Looks like your testes are partly not responding well to your LH/FSH.
E2=44 pg/ml is way too high, ideal is near 22pg/ml for guys on TRT with high T levels, with your depressed T levels, you are very estrogen dominant.
Can you get an Rx for anastrozole to bring this down? Suggest .75mg/week in divided doses.
E2 can be elevated from poor clearance in the liver. AST/ALT labs of interest.
Some meds, including SSRI’s can compete for enzyme pathways in liver that clear E2, thus increasing E2.
More fat means more FT–>E2.
Low thyroid function means more fat.
Not using iodized salt can be a cause of low thyroid function.
Please read the stickies found here: About the T Replacement Category - #2 by KSman
- advice for new guys
- things that damage your hormones
- protocol for injections
- finding a TRT doc
- thyroid basics
eval overall thyroid function by checking oral body temps as per the thyroid basics sticky.
Good to see prolactin tested.
Vitamin Code Men’s Multivitamin Supplement Facts: quite light on iodine, selenium is OK
“need an AI, or if I need TRT + AI?”
- Try to get E2 in lower 20’s and see how body responds
- Get body temps so we know if thyroid function is part of your slump.
Many here happen to have low T and low thyroid function. Thyroid hormone fT3 regulates mitochondrial activity that makes ATP, the universal currency of cellular energy, as part of the body’s temperature control loop. See the connection? If iodine intake is low, everything can slow down and that includes function of cells, organs, systems and other hormones.
With your history, body fat and gyno, we are not looking to get you back to where you were as optimal. You would lean out a lot with high normal TT and Ft, E2 near 22pg/ml and optimal thyroid function.
Your labs were all T centric. Do you have:
fasting cholesterol
fasting glucose
AM cortisol - at 8AM
CBC
hematocrit
AST/ALT
PSA
TSH
fT3
fT4
DHEA-S
IGF-1