T Nation

High E Levels, First Test, 4 Weeks Post-TRT


#1

Hoping anybody can help on this.
40yo M, 240lbs, 20%BF.

I had a blood draw on 12/30, and had not had a T injection (50mg/e3d) for about a month following 2 hospital stays, and missing a follow-up with my Endo.
Endo is an old-school doc, started seeing him because of insurance coverage in Nov. 2013.
Eventually got to TRT after some prodding for fatigue, started inj. in May'14. He never ordered any kind of tests for E because "if my T is low it wouldn't raise my E to counteract." So, no AI of any kind during this run. And thus...
The 12/30 blood draw results came back, and had the following results.

T = 155
PSA = 5.1 !!
E1 = 448 !!!
E2 = 23.3
E = 47145 !!!! WTF??!?!??!

  • So now he's freaking out, too. I have to imainge there's been a huge mistake in the lab or else I'm growing ovaries, or the doc's protocol w/out AI and HCG has set me back to a place worse than when I started.
  • I haven't been watching any Hallmark channel, if that matters.
  • All the low-T symptoms are back, and I'm finished with this doctor's protocol and have a new doc selected who is well-versed in the Trifecta.
    In the meantime, I have been taking DIM, and an OTC PCT supp, but know that won't work as well as the real-deal.

Any addressing of these numbers would be greatly helpful, from KSMan or anybody who has seen this before.
Thanks gang.


#2

Please STUDY the advice for new guys sticky.

Need more info. Your crazy E levels suggest that your liver is not metabolizing estrogens properly. Also your gut flora may be messed up where estrogen metabolites in the liver bile are converted back into estrogens and reabsorbed.

What happened in the hospital might be important info. Drugs, antibiotics, infections etc.

We need labs in list form with LAB RANGES.

Post all labs:
TT
FT
E2
LH/FSH [when not taking T for a while]
CBC
hematocrit/HTC [typically part of CBC
fasting glucose
fasting cholesterol
TSH
fT3 [please not T3, T4]
fT4
AST/ALT [liver]
CRP [general inflammatory marker]
homocysteine [marker of cardiovascular inflammatory processes]
vit-D25
AM cortisol [at 8AM please]

Any drugs in hospital that could damage liver?
Major doses of antibiotics?

Find a good probiotic that has many different types of bugs, better ones will be in a dedicated health food store and refrigerated. May have to take for a while to shift population of gut flora. If taken right after an antibiotic "reset" the outcome would come quickly.

Ask to get labs from docs and hospital.

You need a prostate DRE and perhaps an ultrasound scan.


#3

Thanks again KSman - you are doing us all a great service.
1) 1st trip in the hospital, lung issue, docs thought Pneumonia, and hit it hard with antiobiotics (Tamiflu for 3 days, Amoxicillin, Zythromycin).Total dosing was about 20 days. That flattened my gut bacteria, and I got c-diff from that.
2) 2nd trip, same issue, docs find it to be an allergic reax, no antibiotics this time. Heavy prednisone (from 120mg/day to 50mgday-current) to drop inflammation.
3) I do have an appt with a urologist next week, and both DRE and ultrasound are scheduled.

Here are the results I do have at the moment.
TESTED FOR RANGE RESULT Date
TT 348-1197 ng/dl 155 December 30, 2014
FT 40-250 ng/dl 43.9 August 12, 2014
E2 7.6-42.6 pg/dl 23.3 December 30, 2014
LH/FSH 1.7-8.6 mIU/mL 1.4 December 19, 2014
CBC
hematocrit/HTC 37.5 - 51.0 % 48 December 30, 2014
fasting glucose 70-200 mg/dL 86 December 9, 2014
fasting cholesterol - - -
TSH .45-4.5 uIU/Ml 1.78 December 24, 2013
fT3 [please not T3, T4] - - -
fT4 - - -
AST/ALT [liver] - - -
CRP - - -
homocysteine - - -
vit-D25 - - -
AM cortisol [at 8AM please] 2.3-19.4 ug/dL 10.2 March 27, 2014

Testosterone Results:
Range; 348-1197 ng/DL
date of Test
12/24/2013 357
3/27/2014 409
5/6/2014 335
6/17/2014 799 (1mo on TRT)
8/12/2014 141 (no T for 3 weeks)
9/10/2014 403 (on T, prior to inj)
12/19/2014 178 (no T for 4wks)
12/30/2014 155 (no T for 5wks)
(haven't tested free T since 8/12/14)
====
Thanks again, will dig up what I can.


#4

You low T levels make you very estrogen dominant. Get the AST/ALT labs done. You have secondary hypogonadism. So you can explore a proper PCT or HPTA restart.

Do the probiotic.


#5

Had the DRE, all's good there. Had appt with a bonafide TRT/naturopath doc yesterday to assess and plan for the best path forward.
Thanks again for your input!


#6

Blood draw on 1/15