Lab results - High total estrogen with normal E2

[TRT_User]

A few moths ago I began experiencing some changes such as facial redness and being increasingly emotional. About a month or so ago I noticed I have a decreased libido and a harder time getting and maintaining an erection. I also started to an increase in anxiety and depression and increased mental fog. I previously had some issues with anxiety and depression but the TRT greatly reduced both to where I no longer required any additional medication for them. My self image and self esteem also greatly increased. I recently went for blood work since it appears I have all of the classic signs of having high estrogen and the labs were as follows below. I'm extremely confused with why my E2 seems to be at a perfect level yet my total estrogen is through the roof. I know Dr. Crisler says that total estrogen levels are useless and to only look at E2 levels but why do I have all of the symptoms that are associated with high E2 when I seem to have perfect E2 levels but insanely high total estrogen levels?

[TABLE="width: 98"]
[TR]
[TD]Report
[/TD]
[TD]Result
[/TD]
[TD]Ref. Range
[/TD]
[TD]Units
[/TD]
[TD]
[/TD]
[TD]Status
[/TD]
[TD]Lab
[/TD]
[/TR]
[TR]
[TD]ESTRADIOL
[/TD]
[TD]20.8
[/TD]
[TD]7.6-42.6
[/TD]
[TD]PG/ML
[/TD]
[TD]
[/TD]
[TD]Final
[/TD]
[TD]01
[/TD]
[/TR]
[TR]
[TD]
[/TD]
[TD]
[/TD]
[TD]
[/TD]
[TD]
[/TD]
[TD]
[/TD]
[TD]
[/TD]
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[TD]Report
[/TD]
[TD]Result
[/TD]
[TD]Ref. Range
[/TD]
[TD]Units
[/TD]
[TD]
[/TD]
[TD]Status
[/TD]
[TD]Lab
[/TD]
[/TR]
[TR]
[TD]ESTROGENS, TOTAL
[/TD]
[TD]222
[/TD]
[TD]40-115
[/TD]
[TD]PG/ML
[/TD]
[TD]High
[/TD]
[TD]Final
[/TD]
[TD]02
[/TD]
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[TD]Report
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[TD]Result
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[TD]Ref. Range
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[TD]Units
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[/TD]
[TD]Status
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[TD]Lab
[/TD]
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[TR]
[TD]TESTOSTERONE, SERUM
[/TD]
[TD]977
[/TD]
[TD]348-1197
[/TD]
[TD]NG/DL
[/TD]
[TD]
[/TD]
[TD]Final
[/TD]
[TD]01
[/TD]
[/TR]
[TR]
[TD]COMMENT:
[/TD]
[TD]TESTM
[/TD]
[TD]
[/TD]
[TD]
[/TD]
[TD]
[/TD]
[TD]Final
[/TD]
[TD]01
[/TD]
[/TR]
[TR]
[TD="colspan: 7"]ADULT MALE REFERENCE INTERVAL IS BASED ON A POPULATION OF LEAN MALESUP TO 40 YEARS OLD.
[/TD]
[/TR]
[TR]
[TD]FREE TESTOSTERONE(DIRECT)
[/TD]
[TD]27.8
[/TD]
[TD]8.7-25.1
[/TD]
[TD]PG/ML
[/TD]
[TD]High
[/TD]
[TD]Final
[/TD]
[TD]02
[/TD]
[TD]
[/TD]
[/TR]
[TR]
[TD]RESULT NOTE
[/TD]
[TD="colspan: 6"]FASTING NO
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[TD]
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[/TABLE]


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[TD]Report
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[TD]Result
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[TD]Ref. Range
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[TD]Units
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[TD]
[/TD]
[TD]Status
[/TD]
[TD]Lab
[/TD]
[/TR]
[TR]
[TD]TSH
[/TD]
[TD]1.660
[/TD]
[TD]0.450-4.500
[/TD]
[TD]UIU/ML
[/TD]
[TD]
[/TD]
[TD]Final
[/TD]
[TD]01
[/TD]
[/TR]
[TR]
[TD]TRIIODOTHYRONINE,FREE,SERUM
[/TD]
[TD]3.4
[/TD]
[TD]2.0-4.4
[/TD]
[TD]PG/ML
[/TD]
[TD]
[/TD]
[TD]Final
[/TD]
[TD]01
[/TD]
[/TR]
[TR]
[TD]T4,FREE(DIRECT)
[/TD]
[TD]1.17
[/TD]
[TD]0.82-1.77
[/TD]
[TD]NG/DL
[/TD]
[TD]
[/TD]
[TD]Final
[/TD]
[TD]01
[/TD]
[/TR]
[TR]
[/TR]
[/TABLE]

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I should mention that it seems my body easily converts test to estrogen and I was diagnosed many years ago with Gilbert's syndrome where I have elevated Bilirubin levels. In a recent physical I had done my results were Total Bilirubin 1.8 mg/dL High 0.1 - 1.5. I've read that this may cause my liver to not be able to properly process the excess estrogen caused by the TRT but I don't understand why that's reflected in my total levels but not E2. I'm not sure what can be done at this point since I know an AI will lower my E2 which probably shouldn't go much lower than where it is now. How can I lower my total estrogen level and start feeling normal again without messing with my E2 levels?

 

[TRT_User]

So I started the progesterone and about a week later had some lab work done to further test a couple things. Here are the results:


IODINE, 35.8 40.0-92.0 UG/L

CORTISOL - AM 18.5 6.2-19.4 UG/DL
PROGESTERONE 0.9 0.2-1.4 NG/MLPROLACTIN 13.3 4.0-15.2 NG/ML
LH 0 .1 1.7-8.6 MIU/MLFSH 0.3 1.5-12.4 MIU/ML
TESTOSTERONE, SERUM 882 348-1197 NG/DLFREE TESTOSTERONE(DIRECT) 23.4 8.7-25.1 PG/ML
ESTRADIOL 20.0 7.6-42.6 PG/MLESTROGENS, TOTAL 54 40-115 PG/ML
DEHYDROEPIANDROSTERONE (DHEA) 129 31-701 NG/DL
TSH 1.330 0.450-4.500 UIU/ML

TRIIODOTHYRONINE,FREE,SERUM 3.4 2.0-4.4 PG/ML

T4,FREE(DIRECT) 1.13 0.82-1.77 NG/DL

I'm been off of the accutane now for almost 2 months now and it seems like it is completely out of my system with my skin and lips back to normal. I've noticed recently that my libido has slightly increased and I'm occasionally waking up with morning wood. My erections are still not nearly as hard as they used to be or as easy to obtain. Of notice is the low iodine level. Is there any need to be concerned with my upper range levels of cortisol, prolactin, and low levels of DHEA? It seems like my total Estrogen levels to return to a normal level from a very high 222 just last month. I doubt the progesterone I started only a few days prior to my labs caused it to drop that fast but I'm happy to see it finally in a normal range.

 

[Vince]

iodine helps your thyroid function properly, as long as you don't have Hashimoto's disease. I use J.Crow's one drop a day.

 

[Nelson Vergel]

Accutane can disrupt the hypothalamic-pituitary-gonadal axis. Some men feel like crap on that acne drug. Many recover after stopping it but I have coached two guys who had permanent ED after using it for months.

Can an Acne Drug (Accutane) Cause Negative Hormone Effects?


Antidepressants, Propecia and Accutane Can Cause Permanent Sexual Dysfunction

I hope now that you are off accutane your body will adjust.

I think it is a big mistake for you to use progesterone since this can increase estrogen, fat mass and stroke risk in men. The good news is that your progesterone product must be low concentration since your progesterone is within range.

Thread: Progesterone for men