T Nation

Correcting High Estrogen

Over 35 Lifter
#1 
   After reading many of the posts here I am now currently on 150 mg test cyp once a week instead of 300 mg twice a month. I can't say that I feel that different but it has only been three weeks of weekly injections so far. My reason for posting today is to share the results of some recent blood work.

Total test 496 range 260-1000ng/dl
Test % free 2.0% range 1.0-2.7%
Test Free 100.1 range 50.0- 210.0 pg/ml

Prolactin 12.4 range 2.0-18.0 ng/ml
Progesterone .5 range <1.4 ng/ml

Estro,Total,Serum 208 range 130 pg/ml or less

                      *From what I just read on a lab 
                       "normal" guide 130 pg/ml or < is 
                       "normal" for a post menopausal 
                       woman and 20-80 pg/ml for a man!

  Obviously something has to be done regarding this extremely high estrogen reading and my doctor has agreed as much. I've have read allot about AIs on this site but have no experience with them. Should this be my next step or should I try to find out why these levels are so high.

I can’t believe trt is the sole cause for these raised levels especially since my chief complaints before I even started trt were low libido and ED. The info I have received from the posts I have read has been put to good use when I have seen my doctor so any advice would be much appreciated as usual
Thanks

#2

It’s good your doctor agreed your E number is way too high, but is he willing to give you an AI to combat it?

Three weeks and your E is that high…? It appears you are one of the guys that E convert easily. That’s okay because Arimidex works wonders at low dosages. My E numbers were once twice the high normal, and Adex brought me back to normal again. One of the possible reasons you don’t feel “different” (driven,focused,hornier,etc) may very well be from the high E. It took me a month or so after starting on adex to get “spontaneous” again. And “feel different” too.

High E will definitely cause low libido, and sometimes ED too. When I was on 100mg/week of T-Cyp, my T level was 500+ and this seems to be fairly “normal” as an average. The less you convert to E, the more you have as T and the more “manly” you feel. Talk to your doc, get an AI, and get get your blood checked often. Good luck!

#3

Thanks KNB. I was not clear in this posting but I have been on trt for about two years now. For most of that time I was using androgel and testim but I recently switched to test cyp for convenience and cost. My ins pays for my treatment but the plan does have a limit. Besides one shot a week compared to putting gel on every day is a relief.

Anyway like I stated my doc agrees that my estro has to be lowered and that the trt treatment is not wholly responsible for this raise in estrogen. As far as an AI like Arimidex or something else he hasn't suggested anything and I just wanted some opinions from people on this board. 

On another note my health is in general okay. My tobacco intake is an occasional cigar and I quit alchol a few years back. Unfortuneatly I have read where high estrogen can be the result of the liver not working properly or the result of certain tumors.

I don’t know if anyone can help me with this, obviously my E levels are very high but are they so high that they may be being raised but something else? I know these are questions for my doc but to be honest when I saw him the other day and he told me about the raised E I was just kind of relieved because it explained allot. I didn’t start to worry about it until after I left.

                            Thanks
#4

The total estrogen assay is worthless and inaccurate. It was mainly developed for women, and does not give any picture of what is really going on.

You need an estradoil(E2) test

#5

I’m quite sure how to respond to the whole line of “possible tumors” etc., regarding high E levels, but saying you switched from the gel/cream really “answers” the questions. Gels/creams convert to E and DHT much more highly than the injections do and will raise your E levels, and everybody elses too.

I am of the opinion (from personal experience) rather than presume that something serious is wrong with me, I will follow the statistics and get an AI to lower my E levels. A round of Adex may (A)solve the problem, (B)will be much less expensive than a complete liver panel and MRI’s, © return your peace of mind, and (D) may resolve the libido/ED too.

#6

Don’t bother with the total E lab work. Test for serum E2 0-53 pg/ml. The other estrogens are metabolites of E2. Get E2 down and the metabolites will fall. After you get E2 corrected for a while, you could do a total E test to see if you are having an unusual amount of estrogen metabolites. Total E without E2 does not allow one to determine if metabolites are an issue.

E2 should be in the low 20’s. Some sources suggest 17-20 for optimal libido.

Start with 1.5mg* arimidex/anastrozole every week in divided doses. The liquid anastrozole is very cheap from research chem sites, 50 for 60mg. Arimidex from a pharmacy can cost 9 for one 1mg tablet ;( You could get a script then follow that with the liquid. Liquid also allows for flexibility of dosing that you can’t get with tablets.

  • The typical starting/trial dose for guys with E2 in the 30 - 50\ range is 1mg/week. You might need more than that.

You can get E2 tests (and others) via lef.org to guide dosing changes if your med plan will not cover what needs to be done.

Arimidex/anastrozole can create a huge increase in libido, sometimes in 10-14 days. As this is a fast acting response, this is your best barometer for what is happening. There also will be improved mood, elimination of brain fog, more energy and personality changes as your brain gets testosterone dominated instead of estrogen-progesterone effects. These changes can take 2-3 months to fully complete. You might also get what I term as “dryer emotions”.

As those brain changes and habits of thought are changing, be positive about things and you might shape positive habits of thought while things are changing.

AI can change everything! Your T levels may improve as less T is lost to T–>E conversion. High E can block the effects of high TT, even at TT=1000. You have a lot to gain by doing this. If your doc will not do all required, you can do this on your own as the doctor’s standard of care is not acceptable. Many doctors do not understand all of the issues.

The foundation of TRT/HRT [according to me]is testosterone, HCG and AI [anastrozole]. It is like a tripod. Without all three, the result is less than optimal. HCG keeps the testicles working and healthy. The testes make most of the pregnenolone in the body. When T shuts down the HPTA, that stops as well. Pregnenolone is more than a raw material for sex steroid and DHEA. It is converted in the brain (locally, not systemic) to produce neural steroids. Low levels of pregnenolone can lead to memory and other cognitive deficits.

A good dose for HCG is 250iu SC EOD. Very inexpensive at Sam’s Club with a business membership, $16.25 for 10,000iu. This will also improve your T levels.

#7 
 Thanks to all! I have gotten allot of good advice from many of your posts so I'm glad for all your responses. I'm not sure where any of you get your lab work done but my insurance pays for Quest lab. I remember reading on other posts how the total estro readings are useless but it doesn't appear that Quest tested for anything else.

On the report it lists estradiol and under the range colum it lists <32. Next to that it reads ‘No reference range established for adult males and prepubertal children. The estradiol assay (Extraction/Chromatography/RIA method) is recommended.’ Is this assay just a long way of saying E2 test? I just want to be sure when I talk to my doc I ask for the right test. My doc has been great but even he like many other docs’ can’t compete with the knowledge on this board.

#8

[quote]lastcall704 wrote:
The estradiol assay (Extraction/Chromatography/RIA method) is recommended.’ Is this assay just a long way of saying E2 test? I just want to be sure when I talk to my doc I ask for the right test. My doc has been great but even he like many other docs’ can’t compete with the knowledge on this board. [/quote]

Can you post a link to that or the reference range? I have never dealt with the test methods.

#9

Sorry KSman I only wrote down what was on the lab report. No reference ranges were given. It seemed that the test they were suggesting was in response to the test ‘Estradiol’ that was listed in the ‘Test Name’ column. Next to the ‘Estradiol’ test was the Range column that stated < 32 for in range. Next to that was the statement that no range has been established for males and that an estradiol assay of (Extraction/Chromatography/RIA method) should be requested. Since I wouldn’t be surprised if I wind up needing an AI I just want to be sure when I see my doc I know the exact estradiol test to ask for.

                             Thanks
#10

Quest has these:

�?� ESTRADIOL - (4021)
�?� ESTRADIOL, RAPID - (15577)
�?� ESTRADIOL, ULTRASENSITIVE LC/MS/MS - (30289)

I could not find the test ranges.

Looks like the 30289 would be the best from Quest. I use LabCorp’s basic serum estradiol (0-53)or less than 54.

http://www.allthingsmale.com/word_docs/TRT.doc

Labcorp make info available:

http://www.labcorp.com/datasets/labcorp/html/chapter/mono/ri003600.htm

Read away!

#11 
 Thanks KSman, as always your posts are the pinnacle of trt understanding! Actually the order code for the estradiol assay that Quest recommends is #30289T so I guess thats the one. I have an appointment today with a urologist. My regular doc suggested it after my ED complaints. I also plan on discussing the possible high estro levels as well as hcg. I'll let you know how that goes but the last two docs I mentioned hcg to both had negative responses.

One inferred that scrips for this drug are getting extra scrutiny. I have read many of your posts so there is no need to try and persuade me. There is no one alive who would like a return of the mastiff size nads of days gone by but if I can’t get a legal scrip then hcg is a drug I won’t be able to use. I’ll just keep asking every doc I see about it until one says yes. Pretty soon I’ll be telling my dentist that I read an article on hcg and tooth decay!(lol)

Again KSman thanks for sharing your knowledge and for taking the time to respond to so many of our posts.

#12

I hope this isn’t too far off of the subject:

I have been using REZ-V to reduce testosterone to estrogen conversion. I am also using indole-3-carbinol at the same time! Do both of these perform the same function? Do I only need the REZ-V?

#13

[quote]indiana dave_4 wrote:
I hope this isn’t too far off of the subject:

I have been using REZ-V to reduce testosterone to estrogen conversion. I am also using indole-3-carbinol at the same time! Do both of these perform the same function? Do I only need the REZ-V?[/quote]

Resveratrol doesn’t necessary stop T aromatization into E.

It acts as a SERM, a selective estrogen receptor modulator.

It also has some other nice benefits in it, check the REZV thread.

I3C prevents estradiol(E2) from breaking down into harmfull estrogen metabolits known as 4 and 16 hyrdoxy.

#14

I3C coverts to DIM and there is research showing that DIM acts as an antiandrogen. Not so sure I’d want to take I3C. The research on resveratrol is also pretty sketchy. If you’re seriously interested in aromatase inhibition, do some reading on anastrozole, but be aware that taking an AI is not without potential problems. It might be the right thing for you to do, but not until you fully understand what you’re getting into.

#15

[quote]happydog48 wrote:
I3C coverts to DIM and there is research showing that DIM acts as an antiandrogen. Not so sure I’d want to take I3C. The research on resveratrol is also pretty sketchy. If you’re seriously interested in aromatase inhibition, do some reading on anastrozole, but be aware that taking an AI is not without potential problems. It might be the right thing for you to do, but not until you fully understand what you’re getting into.[/quote]

I3C converting to DIM? First Ive ever heard of that.

There is quite a lot of good things going on with resveratrol. Google it.

I agree, for AI go with adex.

#16

From here:

http://www.diagnose-me.com/treat/T271923.html

“It is generally agreed that 300mg of IC3 converts to 30-40mg of DIM.”

From here:

http://72.14.253.104/search?q=cache:3pJ2fb1sJeoJ:www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/ind_0315.shtml+indole-3-carbinol+metabolites&hl=en&ct=clnk&cd=6&gl=us

“It is converted to DIM and ICZ by stomach acid”

Lots of claims being made about resveratrol, but few of the studies have been replicated successfully. I agree that is it probably worth taking, in general, but I think relying on it for your primary estrogen control is a big mistake since other, well documented and highly effective products are available.