E2 Low, Total Estrogen High. Endo Doc Never Seen This. What to Do?

I had labs run in 2007 as no libido, no morning wood. I was post divorce and not interested in dating and did not pursue doing anything about this at the time except taking Adex - 1 mg / week. I used ChemOne Adex. The results below reflect taking 1 mg / week Adex. I have not done TRT but posting here because need advice about labs and what to do.

I am going to have more labs drawn ASAP. I do want to ask if you have suggestions. The Endo doc said he had never seen low E2 but high E and did not know what to do which scares me.

E2 = 26
Total E = 157 lab normal range = 40 - 115 for adult male
TT = 490
FT = 11.1 pg/mL
LH = 3.0
Prolactin = 4.7
FSH = 11.7
Cortisol = 15.7
Pregnenolone = 138

I am 52 years old, 6’ 2" tall. A few years back I got lean and weighed 170. Today I am 185 so carrying 15 lbs fat. But with Adex my E2 levels are good.

Yesterday I started taking 200 mg DIM, 3x daily and lots of pro-biotics marketed as specifically for men. No change this morning when I awoke. No morning wood. With effort only half an erection.

Any ideas on what could cause high total E with E2 low?

The Endo had an adrenal scan done which came back negative for adrenal tumors.

The Endo doc has never seen this.
He said that the high total E was likely killing my desire.

If DIM and pro-biotics are a fix, how long for them to work?

Can the Adex itself be blocking the other estrogens from clearing my liver?

Esterone hikes can be caused by high levels of stress and adrenal fatigue. How are you feeling and what is your stress level like?

I feel fine and stress levels fairly low. However, caffeine creates a stress response in the body and (I’ve heard) causes adrenal fatigue. When I had those labs drawn years ago I was drinking 4 or 5 cups of coffee a day. Now I’m down to 2 but it has made no difference on morning wood or libido.

I appreciate the feedback. I did not know that estrone hikes can be caused by adrenal fatigue.

About 6 years ago I got off caffeine completely and after about 1 - 2 weeks all those symptoms disappeared. I then went back to drinking caffeine. Could it be that caffeine is causing adrenal fatigue which is causing estrone hike?

And if so, how long after I get off caffeine does it take for adrenal fatigue to clear up?

No caffeine would not be the cause. Prolonged experiences of high distress cause elevated estrone (E1) as well as adrenal fatigue which also relates to hormonal imbalances. You would probably have more difficulties with weight if you were suffering adrenal fatigue however stress can still elevate you E1 which explains your total E levels. Doesn’t sound like you have chronic stress though… Correct?

I definitely do not have chronic stress. Have not been seriously stressed about anything for well over a year.

When FSH is high relative to LH, there is a possibility of a FSH secreting testicular cancer. FSH secreting pituitary adinomas are rare.

Some adverse gut bacterial can recycle some estrogen metabolites in liver bile back into active estrogens, then reabsorbed. I am short on recalling details re E1.

Arimidex needs to be taken in divided doses, not once a week.

Liver clears estrogens and AST/ALT of interest.

Cortisol meaningless without time of day. Best to do AM cortisol, 8AM.

Why were adrenals an issue?
DHEA-S tested?

What is your body shape? Any signs of apple shaped body and thin limbs?

Swamped this weekend. Sorry for slow response time.

Some adverse gut bacterial can recycle some estrogen metabolites in liver bile back into active estrogens, then reabsorbed.

Started a good probiotic 3 days ago. So far not observed difference.

Arimidex needs to be taken in divided doses, not once a week.

I take 4 drops daily. Got it from ChemOne.

Liver clears estrogens and AST/ALT of interest.

I’ve started taking 1,000 mg DIM daily. Anything else I can do to help liver excreet excess estrogen?

Why were adrenals an issue?

Doc thought if an adrenal tumor existed that it could secrete estrogen. Scan was negative.

DHEA-S tested?

Yes. Value = 115.

What is your body shape? Any signs of apple shaped body and thin limbs?

I have very muscular legs and average arms so neither is thin. My 14 lbs of body fat are on my belly but I would not describe my body shape as apple shaped.

Those labs are 7 years old. Haven’t wanted to date so haven’t care. I do want to so I do care. I’m meeting Endo doc on Oct 7th and will have new labs drawn.

From the stickey I have noted I need these.
Any advice you can give me about high total E when E2 is only 26 would be appreciated.

SHBG
LH
FSH
T-total
T-free or bioavailable
E2
Total E
DHT
PSA
Prolactin
Cholesterol
DHEA-S
TSH
fT3
fT4