T Nation

First Labs, T @ 203, E2 < 5


#1

Hi Everyone,

My first post here. Just had blood work done, mostly out of curiosity, for the first time in my life. TLDR: total T at 203ng/dl and E2 < 5pg/ml, with everything else normal as far as I can tell. Images are below for anyone who cares to look.

I was hoping some of the knowledgeable folks here could help with interpreting these. Is it realistic that my E2 is naturally so low? My experience does match some of the specific symptoms of low E2, specifically clicking and popping joints (happens to me all the time, other people notice), and difficulty retaining water. The rest, like fatigue, are hard to judge.

Any help would be appreciated. These are my answers to the newbie questionnaire in case any of it’s relevant.

  • Age: 33
  • Height: 168cm
  • Waist: 31’’
  • Weight: 64.5kg
  • Describe where you carry fat and how changed: Always carried fat on hips. Abs visible despite not being particularly lean.
  • Describe diet: Normal, pretty healthy, balanced macros, weight stable for last 7 years at 2,350kcal/day.
  • Describe training: lift weights 3-4 times a week for 20 minutes, nothing serious.
  • Testes ache, ever, with a fever?: No.
  • Rx and OTC drugs, any hair loss drugs or prostate drugs ever: None.
  • How have morning wood and nocturnal erections changed: I don’t have those, can’t remember the last time I did. Libido has decreased over the last few years from high to basically zero.


#2

Started TRT a few days ago as an experiment to see if it would help with libido.

The regimen is 100mg TE/week, 500IU hCG/week and 0.35mg Anastrozole per week (to be adjusted). I made a solution of 20mL vodka to 1mg Anastrozole so that a 0.2mL pipette (smallest I could find on ebay) corresponds to 10ug Anastrozole. That allows me to easily dose the Anastrozole daily and to vary it in 10ug/day increments.

I got another set of blood work results today (sample taken yesterday at 11AM). They showed total T at 1154ng/dl and E2 still unmeasurably low (< 5pg/ml).

The T result makes sense, though it’s higher than I thought it would be. I doubled up the first dose, injecting 200mg Friday last week in an attempt to achieve stable levels more quickly. From now on I’ll be using 50mg twice per week.

I suppose the repeated low E2 result means my E2 really is very low and the first wasn’t an error. On the basis of that result I’m going to forego the AI and wait a week or two to see if the TRT brings my E2 up (I don’t really see how it couldn’t).


#3

Sounds like a good plan. Any symptoms from the low E2?


#4

Hard to say since it’s presumably been like that for most of my adult life. I do get cracking joints a lot which can apparently be due to low E2. Also difficulty retaining water. Physical fatigue quite regularly, but that could just as easily be psychological.

Then there’s the absence of libido - higher T doesn’t seem to have affected that yet, but I live in hope :slight_smile:


#5

I would just urge you to monitor your E2 levels closely. Getting near 22 and keeping it there is not as easy as it sounds. I’m pretty sure your E2 will rise while on T. You will go from low to normal to high E2. So monitor and pay attention to that time where you feel great.


#6

Thanks. I’ll feel reassured when I get a non-zero E2 result back, even if it’s low, so that I know the first two labs weren’t bogus and I’m on an upward trajectory. In any case I’ll post my progress here.

By the way, is 5-10pg/mL/week a reasonable guess for how fast E2 might change?


#7

As far as I know, there is no formula for determining how quickly your E2 will rise. That’s why I would go by how you feel. Once you begin feeling better you can test.

Most guys need about 1mg of anastrozole for 100mg of T cyp to keep the E2 in a good range.

The idea is to stay on a protocol long enough then do labs and adjust. It’s gonna be a little tough for you because your E2 is going bot be a moving target for awhile.


#8

Feeling better after stopping the Anastrozole completely. I was starting to get fatigue to the point that I would have to go to sleep in the middle of the day, but that seems to have gone now and I feel pretty good.

I got tested again the day after stopping AI, out of curiosity. The results came back today: total T 471ng/dl, E2 still unmeasurable.


#9

Very curious. Please keep us updated.


#10

Just a quick update for anyone keeping score. Labs from yesterday came back with total T at 825ng/dl and E2 at 6.27pg/mL. At least I’m registering on the scale now!

I’m still on TRT, having upped the dose to 120mg Test E. per week which seems to have worked to put me in the high-normal range for total T. Still not taking any AI.


#11

FT, not TT, drives T–>E2

FT drives up SHBG and SHBG was not low. So SHBG stands out as relatively high.

fT3 and fT4 should be mid-range. fT4 was not.
Have you been using iodized salt or are you deficient?
Get cold easily?
Outer eyebrows sparse?
fT3 is the active hormone and should be tested.
See thyroid basics sticky, second post, first forum topic.


#12

Thank you guys for taking the time to look and for your advice, I appreciate it.

KSman, thyroid issues hadn’t ever crossed my mind but I’m certainly open to ideas. Thermometer came in the mail today. At 7PM oral temp was 97.47F but I know that doesn’t mean much, I’ll get some waking and afternoon readings over the next couple of days.

My eyebrows are indeed going bald at the edges. Not sure about the cold. Lymph nodes have been swollen for years for reasons unknown, not sure if that could be relevant. I’m not using iodized salt, I’ve honestly never noticed it for sale here.


#13

Oral temperature at 8AM was 35.81°C (96.46°F).


#14

Lymph nodes have been swollen for years? Are you sure you don’t have lipomas?
Swollen lymph nodes are typically soft and rubbery, lipomas are typically harder with more defined edges.
I would get your PCP to look at them.


#15

They are soft and inflate and deflate periodically so I’ve always assumed it’s something bacterial I never quite shook, but you’re right that I should get them checked out, thanks. I mentioned it in the context of thyroid because I noticed protein buildup in the lymph nodes on a list of hypothyroid symptoms.


#16

No need to use Arimadex with low E2. You are on the right track dropping it and monitoring your results to see if E2 rises to unwanted levels.


#17

See if someone else can get 98.6 on the thermometer, a confidence thing. These things are cheaply made.

Where are you?
In USA, iodized and not-iodized salt are sold on the same shelf in almost identical packaging.

Get iodized salt and throw out what you have at home and dump the salt shakers too.
When deficient and adding iodine to your diets, it is very important to have an identified source of selenium in your diet. Often in a multi-vit.


#18

One month into TRT, E2 is now 9.7 pg/ml, total T 578 ng/dl. SHBG up slightly at 41.48 nmol/L.

In other exciting news my left nipple is sore.


#19

Thanks for the thyroid advice. I had assumed my iodine was OK because I drink half a litre of milk every day, but I’m switching to iodized salt just in case. The morning temps were consistent for 3 or 4 days, but I haven’t been able to verify the accuracy of the thermometer.

For reference I had a thyroid test done which came back:

  • TSH: 1.63 mIU/L (0.270 - 4.200)
  • Free T4: 15.65 pmol/L (12.000 - 22.000)
  • Total T4: 98.6 nmol/L (59.000 -154.000)
  • Free T3: 4.43 pmol/L (3.100 - 6.800)
  • Thyroglobulin antibody: < 10 IU/ml (0.000 - 115.000)
  • Thyroid Peroxidase Antibodies: 6.62 IU/ml (0.000 - 32.000)

#20

Your free T would be low, you should increase dosage and your free T and e2 will rise to more adequate levels .