High Free T and High Estrogen? Lab Work Inside

Hi there,

I was hoping I could get some assistance on my lab work. I am a 29 year old male. I’ve had three blood test in the past that showed testosterone levels all below 400 from my early 20’s. I’ve started noticing that I have been having most of the symptoms of low t (except that I can build muscle mass) so I had my doctor order me some blood work thinking I surely had low T. The results are below.

Free T- 167.2 pg/mL

Total T- 661 ng/dL

Estradiol- 52 pg/mL

TSH- 2.1

SHGB- 24

Cortisol- 11.2

PSA- 0.84

Vit D- 24ng/ml

B-12 - 623 pg/mL

Hgb- 14.9 gm/dL

My Free T and. Estradiol were both off the high range on my labs " normals". My doctor did not want to investigate the issue any further despite these lab abnormalities and my physical symptoms. Is this worth investigating? How can I have high free and total t & high estrogen?

I suppose it depends on how troubling your symptoms are for you. Without knowing specifically what is going on, I’d look at free T3, free T4, reverse T3 and prolactin. Maybe DHEA-S, IGF-1, cortisol?

Your SHBG is not high, so you have a decent amount of free test, at around 2.5%. With more free test, you aromatize more testosterone into estradiol than most.

Sleep, fatigue, erection strength and quality, libido, body composition changing in recent years, memory issues, brain fog, depression.

The only thing that doesn’t fit the picture is that I work out and gain muscle mass pretty easily.

I have been feeling down for years, so recently, I tried to mitigate the factors in my life that I could. This blood work was taken after no Booze for 90 days, no fast food, and no caffeine.

I feel that these symptoms are very troublesome. I assumed it was low T but apparently its not? Perhaps I am looking for an issue because of the skewed lab data?

That sounds frustrating. What’s your height and weight? Lifts?

I think I would run the labs again and get this:

Free test
Total test
free T3
free T4

Honestly, if I couldn’t come up with an explanation for those symptoms, I’d say screw the numbers and give TRT a shot, on a purely functional basis. Some TRT doctors will go more on that than labs numbers. The problem may be finding one. Very small chance, if any, that you’ll get a PCP, endo or uro to think that far outside the box. Age 29, poor libido, erection issues, fatigue, no, not an option. Unacceptable. Good luck.

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What is your BF%? You have good T numbers. Your symptoms are most likely a result of your elevated estrogen.

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5’7 160 Lb

Squat - 285
Bench - 265
Deadlift- 385

I posted most of those labs above. Thanks for mentioning the other labs. I was also curious about what other labs I should ask for.

I am not sure how relevant this is, but I had surgery 5 months ago on two herniated disc in my neck. I lost most of my left tricep, lat, and pec.

Still, I think that my estrogen is too high but not sure how to correct it, seeing how the free and total test are good.

However, I have heard that a high free test can be symptomatic, just as high estrogen can be symptomatic.

My primary would not refer me to a endo.

I normally run between 10-12 %. Within the last year, I have been hanging out around 14-16%.

Previously, I have had borderline low testosterone results with fairly elevated estrogen levels. However, the high estrogen was always within " range". This estrogen is much higher, as is the total testosterone.

I suspect I am estrogen dominant, but I can’t find a clear answer of how to manage it aside from the lifestyle changes I have already implemented.

Well, 14-16% is not a bad body fat percentage. But as you said, you appear to be estrogen dominant. If you used to be closer to 10% BF, then try get there again. Aromatase is highly concentrated in fatty tissue. You may be an outlier on the high side of this concentration level. Move to a more vegetable rich diet. Supplement with dim/boron/zinc/copper. Get your hands on some Cialis for erection issues(Cialis also reported to lower estrogen) and reevaluate with new bloodwork in 8 weeks.


If anything your estrogen is high, anything 35> is considered high for a man, the ranges you provided for estrogen means you’re using the older Roche ECLIA methodology which was never intended for men as far as the ranges go. So you are in fact out of range and estrogen dominant.

Your diet and lack of exercise routine could be to blame, extra body fat can see the amount of aromatase enzymes increase in belly fat which means more T can convert to estrogen. Your testosterone labs are great and FT is very good because SHBG is on the lower end, but if you start cutting to look lean, SHBG could increase deactivating your bioavailable testosterone.

@dbossa I would love to hear dbossa’s infinite wisdom about how high estrogen is of no consequence. This guy here is a perfect example of a natural man with (estrogen dominance) high estrogen experiencing symptoms with perfect testosterone labs and estrogen out of range.

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That is not accurate.

The ECLIA test (aka immunoassay or IA) for E2 management is commonly used for those on TRT. It is not an incorrect test or a test for women, but simply one way to check estradiol levels. The other commonly utilized test is the LC/MS/MS method (aka liquid chromatography dual mass spectrometry, sensitive or ultrasensitive). It is the more expensive of the two. There are inherent advantages and disadvantages to each of these two methods. I have been fortunate to be able to speak with professionals who work with both methods. One is a PhD researcher for Pfizer and the other is a medical doctor at Quest. I’ll summarize their comments.

The ECLIA method is the more reliable of the two in terms of consistent results. The equipment is easier to operate thus accuracy is less reliant on the skill of the operator. If the same sample were to be tested twenty times, there would be very little, if any, difference in the results.

The ECLIA method is not as “sensitive” in that it will not pick up E2 levels below 15pg/mL. If your E2 level with this test is 1-14pg/mL, the reported result will be “<15”. Because of this, it is not recommended for menopausal women, men in whom very low levels of E2 are suspected, or children. In other words, if your levels are below 15pg/mL, and it is important to know if the level is 1 or 14pg/mL, you do not want this test. For us, this is likely moot, since if you are experiencing low E2 symptoms and your test comes back at <15, you have your answer. For a woman being treated with anti-estrogen therapy for breast cancer, it may be necessary to know if the E2 level is zero or fourteen because therapeutically, they want zero estrogen.

A disadvantage to IA testing is that it may pick up other steroid metabolites, which in men would be very low levels, but still could alter the result. Another potential disadvantage is that elevated levels of C-reactive protein (CRP) may elevate the result. CRP is elevated in serious infections, cancer, auto-immune diseases, like rheumatoid arthritis and other rheumatoid diseases, cardiovascular disease and morbid obesity. Even birth control pills could increase CRP. A normal CRP level is 0-5 to 10mg/L. In the referenced illnesses, CRP can go over 100, or even over 200mg/L. Unless battling one of these serious conditions, CRP interference is unlikely.

The LC/MS/MS method will pick up lower E2 levels and would be indicated in menopausal women and some men if very low E2 levels are suspected and it is desired to know exactly how low, children and the previously mentioned women on anti-estrogen therapy. It will not be influenced by elevated CRP levels or other steroid metabolites.

While some may believe the ECLIA test is for women, on the contrary, as it pertains to women on anti-estrogen therapy, such as breast cancer patients, the LC/MS/MS is the test for women as CRP levels are a consideration and it is necessary to know if the treatment has achieved an estrogen level of zero.

On the other side of the coin, LC/MS/MS equipment is “temperamental” (as stated by the PhD who operates both) and results are more likely to be inconsistent. Because of this, researchers will often run the same sample multiple times.

It is not clear if FDA approval is significant, but this appears on Quest’s lab reports: This test was developed, and its analytical performance characteristics have been determined by Quest Diagnostics Nichols Institute San Juan Capistrano. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes. This statement is on LabCorp’s results: This test was developed and its performance characteristics determined by LabCorp. It has not been cleared by the Food and Drug Administration.

It is unlikely that any difference in the same sample run through both methods will be clinically significant. Estradiol must be evaluated, and it should be checked initially and ongoing after starting TRT. It obviously makes sense to use the same method throughout. Most important are previous history and symptoms related to low or high E2. Those are correlated with before and after lab results. Any estradiol management should not be utilized without symptoms confirmed by lab results.


You really need to stop cluttering this copy and paste garbage in people’s threads everytime I take up my position on estrogen testing. I never mentioned anything about the cost differences, sensitivity, just the ranges.

So because you have a few words with as lab tech now you’re the expert on the subject, please!

This is getting old Highpull and you are beating a dead horse.

Skip it then. Perhaps this guy has not seen it. You get to state your position, but I do not? This is not systemlordforum last I checked. You need to stop some of your incorrect statements. It is getting old. Until you do, if I catch them, I’ll respond.


Interesting you mention this. My erection quality is poor despite taking a daily dose of 5mg Cialis. I have taken this low dose for years and it always made a difference. Now, I feel little difference in term of erection or pump in the gym.

I have maintained a healthy weightlifting and exercise regimen for 10 years or so. I am not concerned about that aspect of my life. Furthermore, These lab values were drawn after me eating a healthy diet and no fast food for 90 days. That is what has me concerned.

How would I go about correcting this if an endo won’t see me? Get more labs? Estrogen blocker? Clomid? TRT?

You weren’t addressing him, you were addressing me, nice attempt to deflect. You are simply protesting like you always do. The regular members aren’t fooled.

TRT is for those with low testosterone,you don’t have low testosterone, you have plenty of hormones to go around, but there is an imbalance. If you were to go on TRT your situation will go from bad to worse.

An estrogen blocker is to be avoided if you can help it, estrogen blockers are used for men off label for TRT and are only FDA approved for women. Blocking hormones has consequences, even hair loss drugs that block DHT, another form of testosterone can have severe consequences.

All I know is it will be next to impossible for you to get anastrozole from a sick care doc, you might have to seek care from an anti-aging clinic if you’re unable to lower estrogen by other means. A competent doctor would be prescribing no more than .125 anastrozole 1-2x weekly, any doctor trying to give you .5-1mg anastrozole, run don’t walk out of that place.

You don’t want clomid because it increases estrogen and blocks estrogen in the brain, estrogen is needed for libido and libido is in the brain.

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No, it’s his thread. I was addressing a comment in his thread that was inaccurate and referenced the comment so he would know where mine was coming from. I am assuming he reads posts in his own thread. It’s not all about you. I know you have read that previously and I know what you think about it. I do not expect you to change you mind. Regular members can make up their own minds, some understand and have appreciated that essay. If it makes sense to you, fine. If not, then move on. It’s ok.

You shouldn’t have to think too hard to recall times I have agreed with you, so your “always” comment is, again inaccurate.

@systemlord you’re a waste of my time. I’ll reply for the benefit of the OP. I’ve explained this in every way imaginable and you just fail to grasp it over and over again.

Perfect numbers? What the fuck are perfect numbers?? Perfect numbers for who??

His free T is 16 ng/dL. He has low testosterone symtoms. So what do you do? I know a ton of men, including myself, who have symtoms with free T anything under 30. What would you do if the guy reported low testosterone symptoms but had no means of measuring what his serum levels were? You would give the man testosterone!

What is your obsession with numbers?? Who gives a rat’s ass what his numbers are? If he had diabetes would you control dose based on numbers or how he feels? How about pain meds? How about anything? Why is testosterone different? His estrogen is of zero consequence.

Get your head our of your ass by analyzing every Tom, Dick, and Harry who comes into this place where you immediately compare him to your 7mg a day protocol. It doesn’t work. Stop analyzing numbers. A retarded monkey could look at numbers on a lab report.

When you have symptoms of low T you try a round of testosterone. You determine dose by increasing slowly over time until you feel better.

Why is this concept so unbelievably difficult for you to grasp?

If you were on a deserted island, with no access to labs, but limitless supplies of testosterone, would you not take it if you had symptoms of low T because you would obsess about what the number might be? What’s wrong with you?


Do you not see his body is converting testosterone down other pathways? Testosterone can be converted to FT, estrogen and DHT. His SHBG is on the lower end and Total and Free are good, but estrogen is high.

If we go with your recommendation, his issues will be magnified and the imbalance be worse because his body is out of balance.

As for his free being at the higher end of normal, I’ll have to take his word because no lab ranges were provided because new guys have no idea every lab has different ranges do to a lack of standards.