T Nation

E2 Low on TRT. Increase Dosage/Frequency?

I’m a 42 yr old male, and I was diagnosed primary hypo around 2012. Ive been on TRT for 8+ years or so.
Im using 100mg every 7 days IM. My question is, is it typical for my E2 to be in the lower range? My last test result was 13.1 in the range of

8.0 to 35.0 pg

I’m having some ED symptoms, and feeling anxious a lot and have been on anxiety medicine for the longest I can remember.

I’m going in Fri to my PCP for follow-up blood work. I plan on having the following checked-

Total T
Bio/Free
SHBG
E2
CBC
CMP

Anything else I should be looking at? Ive not had my SHBG checked in along time. But I’m wondering if that is binding to all my free and not to my E2?

Also, ive never had a higher serum than 700 on T. I would like it to dose a a bit higher, but my hemotacrit is close to 50.

So, should I inject more frequent? Should I add anything to my protocol? Adding HCG is very expensive for me as my insurance is the greatest. Ive obviously never need an AI as my E2 has never been over 20. I’m not sure why my E2 is so low even while on TRT. Im wondering if its all being sucked up by SHBG

But, looking to feel a bit better and relieve some of my ED symptoms.

Two options.

  1. Change only dose (I’d go to 150mg/week) OR only frequency (I’d go to at least 2x a week) and see what happens. Give it 6-8 weeks. If still not fixed, then try changing the other.

Or

  1. Do both. Try, say, 75mg 2x a week, 150mg/week total. See what happens there

You could try a number of combos to be honest so pick what you feel good about. I’d go to 2x a week minimum though and bump the dose a bit as well. You could do anywhere in the 100 to 150mg/week and anywhere from 2-3x a week.

The downside of changing both frequency and amount at once is you won’t know if it was one or both that helped resolved your issues (assuming that happens) but if it does the job I’m not sure I’d really care which did the trick.

1 Like

Thanks. I always thought a higher T serum would correlate to a higher E2. But, my E2 doesnt seem to rise very much while on T. So, I suppose that is a good thing and negates my having a need to go on an Ai.

I will speak to my doc and see how see what route she wants to go. My injection was this past Tues, so I’m sure by Fri my numbers will be declining. I tried to get in on the injection date, but doc was filled up on the cal.

So, if my levels are not overtly high, and Hematocrit is ok, I might increase dosage to 150. I believe that is a few ticks up the syringe. Could be wrong as now its 1/2ml in the syringe. Also, hopefully this would lower SHBG if high.

And yes, I dont care what works, as long as it works, and my unit is working lol

I would. Maybe 2x per week. If you’re getting labs at your lowest level, splitting might help

Well, my normal injection days are on Tues. I cant meet with the doc until tomorrow. So, my levels will already be on there way down. I wanted to get in on Tues, but the doc appt is booked full.

So, as far as peak serum levels, I cannot really say for sure. But, again Ive never been over 700.

Once I find out my bloodwork, I will go from there. I might try the 2x week.

I’ve read several posts on this site suggesting increasing frequency is to help lower E2. Everybody’s different, but is that not the general idea?

Its quite possible as the serum levels are more stable and dont rollercoaster all the time.

My E2 is in the lower range anyhow. So, Im hoping it will raise some and my T levels will rise with twice a week.

But, who knows.

Well, you’ve never tested over 700ng, but if this is a trough reading, then your levels are higher during the week. The idea of splitting shots up is to spend more time in that higher therapeutic zone

700 is definitely not a trough reading. The below should indicate where I’m at. Without T, Im usually in the high 190’s low 200’s. So, the below is quite typical for me. My E has never really been high on TRT. I guess thats a good hting.

Here was my last blood work and this was right before my injection on Tuesdays. This was late sometime last year.

Testosterone
283 ng/dL

18 years 264 - 916

Free Testosterone %
1.3 %
Adult Males: 1.5 - 3.2

Testosterone Free
37 pg/mL
Adult Males: 52 - 280

Estradiol Sensitive
13.1 pg/mL
8.0 to 35.0 pg/mL

I’m quite anxious for tomorrow to get my blood work done. However, I probably wont get my results until next week sometime.

But, I plan on splitting dosage next week starting on tues to.25ml and on fri the other .25ml. My T bottle comes in the 200ml. So, 100ml a week which is .5ml.

Hoping to feel a bit better. I just want some results

Get more T. your body will produce more E when you simply give it more of what it needs. Hematocrit rises with T, its not going to cause a blood clot or stroke. The men who get strokes and clots and heart attacks on T have underlying issues. Furthermore if you want to believe western medicines approach on T, then they also say after two years the risk of a CV event declines substantially. the majority of men in one study who had CV events occurred at the start.

To me its all bulshit. they dont give these men enough T, nor tell us their health when they put them on T. they dont tell us if they have underlying or genetics which could put them at risk.

My HCT is high and I have literally never felt like my HCT is high.

You really should realize that higher blood oxygen content is healthy for you. your body needs oxygen to stay alive. the organs and tissues and etc… its a false belief that 50 or higher is dangerous.

even the phlebotomists have stated dont worry about HCT until it gets well above 56. You arent even close and if you were too high, you would have symptoms and plenty of time to get the issue resolved.

Do you really think a hormone that is produced by your body is going to cause these abnormal issues if you simply dose T until all of your symptoms resolve? Maybe your HCT was around 54 when you were in your 20s before T became low. Maybe you are genetically lucky to have this and could kill it in a high intensity sport?

you can go to YouTube and type in doctor rouzier TRT hematocrit / or erethrocytosis I think. the leader in hormone education and training is this doctor and if you can’t take his word for it, I don’t know who we can. definitely not some forum expert.

FYI Estrogen is the cause behind half or more of the reasons men want to get on TRT. Libido, CV health, strong bones and etc.

You really gotta read around this forum and read up on all the different posts regarding E.

Nobody is saying artificially raise your E like some of these idiots like to say we are trying to suggest.

What many of us are saying is “Dose TRT until symptoms resolve and trust the body to do its job” unless your body is totally and utterly broken.

The trt world used to be filled with fear of E, but many studies and professionals have debunked this notion.

Read up on one of my posts where I cite a study showing researchers found libido is due to E in the brain.

Danny bossa has posted many times regarding this topic, so have I and so many others on here have high Estrogen and constantly complain of too much muscle, lbiido and good vibes. Then go find the guys who cannot seem to get TRT to work properly and you will either find they have a fear of E, block E via AI or constantly changing doses.

Dont take my word for it, do your research and observe friend.

If your doctor wont raise your dose, go find a new doctor, you are the customer and they are the supplier.