low e2 symptoms didnt go away after crash

[Nocalves]

Allow me to join in here. I have the same low E2 problem as a few others here, caused by abusing stupid amounts of aromasin several years ago.

Here's what hasn't worked:

• Increasing test dosage. At one point I was doing 400mg/week and still getting low E2 symptoms.
• HCG. Just helps to a very marginal extent
• DHEA. Better than nothing for raising E2, but same outcome as HCG.
• Estradiol cream (Oestrogel). Felt like a new person for 3-4 days and then it just stopped working. Absorption issues perhaps, similar to those who use T creams.

Here's what I found some success with:

• Estradiol valerate injections. I made my own 10mg/ml solution (with cottonseed oil as carrier) and I am still trying to find my sweet spot. Today I injected 2mg and felt good - 1mg in the morning and 1mg in the evening.

Hope this helps some of you guys here. Would appreciate any comments or feedback.

I am on estradiol enanthate and now I try to find ideal dose. 14 ago I pined 1mg and my e2 went up to 212 pg/ml and it took 14days to drop it back to 54 pg/ml. It was Interesting to track how I feel day by day while my e2 slowly went down. My trt is 20mg test E ED and I have to say I felt best libido and erection in somwhere around 80pg/ml … My total test level is 800ng and SHBG of 10.. I did bet fot my low SHBG will fit lower E2 better, now I think My e2 is 35ng/ml. In few days I will check it again before my e2 injection, but now I can say I feel worse every day (libido, sleep, energy). Lets see two last days dropping my e2 to confirm my hypothesis.

So what is your e2 protocol?

Thank you

 

[solothesensei]

I am on estradiol enanthate and now I try to find ideal dose. 14 ago I pined 1mg and my e2 went up to 212 pg/ml and it took 14days to drop it back to 54 pg/ml. It was Interesting to track how I feel day by day while my e2 slowly went down. My trt is 20mg test E ED and I have to say I felt best libido and erection in somwhere around 80pg/ml … My total test level is 800ng and SHBG of 10.. I did bet fot my low SHBG will fit lower E2 better, now I think My e2 is 35ng/ml. In few days I will check it again before my e2 injection, but now I can say I feel worse every day (libido, sleep, energy). Lets see two last days dropping my e2 to confirm my hypothesis.

So what is your e2 protocol?

Thank you

Interesting, that would mean you feel best on a T:E ratio of 10:1. (I assume this is the sensitive E2 test?)

I'm also finding the ideal E2 dose. Currently 2mg/day of estradiol valerate (1mg subq, morning and evening) with 250mg/week of TRT helps me feel good. I simply feel like crap on any lower amount of T.

I will have to see where that puts my E2 numbers at. Even if it's ridiculously high, I have no high E2 sides at all. In fact I feel myself slipping back into low E2 states right before my injections and I always feel better after the E2 jabs.

 

[Cataceous]

...
Here's what I found some success with:

• Estradiol valerate injections. I made my own 10mg/ml solution (with cottonseed oil as carrier) and I am still trying to find my sweet spot. Today I injected 2mg and felt good - 1mg in the morning and 1mg in the evening.

Hope this helps some of you guys here. Would appreciate any comments or feedback.

The average male makes about 50 mcg of estradiol per day. Two milligrams of estradiol valerate contain more than 1,500 mcg of estradiol. I would advise caution to anyone considering this. With a half-life of several days, estradiol valerate can accumulate to high levels before you begin to realize you've overdone it.

 

[JA Battle]

The average male makes about 50 mcg of estradiol per day. Two milligrams of estradiol valerate contain more than 1,500 mcg of estradiol. I would advise caution to anyone considering this. With a half-life of several days, estradiol valerate can accumulate to high levels before you begin to realize you've overdone it.

Yes, back a while 50mcg of estradiol valerate injected brought my level from 15pg to 38pg

 

[solothesensei]

The average male makes about 50 mcg of estradiol per day. Two milligrams of estradiol valerate contain more than 1,500 mcg of estradiol. I would advise caution to anyone considering this. With a half-life of several days, estradiol valerate can accumulate to high levels before you begin to realize you've overdone it.

Yeah, I found it odd myself that I needed such a high dose of Estradiol Valerate to feel good. Either my E2 receptors are not functioning properly, or that serum E2 is not translating into tissue E2, or I'm getting low-purity raw powders.

 

[MIP1950]

The average male makes about 50 mcg of estradiol per day. Two milligrams of estradiol valerate contain more than 1,500 mcg of estradiol. I would advise caution to anyone considering this. With a half-life of several days, estradiol valerate can accumulate to high levels before you begin to realize you've overdone it.

I know I'm a broken record, but Dr. Rouzier prescribes oral estradiol when he feels it would help the men taking testosterone who still aren't doing well. Injecting it is a different story, perhaps. This is the flip side of men who take 1 to 3 mg of anastrazole a week, along with T and feel/function better with E2 <5 pg. For me, I'm an outlier who either needs quite high E2 or E2 in the basement. My urologist and I are going to hash this out.

 

[solothesensei]

The average male makes about 50 mcg of estradiol per day. Two milligrams of estradiol valerate contain more than 1,500 mcg of estradiol. I would advise caution to anyone considering this. With a half-life of several days, estradiol valerate can accumulate to high levels before you begin to realize you've overdone it.

I have an interesting update to share. Before, I needed 2mg of estradiol valerate per day (1mg subq, 2x/day) to feel good.

I have since found that intramuscular shots of EV work twice as good. Even better - the effects last way longer. So now I only have to do 1mg every 2 days, which is great.

I don't have a strong explanation for this but I hope this is helpful information. May have something to do with the lipophilicity of EV making it get broken down quickly with subq administration.

 

[JA Battle]

I have an interesting update to share. Before, I needed 2mg of estradiol valerate per day (1mg subq, 2x/day) to feel good.

I have since found that intramuscular shots of EV work twice as good. Even better - the effects last way longer. So now I only have to do 1mg every 2 days, which is great.

I don't have a strong explanation for this but I hope this is helpful information. May have something to do with the lipophilicity of EV making it get broken down quickly with subq administration.

Anybody have any estradiol supplementation updates? Still doing it? How are you guys that are doing it feeling?

 

[glob]

Just wanted to give an update to this old thread.

I'm doing much better at the moment. I would say that I have pretty much recovered from all the symptoms. Things improved slowly but i'm so glad to be feeling normal again.

Take it easy with the AI's folks!

Do you come off trt or did you continue?
I’m in the same boat as you were, how can I do?

 

[MV0334]

Alright guys, I am a new member on this board but have been a member of ASF forums for awhile now. I literally came here to make one post about this topic. For the last 2 years I have been dealing with this issue and FOUND THE ANSWER. Long story short I crashed my E2 with letro "undetectable sensitive test" and have suffered ever since ( almost 2 years now). Truthfully, I am a resident physician in TX and have went through medical school and with the help of myself and many fellow physicians, we could not figure out what was wrong! I am not sure of the mechanism or how it works, but I had a HRT doc who is really old school that I was working with in Urology tell me that he puts all of his guys on clomid while on TRT to preserve fertility. Long term, he said it works better than HCG despite the HPTA being "shut down" from TRT. Anyways, I started 50mg of clomid daily on top of my normal HRT regimen (50mg 3X week) and 80% of my symptoms have resolved. For the last 2 years I have had weakness, fatigue, brain fog, joint pain, dizziness, insomnia, HOT FLASHES daily, shitty appetite, tingling, itchy skin and more. I have kept my HRT at 50mg 3X a week for 1.5 years and despite having no AI and perfect e2 on sensitive blood work (28 to 34pg) my symptoms persisted. After being on 50mg of clomid now for 3 days while maintaining my HRT regimen I am feeling great. Confidence is coming back, morning wood, pumps in the gym, sleeping through the night....its day and night difference. I called Dr Morris and he said that my e2 should be up around 50-60 on a sensitive test and that the clomid is helping bring it up (which doesn't make sense to me as it is a SERM that makes your HPTA detect low levels). Anyways, I am a scientist and have tried to figure this out forever, but am here to tell you all to at least consider trying 50mg clomid q daily with a consistent TRT regimen only. No HCG, AI etc etc.

 

[Systemlord]

After being on 50mg of clomid now for 3 days while maintaining my HRT regimen I am feeling great.

Please report back in 3 months and tell us if you still feel great. I have heard some guys feel amazing on clomid long term.

 

[Systemlord]

HOT FLASHES daily

That sounds like low E2. No wonder you feel great on clomid.

 

[GreenMachineX]

Alright guys, I am a new member on this board but have been a member of ASF forums for awhile now. I literally came here to make one post about this topic. For the last 2 years I have been dealing with this issue and FOUND THE ANSWER. Long story short I crashed my E2 with letro "undetectable sensitive test" and have suffered ever since ( almost 2 years now). Truthfully, I am a resident physician in TX and have went through medical school and with the help of myself and many fellow physicians, we could not figure out what was wrong! I am not sure of the mechanism or how it works, but I had a HRT doc who is really old school that I was working with in Urology tell me that he puts all of his guys on clomid while on TRT to preserve fertility. Long term, he said it works better than HCG despite the HPTA being "shut down" from TRT. Anyways, I started 50mg of clomid daily on top of my normal HRT regimen (50mg 3X week) and 80% of my symptoms have resolved. For the last 2 years I have had weakness, fatigue, brain fog, joint pain, dizziness, insomnia, HOT FLASHES daily, shitty appetite, tingling, itchy skin and more. I have kept my HRT at 50mg 3X a week for 1.5 years and despite having no AI and perfect e2 on sensitive blood work (28 to 34pg) my symptoms persisted. After being on 50mg of clomid now for 3 days while maintaining my HRT regimen I am feeling great. Confidence is coming back, morning wood, pumps in the gym, sleeping through the night....its day and night difference. I called Dr Morris and he said that my e2 should be up around 50-60 on a sensitive test and that the clomid is helping bring it up (which doesn't make sense to me as it is a SERM that makes your HPTA detect low levels). Anyways, I am a scientist and have tried to figure this out forever, but am here to tell you all to at least consider trying 50mg clomid q daily with a consistent TRT regimen only. No HCG, AI etc etc.

I'm in a similar boat. Glad to have found this thread. You didnt mention anxiety...none?

In the past, I used ecdysterone (cyclodextrin-ecdysterone to be exact) and it increased my e2 from 17 to 26-37 depending on dose and I felt really good. I've read it works through estrogen receptor beta, so even with that small increase in numbers, it worked really well. I stopped using it because I figured daily use for years wasn't a good idea. On the flip side, anxiety and the rest of these e2 symptoms can't be good either. I ordered more to try it out again since it's been a couple years, and I'll use that until I can find a doctor who may be willing to prescribe clomid. I may need to go back to an EOD protocol because I had less of these symptoms then, but my blood pressure is so much lower in ED.

 

[MV0334]

I'm in a similar boat. Glad to have found this thread. You didnt mention anxiety...none?

In the past, I used ecdysterone (cyclodextrin-ecdysterone to be exact) and it increased my e2 from 17 to 26-37 depending on dose and I felt really good. I've read it works through estrogen receptor beta, so even with that small increase in numbers, it worked really well. I stopped using it because I figured daily use for years wasn't a good idea. On the flip side, anxiety and the rest of these e2 symptoms can't be good either. I ordered more to try it out again since it's been a couple years, and I'll use that until I can find a doctor who may be willing to prescribe clomid. I may need to go back to an EOD protocol because I had less of these symptoms then, but my blood pressure is so much lower in ED.

Awful anxiety. Sorry I didn't list it as a symptom. The issues I have experienced are numerous. I first attributed the anxiety to medical school, but i didn't have the anxiety at all till I crashed my e2 during my 3rd and 4th year. Whats incredibly weird is that when I was younger (roughly 8 years ago) I could crash my e2 on purpose to fix gyno. I eventually got the lumps removed, but prior to that I would crash my e2 with letro and bounce back in maybe 1-2 weeks. Now Its all changed! Oh how our bodies develop and adapt over time.

 

[GreenMachineX]

Awful anxiety. Sorry I didn't list it as a symptom. The issues I have experienced are numerous. I first attributed the anxiety to medical school, but i didn't have the anxiety at all till I crashed my e2 during my 3rd and 4th year. Whats incredibly weird is that when I was younger (roughly 8 years ago) I could crash my e2 on purpose to fix gyno. I eventually got the lumps removed, but prior to that I would crash my e2 with letro and bounce back in maybe 1-2 weeks. Now Its all changed! Oh how our bodies develop and adapt over time.

Gotcha. My current symptoms are the anxiety with this feeling of mild stimulation or like a motor running in my chest/upper abdomen, palpitations, joints cracking, occasional brain fog or brain "fatigue", sometimes mild dizziness or out of it feeling, but that's about it right now. I wake up a couple times per night but eventually able to go back to sleep and total 7 hours of sleep at least. But my energy is fine (yet scared to do intense exercise with this anxiety and motor running feeling), and libido is fine. My daily test dose is 10mg, and anytime I try to drop lower, my symptoms get worse. This dose keeps my free T at very top of range and my total T at 550 and e2 sensitive at 18, tested 2 weeks ago. Last shbg was 12-15...can't recall exactly but very bottom of range but several years ago. Guessing it's even lower now. I'm also wondering if my thyroid dose is too high now, yet it's only 125mcg of synthroid and I weigh 220 (I also lack several of the symptoms of overmedicated thyroid).

 

[MV0334]

Gotcha. My current symptoms are the anxiety with this feeling of mild stimulation or like a motor running in my chest/upper abdomen, palpitations, joints cracking, occasional brain fog or brain "fatigue", sometimes mild dizziness or out of it feeling, but that's about it right now. I wake up a couple times per night but eventually able to go back to sleep and total 7 hours of sleep at least. But my energy is fine (yet scared to do intense exercise with this anxiety and motor running feeling), and libido is fine. My daily test dose is 10mg, and anytime I try to drop lower, my symptoms get worse. This dose keeps my free T at very top of range and my total T at 550 and e2 sensitive at 18, tested 2 weeks ago. Last shbg was 12-15...can't recall exactly but very bottom of range but several years ago. Guessing it's even lower now. I'm also wondering if my thyroid dose is too high now, yet it's only 125mcg of synthroid and I weigh 220 (I also lack several of the symptoms of overmedicated thyroid).

Your protocol looks good but your test could come up a little. It is whatever you think is best but 550 can leave some men still feeling symptomatic. How long have you been on the levothyroxine? I am only asking because I have had patients develop weird side effects to this medication "increased HR, palpitations, dizziness, fatigue" but their levels are always "Normal" with a TSH of 2-3 and a free T4/T3 of 1.5ish and 3.0ish.

 

[GreenMachineX]

Your protocol looks good but your test could come up a little. It is whatever you think is best but 550 can leave some men still feeling symptomatic. How long have you been on the levothyroxine? I am only asking because I have had patients develop weird side effects to this medication "increased HR, palpitations, dizziness, fatigue" but their levels are always "Normal" with a TSH of 2-3 and a free T4/T3 of 1.5ish and 3.0ish.

Well, the reason I'm glad my test is where it is is the free test being so high. If my total comes up, my free will be supraphysiogical. I also forgot to mention this is day 3 without dhea as it was also giving me weird side effects and day 1 no fish oil, also giving me bizarre symptoms. I won't be taking anything by the end of the week lol.

I've been on synthroid for like 8 years or even more. I've tried to switch to armour and nature-throid but I felt way overstimulated. But I also see that fish oil was making everything I was taking worse, so I'm basically starting from scratch and need to re-evaluate everything. As crazy as this will sound, I believe the fish oil was suppressing healthy cortisol levels to unhealthy ranges as well as lowering shbg to unhealthy levels. Time will tell.

Also, if my thyroid medicine was a problem, I imagine the side effects like racing heart should stay elevated right? I have periods of feeling normal and heart rate goes back to 60's which shouldn't happen with thyroid issues, right?

 

[Tommy5454]

I want to say thank you for coming here and posting this. You’re a good man to help others without any impetus. I am over year into this, you can read my story on here somewhere, I think. 3 months ago I re-started HCG, which I was on when I had my AI crash, and it is helping me. I took a year off of it to let my body settle. It does seem like I need more HCG and higher E2 now to help me feel better. I also find that anything that decreases E2, from chocolate to NSAIDS, hurts my progress and gives me symptoms again for a few days. I also find that running, especially sprinting, helps significantly.

I was on HCG for post-finasteride syndrome and this past year has been so much worse with low E2. I am able to function again but still not back to where I was. I like HCG because it can be used long term and activates the p450 side chain. But I am interested in why your doc prefers cloMid.

 

[GreenMachineX]

Well, the reason I'm glad my test is where it is is the free test being so high. If my total comes up, my free will be supraphysiogical. I also forgot to mention this is day 3 without dhea as it was also giving me weird side effects and day 1 no fish oil, also giving me bizarre symptoms. I won't be taking anything by the end of the week lol.

I've been on synthroid for like 8 years or even more. I've tried to switch to armour and nature-throid but I felt way overstimulated. But I also see that fish oil was making everything I was taking worse, so I'm basically starting from scratch and need to re-evaluate everything. As crazy as this will sound, I believe the fish oil was suppressing healthy cortisol levels to unhealthy ranges as well as lowering shbg to unhealthy levels. Time will tell.

Also, if my thyroid medicine was a problem, I imagine the side effects like racing heart should stay elevated right? I have periods of feeling normal and heart rate goes back to 60's which shouldn't happen with thyroid issues, right?

@MV0334 Does my reasoning make sense? Honestly asking as I'm in between doctors and not in a good place...

 

[MV0334]

@MV0334 Does my reasoning make sense? Honestly asking as I'm in between doctors and not in a good place...

I highly doubt fish oil and other OTC supplements are compounding the problem. Possibly the DHEA (which I advocate you stay away from), but not fish oil. At the hight of my issues, I tried to attribute all my symptoms to food intolerance's. I switched to keto for like a year because "carbs made my hot flashes and bloating worse." I then attributed it to caffeine, so i tried cutting that etc etc etc, the list went on. Look at the symptoms of menopause/having a hormone imbalance in general. It can lead to some odd symptoms like tingling, burning in extremities, hot flashes, weight gain, bloating in stomach, digestive issues like GERD and constipation, anxiety, depression, brain fog. I used to be able to drink 3-4 cups a coffee a day in med school before I crashed my e2, after I could barely handle a cup without feeling shaky and sweaty. The weird thing is that now being on Clomid almost a week, I can drink all the coffee I want again and have no issues. My stomach issues and bloating are also gone, as well as my anxiety and brain fog. The only symptoms that are left is occasional fatigue, hot flushing and tingling when I am warm/working out. I will also note the Clomid has decreased my libido slightly and made me experience 1-2 brief depressive episodes a day. These things however are way more manageable compared to how I felt just last week. Honestly, if my wife wasn't a physician as well i am pretty sure should would have left me by now. Thankfully she can empathize with me medically and has tried to help me find a solution after all this time.

As for the thyroid you are correct to assume the above, but what is your thyroid condition. You were hypo, but did anyone test your antibodies (TPO, TGAb,TSI) or diagnose you with Hashimoto's disease? I am only asking because there are weird symptoms attributed with that. I should also note that I have had patients experience some hyper symptoms from their meds, but not all....example (they have average resting HR of 65-75bpm but heat intolerance, mood swings, anxiety, insomnia). If you have been on the same thyroid medication and dose for a long time, but your issues only showed up in the last few months after crashing your e2, I doubt your issues is thyroid in nature. However, if your symptoms have been going on for awhile and you cant attribute it to anything, It honestly could be your thyroid medication. YOU DO NOT have to be hyperthyroid and react oddly to your thyroid meds. Many people feel wired and "off" on them despite having perfect labs" Do you need them? Who diagnosed you with hypothyroid and what were your values?

Personal disclaimer since I am a physician: I am not here to give medical advice, only provide feedback as to what I believe to be true. Everyone should speak with their own doctor before changing their medications around.