T Nation

High Total Estrogen from High E1


#1

I have been on trt for over two years now and can't seem to get everything in line.
I started off as many with 200 mg shot every 2-4 weeks, eventually switching to self injections of 100mg testosterone cypionate per week. I felt better but not great, libido swing mostly so I had labs and sure enough total estrogen was 115 on a scale 40-115. All of my labs are from labcorp. I persuaded my doctor into prescribing arimidex, I used 1/4mg every other day and lowered my e2 too low to 10 and total estrogen to 77 in less than a month.

I Had aching joints and no libido at all. I didn't bother to have total estrogen checked since all I have read is that e2 is all that matters. I have also added 250iu of hcg subcutaneous injection the day before shot and increased frequency to every four days at 60mg per injection. E2 has remained low no matter how little arimidex I take so I stopped using it completely for one month and e2 rose to a near perfect 20. Below is a list of my most recent labs.
Total testosterone 721 348-1197 range, two days after last injection of 60mg
Free test 23.4 Range 6.8-21.5

Dht 58 Range 30-85
Shbg. 17.4 Range 16.5-55.9
Prolactin 10.1 Range 4.0-15.2
Cortisol 17.1 Range 2.3-19.4 lab at 10am
E1 70 Range 12-72
E2 20 Range 3-70
E3 <0.1 Not estab.
Total estrogen 161 Range 40-115
TSH. 3.44 increased from 1.16 after switching from synthroid to armour synthroid 30 days ago
Increased armour to one grain from 3/4 grain. Was on dose of .088 synthroid.
My total test numbers have fluctuated greatly on the 60 mg inj every forth day.
Lab one day after injection. 517
Two days after. 1009 and 721
Three days after 679 and 616

I am at a loss of what to try next, doctor suggested 1/4 mg arimidex once per week but I don't think e2 is the problem it's the e1. I think I am going to reduce down to 40 mg every four days and do the hcg 250iu only once per week. When I switched from synthroid to the armour thyroid I felt great for about a week and slowly my energy level has decreased as my TSH has increased.


#2

Some are anastrozole over-responders and need to take 1/4th the expected dose.

Anastrozole levels in your blood [serum] need to match current bio-available or free T levels. You can’t take anastrozole once per week.

Please see these stickies and see if they are helpful:

  • advice for new guys
  • protocol for injections
  • thyroid basics

Please check your waking and mid-afternoon body temperatures. These can be useful as a dosing guide.

Could your thyroid problems have stemmed from an iodine deficiency?

Some estrogen imbalances can be caused by being overweight or adverse gut bacterial that convert estrogen metabolites in liver bile into estrogens that are then reabsorbed. Any digestive issues? You could try a good quality pro-biotic. [Many probiotics are not very good.]


#3

Thanks for the quick reply. I don’t have any digestion issues and I have never been checked for iodine deficiency. I switched to armour thyroid last month because I never felt real good on synthroid. The first week that I switched I felt great but over the last three weeks my TSH has crept up to over 3. I have increased my dosage by 1/4 grain last week to try to get TSH back to around 1.0.

I am most concerned with my total estrogen and elevated estrone levels. Do you think by reducing my dose to 40mg every fourth day would reduce estrogen. I do seem to feel best just before my next injection. Maybe I don’t even need the Arimidex or at the most 1/8 mg with injection. I am 47 years old and 6’3" tall, 248 lbs, 36" waistline. Should I be concerned with the other estrogens or just the e2?

Again thanks for any advice you can offer.


#4

I have a very similar issue with high total E. I’m on a pretty aggressive supplement protocol to lower it and will report back if I see any differences in labs. Like KSMAN mentioned gut health was what my doc said it could be. What’s your diet like?? Fixing the gut takes a lot of time, unfortunately.


#5

I eat a fairly healthy diet, very little fried food. I don’t have any stomach issues, maybe a little too regular when TSH is lower.
I have read other post that we should only concern ourselves with E2 and all the other estrogens would fall into place. Hopefully when I get my TSH back down I will feel better. Hard to tell if the way I feel is from higher TSH or increases total estrogens and high e1.

I plan to start injecting 40mg testosterone cypionate twice a week with 250iu of HCG and 1/8 mg arimidex and retest next month. I was pleased to see that my E2 was 20 at my last lab work without any arimidex, maybe my increased TSH is the problem.
I didn’t post T3 or T4 earlier but will list below.
TSH 3.4
T3 uptake 29 Range 24-39
T4 5.3 Range 4.5-12
Free thyroxine index 1.5 Range 1.2-4.9


#6

I am waiting on lab work to come in from draw last Wednesday.
Injecting 50mg testosterone cypionate on Monday morning and Thursday night along with 250 iu HCG and 1/8 mg
Arimidex. I tried using only 40 mg but energy level dropped before next injection. I think I am an over responder to the arimidex, I may not need any since my last labs showed e2 at 20 while I took a month off from the arimidex.

I was really just trying to lower my total estrogen and e1. I notice a little joint pain in my knees but the most troublesome thing was the blurred vission and trouble focussing on anything more than five feet away. Has anybody out there had blurred vision from low e2? Vission has improved in last couple of days probably because I skipped tha arimidex this past Thursday night. I will post new labs next week.


#7

Did you read the stickies that I suggested?

If you don’t have a history of using iodized salt, you are probably deficient.
My concern is always that one might have thyroid problems from an iodine deficiency then be put on Rx thyroid drugs for the rest of one’s life.

TSH is too high.
T4 is way below mid-range

Please check your waking and mid-afternoon body temperatures. These can be useful as a dosing guide.

You would be better off with:
TSH
fT3
fT4


Thyroid hormone uptake (Tuptake or T3 uptake) is a measure of the unbound thyroxine binding globulins in the blood, that is, the TBG that is unsaturated with thyroid hormone.[2] Unsaturated TBG increases with decreased levels of thyroid hormones. It is not directly related to triiodothyronine, despite the name T3 uptake.[2]


"This test is rarely used now that reliable free thyroxine and free triiodothyronine assays are routinely available."


#8

I have read the stickies and they have a lot of useful information, I appreciate all of your input. I think you are dead on with the iodine issue and I have started supplementing a multivitamin with 150mcg. I know it is a small dose but I have also added a little more iodized salt to my diet. I had a slight blood pressure issue so I had pretty much quit adding any salt to my food. I now take 50mg of cozaar and stay between 110-130 over 60-80. Since I missed my 1/8mg of arimidex with my last injection Thursday night, my vision is nearly perfect for a 47 year old. I don’t see my Endocronologist again until May but he will usually go along with what I request as far as testing and dosing. I will ask him to add the ft3 and ft4 to my next labs.

My temperature does stay at or just below 98.6 every time I have checked it probably because of the synthroid I was taking before switching to armour. My TSH was close to 1.0 before switching to the Armour thyroid and I suspect with the increased dose that I am close to that again. Again thanks for all your advice, I will post my new results this coming week.


#9

New results came in this morning, disappointed in the TSH results from armour thyroid. All results are normal but not optimal.
When I was taking Synthroid.088 my labs from 10-31-14 were see below.
TSH 1.16 range .45-4.5
T4 6.8 range 4.5-12
T3 uptake 28 range 24-39
Free thyroxine index 1.9 range 1.2-4.9

After switching to armour and increasing dosage to 1 grain which should be a higher dose than the .088 synthroid.
“Supposedly 3/4 grain equals .088” also supplementing with a multivitamin with iodine. The armour dose is divided into two
Doses per day, and was instructed to not take it on the day of my lab work.
Results are
TSH 2.64 range .45-4.5 ----------Last month results were 3.44
T4 6.2 range 4.5-12 ----------5.3
T3 uptake 28 range 24-39 ----------29
Free thyroxine index 1.7 range 1.2-4.9 ---------1.5

I have to say that the week after switching from Synthroid to armour, I felt 18 years old again and then energy started to decline.
Rest of results below.
Hematocrit 50.2 range 37.5-51 I donate blood regularly usually stays between 46-50
Total testosteron 735 range 348-1197 ,two days after injection of 50mg and 250iu HCG
Free test 15.2 range 6.8-21.5
Estradiol 15.2 range 7.6-42.6 “crap they did the wrong test again, not sensitive”. Is this good? 1/8 mg arimidex 2x week.
Estrone 59 range 12-72--------------- down from 70
Total estrogen 97 range 46-115 ---- down from 161
SHBG 18.3 range 16.5-55.9 ----------up from 17.4

******I was able to get the lab corrected so I should have the sensitive test posted shortly, will be interesting to see how they match up.


#10

Iodine and salt. You can get more iodine as supplements and use less salt.


#11

Estradiol came back at 13 range 3-70 so evidently I won’t be needing the arimidex that I needed when I was taking 100mg once per week. My estradiol went as high as 40 last year while doing weekly injections of 100mg without arimidex. I got my doctor to fax my lab work results that were done prior to starting on thyroid medication and found that though I was in range I was at high normal. By today’s standards I was hypothyroid 18 years ago but only diagnosed when my TSH rose to 6.6 in 2011. I switched to Nature throid this week and increased dosage to 11/4 grain, will retest in six weeks. Hopefully my total estrogen and e1 numbers will stay normal as well but from what I understand I really just need to be concerned with E2.


#12

We really don’t have much knowledge here about E1 and E2, why these might be high or low and the effects of that and how to change these and what benefits might exist. We have a lot of experience with E2 labs, effects of too high and too low, benefits of correcting etc.

Digestive issues, adverse bacterial flora*, can cause some reactivation of estrogen metabolizes in liver bile back into active estrogens and that can cause some adverse levels of E1/E2. Can’t recall the specifics.

  • Probiotics can be useful.

#13

New labs came in today, and I am disappointed once again with results. TSH decreased from 2.64 to 2.57 while increasing dosage of Naturethroid from one grain to 11/4 grain. Doesn’t make since because I was on a much lower dose (.088) of synthroid and TSH was at 1.16…
Dr. Is increasing dosage up again to 11/2 grain and will recheck in six weeks.
03-10-15 results below with range.
TSH 2.57------------- (.45-4.5)
T3 uptake 27---------(24-39)
T4 5.4------------------(4.5-12)
Free thyroxine 1.5–(1.2-4.9)
T3 free 3.1------------(2.0-4.4)******first time ever tested
T4 free direct .92----(.82-1.77)****first time ever tested

Testosterone and Estradiol also tested… 50mg of testosterone cypionate injection on Monday morning and Thursday evening.
Blood drawn at 10:00 Wednesday morning. Have used no arimidex for last six weeks.
Total testosterone 638--------(348-1197)
Free testosterone 18.3-------(6.8-21.5)
SHBG 19.7----------------------(16.5-55.9)
Total estrogen 145-------------(40-115)
Estradiol 41.8-------------------(8.0-35.0)***not same ranges as previous sensitive test.
Hematocrit 47.5----------------(37.5-51.0)
I know there is a correct combination out there, just wondering how long it’s going to take to get it right.
I am going to get pharmacist to compound my arimidex into 1/10mg dosages since 1/8 twice a week before took my E2 too low.
And go back to 60mg testosterone cypionate twice per week.


#14

What are your body temperatures telling you about your thyroid dose?

Your fT3 is mid range, if body temps are low, then rT3 might be the cause.

SHBG is very low, looking at everything else.

T seems low, seems like you need more.

What is your body weight? - might be a factor.

Thats the labs? How are you feeling? Whats different?


#15

My weight is currently 265 and I have a 36" waist 6’4" tall, could stand to loose 20 lbs.
I am going to increase back to 120mg per week, I was lowering to see if I could get by without taking arimidex.
My SHBG has been consistently low but never under range. Body temps are consistently around 98 degrees.
I will have labs again in 6 weeks, what else should be checked besides rt3?

Morning wood and libido have been better, Hasn’t woke me up like it did when I passed through my sweet spot. I knew E2 had to be creeping back up. Energy level is actually pretty good but trouble focussing and concentrating. I took 1/4 mg arimidex after I got results today and already feel a little better.
Will be nice to get one or the other adjusted so I can concentrate on one thing. Also subcutaneously injecting 250iu HCG the day before injection.