T Nation

Looking to Normalize Hormone Levels

Hi everyone,

New guy, new doctor, new bloodwork, new questions.

New Guy Stats:

  • 26 years old

  • 5’8"

  • 162 lbs, ~ 10-15% bodyfat, athletic and muscular, but a little doughy. I carry fat on my chest, lover’s handles, and belly. It’s been carried in the same spots as long as I remember, but I had 6-10% bodyfat until maybe 3-4 years ago, so it was not apparent. I have gynecomastia which I’ve had since puberty, grade 3 by Cigna standards.

  • size 30 jeans, loose fit

  • Head hair is full, wavy, individually thin but dense. No going bald (yet) but hairline is a little higher than it was 10 years ago.

  • Chest hair is between Pecto-infraclavicular and Pecto-Sterno-infraclavicular.

  • Abdominal hair was sagittal (trail) growing up and is acuminate (Tapered or V) now

  • Facial hair is thick and dark on my chin, becoming thinner with some patches along the cheeks. Mustache is complete but very light in color.

  • Pubic hair is fully developed.

  • Arm and Leg hair is full, blonde, and individually thin but dense.

  • No major health conditions or symptoms other than gyno. Was on Adderall for a year from 12-13 but not since. Did a lot of drugs when I was 16, 17, 18, but got clean about halfway through 18 and have been since. Drink a bit more than I should but I also have high standards for myself.

  • NOW ON NOLVADEX. Please see bottom of post.

  • Diet is pretty good. Protein supplements added to a good diet with low sugar, and a 30/30/40 to 25/25/50 fat/carb/protein ratios. Avoid processed foods for the most part. Drink beer occasionally. Liquor rarely.

  • Workout is pretty good. I workout 3-7 times a week, 4 on average. I rotate muscle groups / types of exercise like this:
    Day 1: Run a mile, Biceps, forearms, shoulders, traps (upper), pecs, abs
    Day 2: Run a mile, triceps, traps (lower), Teres, lats, obliques, hamstrings
    Day 3: All core day (usually only half the length of a normal day)
    Day 4: Leg press, leg extensions, adductors, calf raises, (a bit shorter of a workout, but also lots of sets)
    Day 5: Run a 4.5 miles
    Other days: generally some combination of squat/deadlift/bench/barbell row/overhead press.

I normally hit days 1, 2, 4, and 5 in any given week.

  • Testes don’t ache
  • Morning wood … yeah … I don’t get that anymore. Probably did in high school. It has seriously and literally been years … last I remember it would fade immediately, too. Don’t even have erections when I wake up in the middle of the night really having to pee.

Test Results:
Hormones:
Component Standard Range Your Value
ESTRADIOL <47 pg/mL 49
TESTOSTERONE,TOT SRM 241.00 - 827.00 ng/dL 430.83
TESTOSTERONE,FREE 47 - 244 pg/mL 152.1
HCG,TUMOR MARKER <4 IU/L <1
LH,SERUM 1.2 - 8.6 mIU/mL 4.1
TSH 0.340 - 5.600 uIU/mL 1.503

Lipid Profile:
Component Standard Range Your Value
CHOLESTEROL 0 - 200 mg/dL 178
TRIGLYCERIDES 0 - 150 mg/dL 98
HDL CHOLESTEROL 40 - 59 mg/dL 54
LDL (CALC) 0 - 129 mg/dL 104
<100 Optimal
100-129 Near or above optimal
130-159 Borderline high
160-189 High

189 Very high
CHOL/HDL RATIO 0.0 - 6.7 3.3
TRIG/HDL (CALC) 1.8
NON-HDL (CALC) 124

Comprehensive Metabolic Panel:
Component Standard Range Your Value
SODIUM 136 - 144 mEq/L 139
POTASSIUM 3.6 - 5.2 mEq/L 4.3
CHLORIDE 101 - 111 mEq/L 104
TOTAL CO2 22 - 32 mEq/L 26
ANION GAP 5 - 15 9
GLUCOSE 60 - 99 mg/dL 92
Normals are for fasting, no normals for random.
UREA NITROGEN 8 - 20 mg/dL 19
CREATININE 0.5 - 1.5 mg/dL 0.9
CALCIUM 8.9 - 10.3 mg/dL 10.0
PROTEIN, TOTAL 6.1 - 7.9 g/dL 7.1
ALBUMIN, S 3.5 - 4.8 g/dL 4.5
GLOBULIN 2.3 - 3.8 g/dL 2.6
A/G RATIO 1.0 - 2.0 1.7
BILIRUBIN, TOTAL 0.3 - 1.2 mg/dL 1.0
AST(GOT) 15 - 41 U/L 27
ALT (GPT) 17 - 63 U/L 28
ALK PTASE 38 - 126 U/L 46
EGFR >60 mL/min 102
EGFR (BLACK) >60 mL/min 123
eGFR imprecision is increased for values greater than or equal to 60

CBC with Diff (ABS-%)
Component Standard Range Your Value
WBC 4.0 - 10.0 th/mm3 6.5
RBC 4.40 - 5.70 mil/mm3 4.63
HGB 13.0 - 17.0 g/dL 14.8
HCT 39.0 - 51.0 % 42.6
MCV 81.0 - 100.0 fL 92.1
MCH 27.0 - 35.0 pg 32.1
MCHC 32.0 - 37.0 g/dL 34.8
RDW <15.1 % 13.4
PLATELET CT 150 - 400 bil/L 267
POLYS-AUTO % 40.0 - 75.0 % 56.9
LYMPHOCYTES % 20.0 - 45.0 % 32.3
MONOCYTES % 0.0 - 15.0 % 8.3
EOSINOPHILS % 0.0 - 4.0 % 1.4
BASOPHILS % 0.0 - 3.0 % 1.1
POLYS-AUTO, ABSOLUTE 2.0 - 7.5 th/mm3 3.7
LYMPHOCYTES, ABSOLUTE 1.0 - 4.5 th/mm3 2.1
MONOCYTES, ABSOLUTE 0.0 - 1.5 th/mm3 0.5
EOSINOPHILS, ABSOLUTE 0.0 - 0.5 th/mm3 0.1
BASOPHILS, ABSOLUTE 0.0 - 0.3 th/mm3 0.1

Low Testosterone and high Estradiol levels:
You’ll notice I put the E2 test results at the top. 49. 49. What? I did some reading on this forum and guys with (pre-treatment) 100 more T and 15 less E are talking about how much better they feel once they start taking even just an AI. Wow. And here I am at 430/49.

Why I’m on Nolva:
I went to the doctor (an endocrinologist, about 60 years old, specializing in gyno/male hormones) because of painful gynecomastia (which onset about 10 years ago and recently became tender / painful), looking to get enough tests and whatever done to satisfy my insurance company’s requirements for paying for male mastectomy. He suggested a SERM like Nolvadex to block the pain. I thought, ah what the hell - can’t really hurt.

Why I’m here:
A day later my T and E2 results came back and now I am freaking out. I always questioned my lack of libido, my lack of … manliness, if you will. Mentally I have an extremely strong willpower, so I’m doing alright … I think my mental outlook is very positive … optimistic … but what if I’ve actually just been miserable this whole time compared to how I could be? What if the lack of energy is changeable? What if I could wake up energetic instead of hitting snooze for an hour every day?

I guess just reading up on this forum and stuff … all of these things I thought were just part of life … maybe I don’t have to deal with them. Maybe getting my hormones in balance could fix things I’ve just kinda … accepted.

How I am thinking of proceeding:
Since I’m on Nolva since Friday (this is day 4), I thought I’d continue with the 6 week trial period my doctor prescribed and then meet up with him after getting new bloodwork to discuss the results, etc. However, I also asked him a bit about whether or not an AI might be more appropriate given the high E2 levels. He should reply today or tomorrow.

So, guys … thoughts on how to proceed?

Your E2 is high bro, looking at your total T so u should use an AI and all will be Ok.

You did not list your Nolvadex dosing!!!

SERM’s typically increase E2 levels. Only an AI, preferably anastrozole, will lower E2. If SERM [or hCG] dose is too high, AI will not work as competitive drugs are ineffective at controlling T–>E2 inside the testes.

You should use anastrozole to get near E2=22pg/ml and taper off of the SERM.

Drugs that you took might have been endocrine disruptors.


Read these stickies in this order:

  • advice for new guys
  • things that damage your hormones
  • thyroid basics
    – check oral body temps when you wake up and mid-afternoon to eval overall thyroid function