T Nation

Low E2 Result Would Like to Know Why


Hi all

I recently started on TRT in Feb with a programme of Nebido shots. I have just had my second lot of blood work at the 6 week point following the booster shot (4 weeks before my next shot)

48 years old, clean diet and train with weights 5-6 days per weeks - no other known health problems.

Original bloods at the start of the programme were;

Total test : 340 (249-836)
SHBG : 24.7 (19.3-54.1)
E2 : <5 (25.8-60.7)
Albumin : 4.6 (3.5-5.2)
FSH : 5.03 (1.5-12.4)
LH : 4.46 (1.7-8.6)
Prolactin : 8.21
PSA : 0.083 (0-1.04)
TSH : 1.35 (0.27-4.2)

Current bloods are;

Total test : 456 (249-836)
SHBG : 31.15 (19.3-54.1)
E2 : 6.2 (25.8-60.7)
Albumin : 4.8 (3.5-5.2)

So as you can see, T has increased 34% and I have certainly felt the positive impact of that in many areas. The piece that concerns me is that E2 has changed from <5 to 6.2 pg/ml which seems really low. I was prepared to put the first test result down to an error, but the second test confirms the low levels. The strange thing is that I don't seem to exhibit any of the reported symptoms of low E2 at all.

I have 3 questions really;

  1. Is this low E2 something to be concerned about - and if so what can I do to increase it?\

  2. Why would my E2 likely be this low and why would I not be experiencing the symptoms of low E2?

  3. I am targeting at least 700 as a total T level - can this be achieved with 10 weekly injections of Nebido? I know this is a fairly new ester and so there may not be anybody on here with longer term results.


  1. How do you feel? I would feel awful with my e2 that low.
  2. It could be a lab error or you could simply aromatize very little T to E. Are you very lean? Total T in the mid 400's while injecting is obviously still quite low and a higher T would mean higher E.
  3. No one can answer that question ahead of time.

Question for you. Is Nebido all you have available? There's a reason most people inject with test cypionate. I'm assuming you're not taking an aromatase inhibitor like arimidex/anastrazole?


Hi Hostile

Thanks for the reply.

  1. I feel good - in almost all areas, no symptoms of low E that I recognise

  2. I would say I am around 12% BF so quite lean. T is still lowish and I plan to try to get it to 700+ levels

  3. Nebido is certainly the ester of choice for my local hospital here in Istanbul - I think that a more regular pin with Test C or E might be achievable but might be quite a hard case to sell to my Dr as he cannot see why I want to get to a level over 500..

No AI being taken.


Can you get FT tested?


I had FT tested in the first blood work I had done in November last year;

Free T : 10.8 pg/ml (5.1 - 41)

I did not have it run again this time.



That explains it. The low FT is low enough to not increase e2. It is very low that I'm surprised you feel good.


Thanks. I'm assuming that FT has increased along with total T over the past 5 months.

Does E2 remaining low indicate otherwise?


Not too sure. E2 in TRT cases mostly follow T. Higher T results in more e2. Your FT seems low, just above hypogonadal ranges actually. In some men not on TRT I see that e2 can be dominant in relation to T levels, not on TRT usually. So that's the only reason for low e2 I can think of.

Why are you on nebido? I would recommend enanthate or cypionate for better hormonal modulation. See if your doctor can change it and allow you to self inject. This will lead to more stable FT and e2 levels and will not create lab timing problems.


Thanks - I am assuming FT has increased, but will check next blood test draw.

Nebido is the option of choice for my Dr and although I may be able to request a change at a later stage, it will not be an option for a while. This having been said, I am pleased with the response from Nebido so far and am feeling the positive results of the increased T in most areas.


That's good man. All that's required from treatment at the end. The pursuit of numbers never end with some people. But low e2 is something that's not really good for long term health like osteoporosis. That's the only reason I would change my protocol. But that could wait if you're feeling well.


Thanks - I will keep an eye on it as it does worry me (Hence the desire to understand why it might be so low)


True to some extent. Note that testosterone is important to maintain the collagen matrix in the bone that is the scaffold for mineralization. With the catabolic state that comes with low T, collagen is lost. That also leads to more observable effects like thin fragile skin, sagging and looking older.


Hi K Sman

I have been monitoring morning temps and am seeing levels of 96.8 on waking - rising to 98.6 by afternoon.

My iodine intake is a teaspoon of iodised salt every morning but little else directly.

I have always been somebody who feels cold in the morning but warms up by 10-11am - for years this has been my norm.

The only other symptom boxes I tick is outer eyebrows slightly sparse and what feels like a slightly slow metabolism when it comes to losing the last few kg's of bodyfat (I am around 12% but have some fat on my lower abdomen)

TSH as you can see was 1.35 at last test.

Would you recommend some iodine supplementation?


Using iodized salt is good. But taking it by the spoonful is not going to help much if you are going to try iodine replenishment. But some take salt that way to help with adrenal issues.

Why are you avoiding salt in your cooking?

Try to get an iodine supplement. Have you read the thyroid basics explained sticky?
Found here: https://forums.t-nation.com/t/about-the-t-replacement-category/38/2?u=ksman


I am not avoiding salt in my cooking or eating and can certainly increase it a little. I have also ordered some Ioderal and will give this a try to see if I can increase temps.

I have read the sticky a few times, thanks.