Need help - Naturally Low Estrogen

[Kwanzaa]

Hi Everyone, I know this is a long read and I hope a few of you stick it through to the end. This is my first post so excuse me if its in the wrong sub forum

Tldr: I have naturally occurring low estrogen and I was wondering if anyone had experience with this and knows how it's treated, the reality of it ever being treated and possible causation

I'm looking for information on having naturally Low Estrogen. I have bloodwork showing Low Estrogen, I have had symptoms for 9 years. I am not currently or have ever taken Steroids in my life. I have never taken opiates, and I've done hard drugs 3 times in my life.

Some Background info: I am 27, 6ft tall, 200lb, 25% BF. I have trained religiously and been very active my whole life, until 8 months ago when I had surgery on my shoulder from a snowboard accident. I Trained in the gym 1-3 hours 5-7x per week from the time I was 16, Judo 2x per week since I was 10 years old until 24, Manual labor for work in the summers between school. Currently I am only walking / biking 4x per week for 60-90 minutes due to shoulder recovery. In addition I snowboard in the winters 2-5x per week during the season (I don't lift or do other activities on those days). I have had a cortisone shot put in my shoulder in June 2017, and I have had a cortisone shot put in my hip for a torn labrum in October 2015. Besides that I have taken zero medication for anything. I used to work in a fiberglass shop working with endocrine disruptive chemicals for 2 years between the ages of 18-20, where I suspect my issues originated from.

Diet has been good for 13 years, since I seemingly put on body fat easily I've always tried to eat well and constantly research nutrition. I eat raw foods, lots of veggies, stay away from sugar, and eat fast food maybe twice a year. In terms of macronutrient portioning my diet has changed a lot during the years. I bought into the low fat low sugar bullshit until I was about 25 years old, and have been eating a high fat / moderate carb diet since. I tried a keto diet for 3 months last summer but the time and social constraints of college made it difficult to continue, and my experience with it wasn't earth shattering.

My symptoms Are: Fatigue, Erectile dysfunction, sexual dysfunction, anxiety, depression, irritability, achy joints, constant thirst, Difficulty concentrating, Frequent urination . Maybe oversleeping too. I usually need a 2 hour nap after being awake for 6-7 hours. . again, ive experienced these issues for 9 years since I worked in a fiberglass shop at the age of 18. I have been experiencing Hot flashes for 4 months and had a fatty liver diagnosed 2 months ago.

Estrogen

Estradiol: <30pmol/L Reference: (<200pmol/L) plugging this into a conversion calculator shows 8.17pg/ml. And to re iterate, it is lower then 8.17 because it doesn't show any lower. Reference rage for estrogen are between 20-55pg/ml and 10-40pg/ml depending on who you talk to.

Rest of labs are: (typed out because each result was on a separate piece of paper)

Total Testosterone: 15.5nmol/L Reference: 10.3-29.5nmol/L

SHGB: 30nmol/: Reference: 6-65nmol/L

Testosterone/SHGB: 0.52 Reference: 0.2-1.00

Free Testosterone: 314pmol/L Reference: 175-700pmol/L

Cortisol: 422nmol/L Reference: 120-620nmol/L

Prolactin: 4.4ug/L Reference: <21.0 ug/L

LH: 5.4 Reference <10

FSH: 5.5 Reference <10

Albium:47g/l Reference: 35-40g/L

ALT: 121 u/L Reference: <50 u/L

AST: 26 u/L Reference: <40 u/L

GGT: 18 u/L Reference: <70 u/L

Creatinine: 110 umol/L Reference: 50-120 unmol/L

GFR: 79 ml/min Reference: >59 mL/min

IgA: 0.69 g/L Reference: 0.7-4.00 g/L

Miscellaneous bloodwork (https://imgur.com/a/87UFJ)

I had follow up bloodwork done Today and it showed Estrogen <30pmol/L again and Testosterone 13.1nmol/L. all other blood values similar to posted above

I have found zero information on naturally occurring low estrogen. What can I do? Does anyone have experience with this? I have been told off by 6 doctors and 2 endocrinologist in the last 18 months and I'm at my wits end on trying to convince them having estrogen that is so low its below their reference values is bad. I have searched for information that proves low estrogen is bad in men, only to be blocked by a pay wall or the article citing no sources. I see a lot of medical info posted here, does any of that show proof of low estrogen in men that I can take to a doctor to convince them I need treatment?

Thank you!

 

[Old]

Don't know how the health system in Canada works but you need to see a doctor who knows about problems of low estrogen. A good endocrinologist SHOULD know right away that that is a problem. Next would be a good orthopedic doctors. If you need a referral, approach it from the standpoint of osteoporosis. Since you have less than half the minimum to support bone health, you WILL (not might) get osteoporosis if left untreated. If you have had low E2 for years, then reduced bone density will already show with a DEXA scan. This is a valid argument to get cooperation.

Your symptom list is too non specific to be useful for a doctor who is not listening. But the blood test is clear and warrants proper medical investigation. You can, of course, just buy some 1mg estradiol pills and try one. It may affect your symptoms and will lower T and free T. But be a couple weeks clear before any further blood draws.

Not familiar with E2 being connected to fatty liver ... and you are rather young for that. Perhaps there is a connection. The liver is responsible for breaking down E2, but a problem usually would mean elevated E2, not reduced. If symptoms started at the fiberglass shop, then some sort of toxicity could be involved.

Given there are many disorders out there you need good doctors in the end. With weird problem you have to pester many docs until you find one that actually cares or is knowledgeable to help. Challenge your doctor to do his job. It's shit but when they act like shits you have little choice.

 

[Dr JIM]

^^^

The OP has already been seen by SIX doc TWO of which were endos and none apparently suggested E-2 "therapy"

And why is that ----
- the plethora of signs and symptoms listed by the OP are not specific to hypoestrogenemia, many being present in patients with mood disorders.

- Estradial levels fluctuate considerably throughout the day

- the type of assay, which was not revealed by the OP, is critical in defining "low E-2" levels yet the fact the OPs "today" assay has a lower limit of 30pmol/L indicates a perhaps a less sensitive ELISA was used.

- by my count only TWO E-2 levels were conducted in NINE years and that's hardly evidence a "low E-2"
is the cause of such nonspecific complaints.

- and the presence of a NORMAL TT level in part compensates for a low E-2 in males

-- IME patients with such varied signs and symptoms have already been told their "problems" are FUNCTIONAL, and arrive on Meso in search of "another opinion" and in this case it's OPINION NUMBER SEVEN!

JIM

 

[Kwanzaa]

^^^

The OP has already been seen by SIX doc TWO of which were endos and none apparently suggested E-2 "therapy"

And why is that ----
- the plethora of signs and symptoms listed by the OP are not specific to hypoestrogenemia, many being present in patients with mood disorders.

- Estradial levels fluctuate considerably throughout the day

- the type of assay, which was not revealed by the OP, is critical in defining "low E-2" levels yet the fact the OPs "today" assay has a lower limit of 30pmol/L indicates a perhaps a less sensitive ELISA was used.

- by my count only TWO E-2 levels were conducted in NINE years and that's hardly evidence a "low E-2"
is the cause of such nonspecific complaints.

- and the presence of a NORMAL TT level in part compensates for a low E-2 in males

-- IME patients with such varied signs and symptoms have already been told their "problems" are FUNCTIONAL, and arrive on Meso in search of "another opinion" and in this case it's OPINION NUMBER SEVEN!

JIM

I'm going to clear up your concerns.

[/QUOTE]"The OP has already been seen by SIX doc TWO of which were endos and none apparently suggested E-2 "therapy""[/QUOTE]

- it was 6 GPs and Two endo's. The first 4 GP's flat out refused to even write bloodwork for testing for hormones. The 5th one wrote the script and ignored my concerned when I went back to get the results. The sixth one who ive recently visited consulted with an endo and told me that low estrogen in men doesn't exist.

The first endo did not use a test that showed below <100nmol/l, and at the time I did not think low estrogen was a problem in men

The second endo was an indian man who was 85 years old and said I had to much body hair to have low estrogen - make no sense in his argument.

None of the endo's even addressed the fact I have low estrogen.

"And why is that ----
- the plethora of signs and symptoms listed by the OP are not specific to hypoestrogenemia, many being present in patients with mood disorders.""

hypoestrogenemia" is commonly found in women. I am experiencing hot flashes and lowered libido, two common side effects. I cannot comment about the breast atrophy or ph levels in my vagina since I don't have those. I don't understand how you can ignore two major side effects.

- Estradial levels fluctuate considerably throughout the day

They sure do. and they should be high in the AM when my tests where taken, along side testosterone. My bloodwork was taken before 10am and both show estradiol below 8.17pg/ml, the medically accepted reference range for men is 10-40pg/ml.

the type of assay, which was not revealed by the OP, is critical in defining "low E-2" levels yet the fact the OPs "today" assay has a lower limit of 30pmol/L indicates a perhaps a less sensitive ELISA was used.

I wouldn't know how to ask for a more sensitive estrogen test. the only test available here is E2 - Estradiol. The laboratories cut off the data below <30pmol/l, in other provinces they cut it off below <100pmol/l. I don't think it has to do with the sensitivity of the test but the labs choosing to ignore data.

- by my count only TWO E-2 levels were conducted in NINE years and that's hardly evidence a "low E-2"
is the cause of such nonspecific complaints.

I had one test done on August 16th, 2017, and another done on September 11th, 2017, both showed <30pmol/l. I had another test done in February of 2016 but the data was cut off below 100pmol/l so that data doesn't count. I have had symptoms for 9 years, I didn't take blood tests until February 2016. I don't understand how you can blatantly ignore consecutive blood results and call it "hardly evidence"

-and the presence of a NORMAL TT level in part compensates for a low E-2 in males

Please explain how low normal testosterone compensates for below reference range estrogen. my last testosterone was measured at 13.1nmol/l (378ng/dl) for a reference range of 10.2-29.5nmol/l. I agree it is within range, but hardly.

-IME patients with such varied signs and symptoms have already been told their "problems" are FUNCTIONAL, and arrive on Meso in search of "another opinion" and in this case it's OPINION NUMBER SEVEN!

you haven't done much to back up your claims other then blatantly ignore my test results and pretend like my symptoms aren't found in patients with low estrogen. I challenge you to back up your claims with actual studies.

 

[Kwanzaa]

Don't know how the health system in Canada works but you need to see a doctor who knows about problems of low estrogen. A good endocrinologist SHOULD know right away that that is a problem. Next would be a good orthopedic doctors. If you need a referral, approach it from the standpoint of osteoporosis. Since you have less than half the minimum to support bone health, you WILL (not might) get osteoporosis if left untreated. If you have had low E2 for years, then reduced bone density will already show with a DEXA scan. This is a valid argument to get cooperation.

Your symptom list is too non specific to be useful for a doctor who is not listening. But the blood test is clear and warrants proper medical investigation. You can, of course, just buy some 1mg estradiol pills and try one. It may affect your symptoms and will lower T and free T. But be a couple weeks clear before any further blood draws.

Not familiar with E2 being connected to fatty liver ... and you are rather young for that. Perhaps there is a connection. The liver is responsible for breaking down E2, but a problem usually would mean elevated E2, not reduced. If symptoms started at the fiberglass shop, then some sort of toxicity could be involved.

Given there are many disorders out there you need good doctors in the end. With weird problem you have to pester many docs until you find one that actually cares or is knowledgeable to help. Challenge your doctor to do his job. It's shit but when they act like shits you have little choice.

Your symptom list is too non specific to be useful for a doctor who is not listening.

I understand that, my symptoms can be related to a huge amount of other issues, but the blood work should confirm that it is infact low estrogen.

Not familiar with E2 being connected to fatty liver.

The fatty liver is something I read on a few fluff articles and forum posts. There wasn't any scientific journal that backs it up, ill not treat it as a symptom from now on if there is no tangible connection to it. I was thinking someone here might have a study that links it.

Challenge your doctor to do his job

My goal is to challenge my doctor, but it seems to fall on def ears and I need medical studies to back up that low estrogen in men is bad. there are some, I have ones related to bone health and ones that show what value my estrogen should be at my age. just curious if people have other studies or insight into this issue.

If you have had low E2 for years, then reduced bone density will already show with a DEXA scan.

I appreciate your comment on osteoporosis, ill talk to my doctor in the manner which you refered. I have some studies showing low estrogen in men causes bone loss, so I shouldn't have a problem getting a dexa scan, if it shows bone loss then that is more evidence.

You can, of course, just buy some 1mg estradiol pills and try one

I am a little concerned about self prescribing anything, since to me this is an actual issue I think doctors supervision is required. I don't want to start putting chemical in my body that may exempt me from treatment if they are detected