Low Estradiol Without AI

[Student]

I've been on prescribed TRT for 7 weeks. 150mg a week of Test Cyp with 500iu a week of HCG. I was prescribed adex as well, but haven't taken any.

I just got the results of my 6 weeks blood work w/ blood drawn a few hours before weekly dose. TT was 646, Free T was 8.7, Estradiol (sensitive) was 11. Estradiol wasn't tested in my baseline bloods, so I have nothing to compare it to.

I'm somewhat concerned that low estrogen levels could be a factor in my fatigue. What could cause this?

 

[LW64]

Maybe, but the fatigue could be a leftover from having low T.

[1] What are the ranges for the labs?

[2] Other labs - like SHBG?

[2] How old are you?

 

[Student]

I'm 34

Ranges:

Testosterone, Serum 348 - 1197
Free Testosterone 8.7 - 25.1
Estradiol, Sensitive 3 - 70

She didn't request SHBG. I'll ask for it on the next round.

My doctor upped my dose to 200mg a week with the same biweekly hcg dosing of 250iu's.

My thyroid is also sluggish, so I find it odd I'm bottomed out on everything except TT

 

[LW64]

It is your Free T that really matters and yours is barely in the normal range. The low normal Free T is what explains the low normal E2.

When you need a T dose that large, it's worth looking at other hormones being out of whack and thyroid is one of them.

Have you had a full thyroid panel done? Results?

 

[Student]

Thyroid Panel With TSH
TSH 3.670 uIU/mL 0.450 - 4.500
Thyroxine (T4) 6.2 ug/dL 4.5 - 12.0
T3 Uptake 29 % 24 - 39
Free Thyroxine Index 1.8 1.2 - 4.9

 

[blazinshotguns]

Thyroid Panel With TSH
TSH 3.670 uIU/mL 0.450 - 4.500
Thyroxine (T4) 6.2 ug/dL 4.5 - 12.0
T3 Uptake 29 % 24 - 39
Free Thyroxine Index 1.8 1.2 - 4.9

your thyroid looks a bit low

Also my T levels at 177ng are higher than yours .

Your shgb is high so your T levels and e2 levels are bound .
Your T and e2 are still too low .

 

[LW64]

Thyroid Panel With TSH
TSH 3.670 uIU/mL 0.450 - 4.500
Thyroxine (T4) 6.2 ug/dL 4.5 - 12.0
T3 Uptake 29 % 24 - 39
Free Thyroxine Index 1.8 1.2 - 4.9

Looks normal to me.

What health issues (obesity, hypertension, other?) are you/have you been dealing with?

 

[blazinshotguns]

Looks normal to me.

What health issues (obesity, hypertension, other?) are you/have you been dealing with?

Thyroid is at the bottom of the range . Tsh is over 1.5 which isn't considered optimal

 

[Student]

Just fatigue, moodiness, and inability to change body composition. I'm not overweight; just can't seem to alter bf%.

Lipids and BP are good. My mother has Hashimoto's, which is why I requested the thyroid panel.

 

[LW64]

Thyroid is at the bottom of the range . Tsh is over 1.5 which isn't considered optimal

No endo would treat him with those numbers. Optimal is not a one size fits all concept.

 

[LW64]

I'm not overweight; just can't seem to alter bf%.

What is your percent body fat? If its a lot higher than normal, that would mean you're overweight.

 

[Student]

Around 20%.

 

[blazinshotguns]

No endo would treat him with those numbers. Optimal is not a one size fits all concept.

my PA treats me with numbers better than this

 

[LW64]

Around 20%.

You dont need to lose weight unless that fat is in all the wrong places, but that is a bit on the high side for your age.

Keep an eye on your thyroid - get a full panel done (including Free T3, Free T4, and anti-TPO) at least once a year.

Do you have the labs that made your doc put you on TRT?

 

[LW64]

my PA treats me with numbers better than this

Your history is not the same at all.

 

[Student]

I'm using a TRT clinic. Originally my TT was 445, free was 10. My free has actually gone down. Not by much, but down.

 

[LW64]

I'm using a TRT clinic. Originally my TT was 445, free was 10. My free has actually gone down. Not by much, but down.

A 1 or 2 point drop is just about meaningless. Same ballpark; no real difference between your natural state and 7 weeks of T injections.

You went on T shots while both your Total T and Free T were in the normal range? Ok, it's low normal, but it's still normal. What makes you so certain your fatigue is due to low normal T apart from labs coming back at the low end of the normal range?

For example, why go straight to T injections (an idea which makes more than a few doctors recoil in horror when they have patients whose T is actually, really, below normal!) when maybe you could have tried a tiny dose of thyroid hormone instead? Or maybe a course of clomid? Straight to the hard stuff, huh?

No offense but this sounds a lot like a guy we had on this board a year ago who wanted to go on T for no other reason than to reduce his percent body fat; and that includes the real and/or imagined thyroid problems.

 

[Student]

I never said I had a thyroid problem. I requested a test and my doctor said it was normal, but sluggish.

I'm not interested in arguing about what normal is or should be. I'm interested in improving my quality of life, which has been in the toilet for a number of years. TRT was the first stop as it's the most accessible and fit more symptoms.

Testosterone is hardly "hard stuff", unless you're an agent of the state.

As you said, an endo wouldn't prescribe me synthroid with my levels, and I'm not going to self medicate that. My mother had antibody tests come back positive and she couldn't get medication until her thyroid was severely damaged as her levels were "normal".

 

[LW64]

TRT was the first stop as it's the most accessible and fit more symptoms.

No. Wrong. It should be the LAST resort.

Testosterone is hardly "hard stuff", unless you're an agent of the state.

T isnt the hard stuff? In comparison to clomid which would boost your hypothalamus-pituitary? Or HCG which is not as suppressive as T? Or a short course of very low dose thyroid? Oh yes it is the hard stuff. It's also a bit tricky.

You took T for seven weeks looking to boost your (normal) T level and the net result, after the competing forces of addition and suppression were done with you, was virtually nothing.

As you said, an endo wouldn't prescribe me synthroid with my levels, and I'm not going to self medicate that.

But its ok to go on T instead? It seems to me what hormone you take is a function of what you think you need to insist on. The bottom line in your case is that at the moment it's hard to justify taking thyroid or T.

On a scale of 1 to 10 (weak to strong) how would you rate your fatigue?

 

[Student]

8. Enough to where I don't drive if I don't have to, as it's difficult to keep my eyes open.