39, first bloodwork on TRT, E2 too high?

trtbk · Jul 19, 2017

New to community, would appreciate your advice. At 39 had lower energy during day, and some ED issues. Got blood work done:
T: 146
Free T: 2.9
E2: 15.2
SHGB: 24.8

Ridiculously low T, so started 250mg/week of Pimoteston broken into 2 injections. Felt great 3-4 weeks later, sleeping better, ED issues gone. Then 8-10 weeks after starting, felt like I returned to initial state of lower energy, but with oily skin and occasional acne. Had blood work done again:
T: 1153
Free T: 45.2
E2: 79.7
SHGB: 18.2

Seems like E2 is the issue - what should I do? Take an AI? If so, which one? Or is it even simpler to cut down Primoteston done?

Vince · Jul 19, 2017

The first question would be, is that the right estradiol test for men? A lot of doctors still use the wrong estradiol test,
Why All Men Should be Tested with the Sensitive Estradiol Test
https://www.excelmale.com/showthread...Estradiol-Test

madman · Jul 19, 2017

trtbk said:
New to community, would appreciate your advice. At 39 had lower energy during day, and some ED issues. Got blood work done:
T: 146
Free T: 2.9
E2: 15.2
SHGB: 24.8

Ridiculously low T, so started 250mg/week of Pimoteston broken into 2 injections. Felt great 3-4 weeks later, sleeping better, ED issues gone. Then 8-10 weeks after starting, felt like I returned to initial state of lower energy, but with oily skin and occasional acne. Had blood work done again:
T: 1153
Free T: 45.2
E2: 79.7
SHGB: 18.2

Seems like E2 is the issue - what should I do? Take an AI? If so, which one? Or is it even simpler to cut down Primoteston done?

Are you self treating as 250mg/week is too high for a trt dose? Like Vince said you need to make sure you have the right estradiol test which is the sensitive not the standard. Seeing as you are doing Primoteston I would think you are from a European country where the sensitive assay for e2 may not be used and more than likely your lab values where done using the standard test. Your shbg is very low you may have to look into injecting more frequently using smaller doses. You should lower your weekly test dose as it will help bring down your e2. It would be helpful to everyone if you posted your full blood work with reference ranges.

trtbk · Jul 20, 2017

Madman and Vince, thanks for replies and thoughts on E2 test and dosing. I am in Mexico City, none of doctors understand testosterone here, so yes self treating. I took the estradiol sensitive test, may not have language right, apologies if so. Below is the full blood work, appreciate your thoughts.

[TABLE="width: 570"]
[TR]
[TD][/TD]
[TD="align: right"]2017.3[/TD]
[TD][/TD]
[TD="align: right"]2017.7[/TD]
[TD][/TD]
[TD]Range[/TD]
[/TR]
[TR]
[TD]WBC[/TD]
[TD="align: right"]5.2[/TD]
[TD][/TD]
[TD="align: right"]5.1[/TD]
[TD][/TD]
[TD]3.4 - 10.8[/TD]
[/TR]
[TR]
[TD]RBC[/TD]
[TD="align: right"]5.09[/TD]
[TD][/TD]
[TD="align: right"]5.52[/TD]
[TD][/TD]
[TD]4.14 - 5.80[/TD]
[/TR]
[TR]
[TD]Hemoglobin[/TD]
[TD="align: right"]16.1[/TD]
[TD][/TD]
[TD="align: right"]17.6[/TD]
[TD][/TD]
[TD]12.6 - 17.7[/TD]
[/TR]
[TR]
[TD]Hematocrit[/TD]
[TD="align: right"]47.7[/TD]
[TD][/TD]
[TD="align: right"]51.7[/TD]
[TD][/TD]
[TD]37.5 - 51.0[/TD]
[/TR]
[TR]
[TD]MCV[/TD]
[TD="align: right"]94[/TD]
[TD][/TD]
[TD="align: right"]94[/TD]
[TD][/TD]
[TD]79-97[/TD]
[/TR]
[TR]
[TD]MCH[/TD]
[TD="align: right"]31.6[/TD]
[TD][/TD]
[TD="align: right"]31.9[/TD]
[TD][/TD]
[TD]26.6 - 33.0[/TD]
[/TR]
[TR]
[TD]MCHC[/TD]
[TD="align: right"]33.8[/TD]
[TD][/TD]
[TD="align: right"]34[/TD]
[TD][/TD]
[TD]31.5 - 35.7[/TD]
[/TR]
[TR]
[TD]RDW[/TD]
[TD="align: right"]13.0[/TD]
[TD][/TD]
[TD="align: right"]13.4[/TD]
[TD][/TD]
[TD]12.3 - 15.4[/TD]
[/TR]
[TR]
[TD]Platelets[/TD]
[TD="align: right"]268[/TD]
[TD][/TD]
[TD="align: right"]230[/TD]
[TD][/TD]
[TD]150 - 379[/TD]
[/TR]
[TR]
[TD]Neutrophilis[/TD]
[TD="align: right"]59[/TD]
[TD][/TD]
[TD="align: right"]65[/TD]
[TD][/TD]
[TD][/TD]
[/TR]
[TR]
[TD]Lymphs[/TD]
[TD="align: right"]30[/TD]
[TD][/TD]
[TD="align: right"]26[/TD]
[TD][/TD]
[TD][/TD]
[/TR]
[TR]
[TD]Monocytes[/TD]
[TD="align: right"]8[/TD]
[TD][/TD]
[TD="align: right"]8[/TD]
[TD][/TD]
[TD][/TD]
[/TR]
[TR]
[TD]Eos[/TD]
[TD="align: right"]2[/TD]
[TD][/TD]
[TD="align: right"]1[/TD]
[TD][/TD]
[TD][/TD]
[/TR]
[TR]
[TD]Basos[/TD]
[TD="align: right"]1[/TD]
[TD][/TD]
[TD="align: right"]0[/TD]
[TD][/TD]
[TD][/TD]
[/TR]
[TR]
[TD]Neutrophilis (Absolute)[/TD]
[TD="align: right"]3.1[/TD]
[TD][/TD]
[TD="align: right"]3.2[/TD]
[TD][/TD]
[TD]1.4 - 7.0[/TD]
[/TR]
[TR]
[TD]Lymphs (Absolute)[/TD]
[TD="align: right"]1.6[/TD]
[TD][/TD]
[TD="align: right"]1.3[/TD]
[TD][/TD]
[TD]0.7 - 3.1[/TD]
[/TR]
[TR]
[TD]Monocytes (Absolute)[/TD]
[TD="align: right"]0.4[/TD]
[TD][/TD]
[TD="align: right"]0.4[/TD]
[TD][/TD]
[TD]0.1 - 0.9[/TD]
[/TR]
[TR]
[TD]Eos (Absolute)[/TD]
[TD="align: right"]0.1[/TD]
[TD][/TD]
[TD="align: right"]0.1[/TD]
[TD][/TD]
[TD]0.0 - 0.4[/TD]
[/TR]
[TR]
[TD]Baso (Absolute)[/TD]
[TD="align: right"]0[/TD]
[TD][/TD]
[TD="align: right"]0[/TD]
[TD][/TD]
[TD]0.0 - 0.2[/TD]
[/TR]
[TR]
[TD]Immature Granulocytes[/TD]
[TD="align: right"]0[/TD]
[TD][/TD]
[TD="align: right"]0[/TD]
[TD][/TD]
[TD][/TD]
[/TR]
[TR]
[TD]Immature Grans (Absolute)[/TD]
[TD="align: right"]0[/TD]
[TD][/TD]
[TD="align: right"]0[/TD]
[TD][/TD]
[TD]0.0 - 0.1[/TD]
[/TR]
[TR]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[/TR]
[TR]
[TD]Glucose, Serum[/TD]
[TD="align: right"]89[/TD]
[TD][/TD]
[TD="align: right"]98[/TD]
[TD][/TD]
[TD]65 - 99[/TD]
[/TR]
[TR]
[TD]BUN[/TD]
[TD="align: right"]15[/TD]
[TD][/TD]
[TD="align: right"]14[/TD]
[TD][/TD]
[TD]8 - 19[/TD]
[/TR]
[TR]
[TD]Creatine, Serum[/TD]
[TD="align: right"]0.92[/TD]
[TD][/TD]
[TD="align: right"]1.12[/TD]
[TD][/TD]
[TD]0.76 - 1.27[/TD]
[/TR]
[TR]
[TD]eGFR if NonAfricn Am[/TD]
[TD="align: right"]105[/TD]
[TD][/TD]
[TD="align: right"]82[/TD]
[TD][/TD]
[TD]>59mL/min/1.73[/TD]
[/TR]
[TR]
[TD]eGFR if Africn Am[/TD]
[TD="align: right"]122[/TD]
[TD][/TD]
[TD="align: right"]95[/TD]
[TD][/TD]
[TD]>59mL/min/1.73[/TD]
[/TR]
[TR]
[TD]BUN/Creatine Ratio[/TD]
[TD="align: right"]16[/TD]
[TD][/TD]
[TD="align: right"]13[/TD]
[TD][/TD]
[TD]8 - 19[/TD]
[/TR]
[TR]
[TD]Sodium, Serum[/TD]
[TD="align: right"]141[/TD]
[TD][/TD]
[TD="align: right"]141[/TD]
[TD][/TD]
[TD]134 - 144[/TD]
[/TR]
[TR]
[TD]Potassium, Serum[/TD]
[TD="align: right"]4.7[/TD]
[TD][/TD]
[TD="align: right"]4.9[/TD]
[TD][/TD]
[TD]3.5 - 5.2[/TD]
[/TR]
[TR]
[TD]Chloride, Serum[/TD]
[TD="align: right"]102[/TD]
[TD][/TD]
[TD="align: right"]101[/TD]
[TD][/TD]
[TD]96 - 106[/TD]
[/TR]
[TR]
[TD]Carbon Dioxide, Total[/TD]
[TD="align: right"]22[/TD]
[TD][/TD]
[TD="align: right"]24[/TD]
[TD][/TD]
[TD]18 - 29[/TD]
[/TR]
[TR]
[TD]Calcium, Serum[/TD]
[TD="align: right"]9.5[/TD]
[TD][/TD]
[TD="align: right"]9.6[/TD]
[TD][/TD]
[TD]8.7 - 10.2[/TD]
[/TR]
[TR]
[TD]Protein, Total, Serum[/TD]
[TD="align: right"]7.3[/TD]
[TD] [/TD]
[TD="align: right"]6.8[/TD]
[TD][/TD]
[TD]6.0 - 8.5[/TD]
[/TR]
[TR]
[TD]Albumin, Serum[/TD]
[TD="align: right"]4.9[/TD]
[TD][/TD]
[TD="align: right"]4.7[/TD]
[TD][/TD]
[TD]3.5 - 5.5[/TD]
[/TR]
[TR]
[TD]Globulin, Total[/TD]
[TD="align: right"]2.4[/TD]
[TD][/TD]
[TD="align: right"]2.1[/TD]
[TD][/TD]
[TD]1.5 - 4.5[/TD]
[/TR]
[TR]
[TD]A/G Ratio[/TD]
[TD="align: right"]2.0[/TD]
[TD][/TD]
[TD="align: right"]2.2[/TD]
[TD][/TD]
[TD]1.2 - 2.2[/TD]
[/TR]
[TR]
[TD]Bilirubin, Total[/TD]
[TD="align: right"]0.7[/TD]
[TD][/TD]
[TD="align: right"]0.5[/TD]
[TD][/TD]
[TD]0.0 - 1.2[/TD]
[/TR]
[TR]
[TD]Alkaline Phosphate, S[/TD]
[TD="align: right"]71[/TD]
[TD][/TD]
[TD="align: right"]67[/TD]
[TD][/TD]
[TD]39 - 117[/TD]
[/TR]
[TR]
[TD]AST (SGOT)[/TD]
[TD="align: right"]30[/TD]
[TD][/TD]
[TD="align: right"]19[/TD]
[TD][/TD]
[TD]0 - 40[/TD]
[/TR]
[TR]
[TD]ALT (SGPT)[/TD]
[TD="align: right"]50[/TD]
[TD][/TD]
[TD="align: right"]28[/TD]
[TD][/TD]
[TD]0 - 44[/TD]
[/TR]
[TR]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[/TR]
[TR]
[TD]Cholesterol, Total[/TD]
[TD="align: right"]275[/TD]
[TD][/TD]
[TD="align: right"]236[/TD]
[TD][/TD]
[TD]100 - 199[/TD]
[/TR]
[TR]
[TD]Triglycerides[/TD]
[TD="align: right"]238[/TD]
[TD][/TD]
[TD="align: right"]156[/TD]
[TD][/TD]
[TD]0 - 149[/TD]
[/TR]
[TR]
[TD]HDL Cholesteral[/TD]
[TD="align: right"]39[/TD]
[TD][/TD]
[TD="align: right"]37[/TD]
[TD][/TD]
[TD]>39[/TD]
[/TR]
[TR]
[TD]VLDL Cholesterol Cal[/TD]
[TD="align: right"]48[/TD]
[TD][/TD]
[TD="align: right"]31[/TD]
[TD][/TD]
[TD]5 - 40[/TD]
[/TR]
[TR]
[TD]LDL Cholesterol Calc[/TD]
[TD="align: right"]188[/TD]
[TD][/TD]
[TD="align: right"]168[/TD]
[TD][/TD]
[TD]0 - 99[/TD]
[/TR]
[TR]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[/TR]
[TR]
[TD]TSH
[/TD]
[TD="align: right"]1.34[/TD]
[TD][/TD]
[TD="align: right"]1.93[/TD]
[TD][/TD]
[TD]0.450 - 4.500[/TD]
[/TR]
[TR]
[TD]Thyroxine (T4)[/TD]
[TD="align: right"]6.1[/TD]
[TD][/TD]
[TD="align: right"]4.5[/TD]
[TD][/TD]
[TD]4.5 - 12.0[/TD]
[/TR]
[TR]
[TD]T3 Uptake[/TD]
[TD="align: right"]29[/TD]
[TD][/TD]
[TD="align: right"]32[/TD]
[TD][/TD]
[TD]24 - 39[/TD]
[/TR]
[TR]
[TD]Free Thyroxine Index[/TD]
[TD="align: right"]1.8[/TD]
[TD][/TD]
[TD="align: right"]1.4[/TD]
[TD][/TD]
[TD]1.2 - 4.9[/TD]
[/TR]
[TR]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[/TR]
[TR]
[TD]Testosterone, Serum[/TD]
[TD="align: right"]146[/TD]
[TD][/TD]
[TD="align: right"]1153[/TD]
[TD][/TD]
[TD]348 - 1197[/TD]
[/TR]
[TR]
[TD]Testosterone, Free[/TD]
[TD="align: right"]2.93[/TD]
[TD][/TD]
[TD="align: right"]45.2[/TD]
[TD][/TD]
[TD]5.00 - 21.00[/TD]
[/TR]
[TR]
[TD]% Free Testosterone[/TD]
[TD="align: right"]2.01[/TD]
[TD][/TD]
[TD="align: right"]3.92[/TD]
[TD][/TD]
[TD]1.50 - 4.20[/TD]
[/TR]
[TR]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[/TR]
[TR]
[TD]Prostate-Specific Ag, Serum[/TD]
[TD="align: right"]0.8[/TD]
[TD][/TD]
[TD="align: right"]0.1[/TD]
[TD][/TD]
[TD]0.0 - 4.0[/TD]
[/TR]
[TR]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[/TR]
[TR]
[TD]Insulin-Like Growth Factor I[/TD]
[TD="align: right"]162[/TD]
[TD][/TD]
[TD="align: right"]253[/TD]
[TD][/TD]
[TD]83 - 233[/TD]
[/TR]
[TR]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[TD][/TD]
[/TR]
[TR]
[TD]Estradiol, Sensative[/TD]
[TD="align: right"]15.2[/TD]
[TD][/TD]
[TD="align: right"]79.7[/TD]
[TD][/TD]
[TD]8.0 - 35.0[/TD]
[/TR]
[TR]
[TD]Sex Hormone Binding Glob, Serum[/TD]
[TD="align: right"]24.8[/TD]
[TD][/TD]
[TD="align: right"]18.2[/TD]
[TD][/TD]
[TD]16.5 - 55.9[/TD]
[/TR]
[/TABLE]

Sean Mosher · Jul 20, 2017

If that indeed is the sensitive test, then yes, you are on the high side.
Also, to re-iterate what was said above, 250mg per week is a pretty stout dose.
Maybe 1st step would be to lower it to 200mg per week or even 180 mg per week broken up into 2 injections.
Your Total T at 1153 isn't super high for 250mg per week but there's certainly plenty of room to adjust down.
Can you get access to hCG as well?

trtbk · Jul 20, 2017

May not know enough, but wouldnt the hCG increase the estradiol levels? And do you think the hightened estradiol the reason that I am experiencing the energy and ED issues again?

I can get access to hCG here.