T Nation

Low E2 All Parts of Cycle (Pellets)

Long time lurker, 1st post; This place is a great resource!

I’m in year 4 of TRT using pellets for the past 3 years. Everything was great until this past year. Over the past year my e2 keeps getting lower and lower in relation to my testosterone. Goes up and down but keeps dipping lower and the highs aren’t as high as they should be. I’m using the ultra sensitive estrdiol test.

41 years old
6’1" 185lbs
Lift 3-4x a week, ride mountain bikes 4-5x a week, ski, rock climb etc, very active
TRT pellets, no other prescriptions (to be clear, never taken any E2 inhibitors)
Little to no supplements other than protein powder, 22-44g a day at most.
Moderately clean diet, drink 4-5 drinks per week total.

Mid cycle Jan 2018
Total T 601 (180-917)
Free T 10.35 (3-24)
Ultra Sensitive Estradiol 18.4 (10-42)

Peak cycle May 2018
Total T 1090 (180-917)
Free T 22 (3-24)
Ultra Sensitive Estradiol 22 (10-42)

My recent test at the end of the cycle were:
Total T 349 (180-917)
Free T 5.66 (3-24)
Ultra Sensitive Estradiol 11.4 (10-42)

Prior to this year estradiol was in the low 30’s in a peak and around 15 at the end of the cycle when my T was very low. As you can see, now it’s barely getting over 20 at the peak and is really low on the tail end and causing a lot of symptoms (excessive urination, fatigue, joint issues, blunted emotions and ho-hum orgasms). T3/T4 are steady. Only other oddity in past year has been my Hematocrit has been creeping up to the low 50’s so I donate blood quarterly.

Anyone have any ideas of ways to increase estrogen? I know, not something most men need!

This is something I am concerned about. I have joint issues that have stuck around even after I got my e2 back into check. Wondering if my e1 is fluctuating like this. I saw someone had a similar issue on other boards.

Can I ask you how your e2 is? You need to switch from pellets to injections for a more even hormone profile. Your going high, then low.

What made you check your e1 if you don’t mind me asking? Usually everyone is worried about their e2.

I believe you man. I have issues with supplements lowering my e2. Which brings me to that questions. List everything you take. Any cruciferous veggies?

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How do you know this isn’t e2 as opposed to e1?

E1 is estrone, e2 is estradiol. I don’t know if you got them mixed up after re reading your post and then title.

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Sorry, I wrote it wrong! It’s Estradiol, not estrone in my tests. Haven’t tested E1 though I might on the next round. I’ve edited the original post.

Also, I should mention that my SHBG is always right at 43-45 (10-80 reference).

I’m really leaning toward doing injections after this cycle. I charted my last complete cycle and was high for a month, perfect for 2 1/2 months then low for a month and way too low for 3 weeks. Shots are a pain but so is being unable to do much for a week every 5 months for more pellets! Complication with shots is that it’s not my total that’s the issue, it’s my free and my understanding is that it’s hard to get free that high on shots. Even with a pretty big dose of pellets I’m barely getting to the high end of the range for free and my dr. doesn’t think I’d be even close with shots though it would be more consistent. She wants me to do smaller doses of pellets more often. I’m not wild about the recovery time as that’s getting me close to 3x a year I’d be down for a week.

For my supplements, I really don’t take much of anything.
2-3x a week I take an NOW Adam multi-vitamin
4-5x a week I have a smoothie with Muscle Feast hormone free protein powder

For diet, I’m celliac, so I eat a lot of oats, meats, and veggies and tend to eat pretty cleanly. Veggies are mostly spinach, salads and I keep the cruciferous veggies pretty low though will have a bunch of brussel sprouts or broccoli at least once a week. I have 5ish drinks per week, usually bourbon. I drink 2 cups of coffee a day as well.

You can easily overcome a higher SHBG with injections. You just need more test to spill over the top.

I think your problem is that you are going too low with the pellets. When my e2 goes too low, I can feel it now that I have had issues with my joints and low e2 in the past.

I have felt my knees start to ache a little once I was getting closer to my shot, my trough. I try and keep my e2 as high as possible without having side effects. For my joint health and everything else.

High SHBG people shouldn’t mess with e2 (I have learned the hard way), and I feel like its easier to have problems with low e2 with a higher SHBG. Mine is 45-55 usually.

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Thanks for your feedback, I appreciate it! Yes, knees, elbows, and hands all start to have issues at the low part of the cycle, not fun.
I think you might be right, my body is burning through the pellets too fast so my month long lows are screwing things up. My current doc wants to do pellets more often, every 4 months, to avoid the lows. Kind of thinking a more consistent level may bring the e2 up on average but I’m just am not sure I want to deal with recovering from the procedure 3 times a year. Wonder if doing shots a couple times at the end of the pellet cycle would be a good idea?
Setting up an appointment with another local specialist to get a second opinion as this really sucks!

Dude, just do shots. Its so easy, you can use a 5/8ths insulin needle. I saw the procedure for pellets and I cant believe someone would ever do that! TRT doesn’t need to involve a “procedure”.

Plus with pellets, your stuck with that dose. With shots, you can adjust if you feel you are low. Much better. I take shots twice a week and if I feel like something is going on, ill increase my injection and it helps.

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Where did you hear this? From your doc selling you a pellet procedure? Ive just never heard this and plenty on this board, including myself, have no problem getting free cranked way up.


I may have been simplifying a bit for brevity though I do agree that she’s biased heavily toward pellets. Expanding a bit, it’s hard to keep free up and not on a weekly roller-coaster without doing multiple shots a week and she only does shots in the office so it would get expensive to be going in so often. This is a big part of why I’m scheduling a consult with another doc, why can’t I shoot at home if it’s the better option for me?? I’ll happily shoot myself, it’s just not that big a deal.

Yeah, getting the needle in your flank to numb then dealing with the bruising and swelling pushing into your car’s seat every time you drive for the next week really sucks!

Yeah find a new doc so you can inject twice a week. You will be so much better off I feel.


Appointment set. Just had pellets recently so it will be awhile but can start transitioning over when levels go down. Also, I’m not currently on HCG as my current doc doesn’t like it because it has bad effects for women. That’s some BS right there as far as I’m concerned so I’ll be talking to the new doc about possibly starting that sooner.

Thanks everyone for your input! Hopefully shots will get the E2 worked out to a more manageable level.

A pregnant woman’s placenta produces HCG, testing HCG in the urine is how pregnancy is confirmed.

As for pellets every 4 months, he must be doing great financially. It sounds like this doctor wants to keep you hog tied to the office for weekly injections instead of letting you do it yourself in the comfort of your own home.

If you do self injections at home, he can’t make any money off you.

I am the other blacksheep on the board as I am on pellets and continue to update my progress.

First, WHAT pellets are you on? There are different types.

Second, your “end” of the cycle is too low. This is where you need to adjust. Two options - increase the number of pellets at the front end; or get pellet insertions more often. I have to do both – Ultra high at the beginning and re-pellet every 3 months.

I take DIM to maintain lower E levels, but had to stop taking as much because it was going too low. Historically I have had lower E levels, and are still learning where the sweet spot is. Depending on the pellet, your E should rise.

There’s a “hcG diet” out there a lot of women do that can really make a mess of a woman’s hormones in the long run so she’s not wrong about that part. I love the idea of not having to do anything more than a couple times a year but 3x a year is just too much for me. I fell climbing today, landed on the pad on my pellet site and it hurt like hell. That’s lame. Bonus if my insurance covers the injections, I’ll have to look into that.

They are the bio-identical type, is there more than one of those? I don’t remember the brand.
Man, I don’t know how you tolerate every 3 months, I couldn’t do that. I’m pretty tired of the week of crappy sleep and no exercise every time I get pellets and if my only option is to increase the frequency of that I think I’m switching to injections.

If they are “bio-identical”, they are most likely similar to BioTE, which is what I am on.

You are correct about pellet insertions pain. Some of mine hurt like hell (on the left side) while others are no big deal (right side) – which makes no sense btw.

You said you have been on pellets 3 years. I am surprised you haven’t experimented with the quantity of pellets being inserted to find out where you feel the best. After my first insertion, I went back for a boost, because it wasn’t enough. I have blood work done monthly, so I could argue the point.

I also have been experiencing high hematocrit and had a blood let for the first time last month.

One of the biggest complaints about pellets is the end of cycle crash. And I blame that on doctors who do not want to adjust their procedures per patient. A higher starting dose helps to smooth out that end of cycle dump. In my case, it still wasn’t enough to stretch my insertions out past 3 months.

BioTE doctors are everywhere now. And they do not have the same oversight, which means they can modify the doses (substantially) as needed. And if your doctor will not, it is easy to find another doctor who will.

Four months after a “regular” insertion quantity, I felt like shit. I went back in and made my case for higher initial insertions. I spend twice as much on blood work as I do on pellet insertions — but that allowed me to prove my point.

And btw, if you have been a lurker here, you know that pellets are treated with disdain here. You have been on them 3 years – and are just complaining now. In my book, that is a success. You just need an adjustment in the cycle’s starting quantity, IMO.

Take a look at this article. It was written from the point of watching what you eat to REDUCE estrogen. In your case, you might go against what they say to raise E.

Thanks for the reply!
I’ve varied anywhere from 800-1400mg per dose, 1200 is the sweet spot but it’s looking like I’d have to do at least every 4 months. 1200 puts me too high for about 6 weeks, perfect for 2 months, ok for a month and then too low for about 6 weeks until the next batch kicks in. Pretty sure the best dosing option would be 1,000mg every 4 months but with the downsides of it being not covered by insurance and discomfort I’m heavily leaning toward trying injections. My hesitation is that I I travel a lot so the idea of carrying needles and bottles of T on international flights to 3rd world countries sounds like a invitation for long customs delays.
I wish I could do pellets every 6 months at 1200mg and supplement with injections starting at 4 months until the 6 month mark ramping it up a bit as the pellets go down but my doc isn’t comfortable mixing like that. Have you heard of anyone doing that to extend? Maybe I could get the best of both worlds?

No doctor with half a brain would prescribe you both pellets and injections. You can’t ever reach any sort of balance like that.

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