Low/High E2 Management

**justadude** · 09-25-2013, 08:43 AM

I'm having hell with my E2, never knowing if it's high or low. I've recently created a log I'm keeping at my house, writing down symptoms, what I'm taking, etc. My most recent sensitive estradiol test, taken about two weeks ago, showed my E2 to be 13 on a scale of 3-70. Now, I think I'm on the right track. But, I'm not sure. My symptoms from last night and this morning are:

-had night time erections
-did not have morning wood
-low libido
-acne still present, although not as bad as last week
-not much energy
-had night sweats, woke up and my sheets were soaked
-woke up a few times during the night to piss, woke up more than usual
-had a little insomnia, sleep wasn't great

Any opinions on what my symptoms are showing? High? Low?

Thanks guys, getting this estradiol right is definitely the most trouble for me. I'll be updating this post every day, or at least I'll try to remember to, until I get this figured out.

**bass** · 09-25-2013, 09:55 AM

what is your complete protocol and how long you been on TRT. your symptoms are similar for someone new on TRT, body goes through adjustment then it stabilizes. usually low and high E2 symptoms are similar with the exception of bloating and achy joint, bloating when its too high, achy joints and cramps when its too low. all other symptoms like libido, insomnia, lack of energy and so on can be caused by either.

**justadude** · 09-25-2013, 11:08 AM

Originally Posted by bass

what is your complete protocol and how long you been on TRT. your symptoms are similar for someone new on TRT, body goes through adjustment then it stabilizes. usually low and high E2 symptoms are similar with the exception of bloating and achy joint, bloating when its too high, achy joints and cramps when its too low. all other symptoms like libido, insomnia, lack of energy and so on can be caused by either.

My protocol is 100mg test c a week, subQ, split twice. HCG on non injection days at 100iu. I'm not really on a set program with the adex due to this hell of figuring out the E2. You said low E2 and high E2 symptoms match. Is that true for night sweats?

**justadude** · 09-25-2013, 11:09 AM

But I do have adex, and liquidex. I'm trying to figure out the dosing.

**bass** · 09-25-2013, 11:16 AM

how long you been on TRT?

**ZenFitness** · 09-25-2013, 12:03 PM

Originally Posted by justadude

But I do have adex, and liquidex. I'm trying to figure out the dosing.

If your E2 is in the teens you do NOT need an AI. Wait until bloodwork validates your symptoms - I'm telling you this from personal experience.

**crazy mike** · 09-25-2013, 12:12 PM

Originally Posted by ZenFitness

If your E2 is in the teens you do NOT need an AI. Wait until bloodwork validates your symptoms - I'm telling you this from personal experience.

^^^ If you plug in Adex at this juncture you WILL crash your E2 and you will feel like death warmed over. Do not do this. If you doc is prescribing test then have him do BW and talk to him. WE have no idea what is going on with you at this point, except E2 at that level is NOT high. Do not fool around with this. I tell you BW. AND from MY own experience do not crash your E2. ...crazy Mike

**justadude** · 09-25-2013, 12:33 PM

Ok fellas, thanks for responses. I've been on trt for a little over 2 years, have never quite gotten it figured and and have had low libido, not great erections since the time. Before trt I was worse though. What I've been noticing today is my flaccid hang is quite constricted, and I feel a little "tight" down in that area. I'll probably be ordering labwork soon on my own, but I really need to figure out how to dose and gauge by my symptoms, as I don't want to get bloodwork forever.

**crazy mike** · 09-25-2013, 01:40 PM

When you get the results return to your thread and tell us / show us and someone can and will help. ...crazy mike

**ZenFitness** · 09-25-2013, 01:56 PM

Sometimes erection struggles lead to a sense of poor libido due to sexual aversion. Do you take Cialis? If not, you might consider the 10mgs/day (I do 3 - 5 mgs AM, 5 mgs PM, but some do 10 mgs all at once). That plus hCG made a world of difference in this department for me.

**phaedo** · 09-25-2013, 01:58 PM

OP, I'm right there with you. I've swung from <5 pg/mL to 92 pg/mL and somewhere in between. Exorbitant amounts of hCG is likely the culprit to my hormonal roller coaster. I'm settling in on 300 IU's 3x weekly.

Not to highjack the thread, but what about progesterone? We know members often have E2 troubles when hCG is introduced along side TRT, and given that hCG stimulates pregnenolone production, can there also be an imbalance of progesterone that exacerbates symptoms?

I say this, as my lastest blood work showed E2 at 31 pg/mL, which isn't terribly high, though my symptoms are definitely reminiscent of high E2. The OP has low E2, but not deplorably low, yet still exhibits symptoms of (very) low E2. Could excess progesterone be fault, since an AI is ineffective at this junction?

**kelkel** · 09-25-2013, 02:52 PM

Originally Posted by justadude

Ok fellas, thanks for responses. I've been on trt for a little over 2 years, have never quite gotten it figured and and have had low libido, not great erections since the time. Before trt I was worse though. What I've been noticing today is my flaccid hang is quite constricted, and I feel a little "tight" down in that area. I'll probably be ordering labwork soon on my own, but I really need to figure out how to dose and gauge by my symptoms, as I don't want to get bloodwork forever.

Routine BW is part of this world. You need to fine homeostasis and try to maintain it. Change one thing at a time and make those changes small to avoid radical swings in levels and resultant issues.

Originally Posted by phaedo

OP, I'm right there with you. I've swung from <5 pg/mL to 92 pg/mL and somewhere in between. Exorbitant amounts of hCG is likely the culprit to my hormonal roller coaster. I'm settling in on 300 IU's 3x weekly. Any impact from this amount will be negligible.

Not to highjack the thread, but what about progesterone? We know members often have E2 troubles when hCG is introduced along side TRT, and given that hCG stimulates pregnenolone production, can there also be an imbalance of progesterone that exacerbates symptoms? Prg usually decreases with age while E2 rises. Preg is a transformer hormone and will basically dictate where and what it signals downstream in our hormone pathways. You are correct in that elevated prg levels increase E2. Remember, prolactin will then follow E and rise as well.

I say this, as my lastest blood work showed E2 at 31 pg/mL, which isn't terribly high, though my symptoms are definitely reminiscent of high E2. The OP has low E2, but not deplorably low, yet still exhibits symptoms of (very) low E2. Could excess progesterone be fault, since an AI is ineffective at this junction?

31 on a sens assay is not high at all. But it's all relative to the individual. My norm is 16 and I'm fine there. I prefer mid 20's. The number we all run at is relative only to us. Meaning I may feel great at a lower level where someone else may suffer symptoms

in bold above...

**phaedo** · 09-26-2013, 02:45 AM

Agreed, kelkel, that a the small dose mentioned would have negligible impact on E2 levels and serum testosterone . However, I've been prescribed up to 3,000 IU, 3x weekly, which undoubtedly has significant impact -- and hence estrogen hovers around the 100 pg/mL.

Though 31 pg/mL on an estradiol panel isn't outrageously high, my progesterone came back at at 0.96 ng/mL. My guess is over production of pregnenolone via hCG stimulation?? (at the time of labs, I was injecting 600 IU, 3x weekly)

Not sure how to interpret the high progesterone in light of moderate E2. Regardless, I've decreased hCG to 300 IU, 3x weekly.

I think I've officially hijacked the thread. Sorry OP!

**justadude** · 09-26-2013, 09:30 AM

I've tried Cialis, doesn't work. I have wondered if HCG contributes to the problem, as it seems when I don't inject HCG for at least two days, things do seem to calm down. But, interesting findings last night. As I said, I felt constricted all day yesterday. Last night was the second day in a row where I drank 4 grams of citrulline along with 2.5 grams of arginine before bed. I have erections during the night with this. But still no morning wood and low libido the next morning. While sleeping, I actually had a wet dream, yet no libido when waking? It's confusing. Other notes:

-acne still present, same as yesterday.
-still kind of tight, not good flaccid hang.

What is the no flaccid hang a symptom of? Low or high E2?

**justadude** · 09-26-2013, 09:31 AM

Originally Posted by phaedo

Agreed, kelkel, that a the small dose mentioned would have negligible impact on E2 levels and serum testosterone . However, I've been prescribed up to 3,000 IU, 3x weekly, which undoubtedly has significant impact -- and hence estrogen hovers around the 100 pg/mL.

Though 31 pg/mL on an estradiol panel isn't outrageously high, my progesterone came back at at 0.96 ng/mL. My guess is over production of pregnenolone via hCG stimulation?? (at the time of labs, I was injecting 600 IU, 3x weekly)

Not sure how to interpret the high progesterone in light of moderate E2. Regardless, I've decreased hCG to 300 IU, 3x weekly.

I think I've officially hijacked the thread. Sorry OP!

We're in this together, hopefully lots of good E2 info can result in this thread. I'll be updating my findings along with symptoms.

**ZenFitness** · 09-26-2013, 10:10 AM

Cialis should work if nothing else is interfering. My guess is that it sounds like you have low E2 - this is an erection killer. If you are taking adex or liquedex then that is the issue. You need your E2 to increase. An E2 level of 13 is relatively low and likely is the cause of all your symptoms and issues.

The good news is that low E2 is fixable! You just need to quit taking the adex and liquidex... it may take a couple of weeks to start a strong recovery, but you should feel much better (I did when I was in your shoes).

**justadude** · 09-26-2013, 10:53 AM

Ok, the adex is cut out. Now, feeling how I feel now, I do NOT feel emotional. So when I do start to feel emotional, it is a safe bet to assume my E2 is going high, correct?

**jomamma007** · 09-26-2013, 11:21 AM

What's your complete protocol and ai dosage?

**ZenFitness** · 09-26-2013, 11:58 AM

Not necessarily... I get a little emotional on either side of the E2 fence (too high/too low). The important thing is not to self-administer an AI and take it under a doctor's care with validating bloodwork.

**justadude** · 09-26-2013, 12:04 PM

Originally Posted by ZenFitness

Not necessarily... I get a little emotional on either side of the E2 fence (too high/too low). The important thing is not to self-administer an AI and take it under a doctor's care with validating bloodwork.

I disagree. Most doctors suck. I've abandoned them. The past few months I've been on my own and making way more progress with this stuff than I was when under a doctor's "care." The bloodwork part I do agree on though.

**jomamma007** · 09-26-2013, 12:13 PM

you'll still get more insight from blood work results by posting them here then showing them to your average doctor.
@justadude I tend to be able to cry on a dime when estrogens high, and when it's low I'm emotional but it's kind of irritability and anger, sadness comes but I can't shed any tears when E's low

**ZenFitness** · 09-26-2013, 12:22 PM

Originally Posted by justadude

I disagree. Most doctors suck. I've abandoned them. The past few months I've been on my own and making way more progress with this stuff than I was when under a doctor's "care." The bloodwork part I do agree on though.

I've had my fair share of shitty doctors for TRT, so I get it. I use my GP who is worlds apart from urologists and endos I've visited.

At any rate, I certainly wouldn't fool around with this stuff without bloodwork. It is very easy to get out of whack and not know if you are too high/low and always feel like shit. That's why I suggest going through a doctor - just tell them what you are doing and have them schedule your bloodwork, etc. A doctor can't make you do or not do something, and, if they don't want to work with you, then just move to the next. The main thing is you need the bloodwork and possibly advice if things get crazy.

**jomamma007** · 09-26-2013, 12:44 PM

^ absolutely agree, getting stuck between that high or low estrogen range is such a pain as almost all the symtpoms are the same.

**FRDave** · 09-26-2013, 12:59 PM

What was your Arimidex dosage at the time of blood work and what all have you changed in your protocol since this date?

The number one sign for me when E2 is low is aching joints. I experience this once I dip in the teens. With high E2 I get bloated. Good sign is when I see indentations in my lower leg after removing my socks and it stays like that for a good amount of time vs instantly going away.

**dreadnok89** · 09-26-2013, 09:11 PM

I run better at a little higher e2. Flaccid and balls def look better with higher than lower. When I say higher I mean like 35

**justadude** · 09-27-2013, 07:53 AM

Symptoms from yesterday night/this morning:

-had a libido, felt nice
-had the libido, but can't get an erection to save my life
-again, sensation down there is great, but an erection just isn't going to happen
-flaccid hang is even smaller and tighter than yesterday
-acne about the same, maybe down a little
-took me about a half hour or so to fall asleep, had to urinate three times before falling asleep
-no night sweats

I haven't taken any arimidex since the test, since right after getting the test done I suspected I still had high E2 and took some adex, so it may have crashed. But the symptoms I'm getting now are having me believe it may be getting high again, especially the libido without erection. Although I haven't ejaculated for about 5 days, so that could contribute to the libido... Thoughts?

**ZenFitness** · 09-27-2013, 08:54 AM

Have you ever had a blood test with high E2? I seriously doubt that your E2 would move up that fast in two weeks unless you are running some really high test doses (I mean more than 200 mgs a week).

**justadude** · 09-27-2013, 09:05 AM

Originally Posted by ZenFitness

Have you ever had a blood test with high E2? I seriously doubt that your E2 would move up that fast in two weeks unless you are running some really high test doses (I mean more than 200 mgs a week).

Yes, I see above I put down I was on 100mg a week. Missed that. I have sky high SHBG due to being on T3 for hypothyroidism, so I have been on 200mg a week, which puts my bioavailable and free t in the upper quartile now, with my total test hovering around 1500 or so.

**justadude** · 09-27-2013, 09:05 AM

Also taking DHEA, plus the HCG , so who knows maybe the E2 can come up quick?

**jomamma007** · 09-27-2013, 06:06 PM

How many days since you last took arimidex again?

**ZenFitness** · 09-28-2013, 06:20 AM

That is a high dose - did a doctor prescribe this?

SHBG is probably contributing to your erection issues, and you may have E2 creeping up with that high a dose.

**justadude** · 09-28-2013, 07:30 AM

Something interesting happened yesterday. I injected a large than normal dose Thursday night in an effort to feel like I had high E2. From my symptoms yesterday which I posted, I suspected I might. So I popped a .25 of adex, and told myself I'd wait three days to reevaluate. Well, after having a beer and hanging out last night, I get home later than usual, eat some good stuff, then get to bed. And...I wake up in the middle of the night with a strong erection, something I haven't experienced in a very long time! I was having them all night, but this one was strong! My libido was high too. This morning though, there was no erection but it still had a little bit of blood in it. I think I'm getting closer... Will go next 2 days without adex, then take it again, counting symptoms/benefits along the way.

**vmons01** · 09-28-2013, 09:11 AM

Absolutely forget about the notion that you can determine you E2 level based on how your feel, or symptoms, it's just does not work! I tried that, thought I had a figured out, and I was wrong every time. The ONLY thing that got me dialed in was monthly sensitive tests done on my own along with a detailed log. That is the only way to know whether your E2 is low or high, trust me.

**ZenFitness** · 09-28-2013, 09:45 AM

^^ Agree, no offense OP, but you are flying blind here and throwing reason to the wind.

vmons01, where did you get the tests to do on your own?

**dreadnok89** · 09-29-2013, 08:40 PM

Really guys? I just use my penis as a guide haha. If it takes forever to get hard= too high if erection is hard as hell but organ is lame I'm running to the lower side

**justadude** · 09-30-2013, 09:28 AM

Originally Posted by dreadnok89

Really guys? I just use my penis as a guide haha. If it takes forever to get hard= too high if erection is hard as hell but organ is lame I'm running to the lower side

That's my main thing: I'm using libido and my erection as a guide, logging all symptoms. I've been having decent erections recently, but still nor morning wood. Other symptoms I'm starting to correlate with high or low E2. Keeping a log everyday is helping.