Switched to testosterone cream and was suprised at my blood e2 reading!

[skullmaggots]

After trying many protocols over the last 3yrs, I've ended up trying compounded testosterone cream. My initial starting dose was 75mg (2 clicks) morning and evening. I believe this starting dose was given because I was previously on 150mg cypionate a week.

I went to get my thyroid test completed as I'm also titrating up on t4. However my blood test provider gave me the wrong blood test, which in this case was a full TRT 6 monthly screening!

As I wasn't expecting this I HAD applied my 2 clicks of cream at about 8am, and my blood test was at 11.50am. So given the rapid effect of cream this result should be seen as a peak value.

Every blood test I've had to date is always on the trough at least 12 hrs after my last shot.

I was really shocked when I got my results, my total testosterone was 1390nmol/L (fine with that) but my e2 was 89pg/mL (wtf).

I've only ever once has an e2 reading that high when I was on 175mg sustanon a week, and hcg. Also I've had total test readings much higher e.g. in the 50s when on less but injections. So for me, cream seems to be must more estrogenic that other methods. When I spoke to the doc he said it's usually the opposite!

My question is this, do people find cream on the whole results in a lower e2? Also, as this is a peak value, how much of a drop would expect by 10pm before my next application?

We talk all the time about how testosterone reduces overtime, I can even see this in various calculators. However, I don't see very much talked about in terms of clearance of e2. My SHBG is 48 btw.

Finally some context, I exercise 5 times week, 15% bodyfat, lots of muscle mass. I eat clean, don't drink, don't smoke. I am however a type 1 diabetic. I like cream, the extra DHT and free T increase has been good for my erections and libido. However, looks like I'll have to seriously lower my dose to get my e2 down, and think I'll start to lose some of the positive benefits of higher androgens.

 

[Seagal]

Did your TRT screening include dht? It's maybe very high and has 'anti-estrogenic' effects.
Don't know of any dht:e2 ratio to assess this.

 

[skullmaggots]

No unfortunately not. If it's very high I would welcome the anti-estrogenic effects. In this case my e2 is way higher than I would have expected or wanted at 89pg/mL or 330pmol/L. I need it to be 30-40 really.

 

[Systemlord]

In this case my e2 is way higher than I would have expected or wanted at 89pg/mL or 330pmol/L. I need it to be 30-40 really.

Why do you need E2 between 30-40?

I like cream, the extra DHT and free T increase has been good for my erections and libido.

This is terrible, you must lower your dosage.

 

[skullmaggots]

Why do you need E2 between 30-40?


This is terrible, you must lower your dosage.

I could sort of be ok with <=50, but 60 and above I have trouble keeping an erection. I've now switched to only 2 clicks in the morning so 75mg a day, rather than 150. I suspect my total T and free will also half as a result!

 

[Seagal]

No unfortunately not. If it's very high I would welcome the anti-estrogenic effects. In this case my e2 is way higher than I would have expected or wanted at 89pg/mL or 330pmol/L. I need it to be 30-40 really.

Maybe you misunderstood what I meant.
Anyway, imo one should consider symptoms, e.g. you mentioned erection quality.

 

[Phil Goodman]

I’m not as familiar with cream protocols, but one thing to note is that E2 and Test usually arent gonna peak at the same time. The E2 should trail test levels since your peak test will tell your body how much to convert to E2. It’s generally thought that the ratio is more important than the hard number of levels. But if you lower your test dosage then it should naturally lower your E2, though if and how that affects the ratio remains to be seen in your case.

Just going out on a limb here, but my thought would be that perhaps you’ve completely saturated your bodies need for both test and DHT with your dose, so the bodies natural reaction could be to just convert the rest to E2 since it realizes it’s fully saturated for DHT and E2 is really the only other way to offload the surplus testosterone. I’d also note that blood tests are just a snapshot, so a big anomaly like that should be taken with a grain of salt until it’s repeated at least one more time. Like you said, you usually experience issues when E2 levels are that high, so if you aren’t experiencing that it could be an indicator that there isn’t really an issue, and you just tested at a time when levels were a little funky. Cutting the dose in half seems like a big drop, so you
may experience a decline in benefits regardless of what it does to your E2 levels and/or ratio. Perhaps a better approach would be to lower by 25% instead of 50% then see how you feel. But again if you feel great with no unwanted sides or negative health impacts then it’s possible you don’t need to lower at all, and instead should just wait until either a.) you do experience negatives or b.) the levels and ratios are confirmed with more bloodwork at a later date.

 

[Systemlord]

now switched to only 2 clicks in the morning so 75mg a day, rather than 150. I suspect my total T and free will also half as a result!

Halving of dosages doesn't equal half the hormone levels. That's not how endocrine function works.

 

[Seagal]

Halving of dosages doesn't equal half the hormone levels. That's not how endocrine function works.

When I halved my TU dose, my TT also halved. Don't know about my ft, dht, e2 or shbg.

 

[Jerajera]

I didn't see it specified in your OP but I'm assuming you're applying to the scrotum.

Yes, scrotal application of Testosterone cream will significantly raise E2 as well as DHT. My E2 is much higher on cream than on injections for similar FT levels.

For some people, the (extremely) high DHT levels that come from scrotal application of the cream antagonize E2 enough to more than make up for the rise in E2. However this is highly individual; for some, tissue level E2 still remains too high, and for others, the DHT antagonism is so strong that after a few weeks on cream they start getting low E2 symptoms.

Cream is great if it lands you in the right ratios of everything based on your individual endocrine system (in which I'm including enzymatic composition/ratios, etc...). If you want to give it a chance, I would say make sure you stay on the same protocol for at least 4-5 weeks. Some of the antagonistic effects of DHT on E2 for example take some time to fully settle, and you could very plausibly start with high E2 symptoms which would go away after a few weeks on the same protocol.

Something else you could try would be non-scrotal application. E2 comes back much lower on non-scrotal application. To give you an idea, on high dose cream (as an experiment, didn't know the numbers were going to be that high) applied to my inner elbows/forearms, my Free T came back at 70ng/dL while E2 (sensitive) didn't even reach 40pg/mL. On scrotal application, my E2 was ~55pg/mL for Free T around 35-40ng/dL.

I tested the difference between scrotal and non-scrotal several times and those differences were consistent every time. However DHT was also significantly lower on non-scrotal application, such that the DHT/E2 ratio was actually similar to what it is on scrotal application, but the absolute values of both were significantly lower as a function of Free T levels.

I personally really like the cream, but it's very hard to fine tune because it essentially jacks everything up (FT, DHT, E2) super high, which doesn't give you any control on downstream metabolites, and is very difficult to dose precisely on a daily basis.

I find I like to have more control on T metabolites directly, especially DHT. As such I'm using Test Prop with Proviron (because DHT raws have disappeared from the market entirely for now, but when they come back I'll start using a homebrewed DHT cream).
I like the greater control on DHT and I don't have to worry about absorption with injectable Test.

 

[Forty2]

I didn't see it specified in your OP but I'm assuming you're applying to the scrotum.

Yes, scrotal application of Testosterone cream will significantly raise E2 as well as DHT. My E2 is much higher on cream than on injections for similar FT levels.

For some people, the (extremely) high DHT levels that come from scrotal application of the cream antagonize E2 enough to more than make up for the rise in E2. However this is highly individual; for some, tissue level E2 still remains too high, and for others, the DHT antagonism is so strong that after a few weeks on cream they start getting low E2 symptoms.

Cream is great if it lands you in the right ratios of everything based on your individual endocrine system (in which I'm including enzymatic composition/ratios, etc...). If you want to give it a chance, I would say make sure you stay on the same protocol for at least 4-5 weeks. Some of the antagonistic effects of DHT on E2 for example take some time to fully settle, and you could very plausibly start with high E2 symptoms which would go away after a few weeks on the same protocol.

Something else you could try would be non-scrotal application. E2 comes back much lower on non-scrotal application. To give you an idea, on high dose cream (as an experiment, didn't know the numbers were going to be that high) applied to my inner elbows/forearms, my Free T came back at 70ng/dL while E2 (sensitive) didn't even reach 40pg/mL. On scrotal application, my E2 was ~55pg/mL for Free T around 35-40ng/dL.

I tested the difference between scrotal and non-scrotal several times and those differences were consistent every time. However DHT was also significantly lower on non-scrotal application, such that the DHT/E2 ratio was actually similar to what it is on scrotal application, but the absolute values of both were significantly lower as a function of Free T levels.

I personally really like the cream, but it's very hard to fine tune because it essentially jacks everything up (FT, DHT, E2) super high, which doesn't give you any control on downstream metabolites, and is very difficult to dose precisely on a daily basis.

I find I like to have more control on T metabolites directly, especially DHT. As such I'm using Test Prop with Proviron (because DHT raws have disappeared from the market entirely for now, but when they come back I'll start using a homebrewed DHT cream).
I like the greater control on DHT and I don't have to worry about absorption with injectable Test.

Would you consider alternating one day of cream followed by one day of Prop?

 

[FunkOdyssey]

Finally some context, I exercise 5 times week, 15% bodyfat, lots of muscle mass. I eat clean, don't drink, don't smoke. I am however a type 1 diabetic. I like cream, the extra DHT and free T increase has been good for my erections and libido.

The context we are missing is how long you've been on this protocol. Regardless, if you are feeling good, and key indicators like erections and libido are good, you would be crazy to adjust this protocol on the basis of an E2 lab number.

As others have said, there are mitigating factors that make this less of an issue than it appears. DHT/E2 ratio is very important:

• Your body may need E2 that high to properly balance the supraphysiologic DHT, and it may be playing a major role in your feeling good right now. High DHT without sufficient E2 feels like garbage, believe me.
• You may have captured a peak E2 level vs. an average or a trough.
• You have high SHBG and will have lower free E2 than other folks with the same total E2.

However, looks like I'll have to seriously lower my dose to get my e2 down

You don't have to do anything, as you have yet to identify any problem caused by high E2 besides anxiety about the high E2. Relax, my friend.

 

[Nelson Vergel]

ut my e2 was 89pg/mL (wtf).

Was this e2 measured using LC/MS?

 

[Jerajera]

Would you consider alternating one day of cream followed by one day of Prop?

No, that would add significant complexity and hassle for no tangible benefit I can think of.