Man with Estradiol, DHT, Free T Way High

[SSHSSA74]

Scrotal application.

Last question. I promise. Are you taking hCG?

 

[Axlerod]

So, big shout out to @Nelson Vergel who has already discussed this in some detail in one of his videos (

). I'm one of the guys he describes who freaked out when he got his lab results back with very high E2 and DHT levels. As he points out in his analysis of the JCEM paper, predicted E2 levels can be calculated as follows:
E2 (regular immunoassay- not sensitive)= 138.3xTT/(1470.1+TT)
DHT = 269.4xTT/(2389.6+TT)
Where TT= Total Testosterone

So in my case it works out to 79.3 vs. the lab results of 78 pg/mL. Since I used Discount Labs and their sensitive assay technique, he recommends multiplying the calculated E2 value by .80, so that would put my level at 63.5, vs the 78 of the test result, so still a little high.

For DHT, I'm still quite high at 243 ng/dL, vs. the calculated value which should be 122 (i.e. almost 2x higher than predicted). However, a look at the curves in the paper (graph D, old men DHT vs TT), shows that DHT levels that high at that TT level do occur in some cases.

I'm going to lower dosage to half to 1 ml at 175 mg/mL (vs 2 mL), see how I feel after a few weeks and get new labs done.

 

[Axlerod]

Last question. I promise. Are you taking hCG?

No. Why do you ask?

 

[Tryaero69]

Hi all,
Long-time reader and big fan of the site. Big thanks to you @Nelson Vergel for all the info, the willingness to share, care and effort put into this and other forums). My background: very fit, lean 175lbs, 6'1", 58 work out hard (lift 3 - 4x per week; sprint 2-3x per week; yoga 3 times per week). Practice Time Restricted Feeding 17/7); fast 48 hours every six months; supplement with protein 180 gm / day, eat low-ish carb diet, .

I've been on TRT for 27 months, and for 20 of those using weekly injections of test cypionate 200 mg. Labs always good, no AI. 7 months ago switched to cream (compounded 150 mg/ml; applying 1ML 2x per day); and my Dr. upped this to 175 mg/ml 2ml/day about 3 months ago. Have been feeling really great and everything all good (energy focus, libido, etc.)

I just got my labs back and most results were well within range and consistent with previous blood draws. But a few results were very OUT of range, and got me quite concerned. These were:

• AST = 61 U/L (was 31 on 7/19; note that I have been eating a high protein diet for the past 7 yrs; bilirubin was 1.2 mg/dL)
• DHT =243 ng/dL (!!! - note I take 1 mg Finasteride daily; previously 14 on 7/19)
• Estradiol, ultrasensitive = 78 pg/mL (previously 9 on 7/19)
• Testosterone, total = 1977 ng/dL (previously 1034 on 7/19)
• Testosterone, Free = 395.4 pg/mL (previously 84.3 on 7/19)
• LDL = 114 mg/dL

A few other results of potential interest (all within range) are:

• IGF-1 (LC/MS) = 117 ng/mL
• SHBG = 57 nmol/L
• PSA total = 0.5 ng/mL
• DHEA sulfate = 107 mcg/dL
• Hematocrit -46.4%

Any guidance would be very much appreciated.

Thanks!

Hi all,
Long-time reader and big fan of the site. Big thanks to you @Nelson Vergel for all the info, the willingness to share, care and effort put into this and other forums). My background: very fit, lean 175lbs, 6'1", 58 work out hard (lift 3 - 4x per week; sprint 2-3x per week; yoga 3 times per week). Practice Time Restricted Feeding 17/7); fast 48 hours every six months; supplement with protein 180 gm / day, eat low-ish carb diet, .

I've been on TRT for 27 months, and for 20 of those using weekly injections of test cypionate 200 mg. Labs always good, no AI. 7 months ago switched to cream (compounded 150 mg/ml; applying 1ML 2x per day); and my Dr. upped this to 175 mg/ml 2ml/day about 3 months ago. Have been feeling really great and everything all good (energy focus, libido, etc.)

I just got my labs back and most results were well within range and consistent with previous blood draws. But a few results were very OUT of range, and got me quite concerned. These were:

• AST = 61 U/L (was 31 on 7/19; note that I have been eating a high protein diet for the past 7 yrs; bilirubin was 1.2 mg/dL)
• DHT =243 ng/dL (!!! - note I take 1 mg Finasteride daily; previously 14 on 7/19)
• Estradiol, ultrasensitive = 78 pg/mL (previously 9 on 7/19)
• Testosterone, total = 1977 ng/dL (previously 1034 on 7/19)
• Testosterone, Free = 395.4 pg/mL (previously 84.3 on 7/19)
• LDL = 114 mg/dL

A few other results of potential interest (all within range) are:

• IGF-1 (LC/MS) = 117 ng/mL
• SHBG = 57 nmol/L
• PSA total = 0.5 ng/mL
• DHEA sulfate = 107 mcg/dL
• Hematocrit -46.4%

Any guidance would be very much appreciated.

Thanks!

Looks like your estradiol is very high.Are you still feeling good while on new dosage of testosterone cream?

 

[Axlerod]

Yes I was at 4 clicks (1 mL) twice per day of 175 mg/mL. My total was super high at 1977 and per the journal article analysis in the video provided by Nelson, my E2 at 78 pg/mL is in line with the high total T (based on the formula 138.3xTT/(1470.1+TT)), although slightly on the high side. No ill effects, feeling pretty good overall. I've since halved the dose as I'm not looking to get into the anabolic zone, just the high side of the normal range (although gotta say, the positive impact on my lifts was pretty awesome and my vascularity noticeably more pronounced).

 

[SSHSSA74]

No. Why do you ask?

I am still trying to get dialed in. Whenever I see someone on here who is feeling really good, I ask about their protocol for ideas about what adjustments I might make.

 

[Axlerod]

I am still trying to get dialed in. Whenever I see someone on here who is feeling really good, I ask about their protocol for ideas about what adjustments I might make.

I've been reading the forums here and listening to videos (Nelson's, and his with Dr. Saya, and others too) and it appears that HCG is important to maintaing testicular volume, fertility, endogenous production, etc. So it's something that I'm going to explore and consider TBH.

 

[SSHSSA74]

I've been reading the forums here and listening to videos (Nelson's, and his with Dr. Saya, and others too) and it appears that HCG is important to maintaing testicular volume, fertility, endogenous production, etc. So it's something that I'm going to explore and consider TBH.

Yes. I currently use it. But there have been times in the past when I did not. I know it can spike e2 and some people do not adjust well to it. I don't really seem to notice a difference besides my balls being bigger so I'll probably drop it when I change my protocol. Thanks.