T Nation

E2 Crash with TT/FT Up. Why?

Been on here before, but I’m close to 1 year in and my E2 levels just reset to pre TRT and my FT and TT are both up alot. Other than needing to give blood I’m not sure what is going on. Libido is down and more tired, but strength in the gym is good, weight has dropped about 5 lbs. but that it, any idea what is going on?

Currently 200mg/Test cyp compounded with .5mg Anast per week. 2x injections subQ
5000IU/100mg HCG 1cc/week 2x injections subQ (500IU)

Attached are my labs the past year. switched to subQ in June. Any help or insights on the E2 drop is appreciated. Also is being at the low end of T3 anything to be concerned with?


Thyroid is terrible, TSH is way too high because fT3 is low. You aren’t meeting the requirements for TRT to work effectively, you need optimal thyroid hormones to benefit from TRT. Lagging thyroids are the number one reason for TRT’s poor results, most doctors don’t understand this fact.

Often TRT attempts to restore metabolic rates that lagging thyroids can’t match making you feel tired (crash) even though you have excellent T levels. You are hypothyroid, fT3 needs to be 75% of the range to be optimal and you’re at the bottom. Your body temps will show below 98.6.

There was a thread here yesterday regarding a podcast, cant remember who the guy was, but they are saying that you need a year before your e2 normalizes.

Not sure how much truth there is to it. I have noticed myself, I use to have e2 problems (not bad, some acne, no morning wood) but they have dissipated as I have passed over a year now.

I am still waiting on the host of the podcast to deliver sources of his guest but here is the podcast. http://www.totrevolution.com/tot-sex-hormone-binding-globulin-prostate-cancer-estrogen-suppression-w-dr-nick-sakkas/

Here is the thread: AI's Cause Boneloss?

I was wondering if the thyroid was an issue. Wish I would have ran that panel with the previous (7/2017) blood work. I’m missing the connection between the drop from 34.5 to 14.4 in E2 ties into the low T3. What is the relationship there? I’ve read the thyroid sticky and I’m assuming that if I begin IR that I should see E2 rise as well as T3? I felt pretty good in the 20-30 range and the Dr. stated that should be my target range…but differs a bit person to person…

Can you get your test not compounded with the AI?

Based on what I can see here you’ve always been pretty low. They are running Roche ECLIA on you which is a no no. There is a good possibility you are lower than you think. Most likely crashed out. ECLIA can over state your e2 levels by reading crp like it was estrogen. ECLIA can’t tell the difference between them. You need and e2 sensitive test to be sure and lower the arimidex dosage. We don’t want osteoporosis do We?

The Test and AI are compounded.

I’ve been getting my labs though the same source in hopes of continuity. I’ll take a look at getting the E2 sensitive test…anything/source I should be aware of or avoid…ie I wasn’t aware of the ECLIA issue…I was originally on twice the AI and it was reduced to current levels 3mos into this first year…is there a chance I wouldn’t need it at all? Just shocked it was trending well then dumped back to pre TRT levels…trying to understand the catalyst… FYI the 3/17/17 date was my pre TRT bloodwork.

If you were having the ECLIA E2 labs and they switched them to the sensitive test if would appear to show a sudden E2 crash. Most progress doctors start treating thyroids once they get above 2.5, yours is almost double. Pituitary is yelling at thyroid via TSH to produce hormones do to low fT3, thyroid isn’t responding the way that it should.

We see a guy lot guys who also have thyroid issues who wonder why TRT isn’t working, your thyroid took a dump on you while on TRT. Do you consume iodine in your diet? Most are iodine deficient.

Are test and AI added together by any chance?

regarding compounded test: Can you get just test?

I think it cant hurt to see where your e2 would be without an AI, you can always jump back on it.

Was there ever a time when you weren’t on an AI? How do you know you even need one?

TRT began 3/17/17 with compounded test cyp and AI. The only change was the AI was cut in half about 3mos in. Just a random change for all the Dr’s TRT patients on this regiment. I think the only thing I could do would be to try and change to Dr. Crislers practice where I can buy the individual components separately…just got my 9 week supply meds a week ago.

Your e2 hasn’t fluctuated that much over the past year. 34.5 is not high. If you had an e2 sensitive test you were probably either spot perfect or still low. ECLIA can overestimate men’s e2 by 50%. I’ve seen it overestimate on some guys bloodwork by 10x. It unreliable at best. I’m willing to bet you are lower than you think and that’s detrimental to your health and longevity. You could either drop the AI altogether or ask for a lower dose since they are compounding. You need to get that estrogen back up. It will help your joints. Cognitive function. Libido.

AI and test are compounded, always have been and were changed about 6 mos ago. I don’t supplement iodine, but looks like I should take a run at it…easiest item to modify then test. Just trying to understand why the thyroid decided to take that dump…

I cannot make any sense of your protocol. Please do not report volumes, report in mg’s and iu’s. You take AI once a week? If so, lab timing would determine E2 lab results. If protocol not consistent leading up to labs, results will be reduced usefulness. Fix your post of protocols above using the edit function.

AI’s do not cause bone loss in a proper TRT context. Females with cancer with E2–>zero have bone loss from low E2. With TRT we modulate E2 to a level that is optimal for energy, mood, libido and sexual function. I have been E2=~22 for 12 years and my bone scans do not show any problems. If I was not on TRT, I would be at risk of weaker bones. I can understand why this issue is here creating confusion and distraction.

Most on TRT have E2 get to where is going to be in a few weeks and intervention provided better levels that then can be stable for years. Again, such info is really derailing the learning curve.

Thyroid is a mess because you have not been using iodized salt and/or vitamins that list 150mcg iodine and 150-200mcg selenium? The normal state of most populations on the planet had been thyroid disease from iodine deficiency until iodized salt was introduced in 1922.

To eval your overall thyroid function see reference to ‘oral body temperature’ below.

Please read the stickies found here: About the T Replacement Category

  • 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.

Injecting .5cc/ml 2x week Tues/Fri of Test Cyp/Anastrozole 200mg/.5mg/ml (compounded)
Injecting 500iu HCG 2x week Tues/Fri ( 5000iu in 5ml H20. 50 insulin units .5ml each injection)
Labs are with a few hours of mid point between injection
Protocol is followed like clockwork.
Why the sudden jump in FT/TT, drop in E2 and T3 low…nothing has changed in 6 months diet is consistent.
Can iodine uptake recover the E2 and T levels alone?
Frustrating because my diet, workouts, protocol are the same day after day almost to a fault.