T Nation

Looking to Normalize Hormone Levels


#1

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?


#2

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


#3

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