Starting TRT, need advice on high E2 (?) beforehand and labs overall.

[DexM]

38M, starting TRT in a week but need some advice. New to this forum but hope I can get and give some insight in the years to come with my journey.

I have no clue to why my E2 is on the higher side from the ref range, doc had none either and said it is completely normal and maybe it is? Could this imply I aromatize alot? I am not fat or unhealthy, always been active training 3-4 times a week, but the last years has declined my health to a point I dont recognize myself anymore.

Totalt T hovers from lowest tested at 273ng/dl to highest 432ng/dl (5 tests).

I listened to MPMD talk with psyched substance where he said that testosterone has a direct impact on the Erythropoiesis process and that bordeline low hematology could be a sign of deficiency in testosterone, thoughts? My HB is at the low end and my MCV out of range (high), EVF seems ok?

My protocol for starters will be 75mg Test E every 3.5 days. I will have AI and Nolva on hand if it is the case that I aromatize alot, I have small gyno from puberty if that tells anything. Bloodwork with symptoms of high E2 before using anything ofc.

I'am excited to start but I have no expectations, hopefully it will help me get some energy and drive back to do things, I have always been a hard worker but god damn so depressing it is when nothing responds anymore in the body and mind and most days is a fog.

Total T: 432 ng/dl (164-749 ng/dl)

SHBG: 20 nmol/L (15-95 nmol/L)

Free T: 11.5ng/dl

E2: 42 pg/ml (High <40)

LH: 5.1 IE/L (1.5-9.3 IE/L)

TSH: 3.2 mIE/L (0.4-4.0 mIE/L)

T4 free: 14pmol/L (10-22 pmol/L)

EVF: 0.47 (0.39-0.5)

HB: 136 g/L (134-170 g/L)

MCH: 28 pg (27-33 pg)

MCV: 99 fL (High 82-98 fL)

HBA1c: 40 mmol/mol (27-42 mmol/mol)

HDL: 0.83 mmol/L (0.8-2.1 mmol/L)

Cholesterol : 4.8 mmol/L (3.3-6.9 mmol/L)

LDL: 3.6 mmol/L (1.4-4.7 mmol/L)

PSA: 1.2 ug/L (<3.0 ug/L)

 

[Systemlord]

My protocol for starters will be 75mg Test E every 3.5 days.

This is most likely too much Test and instead of shooting your estrogen into the stratosphere, then possibly needing a drug to counter, why not choose a more sensible protocol.

If I were you I would do 50 mg twice weekly.

I have no clue to why my E2 is on the higher side from the ref range

The high E2 could be genetic or due to being overweight. We men make some E2 in the testes and some from aromatase enzymes in fat tissue.

Aromatase enzymes are the primary source of estrogen in men on TRT.

Free T: 11.5ng/dl

The healthy ranges are 16-32 ng/dL and notice the majority of younger men seeking TRT around the 10-12 ng/dL range.

My HB is at the low end and my MCV out of range (high), EVF seems ok?

The TRT will increase the hemoglobin and the high MCV can be many things, thyroid, liver disease and alcohol consumption and smoking.

 

[DexM]

This is most likely too much Test and instead of shooting your estrogen into the stratosphere, then possibly needing a drug to counter, why not choose a more sensible protocol.

If I were you I would do 50 mg twice weekly.

Yeah sounds reasonable.

The healthy ranges are 16-32 ng/dL and notice the majority of younger men seeking TRT around the 10-12 ng/dL range.

I thought my 11.5 (2.66 %) was a pretty good number but guess not then for optimal. Looking forward to going into the more healthy range then.

The TRT will increase the hemoglobin and the high MCV can be many things, thyroid, liver disease and alcohol consumption and smoking.

Liver values all fine and in range, TSH seems fine at 3.2 albeit not the only thing to look at for thyroid problems I guess. Alcohol consumption very low and never smoked. But as with everything It could just be a normal variation with my MCV and lowish HB maybe? Or is this something I should look deeper into before starting TRT? I think I will start and draw new bloods around week 4-6 and go from there.

Thanks for your input!

 

[Systemlord]

It could just be a normal variation with my MCV and lowish HB maybe? Or is this something I should look deeper into before starting TRT?

The high MCV doesn’t explain the low-T or does it look like the smoking gun. No doctor is going to be concerned with a minuscule elevation in MCV.

Iron deficiency can cause, fatigue and low hemoglobin. I would check your iron before starting TRT. The ferritin and iron saturation should be enough.

 

[Gladiator]

That’s a good starting amount of test. Myself I started on 150 but went up to 175mg a week. This only got me to high normal.
E2 I never take an AI as it’s never been a problem but I have been taking zinc since I started to stop acne.
I only take 25mg of zinc a day but some people take 50 or 75mg a day.
You could start on a lower weekly testosterone amount but I would go with what your provider tells you for now.
It’s hard enough for some people to get a help so don’t go behind his back and risk getting cut off