Bloodwork: Low Test, Low Estrogen

Testosterone Total Serum- 293.7 ng/dL 249.0-836.0
Free Testosterone- 67.12 pg/mL 30.00-150.00
Estradiol,Serum- <5.00 pg/mL 7.02-49.06
Thyroid Stimulating Hormone (TSH) 1.070 Range- 0.178-4.530
Vitamin D, 25-Hydroxy, Serum 38.1 ng/dL 32.00-100.00
Albumin 5.1 g/dL 3.5-5.2
Sex Hormone Binding Globulin 20 nmol/L 10-57

I am 36 years old and I have been lifting since I was 15 years old. I have never done any type of anabolic compounds. I recently began having symptoms of depression and ED. I tried to ignore it as long as I could hoping whatever was causing the issue would resolve itself but the issues continued to progress. I asked my primary physician for blood work and he obliged. Upon receiving the results he immediately wanted to prescribe Test Cyp but I asked him to hold off until I could see the results myself. My total is certainly on the lower side of the spectrum by it seems my free test is holding steady in mid range. The worst result I saw was my estrogen levels which don’t seem to even register on the test. I think this is the source of most of my issues even though the doctor says that “men don’t need estrogen”. What a quack. Anyways, I wish they would have included LH and FSH but they didn’t. Any insight that can be given would be appreciated. I am currently wrapping up a 4 week cycle of DAA in the hopes it will bring my natural levels of test and estrogen back into acceptable range. I have another blood test scheduled 2 days from now to see if the DAA has done its job. Thank you in advance for your insight and expertise. Have a great day.

I lot of guys who have low-T also have got really low estradiol which contributes to the hell you feel, raising your T levels will raise your estradiol. The only concern is your low SHBG which will be driven even lower once you start TRT, diabetes can affect your SHBG. Injections no less than twice a week recommended for someone with low SHBG.

So I am expected to know DAA… D-Aspartic Acid

You need more labs to understand the problem.
LH and FSH - these can only be done prior to TRT
prolactin
TSH
CBC
hematocrit
fasting cholesterol - can be too low
fasting glucose

Have you ever used hair loss drugs and how does timing align with your low-T? Any blows to the head that fit time-line? Any aches or pains in your testes?

Many of the symptoms of low-T are the same as low thyroid function which is quite common with guys who come to this forum.

TRT will take LH/FSH–>zero and testes will shrink and loss of fertility is a strong risk. TRT done right is T+AI+hCG. You need to understand why and not be steamrollered by doctors and most of them are idiots at male hormone health care. You cannot be passive.

Please read the stickies found here: About the T Replacement Category - #2 by KSman

  • 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.

Correct me if I am wrong but arent SHBG and E2 directly related to one another?

No hair loss drugs. I BIC it. No blows to the head.

I was diagnosed with Varicocele when I was 18 and have never taken any action on that. I am 36 now and my wife and I had our 4th child 2 weeks ago. I am scheduled to see a urologist on the 22nd of this month for vasectomy consultation and I am going to see if we can correct the Varicocele while we are under the knife. I always have aches and pains in the testes but I have always assumed its related to the varicocele.

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SHBG goes down with more T and up with more E2. But there are other factors as well.

TSH ~1.0 is great. Thyroid function has many factors and body temps are the bottom line, please report as requested.

I apologize in advance for my ignorance but are you asking me to report body temperatures? If that’s the case I will certainly do so…

3:45pm Temperature 98.5 F

5:00am Temperature 96.4 F

New blood test performed this morning. Should have results by Monday. The doctor would only allow TT, FT and Estradiol to be tested. I had to fight just to get the Estradiol tested as they believe men don’t need any Estrogen whatsoever. It didn’t cost me anything so at least I will know where I stand after 4 weeks DAA and my “Healthy Testosterone” vitamin pack. I will say that I do feel a lot better than I did 4 weeks ago. I have suddenly started gaining weight. I was 184lbs 4 weeks ago when I first saw the doctor and yesterday I weighed myself and was surprised to see I am currently 195lbs. I am assuming this is due to water retention if I have successfully increased my Estrogen levels. I am having some great and very aggressive lifting sessions and it seems like people in the gym are starting to notice a difference. I was approached by an older gentlemen who told me I am starting to look really big again and some girls on the stair masters asked if I was angry for some reason. I told them I was just really focused on my training. Im crossing my fingers at this point and hoping I don’t go back to ground zero now that I have discontinued the DAA treatment. I did some shopping yesterday and will be taking ZMA as well as 5000 iu of Vitamin D3 before bed at night. I checked the house and we have zero Iodized salt in the house. Told my wife we need to get some in the house as well as a dumbed down version of why its important.

@KSman,
Does it make a difference whether the lab does Estradiol Serum or Estradiol Sensitive in regards to male hormone levels? I ask because this previous lab was serum and the results I am recieving today are Estradiol Sensitive…

Very disappointed in these results after the DAA treatment. I did have an increase in Estradiol which explains why I have been feeling much better. I now have clomid in hand and have access to Nolvadex which I think I am going to get as well. I have an appointment with a urologist on the 22nd of this month but that is for Vasectomy consultation. Im going to try and talk to him about all this with blood work in hand. @KSman do you have any recommendations for a path forward? Any help is greatly appreciated.

Met with an Endo last week. She was concerned that they didnt test my prolactin or lh/fsh. We did more blood work. Im confused by all of this. My prolactin seems fine but now my estradiol is through the roof.

Screenshot_20170829-080958

Well I’m back! My endo that I visited with refused to give me adex for my high Estradiol. She essentially told me to stop taking any and all supplements with the exception of a mens daily multi vitamin. I did what she said. That was 8/25/17 as you can see on the test results. On October 4th I followed through with my Vasectomy. We chose not to perform the Varicelectomy. The Vasectomy procedure seemed to go well but the next day I had severe swelling. I call the office in a panic and they told me to keep icing and swelling was normal. I made it through one weekend like that but on Monday morning I was back in their office looking for help. Severe pain. Crazy swelling. Long story short they didn’t help me and eventually did ultrasound. I was told I needed surgery but after getting a second opinion from another urologist I opted out. I followed the second doctors instructions and things started getting better now. I had internal bleeding and had to wait for all the blood to be reabsorbed into my body. Initially, my libido was good but spiraled quickly. I’m back in the same boat I was before. I feel like I have crashed estrogen again. Feel like shit. Joint pain. ED. Weak erections. Emotionally cut off. I’m supposed to go back for more blood work but wont have insurance until December 1st. I’m thinking about going and getting my own blood test just so I know what is going on. I have Test E and Clomid on hand. The only reason I haven’t started at this point is I don’t have an AI on hand. After pouring through this forum I’m now concerned about my SHBG being so low and the fact that I have Test E (longer ester). Any direction would be appreciated.