T Nation

On TRT but Low Estrogen without an AI

I started TRT 1 month ago with SQ injections of 40mg testosterone enanthate every 3.5 day. By the 3rd week I was feeling great. During the 4th week I started feeling anxious and this has not stopped. I had my labs redrawn and here are the results:

Total Testosterone: 739.59 ng/dL
Free Testosterone: 17.2 ng/dL or 172 pg/ml
BioAv. Testosterone: 397 ng/dL
E2: L <10 pg/mL undetectable
Previous E2 right before starting TRT: 16 pg/mL Normal

I suspect that this is the cause of my anxiety. This doesn’t seem normal. What to do next? Increase testosterone dose?

Where do you get your T. Could it have an AI premixed in it?
Do you take any supplements or meds that might lower your E2?
You might also consider a lab error in the E2 will they retest that?
I have never heard of anxiety reducing ones E2.

Increasing your T dose should increase your E2 if it is only T.
Injecting once a week will also give you an E2 spike over twice a week.


See if your Test has the AI compounded into the vial, if it’s mixed in with the Test then you need to look for a competent doctor.

Low E2 = anxiety.

There isn’t an AI mixed in with the testosterone. They are vials of 1ml vials of Testosterone Enanthate. Not taking supplements, either. I will retest the labs though. Good advice, thanks.

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Aromatase enzymes live in fatty tissue, losing weight means losing aromatase enzymes that convert testosterone into estrogen. Your natural production is different, estrogen is produced inside the testicles that is now shut off do to TRT which shuts down the HPTA.

I believe shutting down your HPTA could have ceased estrogen production inside the testicles and you already had low levels of aromatase enzymes in your fatty tissue dropping your estrogen. Adding HCG to your TRT protocol may be the only way to increase estrogen which would keep your testicles producing smaller amounts of testosterone and estrogen.

It could also be the SQ injections, some report very lower levels of estrogen, IM may allow estrogen to increase since it releases faster than SQ. SQ is a slower smoother release and has been known to drastically lower estrogen is some men to undetectable levels.

I don’t think SQ is good for you, try IM in shoulder and quads.

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Having lower estrogen after TRT is uncommon, correct?

I started IM injections instead of SQ.

At this point would it also be a good idea to increase testosterone dosage to 50mg every 3.5 days?

What have you been dosing at? Most guys would start with at least that and work up from there. That might be part of your E2 problem, not enough T to make E.

Do you know where your SHBG is?

I think I was also running into this issue. I was injecting Sub Q and my e2 was always on the lower end. I started doing IM and my e2 is high end of normal, and I feel much better in that sense.

50-55mg IM twice a week.

SHBG was normal at the latest blood draw, 32.1. I’ve started IM and am already feeling better.

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My E2 after 1 month of TRT was 16.1pg/mL. I finally got it up to 31.4pg/mL after 1-1/2 months. I’ve been doing IM from the start but my dose has gradually increased after discovering my SHBG was high slightly out of lab ranges.
A lot of men seem to report anxiety at some point in the first few months of Testosterone administration, though it seems like this is usually reported early on (like myself) and not later. I’ve heard some people go through a short lived honeymoon period with Testosterone in the beginning. It was told to me that this is could be attributed to an initial Dopamine surge after beginning administration.
Low E2 is often related to having anxiety along with a myriad of other issues that are oddly not entirely dissimilar to having high E2.
From what I understand the early stages of Exogenous Testosterone administration is a bit of a shock to the system and it takes time for our physiology to level out and regulate itself with the new exogenous hormone induction. As was mentioned, Estrogen production sites and Aromatase activity in the male body frequently occur together in similar areas of our anatomy, such as the Testicles (though not always in the same areas such as the adrenal glands). Estrogen production results from Aromatase activity on Testosterone but Estrogen production also occurs independently from the Aromatase enzyme active areas in similar locations.
There is more interesting reading on Estrogen in males in the ncbi article linked at the bottom of this post if you feel like checking it out.
My nuts initially shrunk up to the size of grapes. Though I’ve had to increase my dose, my testicles are now slightly larger than they were earlier on.

Estrogen in men

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That’s a decent number. It seems the higher SHBG guys, (higher than 20’s) seem to do better on IM.

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Anxiety has mostly gone away but still lingering a bit. I increased my TRT dose to 105 mg testosterone enanthate per week (30mg EOD IM) from 80 mg per week. My E2 is still low without an AI. I’ve been gaining muscle and fat so I’m cleaning up my already good diet. However, I’m having erectile issues, not able to get fully erect, which seems to have gotten worse since I started TRT. Should I increase my dose even more?

My most recent labs as of 4/6/2019:

Total Testosterone: 1185 ng/dl
SHBG: 32.24. (normal range 18.3 - 54.1)
E2: 25.2 (normal range 25.8 - 60.7)
Albumin: 4.20 g/dL
Free T: 310 pg/mL = 2.62 % (normal range 32-168 pg/mL)
Bio T: 711 ng/dL = 60 %. (normal range 131-682 ng/dL)

List all supplements. ALL supplements. Medicatoins. Diet.

You are probably taking something that is dumping your e2. It was happening to me. It took me forever to figure out what was happening.

What was hitting your E2? @anon10035199

These bloods look dam good but I am one who believes you need to experiment and find your limits hi and low. The trick is to do it slowly and with a lot of thought and planning. No WillyNilly Bro-science crap. Make plans take notes and stick to it, unless something feels life threatening then of course abort the test.

Since my labs from February showed low e2 I started taking pregnenolone eod and DHEA eod, with the intention to raise e2. I also take:
Fish Oil
B-complex once per week IM
B-12 once per week IM

Medications: none

Tropical fruits (I work in Thailand) mangoes, bananas, papaya, mangosteen, yellow plums. 3-5 servings per day. Usually non-organic

Other vegetables (morning glory, purple sweet potatoes, carrots, beets, cucumber, bean sprouts, other Thai vegetables) - 2-4 servings per day, including organic salad bar at least 3 times per week

Rice (white, brown, purple) - 1-3 servings per day

Meat - chicken, fish or pork (conventional, usually not organic) - 1-2 servings per day

Cruciferous vegetables (broccoli, Chinese kale, cauliflower, cabbage) - 1 serving per day

Junk food - chips, coconut dessert, ice cream, chocolate, pizza, burrito 0-1 serving per day

Zinc is used as an AI for some on TRT. Theres one possible culprit.

B vitamins increase your liver clearance and flush out e2.

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@msobro labs look pretty good if you’re looking at the numbers. Besides his E2 being a little on the low side everything else seems to be pretty good. But yet he is still facing signs and symptoms of things that are messing with his quality of life such as the erectile issues. I myself am on testosterone and have been going through ups and downs for the past two years. But lately I have been questioning if you are looking at a set of labs such as his. Will you not think to yourself if the problem actually is testosterone then his testosterone levels seem to be very well and by now it has been going on 4 months Since he started injecting but still faces sexual dysfunction. I wonder if I myself and a lot of people on this form are missing something that might be a bigger picture. I was wondering if anyone can chime in and give me their thoughts.
Maybe peoples thoughts and ideas may help @msobro as well. Any advice is always good advice to all of us