Natural 21M Very Low E2 Relative to T With Symptoms

[Cogwheel5948]

Hello all, I'm at my wits end regarding low E2 symptoms which have been going on for at least 3 years, but have worsened: frequent urination (feels like I can't empty my bladder; underwear is always soaked), constipation, dry mouth, achy joints, complete loss of libido, ED. The blood test I took confirms that my T:E2 ratio of 45 (measured with sensitive assays) is very high compared to the ideal 20:1 or lower I've read on this forum. However, some of my other levels don't make that much sense to me (high Free T, high-normal SHBG, high-normal LH, normal FSH). I'm trying to book an endo, but my insurance requires a referral from my PCP, and the wait times are long. The earliest appointment assuming I get the referral would be in 3 weeks.

Supplements: creatine, carnitine, NAC, fish oil, magnesium, D3/K2, ashwagandha. I've never touched any natural AIs like DIM or calcium D-glucarate and never supplemented with excessive Zn or vitamin E (took a multivitamin before, but haven't taken one in months). I took green tea daily before, but I stopped taking after receiving the blood test results it due to its possible AI effects, but I doubt green tea would be crashing my E2 that much anyway.

Diet: hitting all macros and micros, at a slight deficit at time of measurement, never drank or touched nicotine before. I fast until 10 AM each day. I'm pretty lean year round, 12% now and never go above 14%. I don't really notice a difference in symptoms at different BF levels. Sleep has always been a consistent 8 hours a night, but I wake up once to urinate.

Workout: 4-5 days a week plus moderate cardio from walking to class/work (stopped the weights in the 2 week leading up to blood test as I was feeling terrible).

Past medical history: none.

Other: blood test taken at 8:15 AM (earliest possible appointment). I've read some discussion on calculated vs. measured free T. Mine was measured using equilibrium ultrafiltration, which is the gold standard, however, some calculators give a much lower measurement, which would be more in line with my SHBG. Also, I doubt this explains my bloodwork, but I stopped watching porn about a month before this bloodwork was taken. Any help is appreciated.

 

[bixt]

Creatine significantly enhances DHT levels. And high levels of DHT is anecdotally (very very widely) associated with "low E2" symptoms such as creaky joints.

So while you may not be taking any AIs in your list, you are potentially antagonising the effects of E2 by inadvertantly increasing your DHT.

Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players - PubMed

Creatine supplementation may, in part, act through an increased rate of conversion of T to DHT. Further investigation is warranted as a result of the high frequency of individuals using creatine supplementation and the long-term safety of alterations in circulating androgen composition...

pubmed.ncbi.nlm.nih.gov

"After 7 days of creatine loading, or a further 14 days of creatine maintenance dose, serum T levels did not change. However, levels of DHT increased by 56% after 7 days of creatine loading and remained 40% above baseline after 14 days maintenance (P < 0.001). The ratio of DHT:T also increased by 36% after 7 days creatine supplementation and remained elevated by 22% after the maintenance dose (P < 0.01)."


I

 

[FunkOdyssey]

What bixt said. As I was reading the OP's post, I thought I was going be the clever guy to point out creatine/DHT, but I should have known better on this forum.

 

[Cogwheel5948]

Could someone link me to some sources? I know creatine can raise DHT, but I've never heard of it causing any of my symptoms. Either way, I'll be sure to get DHT and free DHT tested on my next blood work.

 

[Cataceous]

Could someone link me to some sources? I know creatine can raise DHT, but I've never heard of it causing any of my symptoms. ...

The anti-estrogenic effects of DHT seem to be inferred from lower level research. For example:
DHT is an aromatase inhibitor:

FSH-induced aromatase activity in porcine granulosa cells: non-competitive inhibition by non-aromatizable androgens - PubMed

The aim of this study was to examine the inhibitory effect of the non-aromatizable androgens on FSH-stimulated aromatase activity in porcine granulosa cells. The cells were isolated from medium-sized follicles (4-6 mm) of prepubertal pigs, and cultured under chemically defined conditions in the...

pubmed.ncbi.nlm.nih.gov

DHT blocks estrogen through competitive inhibition:

Antiestrogenic action of dihydrotestosterone in mouse breast. Competition with estradiol for binding to the estrogen receptor - PubMed

Feminization in men occurs when the effective ratio of androgen to estrogen is lowered. Since sufficient estrogen is produced in normal men to induce breast enlargement in the absence of adequate amounts of circulating androgens, it has been generally assumed that androgens exert an...

pubmed.ncbi.nlm.nih.gov

 

[madman]

Creatine significantly enhances DHT levels. And high levels of DHT is anecdotally (very very widely) associated with "low E2" symptoms such as creaky joints.

So while you may not be taking any AIs in your list, you are potentially antagonising the effects of E2 by inadvertantly increasing your DHT.

Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players - PubMed

Creatine supplementation may, in part, act through an increased rate of conversion of T to DHT. Further investigation is warranted as a result of the high frequency of individuals using creatine supplementation and the long-term safety of alterations in circulating androgen composition...

pubmed.ncbi.nlm.nih.gov

"After 7 days of creatine loading, or a further 14 days of creatine maintenance dose, serum T levels did not change. However, levels of DHT increased by 56% after 7 days of creatine loading and remained 40% above baseline after 14 days maintenance (P < 0.001). The ratio of DHT:T also increased by 36% after 7 days creatine supplementation and remained elevated by 22% after the maintenance dose (P < 0.01)."


I

Highly doubtful creatine supplementation is going to have a significant impact on increasing DHT!

Deadset on that I see.

Did you read the full study?

Three Weeks of Creatine Monohydrate Supplementation Affects Dihydrotestosterone to Testosterone Ratio in College-Aged Rugby Players (2009)
van der Merwe, Johann MBChB; Brooks, Naomi E Ph.D.; Myburgh, Kathryn H PhD





Look up who Jose Antonio is!

Common questions and misconceptions about creatine supplementation

Abstract Supplementing with creatine is very popular amongst athletes and exercising individuals for improving muscle mass, performance, and recovery. Accumulating evidence also suggests that creatine supplementation produces a variety of beneficial effects in older and patient populations...

www.excelmale.com

Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? (2021)
Jose Antonio*, Darren G. Candow, Scott C. Forbes, Bruno Gualano, Andrew R. Jagim, Richard B. Kreider, Eric S. Rawson, Abbie E. Smith-Ryan, Trisha A. VanDusseldorp, Darryn S. Willoughby and Tim N. Ziegenfuss

Does creatine cause hair loss/baldness?

The vast majority of speculation regarding the relationship between creatine supplementation and hair loss/ baldness stems from a single study by van der Merwe et al. [61] where college-aged male rugby players who supplemented with creatine (25 g/day for 7 days, followed by 5 g/day thereafter for an additional 14 days) experienced an increase in serum dihydrotestosterone.

(DHT) concentrations over time. Specifically, DHT increased by 56% after the seven-day loading period and remained 40% above baseline values after the 14-day maintenance period. These results were statistically significant compared to when the subjects consumed a placebo (50 g of glucose per day for 7 days, followed by 30 g/day for 14 days thereafter). Given that changes in these hormones, particularly DHT, have been linked to some (but not all) occurrences of hair loss/baldness [62], the theory that creatine supplementation leads to hair loss/baldness gained some momentum and this potential link continues to be a common question/myth today. It is important to note that the results of van der Merwe et al. [61] have not been replicated and that intense resistance exercise itself can cause increases in these androgenic hormones.

DHT is a metabolite of testosterone, formed when the enzyme 5-alpha-reductase converts free testosterone to DHT [63]. In males, DHT can bind to androgen receptors in susceptible hair follicles and cause them to shrink, ultimately leading to hair loss [64]. However, in the van der Merwe et al. [61] study, no increase in total testosterone was found in the 16 males who completed the study. Free testosterone was not measured. Moreover, the increase in DHT and the DHT: testosterone ratio remained well within normal clinical limits. Furthermore, at baseline (prior to supplementation), DHT was 23% lower in the creatine group (0.98 nmol/L) compared to the placebo group (1.26 nmol/L). Thus the small increase in DHT in the creatine group (+ 0.55 nmol/L after 7 days of supplementation and + 0.40 nmol/L after 21 days of supplementation), in combination with a small decrease in the placebo DHT response (-0.17 nmol/L after 7 days of supplementation and -0.20 nmol/L after 21 days of supplementation) explains the “statistically significant” increase in DHT noted by van der Merwe et al. [61]. While it is possible that creatine supplementation upregulated 5- alpha-reductase activity in these males (potentially leading to increased formation of DHT), no study has reported hair loss/baldness in humans.

To date, 12 other studies have investigated the effects of creatine supplementation (i.e. doses ranging from 3-25 g/ day for 6 days to 12 weeks) on testosterone. Two studies reported small, physiologically insignificant increases in total testosterone after six and seven days of supplementation [65, 66], while the remaining ten studies reported no change in testosterone concentrations. In five of these studies [67– 71], free testosterone, which the body uses to produce DHT, was also measured and no increases were found.



*In summary, the current body of evidence does not indicate that creatine supplementation increases total testosterone, free testosterone, DHT, or causes hair loss/baldness.

 

[Cogwheel5948]

Could someone else take a look at my profile? AFAIK, I'm the first natural on this forum with these symptoms. @Nelson Vergel

 

[sammmy]

You are overdosing on Vit B12.
I would drop all unnecessary supplements without clear immediate benefit. They are not always as benign or "good for you" as the internet and the "studies" claim. If it ain't broke, don't try to fix it.

 

[Cogwheel5948]

I haven't taken any B12 in months, and I don't take a multivitamin. The only supplements I take are listed in the OP.