High Total Estrogens - Low Libido

Following up, here are my latest test - would love some feedback
SHBG is normal, estradiol is normal - estrone and total estrogens are high.

Testosterone, Serum A 521 ng/dL 264 - 916 01

Free Testosterone(Direct) A 20.3 pg/mL 8.7 - 25.1 01

Estradiol A 33.6 pg/mL 7.6 - 42.6 01

Testosterone, Total, LC/MS B 680.1 ng/dL 264.0 - 916.0 02

Estrogens, Total C 533 High pg/mL 40 - 115 02

Estrone, Serum B 160 High pg/mL 15 - 65 02

Sex Horm Binding Glob, Serum A 36.6 nmol/L 16.5 - 55.9

Did you change anything from the initial post where you were doing 200mg twice weekly?

i am doing 100mg twice weekly for a total of 200 mg per week. The test was done 4 days post injection.

You left out the entire reason why you sought TRT in the first place, symptoms. The numbers on their own mean nothing with knowing how well you are doing.

I a lot of guys get trapped into fixating on the numbers and lose sight of the main goal, symptom resolution and gym performance.

By the numbers FT is high normal and is most likely the inaccurate direct immunoassay, if so FT levels can be overestimated by 40%, but according to the Tru-T calculator your FT is 17.20 ng/dL (16-31 ng/dL) which is below midrange, symptoms or lack thereof then I would be able to judge your protocol.

If you have low libido and trouble maintaining erections, then my advice would be to increase injections frequencies, if no symptoms are present and you feel optimal, then do nothing.

Thanks for responding.

My symptoms are persisting. They have not changed since my original post. I would not be on here if i was symtom free - and I am not obsessed with numbers, just calling out what seems to be obviously high/off/not in range.

The original reason I got trt was low libido and poor erections in my 20s, which lead to testing testosterone (it was around 140 with two separate tests)

I dont mind increasing injection frequency, however before everyone said that is what to do with low SHGB - but mine is high-normal, so these two opinions seem to clash? Will more frequent injections raise free t? or does that require a dosage change?

Thank you!

This is not always true, I have heard first hand accounts of men with high SHBG feeling better on daily dosing, men with shorter CAG repeat length in the androgen receptor may notice declining levels between injections more than men with slightly longer CAG repeat lengths.

I’m more than likely have the shorter CAG repeat lengths because I feel the effects of the injection immediately where some men take several hours and even days to feel the effects, to me the reason is clear.

Looking at your E2, I would be interested in seeing free estrogen percentage, if high then my advice would be increase injection frequencies are slightly dose reduction (10-15%). Your FT levels are good, but FT converts to E2 and smaller more frequent injections will increase the testosterone->E2 ratios.

When men have their T->E2 ratio close together, it can take away perceived benefits, good mental clarity and positive mood. You might actually be slightly estrogen dominant because FT is is only slightly above midrange and E2 is towards the higher end.

There is no one size fits all, the notion that high SHBG men cannot inject daily/more frequently is just false in a world where everyone is biochemically unique.

You should be using Equilibrium Dialysis or Ultrafiltration in TT and FT testing, all other methods are inaccurate.

Weirdly I don’t really feel the effects of injecting at all. Or maybe it is so subtle i don’t notice it. I don’t have any issue injecting more often so can give that a try.

I definitely sense I am estrogen dominant - the tight scrotum/dick thing is one of the most annoying symptoms of this. Basically I feel “squeezed” most of the time and its extremely frustrating.

I have started taking NAC, Lemon Water, real cranberry juice to treat my liver hoping to eliminate more estrogens.

I will request the types of test you have listed at my next testing.

I don’t feel the effects either prius.

I’m currently on 30mg per day. I should feel SOMETHING?!

It’s like the injections are pointless.

Usually when someone says this I suspect thyroid issues, you need adequate thyroid hormones (fT3,rT3 <15 ng/dL) for TRT to be metabolized by the liver, otherwise TRT cannot work. You would need to check TSH, fT4, fT3, rT3 and both antibodies.

If you haven’t been injecting for at least 6-8 weeks, then your concern may be premature, this is how long it takes for the half lives to build up in your system and reach peak levels. There are some guys that are slow to respond to TRT likely do to longer CAG receptor repeat lengths, these men will see improvements every couple of months.

I notice the injection immediately, even at 7mg per day.

see thyroid results in my first post.
I can attempt to get additional testing in my next test for the other things you mentioned.

Just as a recap - TRT did work well for me but was thrown off when I did a blast, i just havent been able to get back to baseline. Ill try to be more patient for improvements.

Thanks again

You can have all the fT3 is the world, but if rT3 is high blocking fT3, then that’s no good. When I started TRT whenever pushing high TT levels I would lose the benefits of TRT, it took me about 3 years to learn I was iron deficient the entire time which led to other mineral deficiencies.

Did fixing your iron deficiency fix your high rt3? trt working well for you now?

I haven’t checked, at the time I didn’t know I was iron deficient and surprised rT3 wasn’t higher. I was able to bring it down to 17 ng/dL on daily injections, eating healthy and weight lifting all while iron deficient.

I stopped TRT about 4 months ago and having trouble treating iron deficiency, I’m allergic to oral iron. I may need iron infusion.

Currently hover between TT 97-120 ng/dL, 3 ng/dL FT and SHBG is 14, 22 on TRT. I’m highly functional, have erections and can’t stop staring at women. It’s not surprising that my hypersexuallity is not dead at theses levels.

I will only need TT 400 and FT 15 pg/mL to thrive.

Sounds like libido/arousal is def more neurotransmitter than anything.

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