T Nation

Need Help Interpreting Lab Reports

Ok, guys, I got my Total T, Free T and estradiol reports back from the lab. Hope you can help interpret them.

Total Testosterone: 718

Free Testosterone: 10.9

Estradiol: 40

So, I have gathered from past discussions here that the above E level is high. I have the Anastrazole ready to go. I think that somebody mentioned before that since I am not doing HRT, I should do .5 mg/week. Do you agree with that?

Also what do you make of the Free Testosterone? Is that low? If it is what can I do to get it higher? My Total T is down from a test I had about 10 months ago. At that time my Total T was 799.

Any help and observations would be greatly appreciated.

We need the context of body weight/fat, fat deposit patterns, muscle mass and how these things have changed.

Many, myself for sure, have had a lot of problems with E levels in that range. That .5mg/week recommendation would have been my suggestion. If you do that, you will soon have some really observation about the effects that will eclipse any theory, facts or discussion.

Your TT is very good for not been on TRT. Your E2 is reducing LH and T production. If you reduce E2, your LH and TT should increase. A good target for E2 is in the lower 20s.

Another slant on things: Some on TRT will have levels the same as yours. So there is an implication that your aromatization activity could be the same as some on TRT. That would seem to suggest that you might need to have a adex dose that is closer to that needed for TRT. Only one way to find out.

With E2=40, many?most would report that they were not feeling there best ---- to ---- feeling brain fog, low energy, low libido, low mood or depression etc. How do you feel? If you try adex and feel better, what else counts?

T–>E aromatization seems to be fed by FT, not TT (SHBG bound T). So that is where some of your FT is leaking out. Reduce that T–>E and your FT should increase.

When you lower E2, SHBG should reduce, thus increasing FT. Less E2 should increase LH and thus TT & FT. A lot of leverage going on with compounding effects that swing both ways.

Try the adex. Whatever happens, at worst, you can stop using it. Read what I have written elsewhere about some who are very sensitive to adex who end up doing well at 1/8th to 1/4 mg/week. If E2 goes too low, you will not feel right. There are ways to judge what is going on with a brief strong improvement that then turns bad. In that case ones E2 has gone very low. Methods exist to dial into a sweet spot guided by libido and how you feel. Lab work is useful, but that will not suggest dose refinements when E2 is single digits or below a lab’s reportable range.

[quote]KSman wrote:
We need the context of body weight/fat, fat deposit patterns, muscle mass and how these things have changed.
[/quote]

Thanks KSman. As usual, great information!

I am at 210 pounds and around 12% fat. Of course, that is just using calipers, so not too scientific. Been lifting heavy pretty steadily so I guess not too many problems in terms of muscle mass, though that is somewhat subjective I realize.

I have in fact been taking closer to the 1mg/week course of arimidex. Today will be the third day I am taking it (I am taking it every other day). I intend to continue with this (unless I “feel” at some point that I have reduced my E levels to low) for a month, then get retested. I will use the levels of E2 you suggest (E2 of circa low 20s) as a working number to play around with. Understood that keeping in touch with my body (no pun intended :slight_smile: is more important than objective measures.

The main symptoms have been “brain fog” and reduced libido.
Also, I would say some low grade depression. If I can rid myself of the “brain fog”, the low grade depression and boost my libido, I would be delighted. I am not pursuing this for athletic performance, so it’s ok if my TT were to stay in the 700 or 800s. Want that Free T to go up and the E2 to go down.

I am wondering how long it usually takes for the arimidex to lower the E2 from 40 to, say, 25. Are we talking about days, weeks or a couple of months. Just wondering and keeping in mind what you have said about others being more sensitive to arimidex than others.

Thanks again so much.

With that body weight, I think that you may need 1.25 to 1.5 mg/wk, but individual response trumps everything.

You will feel something in a few days, strongly by 7-10 days. E2 will change quickly, but what you feel takes time. And there may be some processes that adjust at a longer time scale that might affect E2. SHBG will change and FT will change. E2 levels might yo-yo a bit. No hurry to do the labs. You will want to test when you feel like things are quite good for you.

With your low BF, you might respond better than someone with closer to 20% BF.

Thanks KSman. I am at day 8 (today I took the adex for the 4th time). I can say that I am feeling better. My libido is stronger. The brain fog is lifting a bit, but I still have some. I am definitely feeling better.

I will keep in mind your recommendations for dosage. Last week, I did 1mg/week. I may stay at that strength for a few more weeks until I get another blood test at the 1 month mark. Prefer to be conservative. Then adjust dosage based upon test results && how I am feeling.

Let me ask you this. Once one reaches the low 20s or whatever seems like the best level for them, does one lower the dosage of adex so as to maintian that level? Does one reduce the frequency of adminstration of adex? In other words, how does one maintain a certain optimal level once reached?

All things being equal, you’d stay at the dose that gives you the best E level forever. Bearing in mind that body fat produces aromatase and estradiol so if your body fat goes up or down, your dose may need to go up or down to maintain the same optimum levels of E. Other changes in the body can affect how much T/E/aromatase you’re producing, but that’s just how it is.

The effect of taking an AI is usually to make the body produce MORE aromatase as it tries to make up for the “lost” aromatase. There is, however, a limit to how much can be produced so once your dosage is dialed in to offset your level of production, then you stay at that dose until things change in some way.

[quote]happydog48 wrote:
The effect of taking an AI is usually to make the body produce MORE aromatase as it tries to make up for the “lost” aromatase. There is, however, a limit to how much can be produced so once your dosage is dialed in to offset your level of production, then you stay at that dose until things change in some way.[/quote]

Thanks for the info happydog48. Interesting. I wonder though if some point it stops doing this; that is to say, stops trying to overcompensate for the original homeostatic point, i.e. the “lost” aromatase. Anyway, I will keep monitoring the situation objectively (lab tests) and subjectively.

Unless it is pure placebo effect, I can say that the last couple of days have been great for me. Low-grade depression gone or greatly diminished. Brain fog is clearly receding and libido is up. I haven’t felt this good in a long time.

Ok, so here is where I am at. I have been doing a little over 1mg/week of Adex for around two weeks now. Around day 7 I felt a slight increase in libido, better sleep and feeling better. Last couple of days I have not been having the “sexy” thoughts that I was a week ago. I continue to feel better though, I would say.

I am wondering if this libido thing is not part of the “yo yo” effect some have referred to. It makes me a little anxious. You know, I wonder if I am doing something wrong. I need to let that go and see this as an experiment.

Nonetheless, there are valid questions. Is it the “yo yo” effect? Am I taking too much and has my E2 dropped below normal for me? Has my E2 gone up (in order to reach its homeostasis) and therefore do I need mmore Adex?

These are the questions I have. I will continue on as I am right now (1mg/week) and get retested in another two weeks.

Comments?

I think you’re on the right track:

I will continue on as I am right now (1mg/week) and get retested in another two weeks.

Ok, I have an update and a few questions. In December I got my Total T, Free T and Estradiol checked. I reported those at the beginning of this thread and they were as follows:
Total Testosterone: 718 Free Testosterone: 10.9
Estradiol: 40

Now I am two months into taking anastrazole and here are my numbers as of today:

Total T: 822
Free T: 15.8
Estradiol: 24

Definitely the numbers are much better and remember I am not doing any testosterone replacement. However, here is the thing. About two weeks into the program I started feeling much better…much more libido, etc. I am still doing better than I was before starting anastrazole but not as well (libido not as high) aa I was doing two weeks into the program.

So what do you think? Have my estradiol levels gotten too low? Or do you think that I need to have some other parameters checked or what???

Your body reacts to change and absolute numbers. The change wears off and that is part of what you feel. R2=24 is not too low. Try a one time increase in your anastrozole and see what that suggests. Again, part of what you will feel is transient. If you feel let down for a few days, that can be E2 too low, otherwise not. Your TF is up 50%, that is major, but not a huge number.

Any changes in muscle tone or fat tissue? Any changes to “graininess” deep on your chest? If you are loosing some fat, and that can be slow and progressive, E2 might tend to decline. Some of that can be offset by an [unexplained] need or more anastrozole over time to maintain the same E2 levels. I had to to increase my dose from 1.0 to 1.75 to remain at about the same level.

Any changes in your emotional state? Less emotional? Drier or more analytical?

Any joint ache or stiffness?.. that can be a sign of E2 too low. Any change to snoring? Any change in foods that you seek out.

For the benefit of others who are in similar circumstances… what is your dosing of anastrozole? How fast did your early increase in libido happen?

Just out of curiosity is this physician prescribed arimidex.

Theoretically I prefer a suicidal AI, so that there is no rebound increase in aromatase.

Your testosterone will naturally fluctuate throughout the day, higher in the morning and lower at night. So if you vary the time you get the blood test by a few hours it could account for a difference in the total testo of 50 points or so.

[quote]KSman wrote:
Your body reacts to change and absolute numbers. The change wears off and that is part of what you feel. R2=24 is not too low. Try a one time increase in your anastrozole and see what that suggests. Again, part of what you will feel is transient. If you feel let down for a few days, that can be E2 too low, otherwise not. Your TF is up 50%, that is major, but not a huge number.
[/quote]

I guess part of the problem is that that are bodies are complex open systems and it is impossible to even be aware of all the factors that might influencing the state of your body at any given time. No sooner had I written my post last night, than I went home and had an intense libidinal “glow”.

It’s too bad we can’t have a continual quantitative measure of T, Free T and estradiol. Just because those were the numbers on a given day at a given time does not mean they are static. It would be interesting to know the fluctuations.

I have been taking around 1mg/week. I will definitely try a mega-dose and see what happens. By megadose I mean, like 15 drops. I usually take either 8 or 10 drops every other day.

Any ideas on how to raise the free T even higher?

I don’t know what you mean by “graininess”. I think there has been some change in fat tissue but it is slight and, to be honest, I haven’t been paying that much attention and not measuring.

Yes, there have been, but not what might be expected. I have been feeling better, and when I feel better I am perhaps more emotional in a positive way. By that, I mean that I have more feelings of “friendship” and “love” (ha ha, if I were in one of the other forums I would be accused of getting my “ghey” on for that last statement :slight_smile:

I have had some stiffness, however, it is problematic to attribute that exclusively (or at all) to to the anastrazole. After all, I just started dong the Bill Starr 5 X 5 workout a few weeks ago and so it might be the workout causing the soreness.

Food…I definitely have almost NO carb cravings. I went to an Italian restaurant yesterday and had a fav dish, gnocchi (which is made from potatoes and flour) but I wasn’t craving it. I was just there, seemed like a good time to carb load a bit and so I did. So, I would say that, yes, the change has been that I really don’t crave dense carbohydrates (like bread, pasta, etc) at all.

As far as snoring, I don’t think that has ever been a problem, so no change there. I have never snored (and yes, that’s not my opinion…I have asked bed mates).

Oh, and another thing. My immune system seems to have gotten stronger. There was recently something going around and people were ill all around me. I got a very slight sore throat for a couple of day and that was it.

I guess, the good news is that, yes, I am feeling better but that it tends to fluctuate. In any case, even on “bad” days, it is much better than before I started doing the anastrazole.

Perhaps the perception that I had of being in a heightened state of wellness two weeks after starting anastrazole compared to now is one of gestalt. In other words, compared to way I had been feeling pre-anastrazole, I felt so much better that I noticed it in a big way. Perhaps now that way of being has become quotidian and so it doesn’t amaze me as much. I am not sure of this, just speculating.

[quote]Fawkes wrote:
Just out of curiosity is this physician prescribed arimidex.
[/quote]

No, it’s not. I got it from the pharmaeceutical company that several people here recommended.

Aha, now what is “sucidal AI”? How does it ensure no rebouund in aromatase increase? I would be HIGHLY interested in knowing about this.

As you mention Fawkes, hormone level can vary by time of day. When I had my labs done pre-anastrazole, it was done around 8:10 AM. When I had it done last week, it was taken at exactly 11:34 AM. So far, those are the only two times I have had labs taken for T and Estradiol.

[quote]KSman wrote:
For the benefit of others who are in similar circumstances… what is your dosing of anastrozole? How fast did your early increase in libido happen?[/quote]

Forgot to answer this. Ok, it was around day 10 that I started feeling a change in libido…it was a very noticeable change: more desire and more spontaneous erections. My dosing at that time was (and still is) 1mg/week.

This post was flagged by the community and is temporarily hidden.

Suicidal aromatase inhibitors (AI) attach to aromatase forever, until the aromatase is dumped from the body. Aromatase is what turns testosterone and similar hormones into estrogen.

Arimidex is a non-suicidal inhibitor. It attaches for awhile to the aromatase. THe body responds by increasing the production of aromatase. Then when the arimidex “falls off” the aromatase it was bound to, there is now a larger pool of aromatase in the body and subsequently can convert testo into estro at a faster rate and in larger amounts.

That is not exactly right, but close - pharmacodynamics was not my forte in med school.

If you reduce estrogen too much you can get stiff and achey (too dry of joints) and your libido can crash. You need some estrogen for libido.

[quote]bushidobadboy wrote:

Do you not think that the negative libido change was your body responding to the AI by producing more aromatase enzyme, thus boosting your E numbers upwards, and your libido downwards?

[/quote]

Well, the numbers show that my E levels are down (from 40 to 24) but I guess you mean that I could have had a temporary boost in aromtase. Yes, that could be.

However, now my libido seems to be back up. Even when I said that libido was down a bit, I mean relative to how I felt 10 days after beginning Anastrazole.

[quote]Fawkes wrote:
Suicidal aromatase inhibitors (AI) attach to aromatase forever, until the aromatase is dumped from the body. Aromatase is what turns testosterone and similar hormones into estrogen.
.[/quote]

Ok this sounds interesting. So does this mean that you only take the suicidal aromotase inhibitor for a while and then you don’t have to take it again?

Obviously that sounds better than having to constantly monitor and take arimidex. What are the down sides (are there cases where it is ineffective such as with bushi or was that possibly a case of bad stuff from China)?