E2 levels for low SHBG guys

[Vince Carter]

Prompted by a reply from Dr Saya:

"As a side note, your E2 is lower than we like, but with the somewhat low SHBG you will have a higher free estradiol (same as a higher free testosterone) at any given total E2 level.

Translation...the E2 is a bit low, but not as low as it appears on the surface. Hope that makes sense".


More to the point we've had some light discussions about a Free Estradiol test perhaps being of value or even supplanting the typical (ultra) Sensitive E2 LC/MS/MS testing, or even the suggested 21-30 levels for E2. We know with low SHBG = high Free T = high Free Estrogen, hence the thought to test for that specifically.

 

[CoastWatcher]

My friend Vince Carter and I have dealt with low SHBG and high free testosterone, and been frustrated with the methods free-T is reported, both in the US and Canada, for some time. We've also both adopted daily injection protocols in an effort to manage elevated estradiol. It would be fascinating to see how the results of this test could be a more objective (across the board) metric for managing e2. Needless to say, a check of the LifeLabs website, the largest commercial lab in Ontario, indicates it's not available in Canada.

 

[johndoesmith]

My friend Vince Carter and I have dealt with low SHBG and high free testosterone, and been frustrated with the methods free-T is reported, both in the US and Canada, for some time. We've also both adopted daily injection protocols in an effort to manage elevated estradiol. It would be fascinating to see how the results of this test could be a more objective (across the board) metric for managing e2. Needless to say, a check of the LifeLabs website, the largest commercial lab in Ontario, indicates it's not available in Canada.

Why would this be different than a free testosterone assay, which you say you're frustrated with? I understand there are multiple assays for free testosterone, and that there's only one for free estradiol, but you can stimulate there only being one free testosterone assay.

 

[CoastWatcher]

Why would this be different than a free testosterone assay, which you say you're frustrated with? I understand there are multiple assays for free testosterone, and that there's only one for free estradiol, but you can stimulate there only being one free testosterone assay.

I'm not sure it would be, or wouldn't be, any less frustrating than the free-T results. Nonetheless, it merits my attention and further reading as the free hormone issues continue to fascinate.

 

[johndoesmith]

I'm not sure it would be, or wouldn't be, any less frustrating than the free-T results. Nonetheless, it merits my attention and further reading as the free hormone issues continue to fascinate.

Want a big time sink? Look up the free hormone hypothesis vs the free hormone transport hypothesis. See you in a few days.

 

[Vince Carter]

Test Results

Free Estrogen 1.45 (<0.45)
LC/MS/MS 55
Standard ECLIA 53
SHBG 12

same draw/same day

28mg/D Cyp
250iu E3.5D
.25mg AI EOD

 

[johndoesmith]

Test Results

Free Estrogen 1.45 (<0.45)
LC/MS/MS 55
Standard ECLIA 53
SHBG 12

same draw/same day

28mg/D Cyp
250iu E3.5D
.25mg AI EOD

How do you feel broski?

 

[Vince Carter]

Libido is down just a bit, so is EQ even with PDE5i, kind of been an up and down (pun intended) thing but I would very honestly say the last 6 months I haven't feel the need to run and test anything at all so I don't know that there's anything "wrong" per se, I feel pretty good honestly, I was very curious about the Free E, have a consult with Defy in two weeks which will be primary topic.

 

[Jason Sypolt]

How are free estrogens managed (If at all) if too high/low?

I'm going to request this the next time that I have my Estradiol checked just to see wehat it is at.

 

[Vince Carter]

How are free estrogens managed (If at all) if too high/low?

I'm going to request this the next time that I have my Estradiol checked just to see wehat it is at.

I have a consult on 23 Jun this is the primary topic of discussion; Free Estrogen.

 

[Vince Carter]

Test Results

Free Estrogen 1.45 (<0.45)
LC/MS/MS 55
Standard ECLIA 53
SHBG 12

same draw/same day

28mg/D Cyp
250iu E3.5D
.25mg AI EOD

I had to backtrack my calendar here looking at these E numbers and I had NOT taken the AI that morning though I was due for a .25mg dose so I was ~48hrs from my previous dose. I think I should use the AI in the AM as scheduled for my next test.

 

[CoastWatcher]

I had to backtrack my calendar here looking at these E numbers and I had NOT taken the AI that morning though I was due for a .25mg dose so I was ~48hrs from my previous dose. I think I should use the AI in the AM as scheduled for my next test.

That's probably wise.

 

[Gianluca]

Hey Vince Carter, I think we had a discussion a couple of months a go where you were telling me about the possible Free Estradiol high on lo SHBG guys, I was able to run a test with Defy about it here are the numbers from Quest Lab

Free estradiol 1.12 scale of max 0,45 pg/ml
Estradiol 42

T testosterone 692
F testosterone 213.8

I remember Nelson saying that we don't really have references on what the actual normal range of Free E would be, but I would definitely like to try to stay about 0.45 and see if it would take care of some side effect

Question on FT Quest ranges, would my number considered 21.38 for LabCorp? I'm confused

 

[Vince Carter]

I dont know that you can extrapolate numbers across labs.

 

[Gianluca]

How do you mean?

I dont know that you can extrapolate numbers across labs.

 

[Vince Carter]

Tested again on 5 Jan so pending Estrogen, Free and Ultra-Sensitive, in this case I did take my .25mg Anastrozole appx 2hrs prior to the blood draw...results in about a week.

In the meantime I read something new(ish) that I'll attirubute to Dr Crisler stating that while we low SHBG guys tend to piss away the T so quickly (that's not a quote), experience so fast of clearance of the T from our system, we DON'T experience the same rate of clearance for the Estrogens. So more thinking of the Free Estrogen and even the LC/MS/MS numbers that maybe we need to run a lower point than the typical 21-30 LC/MS/MS range. I know Dr C has also stated that he's had some low SHBG guys that can't tolerate much E, at all.
So I'm still working on the possibility that, me, may need to get closer to a 15-20 LC/MS/MS. I over-aromatase as it is and I'm not too keyed up thinking that .25mg EOD may need to be increase a small amount.

Symptoms are still as above, EQ is a little spotty even with PDE5i's but does work pretty reliably, but still to warm/hot in bed overnite, still some lite or spotty acne if I falter in a very diligent shower regimen.

 

[Kettlebells]

Thanks for creating this thread, Vince. I am also a low SHBG guy. That is how I was able to survive and build muscle in the gym on a total T of 240 ng/dl before I went back on TRT. I read a publication where the investigator stated that free T is a better indicator of low T than total T.

 

[CoastWatcher]

Thanks for creating this thread, Vince. I am also a low SHBG guy. That is how I was able to survive and build muscle in the gym on a total T of 240 ng/dl before I went back on TRT. I read a publication where the investigator stated that free T is a better indicator of low T than total T.

There are certainly those make that argument, and understandably so. However, the wild variation in reporting free testosterone levels from lab to lab is an issue that unsettles many.

 

[Vince Carter]

New E2 numbers this is with having taken .25mg two hours prior to testing, I use .25mg EOD:

LC/MS/MS 42 < = 29 (i can always pull a higher sensitive number than the standard test)
Estradiol 39 < = 29 (I'm not sure this exact test I've not seen it before)
Estrogen, Free .91 < = .45

Still overly warm in bed at nite, PDE5i's work quite well but can be spotty in effectiveness, same with EQ and definite sensitivity degraded, orgasm takes more work and time and effort than I would like it too. Minor acne that takes a lot of care but is under control for the most part.

My little experiment last week netted an interesting improvement. I used a total of .40mg of Anastrozole for one dose and experienced actually feeling horny, had a sex dream, woke up horny and had that prolonged feeling during the day. All rather unusual for my norm but was very positive. for my next dose I maintained @ .25mg and did NOT have a repeat of those feelings.

 

[Systemlord]

Excellent thread! This free E2 test might just be what I need to get dialed in as I'm currently battling high E2 do to my somewhat low SHBG (18-20). I've also heard Dr. Crisler mention that if a guy has SHBG of 20 that having a similar score for E2 could mean it's to high for him do to the free E2 being high relative to his E2.

I'm going to concentrate on free numbers rather than total numbers from now on.