am ready.

I'm thinking it's Sertoli-Only-Cell syndrome and may be infertile.

Now to my question. My testosterone is on the lower end of the range, and my total estrogen is up near the top. I know you guys typically deal with E2, however even using Total Estrogen, we can see that the ratio is out of my favor. Could it be that my estrogen is still high from the cycle? (I did only ran a low dose of arimidex)

I would like to get my estrogen down, and i have some arimidex on hand. Would taking that for a period of time (and then tapering off) get rid of excess estrogen in my body? Or will it return to where it is now after stopping?


#2

Your high LH/FSH numbers and low testosterone is a bit troubling...have you ever performed a self-exam for testicular cancer?

http://www.acor.org/tcrc/tcexam.html

I assume the urologist did this, but I had two doctors who missed the huge lump in my left nut, and it ended up being TC...my LH/FSH were extremely elevated (higher than yours) with not very good T levels...something to consider...


#3

Often times on here w/ people with low T they have low or low normal fsh/lh levels while you had high levels, usually signally some issues with the actual testicles however yours isn't SO high where you have testicular failure or anything. I don't know if estrogen is the real cause for your low T but taking something that blocks some of the T from converting could very well help...what are your symptoms? I just find it odd that before your cycle your labs were worse off.


#4

Thanks for the responses guys. The urologist did an exam in January and said everything was fine. VTBalla34 are you saying they did the exam but missed the lump? I checked out the website and did a self exam, everything seems normal to me. There would be a distingishable lump if I had TC, correct?

In regards to my symptoms, significantly reduced libido, lack of spontaneous and morning erections, excessive perspiration (hands and feet are always clammy), brain fog, anxiety. I took propecia beginning in 2010 for 6 months, which is when i first noticed a greatly diminished libido so i stopped taking it. I felt that I never got back to 100% (with the exception of when I was on cycle). When I came off the cycle libido dropped as expected, then slowly came back, but here I am more than 4 months later still not feeling like I should.


#5

Yeah you're probably fine. Just thought it was odd how similar our bloods looked. Goes to show these issues are never an easy problem to solve.

But every man regardless of risk should be doing a testicular self exam once a month. I found mine myself in the shower randomly after two docs missed it while performing a half assed physical.

Get your DHT checked...5AR inhibitors wreak havoc on DHT and crash the libido of many...could partly explain your high LH/FSH as well if body wants to ramp up DHT production but can't.


#6

Just want to add, in regards to thread title, testing total estrogens isn't really useful... test estradiol (E2)


#7

right... i asked for e2. they obviously tested total estrogens instead. regardless I still think it shows an estrogen dominant ratio, however next time i will make sure to insist that it is Estradiol that is checked.

Scheduled an appointment with an endo, will let everyone know how that goes. Does anyone else have any input?


#8

How is your insurance? Couldn't hurt to add TSH and 8am cortisol to your tests. I know you didn't come to this board for TRT per say, but you do have really low T and might want to investigate more.


#9

They tested TSH back in January, it was .88. Insurance is solid, thank god.

I'm convinced getting my testosterone up and estrogen down would greatly improve how I feel (and I have the means to do this), but I worry that would prevent the doctors from finding what caused this imbalance in the first place.

How long does it take for the body to clear estrogens? My estrogen levels wouldn't still be high from the cycle 4 months ago would they...? It doesn't seem like estrogen is inhibiting the HPTA, because my LH and FSH #'s are fine, right?

Here are some things I am planning on speaking to the doctor about:

1.) Need to figure out what is causing that high FSH number. (this is the only number that he has agreed is abnormal)

2.) Testosterone and estrogen are out balance, not only because of the results, but because of my symptoms. What could have caused this?

3.) I have the means and desire to correct this problem with exogenous hormones, however will doing so simply be masking a greater problem? Or set me up for more issues down the road? It seems to me like everything started back up fine after my first cycle, but the underlying cause of my hormone imbalance is still there.

Something is clearly different in the last year and a half (since taking propecia), but my blood work doesn't fit the same profile of typical post-propecia suffers. Perhaps I coincidentally started taking propecia at about the same time a separate problem developed?


#10

Propecia restrics the conversion of T to DHT which I'm 99.9% certain is the cause of your libido problems. It shouldn't reduce T.

The fact that you had very high FSH/LH and low T before the cycle indicates probable primary hypogonadism, unfortunately you were "in range" on LH by like a thousandth of a point so your doc won't consider it problematic, as it is technically subclinical (problematic, but in range so it's not a problem in doc's eyes).

TSH is good... if I were you I'd test 8am cortisol, as well as a full test of your sex hormone chain to see where it's broken. Cholesterol panel, pregnenolone, DHEA-S, Total/Free T, E2, DHT. Maybe someone else can add to this.


#11

I am not saying that Propeica reduces T. I haven't taken it in over a year, so I do not think it is to blame for my symptoms... unless it somehow caused irreversible damage to my 5-AR enzymes. I think the cause of my libido problem is too much T aromatizing to Estrogen. Why that is, I don't know...

Any other opinions?


#12

Just an update if anyone cares. Met with an endo and he ordered more blood tests and a thyroid ultrasound. Blood work is for a CBC, estradiol, T3, T4, TSH, Free and total testosterone. Also getting a semen analysis done. I will post results when I get them if anyone is still interested.

Also just want to make sure... I wouldn't still be shut down from the nandrolone... right? My blood panel indicates that my Pituitary is producing FSH and LH, indicating that I am "back on", but my testes are functioning poorly?


#13

You may have some luck supplementing DHEA, since that is the precursor to testosterone, but otherwise, I really don't know what to tell you. Your pituitary is putting out the signals, but your boy's aren't responding.

Having you considered having an MRI done to check your pituitary? A benign tumor could be responsible for your high LH/FSH. I think there is something to be said for chronically high LH/FSH desensitizing your leydig cells over a long period of time, resulting in primary hypogonadism. I think this could have been my issue leading to my primary HG.


#14

I get carried away reading stuff on the internet lol. I was reading forums where people were shut down for a long time after cycling nandrolone, and just wanted to make sure I was interpreting my blood results correctly :stuck_out_tongue: Yeah it looks like my boys aren't doing their job...

I'm just going to wait until my next appointment and go from there. Hyperthyroid might make a little sense... maybe a combo of both primary hypogonadism and slightly hyperthyroid? Wish this process weren't so damn slow...


#15

Make sure it's free t3/t4, not total.

Edit - what makes you think hyperthyroid?


#16

Met with the endo, semen analysis came back with 0 sperm count. Blood work showed high FSH and low Inhibin B. The endo recommended I see a fertility specialist, which I am not planning on doing. I wasn't considering having kids right now, so maybe when I'm ready I will seek that out.

Here are the results of my other blood work:

LH 7.5 (1.5-9.3)
Testosterone, total 485 (250-1100)
Free Testosterone 72 (35-155)
E2 44 (13-54)
TSH .82 (.40-4.50)
T4, Free 1.3 (.8-1.8)
T3, total 95 (76-181)
T3, Uptake 36% (22-35%)
Thyroglobulin Antibodies <20 (<20)
Thyroid Peroxidase <10 (<35)

They also did a thyroid ultrasound which I assume came back alright, I didn't ask. A little shocked by the sperm count, but it seems to be consistent with my previous blood work. Clearly my testicles are defective, so I am going to look into TRT. The endo agreed that my testosterone level was low, but that he wouldn't prescribe testosterone because it was still within range. I am going to look for a new doctor that will work with to get my testosterone to an acceptable level.


#17

?


#18

Are you asking about a MRI? I mentioned it to the endo a few weeks ago, he said it was not necessary. He said my blood work shows that my pituitary is functioning well, however my testicles are not.


#19

Fair enough, but track it closely if/when you start TRT. If it doesn't go down, you know something's up.

Also, you never got a DHEA-S test right? Your body may not have enough DHEA to make Testosterone with, which is why I suggested DHEA.