T Nation

First Labs on TRT - Your Take on Total Estrogens and Lab Test Timing?

Hey guys, thanks in advance for the input. I am happy that forums like this exist.

2 Questions for you today (lab results below):

1) I just got my first labs back and they did not run E2 (despite my specific request), just Total Estrogens. I may have to wait some time before I get labs again, so it’s all I have for interpretation for now.

How would you interpret these results? I’ve read a moderate amount of the E2 data (including rational for not taking an AI) on this site, but not much is mentioned about using Total Estrogens as input. How much of my total may be E2? Will the other estrogens (E1 and E3) increase from TRT?

2) I am going to switch from 200mg Test Cyp injected SubQ twice per week to three times per week. Hopefully this will lower my Estrogens a bit?

My question is - How does injection timing affect your interpretation for lab results. Most doctors say to inject once per week and come in right before your next injection is due to give blood for labs (to catch all numbers at their lowest point for the week). However, if you inject 2-3 times per week, your labs will not reach lows as much as the once per week person. Moreover, if you inject multiple times per week, you may have less aromatization of E2, thus, lab values will not be comparable anyways. I wondered how others approach this.

40yo Male
5’9 185#
Pre TRT Labs (6 months ago):
Total T: 281 (350-882 ng/dL)
Free T: 6.9 (3.5-15.5 ng/dL)
SHBG 21.3 (13.3-89.5 nmol/L)
Estradiol, sensitive 15.08 (15-31.5 pg/mL, males)

6 months post-TRT labs last week:
Total T: 1068 (350-882 ng/dL)
Free T: 35.1 (3.5-15.5 ng/dL)
SHBG 15.6 (13.3-89.5 nmol/L)
Total Estrogens 133 (High) (40-115 pg/mL, males)

-Liver, Cholesterol, Thyroid, CBC, PSA all good

Thoughts on question 1 or 2?


Cos it’s not helpful. I wouldn’t make any decision based on total. Just see if you can get e2 ran alone

And most of all, how do you feel when compared to pre-TRT ?

Anything worth mentioning for the better or worse ?

I would not put so much focus on the number. While interesting, I see little association between symptoms and numbers. I spoke with a guy last week who had his E2 come back at 144 (<39), he is feeling great. Spoke with a guy yesterday who is having trouble with his E2 at 42.

If you are not responding well to TRT, you’ll need to change something.

Once moving from two to three injections a week, the timing of the blood draw is less of a factor, I tell guys doing that to go anytime. Once or twice, I prefer the day of the injection, prior to it.

Nobody tests Total Estrogens because it tests all estrogens in the body rather than the estrogen test that is more useful.