DEXA SCAN shows dangerous bodyfat accumulation

[mcs5309]

Stubborn bodyfat is not always a result of eating more calories than we burn. No matter how hard I train, do cardio, count calories, do lo-carb gluten-dairy-egg-free Paleo, take T3 thyroid meds, I have been trapped in this layer that surrounds all that hard work. I can lose weight, but that doesn't mean sh*t. My bodyfat and lean mass remain proportionately the same no matter what. The most frustrating thing is that I don't understand how I can east so strict and be so out of whack when I see others eat tons of processed foods with simple carbs, trans fats, etc. and are lean and symptom-free.

In my case, losing bodyfat is no longer for cosmetic purposes only, but for optimal health, and mine is at risk with the bodyfat % I carry now.

I've now done three of the state-of-the-art technologies for baseline bodyfat measurement and the DEXA scan seems by far the most accurate and informative (see below). It was a dead-on match with UWW. The BodPod was off by nearly 4% from both (in my favor). The DEXA is hands down the best tool for those engaged in a body recomp program as some of you know I've been struggling with for a long time.

As an added "bonus" the DEXA also reports on BMD (bone mineral density) that the other tests do not perform. I had it done at a small, privately-run clinic in Northern California. The cost was $69 and did not require a doc's Rx. The only downside is the minute radiation exposure which isn't a cause for concern in short-term usage.

And the real awesome part is that when I do my follow-up in 6 mos. or so, the computer will automatically do a side-by-side comparison with my initial results.

You can read more on the various technologies here:
http://blue.regence.com/trgmedpol/radiology/rad41.html

Here's the bad news and danger:
As you can see, the danger is the visceral fat accumulation in my largest fatty area - the android - which is composed of the abdomen and trunk.

As in my past threads []Body recomposition issues-part iii, most people would consider me in decent shape by looking at me, but I'm far from optimal and know and can feel it, despite regular training.

This explains the differences between the biggest areas and most dangerous area I showed for fat accumulation -android and gynoid fat:
diglloyd The Wind In My Face - DEXA Body Scan for Fat, Muscle, Bone Measurement - Android and Gynoid Fat
Android/Gynoid Fat Ratio: What it means for your health | Body Fat Testing in Chicago

I strongly suspect these issues to blame which are all inter-related:
-hypothyroidism - specifically, T4 to T3 conversion block, elevated rt3 which = elevated TSH, and mild auto-immune thyroiditis (as reported in my last thread): Thyroid crash - symptoms & underlying causes)
- leptin/insulin resistance
- hypocortisolism (in the first half of the day)
- LGS (leaky gut syndrome from underlying chronic dysbiosis/food allergies)
- Estrogen Dominance
- inflammatory signaling caused by all of the above

Also, I am barely holding onto my strength lately which means I must be losing mass compared to when I was heavier, so I've lost weight, but at the expense of proportionately losing mass as well. I have been on a very lo-carb Paleo diet for a while now.

The bottom line is that the sustained-release T3 I've been taking for over a year is not doing its job in resetting thyroid function and enhancing lipolytic activity as evidenced in my latest thyroid tests (see last link above).

My doc has always said that the bodyfat is largely due to a protective mechanism or sickness behavior as a result of chronic low-grade inflammation (as evidenced by elevated HS-CRP levels, etc.). It's a vicious cycle because the fat (adipokines) produce inflammation themselves.

He wrote me a scrip for Atenolol 25mg and some test cyp 160mg/week, but I held off because I knew there are too many other issues running in the background that going on more stuff might only complicate. Agreed? Besides, my T last measured 513.


What I still to this day cannot figure out is why certain B complex vitamins aggravate these symptoms. Looking into this deeper, it seems that the B vitamins directly involved in energy and hormone production and metabolism (B2, B3, B5, B6) are the ones that affect me the most. But I desperately need them to optimize everything since my diet cannot and does not supply what I need as evidenced by blood work. This is a real dilemma for me.

The symptoms of feeling of tightness around throat; lowering of voice, sluggishness/fatigue, anxious, palpitations, tremors are classic cookie-cutter Hashimoto's thyroiditis symptoms even though my TgAb levels show within normal range, but as it's been said the amount is irrelevant.

Any thoughts as to why B vitamins could exacerbate Hashi's?

 

[CubbieBlue]

None of the links to your old threads work. What meds/supplements are you taking now? Pics? Height/weight? Diet?

EDIT: Ok, just looked at the scan results in the .pdf. I found the problem dude:

YOU ARE 5' 5" TALL.

Sorry man, but at that height and 52 years old you ain't gonna be rocking a six pack unless you are eating like a bird all day every day and training like a maniac.

I doubt your thyroid or testosterone has anything to do with it.

Not trying to be a dick, just telling you like it is.

What have you tried to accomplish your goals? I need more information.

 

[jonkobeck]

My wife has dexa scans to monitor osteopsorasis but I didnt think this was done for men also

 

[mcs5309]

Sorry, the links are working now. You can read more there.

Ht: 5-7, not 5-5
Wt: 170
Taking 60mcg SRT3
TONS OF SUPPS (there's a link to thread on musclechat but much of that has changed since)

Don't know what else I can do; eating like a bird and overtraining doesn't cut it. Age shouldn't matter as much if my diet and hormones are right. There are guys 10+ years older than me that are ripped. It's because they're not inflamed, hypothyroid, and leptin resistant, etc. If you read up on my links, there's more on my history, etc. Also there are some photos as well.

 

[CubbieBlue]

Sorry, the links are working now. You can read more there.

Ht: 5-7, not 5-5
Wt: 170
Taking 60mcg SRT3
TONS OF SUPPS (there's a link to thread on musclechat but much of that has changed since)

Don't know what else I can do; eating like a bird and overtraining doesn't cut it. Age shouldn't matter as much if my diet and hormones are right. There are guys 10+ years older than me that are ripped. It's because they're not inflamed, hypothyroid, and leptin resistant, etc. If you read up on my links, there's more on my history, etc. Also there are some photos as well.

They got your height at 5.58...so maybe you are shrinking.

Why are you taking the T3? If you aren't hypothyroid it ain't doing shit for you.

What is your weight training regimen? Do you have a log we can look at?

Your abs look pretty good in your picture, but you don't look like you have much in the way of muscle and you've got some moobage going on.

I checked out your calories and (to me) it looks like you are eating 300-600 too many calories per day if you really want to lean out - but again, you say you just lose muscle when you lean out that much. Your macros look great.

Honestly man, I think a LOT of it is genetics. If you really want to accomplish your goals, you can definitely get there, but you may need some chemical assistance.

 

[mcs5309]

They got your height at 5.58...so maybe you are shrinking.

Why are you taking the T3? If you aren't hypothyroid it ain't doing shit for you.

What is your weight training regimen? Do you have a log we can look at?

Your abs look pretty good in your picture, but you don't look like you have much in the way of muscle and you've got some moobage going on.

I checked out your calories and (to me) it looks like you are eating 300-600 too many calories per day if you really want to lean out - but again, you say you just lose muscle when you lean out that much. Your macros look great.

Honestly man, I think a LOT of it is genetics. If you really want to accomplish your goals, you can definitely get there, but you may need some chemical assistance.

Hmm - the DEXA says I'm 67" (5-7), I don't know where you're getting 5.58.

I've alway had a lot of breast tissue, but worse now because of accumulation of bf.

I am definitely hypo. But what you mean is that is doesn't do shit for cutting as everyone says it does?

Chemical assistance - well, I have been reluctant to start TRT even though my doc gave me a scrip.

 

[mcs5309]

Also - like I said, when I lose weight, I lose both bf and lean mass, not just fat. So the easiest answer - simply reducing calories - isn't doing it either. I hardly eat much carbs. If you look at the photo of me in my 20s, I was leaner, but I at more cals and carbs. I still say it's that I'm leptin resistant and hormones aren't optimized.

 

[CubbieBlue]

Hmm - the DEXA says I'm 67" (5-7), I don't know where you're getting 5.58.

I've alway had a lot of breast tissue, but worse now because of accumulation of bf.

I am definitely hypo. But what you mean is that is doesn't do shit for cutting as everyone says it does?

Chemical assistance - well, I have been reluctant to start TRT even though my doc gave me a scrip.

Re: the height - whoops! you are right.

How are you definitely hypo? Based on what labs? Why are you using T3 instead of T4?

And no, unless you are hypothyroid I don't think T3 is going to do much for you as far as "cutting" goes.

What about your training?

 

[mcs5309]

Re: the height - whoops! you are right.

How are you definitely hypo? Based on what labs? Why are you using T3 instead of T4?

And no, unless you are hypothyroid I don't think T3 is going to do much for you as far as "cutting" goes.

What about your training?

Again, yes, definitely hypo (elevated TSH; rT3); and being hypo cause your skin to thicken (mucin). So not treating it will only worsen. I made good progress initially, then crashed (see link). The source of the inflammation is still there which is why still problem.

T3 is the active hormone; T4 does no good for those with conversion block from T4 to T3. T4 makes hypo worse if you have elevated rT3 (which I and a lot of us do).

Training - I do my best 4x's/week 75 min. avg workout, it can always improve; still weak on major compounds like squats and bench. Cardio I don't overdo since I really don't see any results and if I overdo, I lose strength/size.

 

[iainf]

I think you'll find a lot of issues you think you have disappear once you start taking test. To be honest, if you really want to change your body composition there's no supplement regimen in the world that will help like testosterone will. Everyone's different; while your buddies at the gym can eat and drink shit all the time and still be strong and well built, you may not be able to do the same(even given similar hormone levels). Optimal levels are not the same for everyone, you may just need that hormonal kick start to get things moving the right direction.

If you let your morality get in the way with the whole anti-AAS mentality then you're just cheating yourself man. Testosterone is the nectar of the gods, don't deny yourself its benefits.

 

[mcs5309]

I think you'll find a lot of issues you think you have disappear once you start taking test. To be honest, if you really want to change your body composition there's no supplement regimen in the world that will help like testosterone will. Everyone's different; while your buddies at the gym can eat and drink shit all the time and still be strong and well built, you may not be able to do the same(even given similar hormone levels). Optimal levels are not the same for everyone, you may just need that hormonal kick start to get things moving the right direction.

If you let your morality get in the way with the whole anti-AAS mentality then you're just cheating yourself man. Testosterone is the nectar of the gods, don't deny yourself its benefits.

Nope, no morality blocking me on TRT - for all the wonderful things about TRT, I am more like hesitant because of sides such as:

- negative FB shutdown (I would fear would the risk of destroying my body's ability to make a reasonable amount of its own testosterone, and of losing my fertility & erections which are perfect now)

- decreased thyroid (http://www.definitivemind.com/forums/showthread.php?t=576&highlight=testosterone+replacement+therapy)

- increased DHT = hair loss

- increased water retention

- increased E2 (aromatization) (then I'm going to need arimidex, then we need to fine tune this that and the other thing).

- testicular shrinkage

My last T measured @ 513 without anything.

The question is if it's worth it to put up with all these possible sides just to lose bf and gain mass.

Also, perhaps your body reacts differently. Tell me.

 

[iainf]

I can only speak from my experience of course, but the negative side-effects I've experienced with TRT have been minimal and very tolerable.

-Moderate chest/back acne
-Increased sweating(doesn't really bother me)
-Testicular Atrophy/ZERO Sperm count (This is the only one I've stressed about really, I'll be starting HMG at some point in the next few months though so I can bank some swimmers)
-Annoying to fine tune arimidex dosage

All of those problems are very treatable. As for the benefits:

Diagnosed Hypopituitarism with Secondary Hypogonadism. Started taking testosterone cypionate 100mg/week(eventually 150mg/week) on Jan 19, 2011.

Started 5'9", 165lbs ~12%bf

June 19, 2011: 5'9", 210lbs ~15%bf
August 19, 2011: 5'9", 195lbs ~7%bf (cut from early July to mid-August)

Lifts:
Bench 145lbs -----> 265lbs
Squat 155lbs-----> 415lbs
Deadlift 185lbs -----> 525lbs

The results were nothing short of mind blowing from a body composition and physical performance standpoint. There were tons of other little things that changed too; stronger immune system, allergies and food sensitivities dissapeared.. etc. Not to mention I walk around with a massive boner for most of the day, its good stuff.

Mind you, my T levels were in the low 200s to start and I'm also 20 years old. Your milage may vary, but it worked absolute wonders for me. Purusing TRT was the best decision I ever made.

Oh and just wondering, why do you care about fertility if you're 52? Unless you're looking to have another child fertility is more of an inconvenience at your age than anything I'd imagine... condoms suck.

 

[mcs5309]

I can only speak from my experience of course, but the negative side-effects I've experienced with TRT have been minimal and very tolerable.

-Moderate chest/back acne
-Increased sweating(doesn't really bother me)
-Testicular Atrophy/ZERO Sperm count (This is the only one I've stressed about really, I'll be starting HMG at some point in the next few months though so I can bank some swimmers)
-Annoying to fine tune arimidex dosage

All of those problems are very treatable. As for the benefits:

Diagnosed Hypopituitarism with Secondary Hypogonadism. Started taking testosterone cypionate 100mg/week(eventually 150mg/week) on Jan 19, 2011.

Started 5'9", 165lbs ~12%bf

June 19, 2011: 5'9", 210lbs ~15%bf
August 19, 2011: 5'9", 195lbs ~7%bf (cut from early July to mid-August)

Lifts:
Bench 145lbs -----> 265lbs
Squat 155lbs-----> 415lbs
Deadlift 185lbs -----> 525lbs

The results were nothing short of mind blowing from a body composition and physical performance standpoint. There were tons of other little things that changed too; stronger immune system, allergies and food sensitivities dissapeared.. etc. Not to mention I walk around with a massive boner for most of the day, its good stuff.

Mind you, my T levels were in the low 200s to start and I'm also 20 years old. Your milage may vary, but it worked absolute wonders for me. Purusing TRT was the best decision I ever made.

Oh and just wondering, why do you care about fertility if you're 52? Unless you're looking to have another child fertility is more of an inconvenience at your age than anything I'd imagine... condoms suck.

Thanks for responding. Tell me more about HMG, this is the first time hearing about it.

Wow, you're so young to be having these issues!

Do you attribute the bf loss and gain in strength/size to the TRT? How do you know it wasn't also diet and training? You're right, don't care about fertility so much as sexual performance which is fine right now and don't want to mess with it is the concern (perfect morning wood, no ED, orgasms, etc.) I don't want to lose one thing in order to gain another, i.e., look great, but a wimp in bed. Als, what about hair loss on TRT? You still have many more years to go!

Lastly, are you under a doc'c supervision on TRT or DIY?

 

[iainf]

Thanks for responding. Tell me more about HMG, this is the first time hearing about it.

Wow, you're so young to be having these issues!

Do you attribute the bf loss and gain in strength/size to the TRT? How do you know it wasn't also diet and training? You're right, don't care about fertility so much as sexual performance which is fine right now and don't want to mess with it is the concern (perfect morning wood, no ED, orgasms, etc.) I don't want to lose one thing in order to gain another, i.e., look great, but a wimp in bed. Als, what about hair loss on TRT? You still have many more years to go!

Lastly, are you under a doc'c supervision on TRT or DIY?

Yeah I agree, it was certainly not a great experience to have low T as a 19 year old. My doctors attribute the failure of my pituitary gland to repeated concussions(I've played AAA Ice hockey since I was a kid and had 6 concussions over a 2 year period.. last one cracked my skull). Not being able to pop a woody when your smoking hot 17 year old blonde girlfriend is rubbing her scantily clad ass in your face is emasculating to say the least.. that was kind of the final straw for me.

I can definitely understand why you don't want to mess with something that works. You're lucky to still be able to perform at your age, most guys in their 50's are seasoned veterans of viagra/cialis. It's up to you to weigh the pros/cons of TRT in that regard; on paper, higher testosterone levels = higher sex drive. That was certainly my case anyways, but I started much lower than you are. I'd definitely argue though that E2 plays a greater role in sexual performance(assuming optimal testosterone levels). In my opinion, and my experience for that matter, successful E2 management is the KEY. It takes awhile to get dialed in, but holy shit when you find that sweet spot you can cut diamonds with the goddamn thing.

As for those changes in my body comp, I can't give testosterone ALL the credit. I have a tremendous work ethic(good genes for bodybuilding too) when it comes to taking care of my body. I'm in the gym 6 days a week, and I definitely know how to train properly. I also eat well and rest well, I don't drink or smoke, etc. That said though, no diet and training regimen alone will give results like mine in that period of time. It's hard to describe it, every time I stepped on the scale I was heavier, but I never got any fatter. Every workout I put up more weight. Then during the cut, when I was on a low carb diet (350g protein/100g carb/80g fat/ 2900cals) the fat just melted off and I didn't lose an ounce of muscle(I actually gained strength during the cut). The added testosterone noticeably partitions your nutrients much more towards your muscle mass. The test and some hard work completely transformed my body, there's no doubt about it.

I haven't had any noticeable hair loss although it may very well be in the cards for me from a genetic standpoint, seeing as EVERYONE is bald on my mothers side(fuck me). From my extensive research on steroids though, hair loss as a side effect of testosterone(or any anabolic steroid) are totally dependent on genetic susceptibility. If you're 52 and you still have a full head of hair, then it's fairly safe to say you will stay that way.

On that note, I did definitely get a fair bit more hirsute(thicker beard, hairier legs, arms, even got a hair or two on my back). It's nothing a little manscaping can't fix though.

Oh and HMG is Human Menopausal Gonadotropin; it mimics the FSH signal to the testes(where as HCG mimics LH primarily). FSH is most responsible signalling the testes to produce sperm(LH more so signals testosterone production), As such it is much much more potent than HCG in kickstarting spermatogenisis and thus fertility. I have no doubt it will restore my fertility in short order. It also in theory shouldn't fuck with E2 and aromatase levels like HCG does. The only downside it seems is the price, but luckily it's not something you have to run for a long time.

 

[mcs5309]

Yeah I agree, it was certainly not a great experience to have low T as a 19 year old. My doctors attribute the failure of my pituitary gland to repeated concussions(I've played AAA Ice hockey since I was a kid and had 6 concussions over a 2 year period.. last one cracked my skull). Not being able to pop a woody when your smoking hot 17 year old blonde girlfriend is rubbing her scantily clad ass in your face is emasculating to say the least.. that was kind of the final straw for me.

I can definitely understand why you don't want to mess with something that works. You're lucky to still be able to perform at your age, most guys in their 50's are seasoned veterans of viagra/cialis. It's up to you to weigh the pros/cons of TRT in that regard; on paper, higher testosterone levels = higher sex drive. That was certainly my case anyways, but I started much lower than you are. I'd definitely argue though that E2 plays a greater role in sexual performance(assuming optimal testosterone levels). In my opinion, and my experience for that matter, successful E2 management is the KEY. It takes awhile to get dialed in, but holy shit when you find that sweet spot you can cut diamonds with the goddamn thing.

As for those changes in my body comp, I can't give testosterone ALL the credit. I have a tremendous work ethic(good genes for bodybuilding too) when it comes to taking care of my body. I'm in the gym 6 days a week, and I definitely know how to train properly. I also eat well and rest well, I don't drink or smoke, etc. That said though, no diet and training regimen alone will give results like mine in that period of time. It's hard to describe it, every time I stepped on the scale I was heavier, but I never got any fatter. Every workout I put up more weight. Then during the cut, when I was on a low carb diet (350g protein/100g carb/80g fat/ 2900cals) the fat just melted off and I didn't lose an ounce of muscle(I actually gained strength during the cut). The added testosterone noticeably partitions your nutrients much more towards your muscle mass. The test and some hard work completely transformed my body, there's no doubt about it.

I haven't had any noticeable hair loss although it may very well be in the cards for me from a genetic standpoint, seeing as EVERYONE is bald on my mothers side(fuck me). From my extensive research on steroids though, hair loss as a side effect of testosterone(or any anabolic steroid) are totally dependent on genetic susceptibility. If you're 52 and you still have a full head of hair, then it's fairly safe to say you will stay that way.

On that note, I did definitely get a fair bit more hirsute(thicker beard, hairier legs, arms, even got a hair or two on my back). It's nothing a little manscaping can't fix though.

Oh and HMG is Human Menopausal Gonadotropin; it mimics the FSH signal to the testes(where as HCG mimics LH primarily). FSH is most responsible signalling the testes to produce sperm(LH more so signals testosterone production), As such it is much much more potent than HCG in kickstarting spermatogenisis and thus fertility. I have no doubt it will restore my fertility in short order. It also in theory shouldn't fuck with E2 and aromatase levels like HCG does. The only downside it seems is the price, but luckily it's not something you have to run for a long time.

Wow, it's great you're so knowledgeable at your age. You know more than most men twice your age and definitely more than most of these worthless mainstream docs that know zip when it comes to HRT. Your doc must be very knowledgeable as well!

Already had 3 hair transplants (just now finishing my 3rd), so I have probably bottomed out on my native hairs and fortunately the transplanted ones are resistant to the effects of DHT. A shitload of $$$, but it's either that or do the bald thing and I'm not Jason Statham!

I feel that I'm no less a man than I was in my 20s, still feel the "need to release" daily, if not several times a day, hence, my hesitation to take the TRT plunge and go for it and risk the sexual sides. Then again, I really want to cut my bf by 50% and bump my lean mass up 25% of what it is - and so far, diet and training has been lackluster. My last T level was in the low 500s without anything. A couple years back it was in the mid 700s. I'm aging a lot slower than my counterparts my age, no doubt. I am constantly told I look in my mid 40s.

I tend to be estrogen-dominant. I have a scrip for adex @ 1mg/day. Haven't started it yet either. Have you noticed any sides on the adex?

 

[iainf]

Wow, it's great you're so knowledgeable at your age. You know more than most men twice your age and definitely more than most of these worthless mainstream docs that know zip when it comes to HRT. Your doc must be very knowledgeable as well!

Already had 3 hair transplants (just now finishing my 3rd), so I have probably bottomed out on my native hairs and fortunately the transplanted ones are resistant to the effects of DHT. A shitload of $$$, but it's either that or do the bald thing and I'm not Jason Statham!

I feel that I'm no less a man than I was in my 20s, still feel the "need to release" daily, if not several times a day, hence, my hesitation to take the TRT plunge and go for it and risk the sexual sides. Then again, I really want to cut my bf by 50% and bump my lean mass up 25% of what it is - and so far, diet and training has been lackluster. My last T level was in the low 500s without anything. A couple years back it was in the mid 700s. I'm aging a lot slower than my counterparts my age, no doubt. I am constantly told I look in my mid 40s.

I tend to be estrogen-dominant. I have a scrip for adex @ 1mg/day. Haven't started it yet either. Have you noticed any sides on the adex?

Holy shit 1mg/day, that would still be a high dose even if you were running 700-800mg test/week. Start slow with the arimidex, some people are hypersensitive to it(such as myself). I keep my E2 in the sweetspot at exactly 0.09mg EOD(ridiculous I know). I tried taking still quite conservative dose of 1mg/week(0.3mg EOD) when I started taking it, and I completely bottomed out my E2 overnight.

When it comes to things to watch out for, your best indicator of where you are on the E2 range is sex drive and EQ in my opinion at least. I'm also very lean so I use water retention and any puffiness/itchyness in the nips as a secondary indicator. Some general guidelines are:

LOW E2-

Little to no water retention(so you'll actually look better the lower your e2 to be honest)
Very low sex drive
Very good erection quality(weird I know)
weak/no morning wood
brain fog
fatigue
irritability
clicky, sore joints
appetite increase
difficulty achieving orgasm(or weak orgasm)

HIGH E2-

lots of water retention(look fat, feel bloated)
moderate/low sex drive(gets lower the higher your E2 gets)
extremely weak erections
no morning wood
fatigue
overly emotional
Itchy/puffy nips

OPTIMAL E2-

light water retention
extremely high sex drive
excellent EQ
mind blowing orgasms
consistent morning wood
good energy

From what you describe you sound to be pretty much optimal, but you can always play around with it. Adex has a 48 hour half-life so if you crash your E2 it wont be fun, but it's not a big deal. Everything will normalize completely after a week or so. If you decide to give it a try, definitely start with a quarter pill at most(0.25mg) just to test the water. You'll know quickly if you go too low, 24 hours or so. Get on board the exercise and diet train too man, that'll work wonders. You could easily reach your goals with just those two things in check. Maybe not as easily as if you were loaded up on test, but still easy nonetheless

 

[mcs5309]

Holy shit 1mg/day, that would still be a high dose even if you were running 700-800mg test/week. Start slow with the arimidex, some people are hypersensitive to it(such as myself). I keep my E2 in the sweetspot at exactly 0.09mg EOD(ridiculous I know). I tried taking still quite conservative dose of 1mg/week(0.3mg EOD) when I started taking it, and I completely bottomed out my E2 overnight.

When it comes to things to watch out for, your best indicator of where you are on the E2 range is sex drive and EQ in my opinion at least. I'm also very lean so I use water retention and any puffiness/itchyness in the nips as a secondary indicator. Some general guidelines are:

LOW E2-

Little to no water retention(so you'll actually look better the lower your e2 to be honest)
Very low sex drive
Very good erection quality(weird I know)
weak/no morning wood
brain fog
fatigue
irritability
clicky, sore joints
appetite increase
difficulty achieving orgasm(or weak orgasm)

HIGH E2-

lots of water retention(look fat, feel bloated)
moderate/low sex drive(gets lower the higher your E2 gets)
extremely weak erections
no morning wood
fatigue
overly emotional
Itchy/puffy nips

OPTIMAL E2-

light water retention
extremely high sex drive
excellent EQ
mind blowing orgasms
consistent morning wood
good energy

From what you describe you sound to be pretty much optimal, but you can always play around with it. Adex has a 48 hour half-life so if you crash your E2 it wont be fun, but it's not a big deal. Everything will normalize completely after a week or so. If you decide to give it a try, definitely start with a quarter pill at most(0.25mg) just to test the water. You'll know quickly if you go too low, 24 hours or so. Get on board the exercise and diet train too man, that'll work wonders. You could easily reach your goals with just those two things in check. Maybe not as easily as if you were loaded up on test, but still easy nonetheless

Shit, I was wondering why there were only 8 tablets in the bottle. I misread the label; the dosage is for 1/4 tablet a day, but it looks like the tablet size is 1mg. How the hell am I supposed to cut this tiny pill into 4 even amounts to give me exactly 0.25mg?

BTW, on a scale of 1-10, my EQ is 10. Of course, I have nothing to compare it to but my prior erections, right? But my last E2 was elevated @ 32 and before that 51 (when I was on DHEA and pregnenolone). I am back on preg and DHEA to help raise low a.m. cortisol. Also taking T3 for hypothyroid.

Have you measured your other hormones - thyroid (tsh, t3, t4, rt3), prog, preg, cortisol, SHBG, IGF-1, DHEA-S, FSH, LH, etc.?

Yes, I've been training 4x's/week and eater cleaner than anyone I know (low-carb Paleo) for the last year. Have been eating ultra-strict since I was your age. Got back into more serious training in the last 2 years, but not seeing the results I'd like.