T Nation

Low E2

Hi Guys, I’m relatively new to TRT and have found this forum a wonderful resource. Thanks for all your information you’re willing to share.

I’m 46. In November 2011, I suffered a sudden, noticeable decrease in Libido and lack of energy. Initially I attributed it to an extensive weight loss and exercise regimen and some possible hormonal imbalances, but I normalized by diet and the symptoms did not go away completely. In February of 2012 I visited a wellness physician and had some blood work performed.

Results were TT- 200, FT- 26.6, E2-23

Based on the lab results, I was placed on Test cyp, 200 mg, given once weekly via injection. I was also placed on Letrozole, compounded by a local pharmacy to .39 mg twice weekly. The doctor also said I had a mild case of hypothyroidisn, I assume based on symptoms and Free t3 which was 2.2. Free t4 is 1.1 and TSH is .99l. He placed me on Armour thyroid 30 mg/ day

I remember about two weeks into therapy feeling pretty good and libido rebounding, but then a good part of that went back away. I’m better than I was before, but it’s still a far cry from where I was a year ago. I guess I should be specific, I’m getting frequent night time/morning erections but the desire to do much with them is not nearly as strong as it was before all this started. I also am not sleeping well at night and take frequent naps during the day. My testicles have ached a little bit also since starting TRT. Not bad, just enough to notice.

Last month I went back for a follow up interview and blood work. I did mention I was a little disappointed to my doctor about my libido but he didn’t really offer any options, other than Cialis.

I just received my lab results performed about ten weeks post therapy and noticed my E2 is below the range of testing. Results were TT 789, Free T 154.5, E2 <12, and SHBG 42.4. Thyroid labs are TSH .082, Free T4 1.3, and Free T3 3.3 The doctor seemed please with the overall lab results but we did not discuss E2. Based on what I’ve read here concerning low e2 I think it’s probably worth a try to get that number up somewhat to see if my energy and libido improve.

If raising E2 seems to be a good idea, I’m wondering the best way to approach this. My assumption is the most logical reduction in letrozole, but I’m not sure how to accurately reduce dosage in a .39mg capsule. I didn’t take my last dose, but I’m assuming I want to reintroduce the product at perhaps a half dose.

I also was wondering if it’s worthwhile to have lab results performed immediately if I hit a “sweet spot” in the next few weeks.

Any Input from you smart guys is appreciated. Thank You.

I would just stop taking the letrozole for a couple weeks and monitor your reaction. Letro is some very harsh shit man…most guys use adex or aromasin. I dont know many guys at all who are on Letro for their TRT. I’m also laughing at the exactness of the dose “0.39 mg”. No clue how your doctor decided on that dose. Are you using the compounding pharmacy in your doctor’s office? If so, it sounds like they are just taking you for a ride.

But regardless, monitor symptoms as your E2 rises without the Letro. You can get bloodwork done as you feel good, but this might not be entirely accurate as bloodwork is a snapshot and your body works in many facets other than just current bloodwork (processing the bloodwork, etc.). BUt it will be close. You can fine tune from there.

Thanks VT for your input. I was worried there might be a rebound effect by going cold turkey back off the product. I’m not scheduled to go back and see him until the Fall, so I hope I can get fine tuned before then. Regardless, I’m hoping elevating my E2 will improve my feeling of well being. I’m also planning to swap to a bi-weekly SC injection. In all honesty, I’m not sure I’ll bother to continue TRT if this is as good as it gets.

Yes, that is a strange dose. He does have a pharmacy next door, but I chose to use one next to my house, which he mentioned when telling me where to get the medicine. It is compounded though, which makes it quite expensive. I think it’s in the range of $3/tab. My insurance does not cover TRT, so the in itself motivates me to find another source for the smaller dosages.

Then why not just tell your doctor you will use adex or another AI at a less approxiamte dose that you can just buy at a normal pharmacy? Arimidex went generic a couple years ago (as anastrozole) so there are many cheap bottles available.

Ridiculous your insurance won’t cover anything with TRT–what insurance do you have?