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  1. #1
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    Need test or just AI is enough?

    My dad is 61 years old. I told him to do bloodwork to check hormones for just well being (he doesnt workout).
    result:

    Testosterone 3.9 ng/dl (2-6.9)
    Free Test 4.2pg/ml (3.8-34.1)
    Estradiol 82.4 pg/ml (up to 56)

    His total test looks okay but because of the estrogen conversion his free test is low. Needs AI? or whole replacement (test + ai and etc)?

    Anyway I care for him and want him to be happy, what does he need to do?

  2. #2
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    He needs to find a good doc who knows hormones. Obtain full blood work. An example is in the Finding a Doc Sticky Thread at the top of this forum. Then you can make a more informed decision. Many issues effect T levels, including simply age. But yes, lowering estrogen will help to elevate testosterone . How much it brings up his free T remains to be seen.

    Full blood work then get back to us! 61 isn't that old, keep him healthy!
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  3. #3
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    Quote Originally Posted by kelkel View Post
    He needs to find a good doc who knows hormones. Obtain full blood work. An example is in the Finding a Doc Sticky Thread at the top of this forum. Then you can make a more informed decision. Many issues effect T levels, including simply age. But yes, lowering estrogen will help to elevate testosterone . How much it brings up his free T remains to be seen.

    Full blood work then get back to us! 61 isn't that old, keep him healthy!
    He lives in iran, donno if they even have TRT there.... or the doctors are even good with hormones lol

    EDIT: Ok he is gonna do the full bloodwork as suggest. Btw does he have to fast for the full bloodwork? If yes how many hours?
    Last edited by EquilibriumZ; 12-18-2013 at 10:41 AM.

  4. #4
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    Test and free test are low and E2 is high. Getting his E2 down will boost his test levels but might not be ideal levels.

  5. #5
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    Quote Originally Posted by EquilibriumZ View Post
    He lives in iran, donno if they even have TRT there.... or the doctors are even good with hormones lol

    EDIT: Ok he is gonna do the full bloodwork as suggest. Btw does he have to fast for the full bloodwork? If yes how many hours?
    Yes, suggested is 12 hrs.
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  6. #6
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    OK just got the test results:

    TSH (ECL) 2.39 ulU/ml 0.17 - 8.9 (>50 years)
    Free T3 (ECL) 3.77 pg/ml Adult: 2.02 - 4.43
    Free T4 (ECL) 1.4 ng/dl 0.9 - 1.7 (Adult)
    FSH (CLIA) 13.1 mIU/ml Male : 1.3 - 11.8
    LH (CLIA) 4.86 mIU/ml Male : 2.8-6.8

    Prolactin (CLIA) 5.77 ng/ml Male :4.1 -18.4
    Free Testosterone (EIA) 4.9 pg/ml Male (Adult ) : 4.25 - 30.3
    SHBG(ECL) 49.5 nmol/L Male : 14.5 - 48
    Cortisol .morning (ECL)17.0 ug/dl 5.0-23 (10AM-12Noon) Fever, Stress : 20 - 54
    IGF-1 (CLIA) 203.3 ng/ml (55-186)
    IgFBP-3 (EIA) 2376 60-70 years: 1280-4670 ng/ml
    Dihydrotestosteron (EIA) 380 Pg/ml Male: 250 - 990
    Total PSA (ECL) 0.63 ng/ml 60-70 years: Up to 4.1
    25OH-Vit.D Total (CLIA) 20.4 ng/ml Insufficiency :10-30

    So by looking at the results:
    He has high FSH, low free test, high estradiol, low prolactin, high SHBG, high IGF-1, low Dihydrotestosteron and insufficiency in vitamin D

    Any comments on what is causing the low test and high estradiol?

  7. #7
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    Quote Originally Posted by EquilibriumZ View Post
    OK just got the test results:


    So by looking at the results:
    He has high FSH, low free test, high estradiol, low prolactin, high SHBG, high IGF-1, low Dihydrotestosteron and insufficiency in vitamin D

    Any comments on what is causing the low test and high estradiol?
    Yes. He's 61 years old. Probably just andropause which is really just a fancy name for your hormones declining. He's getting older, it happens. Thoughts would be to either begin a TRT protocol or to work on E2 first and see how he feels if that is reduced and brought into range. A sensitive E2 Assay needs to be used though. Anything else is not really accurate. Get him on D3 asap. Maybe start at 5K per day. Always test it.
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  8. #8
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    Quote Originally Posted by kelkel
    Yes. He's 61 years old. Probably just andropause which is really just a fancy name for your hormones declining. He's getting older, it happens. Thoughts would be to either begin a TRT protocol or to work on E2 first and see how he feels if that is reduced and brought into range. A sensitive E2 Assay needs to be used though. Anything else is not really accurate. Get him on D3 asap. Maybe start at 5K per day. Always test it.
    The only way he can trt is to self administer (no Trt doctors in iran). He has access to all the test, ai and bw that he ll ever need (pharmacy grade). The only thing is that only i have the knowledge about these things and i only see him 3-9 weeks a year but i can definitely tell him what to do. In your opinion, do you think self trt is a safe option in this case? Or just try to control the E2 with Ai since it's less complicated? Or just not do anything? I do not want him to get harmed cause of taking a risky actions.

    Thanks alot guys

  9. #9
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    First question really should be how does he feel? If he feels ok with no debilitating issues I'd have him work on lifestyle, nutrition and of course add vit D.
    What's causing the low test and higher estrogen is simply aging. As we age test decreases and E rises. A mid-fifties out of shape male can have higher E than a female of the same age. Lifestyle, good nutrition and lower body fat can combat this to some extent.

    So, how does he say he feels?
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  10. #10
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    Quote Originally Posted by kelkel
    First question really should be how does he feel? If he feels ok with no debilitating issues I'd have him work on lifestyle, nutrition and of course add vit D. What's causing the low test and higher estrogen is simply aging. As we age test decreases and E rises. A mid-fifties out of shape male can have higher E than a female of the same age. Lifestyle, good nutrition and lower body fat can combat this to some extent. So, how does he say he feels?
    It's hard to say how he feels cause he lives in a country with shitty economy and etc. In the past few years i see him more tired and stressed than ever (due to work and etc) he smokes alot of cig and probably wont quit. Doesnt exercise at all. Nutrition is not that good. He doesnt seem to have motivation for a better lifestyle, physically and mentally drained and tired of life.

    Does this answer the question?

  11. #11
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    Quote Originally Posted by EquilibriumZ View Post
    It's hard to say how he feels cause he lives in a country with shitty economy and etc. In the past few years i see him more tired and stressed than ever (due to work and etc) he smokes alot of cig and probably wont quit. Doesnt exercise at all. Nutrition is not that good. He doesnt seem to have motivation for a better lifestyle, physically and mentally drained and tired of life.

    Does this answer the question?
    TRT (especially unsupervised) would be a bad idea for him.
    He needs to improve his diet and lifestyle before anything else. If he doesn't care enough to do that, he wont do his HRT properly either, and will only damage his health further. Everything you just told us accounts for his hormone levels.

  12. #12
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    Op, Bonaparte and I are both telling you the same thing. It's lifestyle choices first and foremost. TRT, especially unsupervised is no panacea. I sincerely empathize with what you're going through. Watching your parents slow down with the aging process is not pleasant.
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  13. #13
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    Quote Originally Posted by Bonaparte
    TRT (especially unsupervised) would be a bad idea for him. He needs to improve his diet and lifestyle before anything else. If he doesn't care enough to do that, he wont do his HRT properly either, and will only damage his health further. Everything you just told us accounts for his hormone levels.
    Now that i rethink about the diet, it's just homemade persian food that the maid makes. It's not like he eats anything fast food as in mcdonalds. The food that he eats outside the house is basically kebab with rice not burgers and etc. He does care about his health in a way that if you tell him to take this medication on these day, he will or get a bloodtest and etc. And he can show his result to a doc but they will probably tell him to discontinue "steroid use " cause that's what the book taught them.

    My question is what are the criterias that need to be fulfilled in order to consider unsupervised trt ? I strongly believe that if he gets a "boost", he will make significant change in his exercise habits because he ll have the energy to do it. I m saying this cause i have seen him do random stretches small exercises on the ground before going to work as in he is trying to get back in life


    Thank you for taking the time to read these things and giving your advice! And oh ya, any advice on how i can help him drastically?
    Last edited by EquilibriumZ; 11-23-2014 at 05:08 AM.

  14. #14
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    He needs to quit smoking. Smoking is already a huge risk factor for cardiovascular disease and strokes, as is HRT if done wrong.
    I assume he is also overweight, since it would explain the high estrogen.

  15. #15
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    I believe Kel and Bonaparte said the most important things to you. It's a no brainer: It's up to your dad to make the decision to take control of his health. You can't make him do it; he has to make the decision for himself.

    Why don't you talk to him about getting onto this forum, getting involved and taking part in the discussions?
    A little tough love - kind criticism - wouldn't hurt. Get't him off his behind and give him some homework to do. Have him READ some books! Start him with The Testosterone Syndrome. It's a very encouraging and uplifting read and describes the changes in men's lives with case studies.

  16. #16
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    As a guy who smoked many many years ago, I can tell you that in and of itself can be the healthiest thing that he can do. You can't have much energy when you are smoking on a daily basis. I guarantee he'll feel better just quitting. I know I could breathe better, food tasted better, my immune system got better.
    I was really a young guy and felt a great difference. I recently had a Army friend of mine quit smoking about a year ago now. He's running again and tells me how much better he feels since quitting. Hasn't gotten sick since quitting either.

  17. #17
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    whats his psa? high estrogen in older gentlemen isnt good for prostate

  18. #18
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    Quote Originally Posted by kelkel View Post
    First question really should be how does he feel? If he feels ok with no debilitating issues I'd have him work on lifestyle, nutrition and of course add vit D.
    What's causing the low test and higher estrogen is simply aging. As we age test decreases and E rises. A mid-fifties out of shape male can have higher E than a female of the same age. Lifestyle, good nutrition and lower body fat can combat this to some extent.

    So, how does he say he feels?
    A middle age man can have more Estrogen than a woman of similar age? How is that possible? Wouldn't he just 'turn' female?

  19. #19
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    Quote Originally Posted by Lee_1978 View Post
    A middle age man can have more Estrogen than a woman of similar age? How is that possible? Wouldn't he just 'turn' female?
    He is still producing test, which is converting to estrogen.
    A middle aged woman will have gone through menopause, so she no longer produces test or estrogen in any significant amount.

    And he wouldn't "turn female", because the test still overpowers the feminizing effects of the estrogen.

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