Normal And High Estrogen? A Few Questions

Pre-TRT labs when starting about 4 weeks ago:

Estradiol: 53.9 pg/ml RANGE: 7.6−42.6 pg/mL

Now obviously this is high.

Estradiol Sensitive as tested by Defy Medical:

17.4 pg/ml RANGE: 8.0-35

Looks to be relatively healthy…

Now I am taking 50mg Test E E3D and believe that estrogen might have shot up… Had great energy increases almost immediately after starting TRT and am now down a bit in energy. A few insomnia symptoms I didn’t have before, feeling more emotional than usual.

I know most would respond with “go get labs” and I want to but which test do you guys rely on? Estradiol Sensitive or just estradiol?

SIDE QUESTION: I don’t want to be on an AI forever… Are there guys here who have taken an AI until you’ve gotten down to low body fat and then done something natural like grapeseed extract to maintain healthy levels of T?

Other Pre-TRT labs:

Free T 73.2 pg/ml Range: 46-224

Total T 486 ng/dl Range: 250-1100

Ambumin, serum 4.4 g/dl Range: 3.6-5.1

Bio Available T 147.3 ng/dl Range: 110-575

SHBG 29 nmo/L Range: 10-50

PSA .57 ng/ml Range: 0.0-4.0

DHEA-Sulfate 144.4 ug/dL Range: 138.5-475.2

TSH 0.987 uIU/mL Range: 0.450-4.500

LH 11.0 H mIU/mL Range: 1.7-8.6

A standard estradiol test is not for men, it is for women in their reproductive years. The E2 sensitive test is for all others. Men and women in tanner stages 1-5 (childhood prior to 18) and adult males, and verification of post-menopausal state of women. E2 sensitive is just a more accurate test that is able to determine E2 levels accurately in “trace” levels. The e@ sensitive test uses a analytical method known as Liquid chromatography/tandem mass spectrometry (LC/MS-MS). This analytical method is actually amazing at detecting trace amounts of near anything (that has a known peak). I use a GC/MS (gas as opposed to liquid) everyday at work to check for ppm and in some cases ppb of trace impurities in medical products or primary calibration standards. HEre is a short video on how the analytical method works:

It is just as common for folks to feel great when starting TRT to feeling nothing at all. There are a variety of explanations. Most commonly proposed for feeling great is that with the introduction of exogenous testosterone the levels of course increase and are atop of your natural production. However, soon your body notices the exogenous testosterone and the pituitary gland ceases production of LH and FSH causing the down-regulation of your HPTA. Once this occurs, your body notices the drop in testosterone and you may not feel as well. This does not mean your E2 has increased in and of itself (though more T -----> E unless inhibited by an AI), you may be noticing the effects of lower than the previously noted testosterone levels. In addition if you are on an AI, the symptoms of low estrogen and high estrogen are nearly identical (with the exception of hot flashes) so labs are the only way to know for sure. Let science guide you, I have found it lets me down far less often than my gut feeling.

If you do not want to take an AI then you need to keep your SHBG in range, preferably mid-range. In addition 100mg weekly is a good starting point, but you may find 80mg weekly to be sufficient to reduce the need for an AI. Spacing your shots out to reduce the “peaks and valleys” will add in not crashing your SHBG. The more frequent the injections the less likely you are to crash your SHBG. Some members of this forum report than subq injections aid in preventing conversion of test to estrogen. However, those folks tend to begin that change in administration in conjunction with E3.5 or EOD injections so the resulting correlation may be non-causal in nature.

Pre-TRT labs will be the best indicator of T–E2 conversion rates, for instance my pre-TRT labs showed undetectable E2 levels, low TT and low FT. I do not require the use of an AI because my conversion rate was already low.

Your response was incredibly thorough and useful to me. I couldn’t find anything on which test is more recommended than the other. Thank you for all of the useful info here. Will be referencing this in the future as well.

The initial increase in energy explanation you gave makes total sense. Now that the balls aren’t working I will obviously have less than when I first started.

I’m going to introduce a low dose AI for now.

.25 Arimidex every other day while also giving my 100mg of Test E a chance to really start “taking over” so to speak. Will get labs for T and E2 sensitive done in two weeks.

Thanks again

Makes perfect sense. Idk why that wasn’t more obvious to me to begin with. Thanks a lot!