T Nation

How to Raise E2?


#1

Im 32 years old on TRT and I’m hoping for some advice on how i could go about raising my e2.

I have been on trt to treat secondary hypergonadism (cause unknown) for nearly 2 years.

I have been VERY slow to respond however I am now on 1000mg Test U (nibedo) every 6 weeks

My test is still way lower than where id like it to be but my endo is telling me its as good as i can get as he cannot increase the Nibedo frequency.

My current Serum T is 14.7 nmol (424 ngdl)

right at the low end of “normal”

I am convinced that the main cause of most of my sides is actually low E2 - for pretty much the whole of the last 2 years my E2 is non existent <18 pmol range 99-192

I am not, or have ever been, using any anti-e medication

My Endo, like most in the UK don’t seem to be very experienced with TRT in young guys as I am continually being told “you don’t need to worry about low E2”

I know everyone seems to be more concerned with lowering rather than raising so I appreciate that its not a common problem to address. After researching I have come up with a few options that may work.

1 - Get my testosterone dosage higher, either by working with the doc or taking matters into my own hand. I am guessing that if I were to add another 100 - 200 mg test per week for a few months then it should push me to the higher end of “normal” and in turn I should convert some of that test into E2. I

If I raise the testosterone levels high enough to get my e2 in range, when I stop the additional test, will my e2 fall back to the levels I am at currently ?

2 - Use HCG. I have read many reports of people using HCG within a TRT protocol to keep the boys working and in turn using HCG will raise my E2

The main drawbacks I have with this one is that HCG is not available in the UK as part of a prescribed TRT so like option 1, i’d be taking things into my own hands but I’m not familiar with HCG use and I’m ideally looking to take something that will raise my E2 and keep it there.

3 - Taking DHEA. I have read a few articles with people claiming success in raising E2 by taking DHEA 50-100mg per day

4 - Adding some D-bol. I know this is a bit leftfield but I would assume that taking a high aromatising compound like D-Bol it would defiantly raise my E2, again though if I stop taking the D-Bol will my levels drop to their current level? I was thinking about taking 15-30mg of Dbol for 10 days and then testing my blood, if E2 looks good (and I feel good) then discontinue and hope the e2 stays where it is.

I know most guys are trying to lower theirs but trust me, low E2 sucks and I’m getting so fed up of feeling like this.

Any thoughts or ideas would be greatly appreciated.


#2

Your lab results are largely determined by when you do the labs! Labs after 6 weeks are rather useless. You cannot get FT tested there. Get SHBG tested.

Please post all available labs with ranges.

Transdermal T has the highest T–>E2 potential of all T delivery methods. Gels the most, creams are a bit less.

Pre-TRT, did you test?

  • LH
  • FSH
  • prolactin
  • to try to find the cause? At your age, low-T is symptom, not the disease.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.


#3

I get my injections every 6 weeks now, my blood is tested periodically throughout the injection cycle to ensure stability, which it largely has been.

Pre trt the only thing my endo tested was serum-T. i know all of these things should have been tested prior to starting, unfortunately at the time I still had faith in the medical community and, naively, trusted doctors blindly. I didn’t take any AAS or anything so all this was completely unknown. Might be worth pointing out that i’m based it the UK, TRT is extremely immature here, the general view is that if your in “normal” range you are fit and healthy. Ive had to kick and scream to get anything other than serum T tested, even at that it depends on who i get on the phone. I would love to address the cause rather than treat the symptoms but i’m not a doctor and the practice in the uk is to treat the symptom and cheaply as possible. It took me nearly a year to even get to see an endo.

The TRT treatments in the UK are Tosteran Gel daily or Nibedo injections (Test U) every 12 weeks usually.

I was on the gel at first, all the gel did was wipe out what was left of my natural production I didn’t absorb it properly so I got no benefit from the gel, after being on the gel for 2 weeks I went from 400ng/dl to 125ng/dl which is why I was moved onto Nibedo which to be frank, I do not feel is working.

Pre TRT

LH - 6iu\l (Range 2-9)
FSH - 2iu\l (Range 2-12)
Prolactin 273 mu/L
Serum T 14.2 (8.7 - 29.00)
E2 - Not Tested
SHBG - Not Tested

Last Results

LH - <0.1 (Range 2-9)
FSH -<0.1 (Range 2-12)
Prolactin Not Measured
Serum T 14.9 (8.7 - 29.00)
E2 - <18 (range 99-19)
SHBG - Not tested.

I will post latest bloods next week but as you can see, 2 years on being on TRT and my blood work looks worse than it did in the first place. Don’t get me wrong, I feel a wee bit better on TRT but not significantly but i’m sure most of what was diagnosed at “low T symptoms” is actually due to Low E2 but hey, im not a doc so what do I know.


#4

No problem here: The normal values for prolactin are: Males: less than 20 ng/dL (425 mIU/L )

Serum T may look OK, but if TT is dominated by high SHBG+T, FT can be quite low.

If you used some supplemental T-gel you might get your E2 up.

Many guys from the UK are iodine deficient. I asked that you eval thyroid function via oral body temps.