TRT Qualifier? High Estradiol (105)

Pharma / TRT Testosterone Replacement
1

I am new to the forum and just recently received the results from my endocrine panel and my Estradiol level is 105 (20-160pg/mL range )?! Is that even possible for a 28yr old? My diet is clean, I workout, take a multivitamin and a zinc supplement.

I have been experiencing almost all the symptoms of low T for years (NON EXISTENT libido, low mood, gynecomastia, no morning wood and TOTAL energy depletion), tested T levels with my primary doc in Early September TT 382ng and again this week with TT at 536ng (range 332-1150ng).

-age: 28
-height: 6’1
-waist: 35
-weight: 215
-describe body and facial hair: Virtually NO body hair, minimal facial hair (shave twice a month)
-describe where you carry fat and how changed: chest (gyno) and in mid-section
-health conditions, symptoms [history]: Allergies, severe gyno w/ discharge)
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: None.
– real dangers! see this http://propeciahelp.com/overvi…

-lab results with ranges:

Endocrine

LH: 3.22ml (1.10-11.6)
FSH: 4.33ml (2.80-11.3)
Estradiol: 105pg/mL (20.0-160)
Progesterone: 0.227ng (0.20-1.13)
TT: 536ng (72-853)
Prolactin: 10.5ng (2.5-17.0)
Androstenedione: 1.23ng (0.60-3.10)
Cortisol:7.29ug (5.00-25.0)
DHEA-SO4:208ug (35.0-430)
SHBG:66.2nmol (13.0-71.0)
TSH PSA:3.2ng (2.00-4.00)

Lipid

CHOLESTEROL, TOTAL: 168 (100 - 199 mg/dL)
TRIGLYCERIDES: 75 (0 -149 mg/dL)
HDL CHOLESTEROL: 63 (>39 mg/dL)
VLDL CHOLESTEROL: 15 (5 - 40 mg/dL)
LDL CHOLESTEROL: 90 (0 - 99 mg/dL)
LDL/HDL RATIO: 1.4 (0.0 - 3.6 ratio units)
BILIRUBIN DIRECT: 0.22 (0.00 - 0.40 mg/dL)

Metabolic

GLUCOSE: 91 (65 - 99 mg/dL)
BLOOD UREA NITROGEN: 21 (6 - 20 mg/dL)
CREATININE: 1.38 (0.76 - 1.27 mg/dL)
EGFR MDRD NON AFRICAN AMERICAN: 69 (>59 mL/min/1.73)
EGFR MDRD AFRICAN AMERICAN: 80 (>59 mL/min/1.73)
BUN / CREATININE RATIO: 15 (8 - 19)
SODIUM: 140 (134 - 144 mmol/L)
POTASSIUM: 3.8 (3.5 - 5.2 mmol/L)
CHLORIDE:101 (97 - 108 mmol/L)
CARBON DIOXIDE: 24 (18 - 29 mmol/L)
CALCIUM: 9.5 (8.7 - 10.2 mg/dL)
PROTEIN, TOTAL: 7.3 (6.0 - 8.5 g/dL)
ALBUMIN: 4.7 (3.5 - 5.5 g/dL)
GLOBULIN : 2.6 (1.5 - 4.5 g/dL)
A/G RATIO: 1.8 (1.1 - 2.5)
BILIRUBIN TOTAL: 0.9 (0.0 - 1.2 mg/dL)
ALKALINE PHOSPHATASE: 72 (39 - 117 IU/L)
AST:26 (0 - 40 IU/L)
ALT: 32 (0 - 44 IU/L)

CBC

WHITE BLOOD CELL COUNT: 4.6 (3.4 - 10.8 x10E3/uL)
RED BLOOD CELL COUNT: 5.41 (4.14 - 5.80 x10E6/uL)
HEMOGLOBIN: 16.5 (12.6 - 17.7 g/dL)
HEMATOCRIT: 47.9 (37.5 - 51.0 %)
MEAN CORPUSCULAR VOLUME: 89 (79 - 97 fL)
MEAN CORPUSCULAR HEMOGLOBIN: 30.5 (26.6 - 33.0 pg)
MEAN CORPUSCULAR HEMOGLOBIN CONC: 34.4 (31.5 - 35.7 g/dL)
RED CELL DISTRIBUTION WIDTH: 13.3 (12.3 - 15.4 %)
PLATELET COUNT: 188 (150 - 379 x10E3/uL)
NEUTROPHILS % 50
LYMPHOCYTES % 40
MONOCYTES % 6
EOSINOPHILS % 4
BASOPHILS % 0
NEUTROPHILS ABSOLUTE: 2.3 (1.4 - 7.0 x10E3/uL)
LYMPHOCYTES ABSOLUTE: 1.8 (0.7 - 3.1 x10E3/uL)
MONOCYTES ABSOLUTE: 0.3 (0.1 - 0.9 x10E3/uL)
EOSINOPHILS, ABSOLUTE: 0.2 (0.0 - 0.4 x10E3/uL)
BASOPHILS ABSOLUTE: 0.0 (0.0 - 0.2 x10E3/uL)
GRANULOCYTES, IMMATURE % 0
GRANULOCYTES IMMATURE , ABSOLUTE 0.0 - 0.1 x10E3/uL 0.0
C-REACTIVE PROTEIN: 0.5 (0.0 - 4.9 mg/L)
HEMOGLOBIN A1C: 5.3 (4.8 - 5.6 %)

-describe diet [some create substantial damage with starvation diets]: Lean meats, salmon, complex carbs, veggies
-describe training [some ruin there hormones by over training]: 3 day mass program (pyramid sets)
-testes ache, ever, with a fever? Yes. Aches and tingling.
-how have morning wood and nocturnal erections changed: Noctural erections but no morning wood. It’s becoming more difficult (duration) to ejaculate.

2

You need to have your testes examined, perhaps an ultrasound.

FT would have been very useful.

Please use the [edit] in the right hand lower corner of your post and correct units. There are no lab results that are reported in “ml”.

Range for estradiol seems very strange: "Estradiol: 105?? (20.0-160) " Units are measure by volume, IE: pg/ml
Is that estradiol or total estrogens?
Was the correct lab done? Appropriate for males?

TSH PSA:3.2ng (2.00-4.00)

  • you have hypothyroidism
  • read the thyroid basics sticky
  • evaluate your long term use of iodized salt and/or vitamins that list iodine
  • check waking and mid-afternoon body temps <<<<<<< important, please do ASAP
  • more labs:
    – TSH, fT3, fT4 [please not T3, T4]

LH, FSH and TT indicate that these are OK. However, without FT and E2, we have to suspect that too much of your TT might be T+SHBG that is not bio-available.

SHBG is elevated, so FT may be low. SHBG is consistent with high estrogens.

Action items:

  • thyroid basics sticky and other related listed above
  • clarify your E2 lab data
  • get testes examined, issues on going or only with a fever event?

Focus on thyroid. You might get a lot of benefit from anastrozole to reduce E2 levels and Nolvadex to further reduce E2 effects on breast tissue.

Don’t be afraid to have more cholesterol in your diet.

Drugs: Also interested in off the shelf items such as acid reflux pills etc.

Cortisol is low. Did you have labs done at 8AM? when? Review advice for new guys sticky and look for references to cortisol, fT3, adrenal fatigue and Wilson’s Book. Note references to stress, starvation, chronic infection/inflammation, acute illnesses, accidents, surgeries etc.

3

I spoke with my doc about my “thyroid issue” and it turns out my value is actually 1.40 nmol/L (a normal level) - misread results (human error). My estradiol level however has been confirmed and at last exam (9/22) was 105. None of my other results indicate a cause for my symptoms and my high estradiol level.

I’ve been given a script for anastrozole and told to take 1mg daily (which is obviously too high). Took 1 pill and will take .5mg EOD for 2 weeks, eventually winding down to .25mg E3D.

Thoughts on the dosage?

I expect to have my levels re-tested within the next 60 days or so with hope I FEEL (and my results reflect) some improvement.

Thanks for your feedback and insight!

4

With my current two test numbers, would it make sense to give a topical gel a try? Should I wait for the anastrozole to do it’s work and see it raises my total and free (8.2pg) test?

5

To be sure:

  • read the thyroid basics sticky
  • evaluate your long term use of iodized salt and/or vitamins that list iodine
  • check waking and mid-afternoon body temps <<<<<<< important, please do ASAP

The range for this seems wrong:
Estradiol: 105pg/mL (20.0-160)

  • makes sense for total estrogens or this lab was for a female.

You may have a problem with gut flora where adverse bacteria convert metabolized estrogens in the liver bile back to active estrogens. Any digestive problems? You could try a good quality probiotic and it may need to be taken for a while to create a population shift.

Anastrozole may be very useful.

Don’t ignore the thyroid and body temperature issue. You want to make sure that there are no issues there because after you get E2 levels down [lower 20’s], thyroid problems would thwart the weight loss that you should be able to achieve.

With lower E2, your T and FT should increase very nicely.

6

[quote]KSman wrote:
The range for this seems wrong:
Estradiol: 105pg/mL (20.0-160)

  • makes sense for total estrogens or this lab was for a female.
    [/quote]

I’m guessing someone has mixed up the units. 20-160 pmol/L (5-44 pg/mL) is a male range and 105 pmol/L = 28pg/mL. In BC pmol/L is the unit labs use for e2.

7

asked my doc and he says the units should be mIU/mL. So 105mIU/mL?

8

I have never heard of milli IU for E2

Can you get the original report? This to too important to not know what the numbers mean.

Don’t get side tracked on this one, issue. Note other things in my post above.

9

screenshot via link
http://cl.ly/image/3b163h3g3j0i

10

Well I lost patience trying to convert the units but the range implies that 106 at least isn’t a terrible value. If I were to guess I’d say it’s about 25pg/mL

11

Still looks bogus and that appears to be ranges for females. I have no idea what these numbers mean.

12

Well, I’m going back in mid-November for a followup with another endo. The new results should come from a different lab.

13

Update

I’ve been taking anastrozole for the last few weeks (.5mg E3D) and have noticed a huge improvement (better modes, morning wood, some return of libido). However, I have noticed that when i go too long without, all my symptoms return.