Blood Work Results (High Estrogen)

[pete69]

Just got my results from my blood work. I'd greatly appreciate any feedback about my numbers. My symptoms have been forever. They include depression, very low energy, no self esteem, no sex drive, poor sexual performance (trouble getting aroused and when I do, trouble maintaining it and it loses rigidity easily), body dysmorphic disorder, really hard time losing fat despite very strict dieting, abdominal obesity, bloating from eating almost everything (carb intolerant regardless of source, and tons of food allergies/intolerance including bloating from even moderate amounts of fat in the diet) , puffy face, etc etc.

Glucose
100 - Range 65-139mg/dL (according to mayo clinic, now anything at 100 or greater is prediabetic/impaired glucose metabolism) Which is probably even more true for me b/c I usually follow a keto diet w/ infrequent carb loads, and my last meal before this test was 12 hours prior and was 8oz. of beef, no carbs.

TSH 1.94 - Range .40 to 5.50 mIU/L
T4, Total 9.5 - Range 4.5 to 12.0 ug/dL
T3 Uptake (Low) 26.4 - Range 27.8 to 40.7 percent
T4, Free, Calculated 2.51 - Range 1.53 to 3.85 Units

Monocytes, Absolute (Low) 193 - Range 200 to 950 Cells/mcL (not sure what this might indicate besides increased risk of infection)
Eosinophils and Basophils were very low but within range

LH 3.2 - Range 1.5 to 9.3 mIU/mL
FSH 3.3 - Range 1.6 to 18.0 mIU/mL
Prolactin 10.5 - Range 2.0 to 18.0 ng/mL
HCG, Serum <5.0 - range <5.0 mIU/mL

SHBG 32 - Range 7 to 50 nmol/L
PSA, Total .71 - Range 0.0 to 4.0 ng/mL
Total Testosterone 479 - Range 260 to 1000 ng/dL
Free Testosterone % 1.8 - Range 1.0 to 2.7%
Free Testosterone 86.2 - 50.0 to 210.0 pg/mL

TOTAL SERUM ESTROGEN 156 (HIGH) - Range 130 or less pg/mL
(probably would be even higher b/c I've been taking 2 Bioresponse DIM every day)

 

[mranak]

Why the heck did they run an hCG test on you? If I'm not mistaken, that test is only appropriate for women.

 

[pete69]

That's a good question, I honestly don't have an answer. The Dr. didn't get into specific tests she was going to run. Perhaps it was part of another of a group of tests, since it's group along with LH, FSH and Prolactin.

 

[ASaxon]

My impression

Until someone more knowledgeable posts heres my two cents.

Looking at your numbers they all seem, although not optimal, okay as a whole except for your estrogen levels. Im still learning a lot as I am new to this whole hypogonadism business so Im sure I will be corrected if Im wrong with this. From what I hear optimal Free Testosterone levels should be in the upper 1/3rd of the reference range but if you are obese then its not uncommon for Free Testosterone to be in the lower 1/3 of the reference range or even right at the lower borderline depending on your level of obesity. Also, its not uncommon for obese people to have higher estrogen levels because more Testosterone is converted to estradiol (E2) via an enzyme called aromatase in fat cells but you probably already know that if youre taking DIM. You should probably have your estradiol levels checked although Im not sure that would lead to any further diagnosis in-and-of itself.

Have you had a Liver function workup done? If so what were those results? Just curious because the liver has a part in filtering out estrogens from the bloodstream and if youre not on Testosterone Replacement Therapy (which I assume you are not given your LH and FSH numbers) then estrogens shouldnt be high. Im sure your doctor has already done those tests but its just something to double check on.

From your description of symptoms I would have thought Hypothyroidism might be a possibility but your blood tests dont indicate that condition.

 

[pete69]

ASaxon, thank you for the reply. I am fairly new to this as well, have really been reading more extensively for the last week months.

I don't think aromatization from bodyfat is a big issue b/c i'm not obese, i'm 6'3", 205 lbs and around the 10-12% range, but have the hardest time getting lower. Back in HS (8 yrs ago), I weighed 260 lbs.

Liver function test is a good idea. I have stopped taking antioxidants for the last few months. I have them sitting here, just have to start up again. I'm going to be taking Vit. C, E, R-ALA, N-acetyl Cysteine, Milk Thistle and Kyolic. Going to also add Calcium-D-Glucarate and TMG to the DIM.

I believe that Arimidex is my best bet for dropping the estrogen.

I also have a family history of hypothyroidism, and have all the symptoms. I've been taking Nutri-meds Thyroid, which according to several sources, is said to be equivalant to Armour Thyroid (dessicated porcine thyroid), and this supplement is the only one w/ active thyroid in it. Not knowing I was getting the blood work the day I did, I have been taking this supp. for the last 2 months and the day blood was drawn, so my thyroid numbers might be worse without it.

Either way, my T3 uptake was below range low, and this suggests hypothyroidism. According to what I read, the main cause of low t3 uptake is high estrogen, so this makes sense. It basically means that t3 is bound to carrier proteins so its not free to excert metabolic effects in the body. I really wish free T3 was checked.

 

[ASaxon]

Yea, free T3 and free T4 would have been essential but it doesnt seem your TSH isn't reacting as if your fT3 or fT4 are too much out of whack, of course that could be because of the supplements you are taking, I wouldnt know. My free T3 came back out of range too, but my endocrinologist didnt consider it significant because my other thyroid and pituitary hormones were normal.

If you have yet to get a good baseline for your blood work you might want to lay off the supplements for a while and then do a full workup again. However, I wouldnt know how long it takes for supplements to work their way out of the body in order to do this. As you suggest, supplementation can alter blood work enough to make it difficult to see what might be going on. Of course if you are taking these supplements under a doctors order then youll need to consult your doctor before changing anything.

I think your best bet for dropping the estrogen would be to see if you can figure out what the root problem is if possible. Arimidex may bring it down but you should try to find out why its high. If you can find the source of the problem that would obviously be better.

In my case I have had a clue of my low testosterone problems for years. For me my clue was Alkaline Phophatase. Every time I tested Alk Pho it would always come back low. Doctors couldnt figure out why but I knew that it could be related to osteoporosis. Unfortunately the only test I could get my doctor to perform was a heal scan which came back normal. I always wondered why they do a heal scan instead of scanning some other bone. It seems to me that the heal would be the last bone that would show osteoporosis because its a weight bearing bone. Seems like if they wanted to detect early stage osteoporosis theyd scan something like the forearm. Of course Im no doctor so what do I know?

Regardless, it turns out that low testosterone can cause osteoporosis and that my low Alk Pho levels could be related to an early stage of osteoporosis. I may not know until I get my T levels back up to normal and wait and see if my Alk Pho returns to normal. Then Ill know for sure.

Anyhow, good luck and I hope you figure your mystery out. I know how frustrating it can be as Ive been though tons of tests over the past four + years trying to figure out what was the cause of all my symptoms.

 

[cpeil2]

In my case I have had a clue of my low testosterone problems for years. For me my clue was Alkaline Phophatase. Every time I tested Alk Pho it would always come back low. Doctors couldnt figure out why but I knew that it could be related to osteoporosis. Unfortunately the only test I could get my doctor to perform was a heal scan which came back normal. I always wondered why they do a heal scan instead of scanning some other bone. It seems to me that the heal would be the last bone that would show osteoporosis because its a weight bearing bone. Seems like if they wanted to detect early stage osteoporosis theyd scan something like the forearm. Of course Im no doctor so what do I know?

Regardless, it turns out that low testosterone can cause osteoporosis and that my low Alk Pho levels could be related to an early stage of osteoporosis. I may not know until I get my T levels back up to normal and wait and see if my Alk Pho returns to normal. Then Ill know for sure.

Anyhow, good luck and I hope you figure your mystery out. I know how frustrating it can be as Ive been though tons of tests over the past four + years trying to figure out what was the cause of all my symptoms.

ASaxon;

Those heel scans are too unreliable to even be of much use as a screening test for osteoporosis. I had one done and it showed that I was osteopenic. My doc ordered a DEXA scan, and it turned out that my bone mineral density was twice normal! A better osteoporosis screen is urinary n-telopeptide, a marker for bone resorption that is measured in the urine. If your insurance won't pay for it, it costs about $80-$100.

 

[mranak]

<snip>
Have you had a Liver function workup done? If so what were those results? Just curious because the liver has a part in filtering out estrogens from the bloodstream and if you*re not on Testosterone Replacement Therapy (which I assume you are not given your LH and FSH numbers) then estrogens shouldn*t be high. I*m sure your doctor has already done those tests but it*s just something to double check on.

You've been doing lots of homework, much like I was 9 months ago. Very good!

Just a few comments. I'm not sure that elevated liver enzymes would have an impact on the estradiol/estrogen levles, but I may be wrong. I would like to know more about this.

As for elevated estradiol for patients on TRT, it is actually very common. Testosterone goes up and so does estradiol; no surprises there.

And I wouldn't go so far as to say that most non-obese men have their testosterone in the upper 1/3 of the range. But that is where we want out testosterone if we are on TRT.

 

[pete69]

I am not currently on hormone replacement, and unfortunately don't think I will based on my numbers b/c even though they are low they are technically within range.

I've suspected liver problems for a while based on my fat intolerance, leading me to believe that I have stagnant bile and wasn't "dumping" what my liver was processing properly. I supplement with artichoke, lecithin granules, and a lipase supplement and although definitely "alternative", I get temporary relief every time I perform a liver flush.

 

[ASaxon]

Liver function

I was thinking that a Liver test would show how the liver was functioning. Its not that the elevated liver enzymes would cause high estrogen but elevated liver enzymes would show if theres liver disease present. If theres liver disease then that may explain high estrogen levels in the absence of being on TRT. Of course if someone is on TRT then high estrogens are a common problem, I agree.

Another test to do would be SHBG (Sex Hormone Binding Globulin) as this is sometimes high in Liver disease which would in-turn cause free testosterone to be on the low end. Petes free testosterone is a little on the low side and that may be the reason. Can't know without more tests.

The only way to really know is to have a liver panel done and perhaps an ultrasound of the liver. If these tests all indicate a liver problem then a liver biopsy might be appropriate to gauge the severity of the condition depending on the results of the previous tests.

The liver is an amazing organ, You can remove half of it and it will grow back to full size within a few years (i.e. living liver donation). One of the only organs that actually can regenerate itself after being damaged (to a certain extent). If liver problems exist there are a lot of treatments that can improve liver function and halt and reverse any disease. The important thing is to get any liver problems identified early so it can be treated.

Hope this helps in some way.

 

[ASaxon]

Oops, just realized Pete had the SHBG test done...wasn't high...so that doesn't seem to indicate a Liver problem. Although SHBG levels arent highly predictive of liver problems, sometimes SHBG doesn't become high until advanced liver disease is present so I'd still get a Liver panel done and take it from there. My two cents.

 

[pete69]

Based on this chart, I wonder how much this can contribute to one's actual hormone levels. Looks like i'm gonna have to start boiling my skinless chicken breasts.

Another thing, does anyone know, for a 26 yr old, if an Endo would treat my Test levels, even though they are technically in range.

 

[ASaxon]

Okay, the chicken-chart may be going a bit too far.

 

[pmgamer18]

Just got my results from my blood work. I'd greatly appreciate any feedback about my numbers. My symptoms have been forever. They include depression, very low energy, no self esteem, no sex drive, poor sexual performance (trouble getting aroused and when I do, trouble maintaining it and it loses rigidity easily), body dysmorphic disorder, really hard time losing fat despite very strict dieting, abdominal obesity, bloating from eating almost everything (carb intolerant regardless of source, and tons of food allergies/intolerance including bloating from even moderate amounts of fat in the diet) , puffy face, etc etc.

Glucose
100 - Range 65-139mg/dL (according to mayo clinic, now anything at 100 or greater is prediabetic/impaired glucose metabolism) Which is probably even more true for me b/c I usually follow a keto diet w/ infrequent carb loads, and my last meal before this test was 12 hours prior and was 8oz. of beef, no carbs.

TSH 1.94 - Range .40 to 5.50 mIU/L
T4, Total 9.5 - Range 4.5 to 12.0 ug/dL
T3 Uptake (Low) 26.4 - Range 27.8 to 40.7 percent
T4, Free, Calculated 2.51 - Range 1.53 to 3.85 Units

Monocytes, Absolute (Low) 193 - Range 200 to 950 Cells/mcL (not sure what this might indicate besides increased risk of infection)
Eosinophils and Basophils were very low but within range

LH 3.2 - Range 1.5 to 9.3 mIU/mL
FSH 3.3 - Range 1.6 to 18.0 mIU/mL
Prolactin 10.5 - Range 2.0 to 18.0 ng/mL
HCG, Serum <5.0 - range <5.0 mIU/mL

SHBG 32 - Range 7 to 50 nmol/L
PSA, Total .71 - Range 0.0 to 4.0 ng/mL
Total Testosterone 479 - Range 260 to 1000 ng/dL
Free Testosterone % 1.8 - Range 1.0 to 2.7%
Free Testosterone 86.2 - 50.0 to 210.0 pg/mL

TOTAL SERUM ESTROGEN 156 (HIGH) - Range 130 or less pg/mL
(probably would be even higher b/c I've been taking 2 Bioresponse DIM every day)

It looks like to me that the wrong Test was done for checking your Estrogen you need to have your E2 Estradiol checked. You need to have an Assy Test done. It is for men Quest does it it is called "The Nichols Estradiol Assay (Extraction/Chromatography/RIA Method) (Order Code 30289).
If it is found to be high then that could be why you feel this way. It was the cause of my feeling like that.
Phil

 

[Random987]

I don't think that total E is a useless test. Although E2 is a much more active estrogen, the others are important and I think that a lot of the trt docs are starting to pay attention to the overall number.

It looks like to me that the wrong Test was done for checking your Estrogen you need to have your E2 Estradiol checked. You need to have an Assy Test done. It is for men Quest does it it is called "The Nichols Estradiol Assay (Extraction/Chromatography/RIA Method) (Order Code 30289).
If it is found to be high then that could be why you feel this way. It was the cause of my feeling like that.
Phil

 

[Weatherlite]

I don't think that total E is a useless test. Although E2 is a much more active estrogen, the others are important and I think that a lot of the trt docs are starting to pay attention to the overall number.

Unfortunately there's not much we can do about the total number. We can reduce E2 but that usually just makes the total E go up.

 

[maxzax]

From what I read Arimidex and Aromasin will lower E2 and total E's.

But please correct me if I am wrong.

Unfortunately there's not much we can do about the total number. We can reduce E2 but that usually just makes the total E go up.

 

[pete69]

How about Femara (Letrozole) as an anti-estrogen. I know it is supposed to lower all 3 forms of E lower than Arimidex, as well as penetrate adipose tissue as well stopping aromatization there.

 

[Weatherlite]

This is what I found on Femara...

"Letrozole is a nonsteroidal competitive inhibitor of the aromatase enzyme system; it inhibits the conversion of androgens to estrogens."

"Letrozole inhibits the aromatase enzyme by competitively binding to the heme of the cytochrome P450 subunit of the enzyme, resulting in a reduction of estrogen biosynthesis in all tissues. Treatment of women with letrozole significantly lowers serum estrone, estradiol and estrone sulfate and has not been shown to significantly affect adrenal corticosteroid synthesis, aldosterone synthesis, or synthesis of thyroid hormones."

This comes directly from the package insert. It states that it only affects serum levels of three specific metabolites of E. There are dozens and dozens of E metabolites out there so I don't think it could affect total E levels other than through the fact that it is not allowing the addition of those three metabolites.

 

[Random987]

Yeah, this is one of the gray areas of TRT, it is sorta like eating soup with a fork. I have great E2 levels, but high Total E levels. Good ol' doc is still monitoring everything to see what we can do.

Unfortunately there's not much we can do about the total number. We can reduce E2 but that usually just makes the total E go up.