I suppose that because my numbers for Total T, Free T and E2 are all high I might simply reduce the weekly T input and resolve my out of balance E2 that way.
Waiting for KSman to give me his opinion.
I think that you should go towards serum E2=22pg/ml then based on how you feel, do what you are motivated to do from there. You can always go back to where you were. Why be a slave to a whim of a doctor who does not understand this issue.
[quote]KSman wrote:
I think that you should go towards serum E2=22pg/ml then based on how you feel, do what you are motivated to do from there. You can always go back to where you were. Why be a slave to a whim of a doctor who does not understand this issue.[/quote]
Oh that is not even under consideration. See my follow up post just above yours, I was wondering if I should simply back off the T quantity per week and see if that brings E2, Free-T and Total T down. Do you think my situation is that simple ?
I also need to get on the monthly self lab tests using the post I got a ways back in this thread.
New Anastrozole pills just arrived. I got a lot. These are different - blue and pink CMP Anastrozole 0.25 MG Cap. Says ‘Take 1 capsule by mouth daily’.
Now this is not the original doctor, that one imploded when they got raided for pain clinics last week. So this number means nothing. However if I was at .5 mg per week this is suggesting 1.75 per week and seems spot on since I have almost double E2 rule of thumb would suggest going to just under double the Anastrozole… so .5 X 2 = 1.0 per week. so .25 every other day would be 1.0 per week.
This Anastrozole is compounded and not name brand. Does that throw off the calculation at all ? I bet the answer is we just make the adjustment and go get the bloodwork done to be sure.
Thanks
Wow GeoBob’s free test blows mine away. Does correcting E2 help with free test ?
Yes, less E2 should lead to less SHBG bound T and more FT. In any case, less E2 interfering with T is the major effect. My FT is >49 with LabCorp. That is the upper reporting limit. FT=38.6 is not really that high when you consider youthful non-age adjusted ranges. When I turned 60, suddenly my FT range limit became something bogus like 28.
[quote]KSman wrote:
Yes, less E2 should lead to less SHBG bound T and more FT. In any case, less E2 interfering with T is the major effect. My FT is >49 with LabCorp. That is the upper reporting limit. FT=38.6 is not really that high when you consider youthful non-age adjusted ranges. When I turned 60, suddenly my FT range limit became something bogus like 28.[/quote]
Will I ever achieve his ‘Free testosterone 266.7 pg/mL down from 273.8 six weeks ago. (range 50-210)’ at age 46 ? Certainly I am putting enough T in, how the heck did he get 266 ??
Is Geobob’s 266 incorrect ???
It depends on a man’s age. The normal range of free testosterone is 1.0-5.0 ng/dl. However, a guy in his 20’s may have levels around 41.0 pg/ml ( p grams/milliliter) while a gentleman in his 80’s may have around 9.0 pg/ml – and they would both be considered normal.
1st post. I have been lurking and reading for awhile. I have been on TRT, 1st Androgel and now T injections. My doc is doing it, but is really not very knowledgeable. How do I find someone a little more familiar with these protocols. I have not been taking hCG or an E suppressor.
Chopperdog: Where are you located? Insurance or paying out of pocket? How long on A-gel and how long on Injections? What dose and frequency? Why did you quit A-gel?
I am in Memphis. My insurance is a little funny. I have to pay out of pocket for a large part on the front end. I was on Androgel for about 6 months and quit for 6-9 months and then started again for 6 months or so. I found that the daily ritual of rubbing on the gel was inconvenient and I just did not see much difference. I also have a 9 year old and don’t want to take a chance of getting it on him. It is just so much easier to get a T Cyp shot. I was getting a shot once a month and then just switched to a divided 2 week dose and now after rereading I think I need to go on an every week shot. I have known my doc for 30 years and we can have a very open conversation, I just think that this will probably take him out of his comfort zone and he will recommend an Endocrinology consult. If I have to go to someone else, I would just as soon get someone that knows what to do. Thx for any advice
http://jcem.endojournals.org/cgi/content/full/85/9/3024
This is why lowering E2 when not on exogeneous Testosterone can be risky business.
[quote]chemman wrote:
http://jcem.endojournals.org/cgi/content/full/85/9/3024
This is why lowering E2 when not on exogeneous Testosterone can be risky business. [/quote]
We know that we should not lower E2 to very low levels, nothing new there. That paper does not change that perspective. When not on TRT, if E2 needs to be lowered, one simply needs to find the small dose that creates the desired target level.
With some men not on TRT, T and E can be low. Yet there can easily still be an adverse E:T ratio and obvious symptoms of that. This type of estrogen dominance can be found discussed in some TRT books.
If you fix the ratio with these guys, there might be some gains, but overall, you still have a T deficient male and may end up with problems with low absolute E levels.
With those who are not on TRT who have low T and elevated E, they can benefit quite a bit and feel an improvement over many dimensions. This could help break the cycle of syndrome-X and growing insulin resistance for some.
Why are some with low T having higher E and some low? There can be differences in aromatization rates or more aromatase from fat gain. Then there is the liver where there can be differences in how estrogens are removed from the body. This can be affected by liver health and other substances that make demands on the same metabolic pathways. Yet another factor, is an adverse flora in the gut that frees up estrogens secreted in the bile, allowing for reabsorption by the gut.
What I am pointing out is that going too low without a buffer of exogeneous T is a worse situation because recovery of E2 to original levels will be more difficult.
Estradiol is needed for proper hyopothalamic signaling. Bring it too low and you can LOWER testosterone levels.
I am also interested in the relationship between estradiol levels and thyroid function. I have heard that there is a relationship.
I think I know the answer before I ask but I throw it out there just to get a second opinion. I am going to have blood drawn to test for E2, Total T and Free T. I have been on my arimidex dose of 1mg EOD for over 6 weeks and not change my testosterone injection dose or HCG dose. I inject T on Tuesday night and Saturday morning. The arimidex and HCG dosing obviously falls on different days of the week.
I have had each of my previous blood test collected on Tuesday. I understand that my testosterone levels will likely be lower that if I had my blood sample taken on Wednesday morning but I�¢??m not too worried about that yet. I really want to get an accurate assessment of what 1mg of Arimidex EOD is doing to my E2 level.
So the question is when would be the best time to draw the blood sample or does in not matter because they remain relatively steady on an EOD dose.
I’ve recently gotten some Anastrozole liquid that’s 1 mg/ml. My dosage of .25 mg capsules is one capsule 5 days/week. I’ve been searching the forums here but I suppose my search-fu fails as I can’t seem to find a conversion to let me know how many drops equals how many mg.
Right now I believe I should up anastrozole doses up to .5 mg/day
so how many drops and when should I take them?
Try putting drops into a 1ml syring. It’s like a very small graduated cyclinder. I found out my liquid product pumped out very close to .125 ml per squirt. It was a little difficult to shoot it into the syring but with a dropper you should have no problem. Just ad drops until you get up to .25 ml or .5 mls. You could also use a larger syrige and just divide by 10. That might work better. Say 10 cc or 1000ml is 500 drops then 25 drops would equal .5ml (I think?, it’s early) Might sound simple but I had the same question and it took me several months to come up with a way to measure out my dose.
If liquid comes with a dropper that has markings for fourths of an ml, count the drops per 1/2 ml and double the number. Drops per ml change with the formulation and the material of the dropper [plastic VS glass] from surface tension effects. If the dropper does not have marks, inject a measured amount it the dropper and count.
Divide the number of drops per ml by 3.5 and that will be the EOD dose for 1mg/week.
I still do not understand how Geobob got his Free T so high.
Are these two labs measuring the same thing ?
Reference Intervals for Free Testosterone from LabCorp
- 20-29 years 9.3-26.5 picogram/mL
- 30-39 years 8.7-25.1 picogram/mL
- 40-49 years 6.8-21.5 picogram/mL
- 50-59 years 7.2-24.0 picogram/mL
- 60+ years 6.6-18.1 picogram/mL
From Quest Diagnostics follow:
Adult Male (20-60+ years): 1.0-2.7% 50-210 pg/mL
My 38 from Labcorp looks fine until you see the 50-210 range at Quest and Geobobs came in higher than that.
This is the fly in the ointment. You have two different lab methods that can create vastly different results from the same blood draw. You cannot look at the Quest range then dose T to chase those levels while measuring your own with Labcorp. With FT, it is essential to show ranges with the result. The methods vary by ~4:1. So the upper range from Quest would seem to translate to ~50 with Labcorp.
Labcorp’s FT reporting limit is 49 and higher levels report at “>49”.
I used to be FT=36 with 100mg/week T cyp. That then dropped and I had symptoms to match. My T dose is higher now and my FT is high as well. While E2 was maintained near E2=22, my SHBG must have increased - the age related increase.
After my 60th birthday, Labcorp did drop my upper range.
Read through this entire thread. Good stuff.
I am a 32 y.o. male. 182 lbs 8.5-9% body fat. Here is my blood work done at Quest after a 12 hour fast. Note that this is after 6 weeks of very hard dieting, probably 30% below maintenance calories plus heavy cardio.
I picked out the more interesting values:
HDL 50 (RR >40)
Triglycerides 41 (RR <150)
LDL 92
Cardio CRP 0.2 mg/L (RR<1.0)
Glucose 72
TSH, 3rd generation w/reflex to FT4 1.69 (RR 0.40-4.50 mIU/L)
T3 Uptake 32 (RR 22-35%)
DHT 45 (RR 25-75 ng/dl)
Iron, total 144 (RR 45-170 mcg/dl)
Ferritin 47 (RR 20-345ng/ml)
Cortisol, Total 16.3 (RR 8 a.m. 4.0-22.0 mcg/dl)
DHEA Sulfate 278 (RR 110-370 mcg/dl)
Prolactin 5.6 (RR2.0-18.0 ng/ml)
Estradiol 37 (RR 13-54 pg/ml)
Testosterone, Free and Total, LC/MS/MS(WTF?) Pending
I’ll get the test levels on Wednesday. Interesting thing is I’ve had low libido most of my life. After I went off of my SSRI’s my libido NEVER fully returned (the only thing that ever worked was high dose 50:1 extract of tongkat ali). Bupropion made me aggressive as hell, dopaminergics are out (bad sides and I like my heart valve the way it is, beside prolactin is normal). Survector was a godsend but it’s banned everywhere now and impossible to find unless you want something made in someoneâ??s bathtub. Stablon didn’t do anything.
Anyway apparently some feel that having an E2 level of 37, although in reference range, can still be symptomatic. Once I get my T results back Iâ??m going to experiment with a very low dose of an AI. I’m hoping my mood/libido/brain fog/very poor memory will improve. Right now i get by with Provigil during the day and 5mg Ambien with 50 mg Trazodone at night for sleep. Libido is shot but that is common durring dieting but, like I said, I’ve always had a low libido ever since i went off SSRI’s years ago.
Also interesting is my serum ferritin level of 47. Apperently some also feel this is low enough to be symptomatic even though it is in reference range. There is some data showing a correlation between low ferritin and mood/memory.
Any opinions? Also does anyone have an opinion of Trazodone vs. Remeron as a daily long term therapy for insomnia? I know they donâ??t affect libido like the SSRIâ??s do but Iâ??m nervous that they will make my already low libido worse.