40, Low Free T, High E2 - What to do?

[Ovr Thinkr]

Hey guys, I’m new here, been studying the board and TRT for 6 months and am at a loss as to what to do. Long story, I’ll try to keep it short. I’m pushing 40 yr old, 6’2” 200lb, 12% BF, been lifting 3 yrs, no cycles (yet).

Had a vasectomy 2 yrs ago. Started having classic low T symptoms and mild prostate issues. I had two total T test in the 300’s. My Uro is clueless, but cooperative. Tried the T Gel for a month, prostate felt like a watermelon immediately. Tested before stopping Gel – 585 T and 29 E2. Asked Doc for self T injections, (lower DHT response was my reasoning) he obliged. I started to research it and decided to hold off, still hadn’t pinned ( but you know I want to).

I let things settle down from Gel for several months and retested "stock" equipment, strangely I tested higher total T(620) ,Flagged Low Free T (6.1), found E2 to be elevated (30). (Maybe Gel restarted my HPTA, or first two low test were flukes?) Asked doc for Adex thinking the AI will lower E2, SHBG, and raise Free T, problem solved I hoped. Nope. Adex was intolerable at anything over .8 E3D. Major fatigue etc. Not sure if it was a side, or if I took E2 too low, maybe I’m an “over responder”? I was able to handle .8mg E3D and ran the Dex for 6 weeks, prostate was much improved, I still felt tired, mentally cloudy etc. Wish I had tested then, instead, I switched to Aromasin – .3mg E3D – within a week I felt Awful, worst anxiety I’ve have ever experienced, allergic rash, etc.. I stopped it and tested 3 days later – Total T (757) Free T (16) E2 (37)… E went higher??

That’s my story, its now been over a week since I stopped the AI, I felt really good until yesterday, prostate pressure started, and woke up totally moody, low energy, watermelon prostate feel. I know my Doc doesn’t have the insight to help me. I have read on this for months and have no clarity about the next step. I don’t seem to be low T, now its low free T ( without an AI) and still high E2. I don’t know what to do? I’ve got the gear, but I really don’t want to do TRT for life if it’s not necessary. Side note, I DO want to do my first cycle, but I need to figure out a solution to the prostate and mood problems (e2) before adding in yet more variables of a cycle. A true baseline would be good also, as a goal for a future PCT. But right now, prostate, mood, energy is the issue. Any Advice? Wait it out and retest? Start back on the adex, pin the cyp.? Thanks in advance.

[steroid.com 1]

Looks like a Doc who just threw Testosterone at you without conducting any type of clinical diagnosis.

There dozens of reasons why you present like you do and with the symptoms you have.

Anything from Cancer to Thyroid issues and more could be the culprit.

Did your Doctor do a complete blood work up on you before he started you on the TD? If so, can you post those complete with ranges here in this thread?

You didn't need an AI if your lab of 30 was pg/ml. If anything, it was perfect.

You need a Doctor who can conduct a thorough examination of you and one who have a full and complete understanding of hormones in men.

BTW, the TD won't restart you, if anything it shut you down.

Finally, get your Prostate checked as soon as you can, it's not supposed to balloon up on exogenous testosterone.

[Ovr Thinkr]

Yeh, Doc pretty much threw TD at me. No Blood work. I made him do a PSA at the time, that was all I knew at the time.
Here are the labcorp labs I later ran PRE AI - (months after the Gel)
So these are "all natural" so to speak

Total T 622 (348-1197)
Free T 6.7 (8.7-25.1)
LH 6.4 (1.7-8.6)
FSH 3.3 (1.5-12.4)
E2 32.8 (7.6-42.6)

Also have the CBC and Metabolic panels, but no thyroid.

A friend that is pretty knowledgeable on the subject interpreted this as estrogen dominant, and told me to ask for the AI. I've read that around 22 is optimal, so I believed him. (Clearly I need a qualified Dr. ) Uro also did a DRE, collected fluid, said I had chronic prostatitis..non bacterial.. and called it "boring". Apparently it didn't concern him. The prostate quieted down on the AI, and ballooned up as soon as I came off it.

[Trific]

Until you get more BW I'll venture a guess and say you could probably stand taking like 7,500iu per day of vitamin D.

You probably should lay off the AI until BW tells you different.

[Rusty11]

Regarding estrogen, please read the sticky. Pay particular attention to the section on testing. The test you had done is geared towards women. You need the sensitive assay. Read it. It's all the info you'll need on the subject. And, take what your friend says with a grain of salt.

[Ovr Thinkr]

I just had BW last week after I stopped the Aromasin.. so keep in mind the Total and free here are probably boosted by the AI.. have no idea why the E2 was high, could have been Adex rebound, Aromasin didn't have time to reach steady state before sides made me stop.. not an ideal time to test.. but I had felt so bad I wanted to see what was going on... wouldn't you say E2 of 37 calls for the AI, especially with the prostate issue going on now.. I prob. need to just stop playing Dr.. but I don't know any local Docs that have a clue.. I dread trying to find one.. mine didn't even know what SHBG was... I thought with all the forums and web info.. and him to write the scripts.. I could dial it in... but inconsistent labs have only served to confuse me...and I haven't even pinned anything.

Thats a lot of Vit D. - what for? I take like 1300iu a day now.

Total T 757 (348-1197)
Free T 13 (8.7-25.1)
LH 6.0 (1.7-8.6)
FSH 3.3 (1.5-12.4)
E2 37.4 (7.6-42.6)

[Trific]

Thats a lot of Vit D. - what for? I take like 1300iu a day now.

I was looking at your previous free T and it was low so I was guessing your SHBG was probably high and vitamin D lowers SHBG. Some guys here are taking 10,000iu of d per day.

Your free T looks better now, it's at least in range...could still go higher though.

Might consider getting your own BW and posting it here for review....

https://www.privatemdlabs.com/

[Ovr Thinkr]

Rusty - trust me, I have read the post, but I went ahead and read it again. I have read on all this for months and months... wife thinks I am nuts. I knew about the E2 sensitive testing, but I had read on another board that was Quest and Labcorp E2 test was good to go.. I order my test at privatelabsmd, and read the most economical panel for what we needed was the female hormone, and private labs site does say its also for males when you check "male", they adjust the ranges.. so if this is an invalid test for our purposes, I got bad information... you guys tell me if this is total invalid info to work with.. I'll take the more expensive male profile next time, which includes the sensitive test.

Trific- my guess is the AI's had a positive effect on the free T.. I believe my real issue is high E2 - causing High SHBG - low free T - and the prostate issues.. but that's just an uneducated guess based on the way I feel, the labs, and what I have read on the web. Maybe I do need to mega dose Vit. D.... or Zinc, or nettle root, DHEA, or take pygeum or saw palmetto for the prostate... ha.. sorry.. I really don't know what to do. I hate to start throwing supps at it.. but I am tempted to take the Adex again, cause the prostate is hurting... and I have a feeling the doc will just say I have chronic inflammation again with no real solution.

[Ovr Thinkr]

Might consider getting your own BW and posting it here for review....

https://www.privatemdlabs.com

that's where I have been getting labs.. if I have normal total T, low free T, Higher E2.. what do I do with that information?

[steroid.com 1]

If the E2 assay was not the "sensitive" assay the lab will default to the standard estrogen assay designed for women. This assay will over estimate a mans serum level and why you need a sensitive panel done.

You need a complete hormonal panel run. Read kel's sticky on finding a TRT Doc and you will see what you need.

I suspect high SHBG as well. But don't do or take anything till blood work is completed so you have a base line.

Post your blood work here in this thread when you get them.

[Ovr Thinkr]

ok, thanks.. I probably need to be another week removed from the AI at least.. to let things balance out... do you think 2 weeks post AI would good enough for a baseline? Any other test I should get.. DHEA, Vit D. Thyroid etc.?

[Trific]

I have read the post, but I went ahead and read it again. I have read on all this for months and months... wife thinks I am nuts. I knew about the E2 sensitive testing, but I had read on another board that was Quest and Labcorp E2 test was good to go.. I order my test at privatelabsmd, and read the most economical panel for what we needed was the female hormone, and private labs site does say its also for males when you check "male", they adjust the ranges.. so if this is an invalid test for our purposes, I got bad information... you guys tell me if this is total invalid info to work with.. I'll take the more expensive male profile next time, which includes the sensitive test.

I am going to use that test also, but I'm not going to trust their E2 test unless it says it was Labcorp's #140244 CPT code 82670 sensitive assay....if it's anything other than that I'd ignore it. You can check and see what the test code # is on your test or call them....Maybe you can get them to redo that E2 test for free?

Wonder if GD thinks if tadalafil would help that bloated prostate issue? That's gotta suck....

[steroid.com 1]

^^^^It's now FDA approved for BPH so yes, it would help.

[Ovr Thinkr]

Wonder if GD thinks if tadalafil would help that bloated prostate issue? That's gotta suck....

yes it does... think constipation feel..

So I have to press the question.. if labs confirm 600's + T, lower free T, and High E2 - whats the next step in search of a solution??

What other labs beside standard hormone panel should I go ahead and get?

[Trific]

So I have to press the question.. if labs confirm 600's + T, lower free T, and High E2 - whats the next step in search of a solution??

What other labs beside standard hormone panel should I go ahead and get?

LOL...we don't believe your High E2 at this time, and so we'd like a sensitive assay E2, SHBG, vitamin D...Oh, what am I saying.....this:

You need a complete hormonal panel run. Read kel's sticky on finding a TRT Doc and you will see what you need.

Also make sure you get the thyroid labs GD likes.

If your wife's BW needs checked out sometime, post it up too....

[Ovr Thinkr]

Oh, what am I saying.....this:

You need a complete hormonal panel run. Read kel's sticky on finding a TRT Doc and you will see what you need.

Aight.. thanks.. sorry, I missed seeing the last part - the labs I need are in the sticky.. distracted cooking dinner for the fam.. I'll check it out..

LOL...we don't believe your High E2 at this time, and so we'd like a sensitive assay E2, SHBG, vitamin D...

I think I'm high E2, cause of the low free T... and I feel like a biaaatch a lot of the time... and the prostate thing cleared on adex and came back as soon as I was off.. but maybe not.. we will let the labs tell us... hate I pissed away $300 in labs trying to save a few bucks..

If your wife's BW needs checked out sometime, post it up too....

ha, thanks, how did you know? she's been easier to dial in.. a little T, a little progesterone, DHEA.. working on her adrenals now.. I almost have a new lady.... but she did bust my balls for the Avi pic...which was 1 yr and 10 lbs ago...lol

[Ovr Thinkr]

So I have given it 4 weeks + since any AI's .. going tomorrow to get a plethora of labs... E2, E2 sensitive, dht , shbg, total free T, thyroid, liver, Vit. D., DHEA etc.....still having trouble with the prostate AND NOW... my nipples have started to be sensitive, itch etc.. becoming more frequent.. what in the world is going on with me? looking forward to getting labs to shed some light on this.. I could understand sore nipples if I was on T and E2 was being elevated.. but why would I be having nip issues on nothing?? E2 rebound shouldn't last 4 weeks... lab report soon...

[Ovr Thinkr]

You guys were right.. E2 is not high, (no idea why the sensitive nips and the prostate issues)... T is fairly normal...everything looks in line... SHGB is a little high.. I guess Vit. D and DHEA could probably use more support..

thoughts? thanks

T Serum 653 (348-1197)
T Free 15 (5-21)
T Free 2.3%
DHT 56 (30-85)
DHEA 173 (89-427)
LH 5.3 (1.7-8.6)
FSH 2.8 (1.5-12.4)
IGF-1 157 (69-226)
Vit. D 44.3 (30-100)
PSA .04 (0-4.0)
E2 26.3 (7.6-42.6)
E2 Sen. 10 (3-70)
SHBG 59 (16-56)
TSH 2.9 (.45-4.5)
T4 7 (4.5-12)
T3 up 33 (24-39)
Free Thyrox 2.3 (1.2-4.9)