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Test is Great. No AI at All. E2 Still Dips Too Low

I did labs a week ago. I do 1 ml a week, 2 injections. 200 mg. No AI at all. My e2 is still only a 23. I’ve been running this for 3 months. What could cause my e2 to stay so low? Any ideas? I’m not complaining, but because I still feel crappy sometimes and I think something could be impacting my e2. My doc has mentioned cortisol.
Bioavailable test-616
Free test 254
SHBG 35.9
DHEA 70.0
TSH 2.7
E2 23.4
Vit D 41.2
These are Lab Corp numbers. I appreciate the help

Your Estradiol is in the ideal range of 21-30. Some of us tend to convert more test to estradiol and others DHT.

Here are the issues I see in order of significance. By problem I mean not optimized:

  1. Thyroid; TSH no greater than 1. At 2 its time to add armour not levothyroxine;
  2. Vitamin D (50 ideally);
  3. SHBG is slightly high.

Why praytell, would you do 2 small does of T when you could do 1 larger. Each injection adds some trauma to the muscle (or are you doing subq) and when you have done 1500 it can be problematic.

My experience is that we experience symptoms when the the amplitude of the concentration curve drops below a certain point (seems to be a bit different for each person). As long as you are above this point at the trough (just prior to the next injection and when you are collecting lad data), then all is well. This also assumes you are managing estradiol (you don’t seem to have an issue with aromatase activity).

We are treating a testosterine deficiency, the high end is not as important.

Of course your lab data was collected in the morning just before your next test injection, correct? If not, then it’s doesn’t really provide the full picture.

Lastly, a word on cortisol. It’s fine if you want to supplement however; it’s more complicated than some of the other hormones in interpreting data.

That diagnosis is made more on physical sysmptoms and compaints and verified with an 8 am lab draw. The 24 hours prior you must be sedentary. No commuter traffic, sex, arguing stressful situations ect. You have a nice relaxing day and someone drives you to the lab, else the data will be skewed. Lastly, during therapy you must do 24 hour urine collection (also while sedentary)

It would be very helpful if you can describe your symptoms more thoroughly.

You don’t aromatise. Simple. You could bump the dose, but I doubt it’s worth it. Twice a week pinning is a great schedule, it’s more even than once a week. Your TSH is fairly irrelevant. Not a lot of evidence that being 1 or less actually matters. Vit D is a little low but not going to kill you. T3 and reverse T3 would be informative. Muscle trauma from pinning twice a week, even with a javelin, is an invented issue. I have never met anyone that has experienced that, and I know lot of guys that have done a lot of injections in the pursuit of sporting success. Sometimes you just feel a little off, even when you’re on.


Plenty of the guys around here have e2 above 50. I rarely find anyone who stays in 20s unless there on an ai or genetically low. 20-30 is a false notion. You’ve been duped.

Whatever your body converts to free t and e2 at the same time is what is optimal.

You should check ft3 and more of your thyroid like @hardartery stated. 2.7 is higher than where you want it. TSH is unreliable, but when it increases its a good indicator saying check me.

What other medicine are you taking? Are you taking supplements, zinc, dimm.

The estrogen has ups and downs. If you are that low it could be that your estrogen is below 20 at times and that causes the symptoms.

I would take a bit more t to increase estrogen, because estrogen is a very important hormone that needs to rise with free t. Thats if you are genetically low and you are not taking anything else on a daily basis. Estrogen helps joints, brain, bone, blood, sex, and so much more. Free t with estrogen is a good combination.

If your body truly stays that low there’s not much else to do but raise your dose by a little.

Most members who have trouble controlling E2 or at least are forced to inject multiple times to avoid using AI’s to keep E2 under control, we don’t see those often with E2 <25 often with high normal levels, I’m sure there are more and just never bother with the forums.

There is a new member on TRT and recently had a TSH score of 2.7 shortly after starting TRT and his Free T3 was abnormally low, TRT has a way of exposing other weak systems on the brink.

Have you done thousands of IM injections? Of course you haven’t or you wouldn’t say that it’s an invented issue. I can’t inject in my quads or delts.

You don’t convert to free t and then E2 as though they are optimal. Testosterone is either converted via the aromatase enzyme to the estrogen pathway or 5 alpha reductase enzyme to DHT and then androstanediolglucuronide (AG). AG is actually the best indicator androgen metabolic activity as it produced only after DHT has exerted its activity.

Life Extention Foundation has been collecting serum data from their members for over a decade and analyzing the data. They have also posted data from various trials indicating that all cause mortality increases when E2 is greater than about 30 and less than about 21. I work in the professional science community and have no problem changing my opinion or even admitting that I have been duped. It will not be the first or last time, I’m sure. It would be helpful if you could provide evidence to support to claim. I certainly don’t want to pass along bad information if my understanding is dated.

We have all familiar with the metaphor comparing the endocrine system to an orchestra. The idea is that there is balance. One of the hormones that balances testosterone (along with others) is estradiol. Elevated estradiol minimizes some of the effects of testosterone. Of course as estradiol increases, so does SHBG.

A few more quick points (these are all in addition to the increased all cause mortality) with elevated estradiol is that is can cause moodiness, it does increase the size of the prostate (DHT does not), causes female fat deposits, gynocomastia and increases the number of aldosterone receptors. These are responsible for a number of processes including water retention and elevated blood pressure.

The following is obviously a fallacy. “Plenty of guys have around here have E2 above 50”. Obviously we are not going to do something and assume it’s safe simply because a few or even a majority are doing so.

Yes estradiol is very important. It does need to be kept in the range of 20-30 (this assumes a total T in the 800 range).

One more quick point. Free T is irrelevant when reviewing lab data. It fluctuates wildly throughout the day. Total T and SHBG are the best last indicators (unless you have access AG).

Lastly, lab data is used to confirm to a diagnosis and catch analytes that are grossly out of range. Medical students are taught to treat the patient and not the lab form in their first year.

you could try increase your D lvls (around 70) and your T doses, to stay above 900 and see how you feel.

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Any chance of some links, or specifics I can search for? I am interested in reading this. I have unfettered access to the repositories like Pubmed if that is necessary.


Yeah, My TSH stays high, I take a small dose of Armour. 60 mg

T3 -3.8 (2.0-4.4)
Reverse T3 21.7 (9.2-24.1)
T4-1.24 (0.82-1.77)

I take armour. 1 grain.

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I think you’re probably fine. You could bump the dose a little, you have the room. Mostly though, I think you are probably fine. Everybody feel crappy sometimes, especially if you’re taking thyroid meds.

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@episodic Yes I too would like read some because I have definitely read data on the other side.

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Must have your numbers reversed, because I’ve heard the polar opposite from Dr.Rouzier, Dr.Nichols, Meehan, Eric Serrano, Dr. Robb , Jay Cambell guests. the Indian doctor forgot his name. Doctors who once prescribed ai realize it is wrong and stopped doing it. So many men here have stopped and feel better. So many men have 50+ e2. Im well into the 50s if not 80s.

Watch this video. You should know who Dr. Rouzier is.

if not you should review his experience and why he’s the wizard of hormones.

Logically thinking: Young men have higher than 30 E2 in their 20s and early manhood. Yet they are the ones who will have the least mortality. It just doesn’t make sense.

An imbalance of hormones is probably why an e2 level above 30 is bad. But so is having it low. There is a reason why our estrogen increases with free t.

Life extension foundation is never cited and I have never heard , read or watched from any of their professionals talk about this. None of the docs or experts I follow have ever discussed this either. Any sources would be great to hear, because estrogen is not our enemy and telling others to control estrogen is actually causing more harm than good.

Let’s not go there. I have heard of this place, but know nothing about it. Lots of experts and “experts” are unaware of or straight up fail to cite contrary opinion or information. It would be logical that the E2 range makes a difference, so I would really like to see information on it.

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I’ve simply never heard of it during all the research I’ve done. I’ll agree and I’m not going to try and bash an organization I’ve not heard of .

I’m open to any study that can be shared. I’ll be looking out for it.