All tests come back normal except total e

[audiocontr]

Symptoms: Irritability, weight gain, low libido, minor ED. Age of 34. 6ft tall, 178lbs

I have a full workup so i can answer any questions needed, however they all came back in the normal ranges. Except the big ones, Total T and Total E came back as follows:

Total T: 680
Total E: 140

My cholesterol is just slightly above max and so is LDL.

My suggestion is Aromatase inhibitor (AI). Any recommendation on dosage and type?

 

[mlc31]

Total T is in the "normal" range according to most doctors and studies. But you're total E is a disaster. I thought mine was high at 92! How are you alive? You do need your E2 though to get a better picture as well as your free T. My recommendation is to get your paperwork to Chip and let him have a look. He'll sort it out for you. Just ask around.

 

[JOWS6]

To clarify, is the lab value marked "Total Estrogens" or "Estradiol"? The range for total estrogens (Estrone, Estradiol, Estriol), depending on the lab is roughly <200pg/mL. So we can be comparing apples to oranges if we are talking about estradiol specifically.

There are other factors that can mimic your symptoms such as hypothyroidism, adrenal fatigue and high estradiol numbers. Hypogonadotropic Hypogonadism usually manifests itself in low testosterone values with low gonadotrophins. Adrenal fatigue dips testosterone scores slightly because the adrenal glands produce a minimal amount of testosterone in comparison to the testes.

I would test:

Androgens:
Total Testosterone
Free Testosterone
SHBG
Estradiol
LH
FSH

Thyroid:
TSH
Total T4
Total T3
Free T4
Free T3
Reverse T3

Adrenals:
Cortisol via saliva
DHEA-S

 

[Nordic11]

Total T looks great. Figure out the estrogen and then you will know if it is something else that is giving you symptoms.

 

[audiocontr]

Here are my total tests. It does not look like total E is estradiol only, yet the reference scale is indicated.

LH 6.5 1.5-9.3 mIU/mL Final
PSA 0.61 0.10-4.00 ng/mL Final
Testosterone, Total 678.86 350-890 ng/dL Final
Sex Hormone Binding Globulin 38 13-71 nmol/L Final
Testosterone, Free 138.1 47.0-244.0 pg/mL Final
Ferritin 230 22-322 ng/mL Final
Vitamin D (25-Hydroxy) 40 30-89 ng/mL Final
Total Estrogen 130.8 *** pg/mL Final

Comments:
*** Unable to flag abnormal result(s), please refer
to reference range(s) below:
Total Serum Estrogen Reference Ranges:
Males:
Prepubertal: <40.0 pg/mL
Adult: 40.0-115.0 pg/mL

CMP with Estimated GFR - Final
Analyte Value Flag Reference Units Status Site
Sodium 142 135-145 mEq/L Final
Potassium 4.7 3.5-5.3 mEq/L Final
Chloride 105 96-112 mEq/L Final
CO2 24 19-32 mEq/L Final
Glucose 90 70-99 mg/dL Final
BUN 18 6-23 mg/dL Final
Creatinine 0.98 0.40-1.50 mg/dL Final
Bilirubin, Total 1.0 0.3-1.2 mg/dL Final
Alkaline Phosphatase 81 39-117 U/L Final
AST/SGOT 22 0-37 U/L Final
ALT/SGPT 18 0-53 U/L Final
Total Protein 7.8 6.0-8.3 g/dL Final
Albumin 5.0 3.5-5.2 g/dL Final
Calcium 10.1 8.4-10.5 mg/dL Final
Est GFR, African American >60 >60 mL/min Final
Est GFR, NonAfrican American >60 >60 mL/min Final

Urinalysis, Complete - Final
Analyte Value Flag Reference Units Status Site
Color YELLOW YELLOW Final
Appearance CLEAR CLEAR Final
Specific Gravity 1.024 1.005-1.030 Final
pH 5.5 5.0-8.0 Final
Glucose NEG NEG mg/dL Final
Bilirubin NEG NEG Final
Ketone NEG NEG mg/dL Final
Blood SMALL NEG Final
Protein NEG NEG mg/dL Final
Urobilinogen 0.2 0.0-1.0 mg/dL Final
Nitrite NEG NEG Final
Leukocyte Esterase NEG NEG Final
Squamous Epithelial/ HPF NONE SEEN RARE Final
Crystals NONE SEEN NEG Final
Casts NONE SEEN NEG Final
WBC NONE SEEN <3 WBC/hpf Final
RBC NONE SEEN <3 RBC/hpf Final
Bacteria/ HPF NONE SEEN RARE Final

CBC with Diff - Final
Analyte Value Flag Reference Units Status Site
WBC 5.3 4.0-10.5 K/uL Final
RBC 5.11 4.22-5.81 MIL/uL Final
Hemoglobin 15.4 13.0-17.0 g/dL Final
Hematocrit 47.2 39.0-52.0 % Final
MCV 92.4 78.0-100.0 fL Final
MCH 30.1 26.0-34.0 pg Final
MCHC 32.6 30.0-36.0 g/dL Final
RDW 12.9 11.5-15.5 % Final
Platelet Count 207 150-400 K/uL Final
Granulocyte % 54 43-77 % Final
Absolute Gran 2.9 1.7-7.7 K/uL Final
Lymph % 33 12-46 % Final
Absolute Lymph 1.8 0.7-4.0 K/uL Final
Mono % 9 3-12 % Final
Absolute Mono 0.5 0.1-1.0 K/uL Final
Eos % 3 0-5 % Final
Absolute Eos 0.2 0.0-0.7 K/uL Final
Baso % 1 0-1 % Final
Absolute Baso 0.0 0.0-0.1 K/uL Final

Lipid Panel w/Direct LDL:HDL Ratio - Final
Analyte Value Flag Reference Units Status Site
Cholesterol 204 H 0-200 mg/dL Final
Triglyceride 62 <150 mg/dL Final
HDL Cholesterol 68 >39 mg/dL Final
Total Chol/HDL Ratio 3.0 Ratio Final
LDL, Direct 125 H mg/dL Final

Comments:
ATP III Classification (LDL):
< 100 mg/dL Optimal
100 - 129 mg/dL Near or Above Optimal
130 - 159 mg/dL Borderline High
160 - 189 mg/dL High
> 190 mg/dL Very High

LDL:HDL Ratio 1.8 Ratio Final

Comments:
LDL/HDL Ratio Table
Men Women
1/2 Average Risk 1.0 1.5
Average Risk 3.6 3.2
2 X Average Risk 6.3 5.0
3 X Average Risk 8.0 6.1

[Kannel WB, Castelli WP, and Gordon T, Ann Int Med, 1979, 90:85]



TSH 1.015 0.350-4.500 uIU/mL Final

FSH 3.0 1.4-18.1 mIU/mL Final

Prolactin 5.4 2.1-17.1 ng/mL Final

 

[Nordic11]

what did your doctor think of the E number?

 

[audiocontr]

Doc just said she doesnt think its an issue, just a lil high but shouldnt cause my symptoms. I asked her to get E2 results today.

 

[Nordic11]

It looks like E is an issue but you may also want to pursue other potential causes of your symptoms at the same time.

 

[MoparMuscle]

What's causing it to be so high?

Do you drink a lot of soy and/or use a lot of plastic containers to eat/drink out of?

 

[audiocontr]

Well my first question is are we sure its that high? My doctor seems to think its barely a concern.

Anyways, zero soy products are consumed, zero plastics used. I eat relatively well for a 34 year old. I'm at a loss.

 

[MoparMuscle]

The reference ranges I found for total E, say less then 200 is "normal" range for a male. I'd say that since at 130 your just over the mid-normal point it might not be an issue. Get just e2 tested.

 

[MoparMuscle]

Look at your food. What's diet like?

Lots of non-organic meat for one can raise total e as they (the animals) are pumped full of hormones including estrogen


List:
Foods Containing Natural Estrogens
Alfalfa
Animal flesh
Anise seed
Apples
Baker's yeast
Barley
Beets
Carrots
Cherries
Chickpeas
Clover
Cowpeas (black- eyed peas)
Cucumbers
Dairy Foods
Dates
Eggs
Eggplant
Fennel
Flaxseeds
Garlic
Hops
Licorice
Oats
Olive oil
Olives
Papaya
Parsley
Peas
Peppers
Plums
Pomegranates
Potatoes
Pumpkin
Red beans
Red clover
Rhubarb
Rice
Sage
Sesame seeds
Soybean sprouts
Soybeans
Split peas
Sunflower seeds
Tomatoes
Wheat
Yams

Estrogen Inhibiting Foods

Berries
Broccoli
Buckwheat
Cabbage
Citrus Foods
Corn
Figs
Fruits (except apples, cherries, dates, pomegranates)
Grapes
Green beans
Melons
Millet
Onions
Pears
Pineapples
Squashes
Tapioca
White rice
White flour

 

[Packgus]

holy crap! that list of estrogen foods is long and I eat that stuff all the time.

 

[JOWS6]

I don't know how to interpret the other lab values. One thing though is ketones. I didn't know males produce ketones. I thought it was something that was monitored during pregnancy? Learn something everyday.

One thing I want to add is that your LH value seems pretty good but your FSH value is in the tank. LH and FSH mirror each other and paint a picture of your pituitary gonadotropins signal strength. However, FSH is a more stable gonadotropin and is a more concrete indicator of your pituitary signals. LH signals vary a bit. It's kinda like testing for growth hormone levels. It's better to test for insulin-like growth factor IGF-1 to evaluate your HGH levels because IGF-1 is more stable. For adrenal functioning it's better to test DHEA-S instead of DHEA because the sulfate is more stable for testing.

 

[audiocontr]

Jows, thanks for the response. As FSH falls within the range listed, my doctor will come back saying its a non issue. Would you be so kind to explain why the FSH at a value of 3 is something to look into? I'd like to be prepared when i head back. I will also request a DHEA-S test.

 

[audiocontr]

Estradiol came back

Estrogens, Fractionated - Final
Analyte Value Flag Reference Units Status Site
Estrone, LC/MS/MS 47 < OR = 68 pg/mL Final
Estradiol, LC/MS/MS 31 H < OR = 29 pg/mL Final
Estriol, LC/MS/MS, Serum <0.10 ng/mL Final

Comments:
Ref. range: ADULTS: < OR = 0.18