T Nation

E2 Less Than 18pmol/l on a Restart Protocol

Basically I have been on TRT for three years and was diagnosed with secondary hypogonadism by an endicronologist after multiple low readings.
I’ve recently started the HPTA restart protocol 2 weeks ago and have 2 weeks remaining on HCG.

Reduced Adex to .25 twice a week and had labs done last week which showed Esteogen <18 (australian conversion, I believe pmol/L) I was usually around 78 or 79 which is normal.

This lab says anything under 150 is normal but this Doctor does not think anything can be wrong with low readings. I also started getting bad forearm pain similar to tennis elbow in both arms about 4 weeks ago so well before the labs last week but I am not sure what has caused it. I am now thinking the low E.

I stopped the AI last week after I got labs and am on HCG 500 EOD . Anyone ever had E2 this low?

Yes, that is what aromatase inhibitors do. Decrease E2, hypothalamus does not “see” enough E2 and signals the pituitary to get the boys working. In this case, making LH/FSH to target the testicles and produce more testosterone, some of which will aromatize to E2.


Generally, anastrozole and/or hCH are not good long term solutions to low testosterone.

Thx mate. Yeah I will be back on TRT as soon as I can. The reason for the restart is to boost/kickstsrt sperm production which was zero after 3 years on TRT. I’m in Australia so finding a good doctor that is knowledgeable on the importance of HCG whilt on TRT is like finding a needle in a haystack. I’m lucky I was given HCG as they are treating it as s fertility issue and I do have Nolva to continue the restart. I’ve stopped the AI so hoping the E starts climbing as the HCG should result in increased Test by mimicking LH. I’ve never had forearms this sore, I had an ultrasound on both showing no tennis elbow but man I can barely make as fist.

The fact that there is an unexplained onset (no injury, etc.) and it is bilateral (what are the odds that both elbows shoot craps at the same time?) point to a systemic cause. We know low E2 is not good for the joints. It’s a reasonable bet it’s low E2 causing it.

Testosterone restoration with hCG works fine for maintaining fertility. Guys do it all the time and conceive. Good luck.

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