Lab results unexpectedly high

[Virginian]

My last set of lab results gave levels of total test and free test that were unexpectedly high. I am looking for an explanation.

I’m 71 years old, on TRT for 9 months, and am still gradually reducing test cyp injection amounts trying to find the smallest dose that gives good effects. I inject sub Q every 4 days.

These are previous results:

10/24/13: Dose 150mg/week, T=1244 ng/L (range 250-1100), free T=331 pg/mL (range 30-135). I felt fabulous. Doctor suggested lowering dose because levels out of range.

12/16/13 : Dose = 112mg/week, T=919, free T=257. I felt just as good, but doctor wanted lower levels and suggested a lowered dose.

3/4/14: Dose = 88mg/week. T=566, free T=130. I still felt almost as good, but PSA increased somewhat so doctor suggested lowering the dose some more.

4/17/14: Dose=70 mg/week, T=827, free T=162. The labs were taken 7 days after the last injection. (I delay my injection just before a lab test because the doctor seems to like low numbers and I want to make her happy.) I felt good, but not quite as good as with higher doses.

But why are the Test and free Test levels so high relative to when I was taking much higher doses? What’s going on? Anyone have a suggestion?

 

[Alpin]

Estradiol will raise PSA too. Did doc test for this?
Rising PSA is age, genetic, and environmental related as well. Lowering T dose is not a bad thing. Your numbers are great especially for your age.
Take a high quality gel cap supplement that has prostate nutrients in it. I do and it does help.

 

[Virginian]

Estradiol will raise PSA too. Did doc test for this?

I have never heard about estradiol affecting PSA. Are you sure of that?

Estradiol was checked only once, on 3/4/14, which is the test that gave my lowest Test levels. Value was slightly high
at 41 pg/mL (range <39). Doctor was not concerned and does not like to test for estradiol so it has not been repeated.

Maybe I should be using an AI?

 

[jozifp103]

yes estro does effect psa. with the somewhat resent debunking of the myth that androgens harm the prostate, they discovered that estrogen was the real culprit. unfortunately most doctors are running off information from the 80's and still think trt causes prostate cancer.

 

[Alpin]

41 pg/ml is a tad high for me. I like to be at no more than 30 pg/ml for Estradiol. I'm all too familiar with docs like yours that blame the T for everything that may not reflect PSA levels they may not like. Off couse he doesnt test estradiol. He's a TRT pro by the sound of it.
Btw its totally normsl for some increase in PSA when first going on TRT. Mine went quite up there but I stayed consistent with the ADEX and it came down without reducing dose.
Your doc sounds like the type that would mot even entertain tbe thought of precribing an AI.
At those 1200 ng/dl TT levels I imagine you would have had quite a bit of estradiol.

 

[Alpin]

Btw....
He doesn't want to test for estradiol cause he would have to treat it if it came back high.
Good practice in TRT involves frequent monitoring of estradiol, hct, liver enzymes, psa e.t.c.
Elevated estradiol causes all the nasty side effects of TRT like high bp, anxiety, blood clots, higher PSA, irritability etc

 

[Gossamer]

Remember, that 41 estradiol reading was at trough, correct? There's a good chance that your estradiol is much higher at peak. That was my issue. I was at around 40 at trough, and my dr. didn't want to prescribe an AI. I had to insist that I had bad high e2 symptoms 24-36 hours after my injections twice a week. She finally understood, and I got an anastrozole prescription.

 

[Alpin]

What symptoms Gossamer?
Good thing u convinced her. Alot of endos wont touch the Ai.

 

[Alpin]

Is virginian injecting twice weekly or once?
He never said if he was injecting E7D?

 

[Virginian]

I'm all too familiar with docs like yours that blame the T for everything that may not reflect PSA levels they may not like. Off couse he doesnt test estradiol. He's a TRT pro by the sound of it. Your doc sounds like the type that would mot even entertain tbe thought of precribing an AI.

Let's not jump to conclusions. Actually the doctor is a she, and I am her only TRT patient. I see her because of another underlying medical problem on which she is an expert. She readily admits that she knows little about TRT.

 

[Virginian]

Is virginian injecting twice weekly or once?
He never said if he was injecting E7D?

I inject every 4 days. I then divide by 4 to calculate a daily dose and multiply by 7 to get a weekly dose. I have never have ups and downs. It always feels about the same.

 

[Virginian]

Remember, that 41 estradiol reading was at trough, correct?

Yes, it was at trough.

 

[STAUNCHED427]

Let's not jump to conclusions. Actually the doctor is a she, and I am her only TRT patient. I see her because of another underlying medical problem on which she is an expert. She readily admits that she knows little about TRT.

Well then, maybe you can try educate her in a subtle way to get treated correctly. Show her studies and hint things like estrogen being highly important... The big 3 things that need to be monitored and controlled on TRT is Testosterone, Estradiol aka E2 and Hematocrit. Keep those in check and your laughing.

 

[Mprtz]

Let's not jump to conclusions. Actually the doctor is a she, and I am her only TRT patient. I see her because of another underlying medical problem on which she is an expert. She readily admits that she knows little about TRT.

She??? Oh great - probably a lesbian and and an advocate of chemical castration for all men

 

[STAUNCHED427]

Lol no I think being a female doctor she may not take it the wrong way if you try to hint an AI or suggestions on how to run TRT...

 

[Alpin]

She??? Oh great - probably a lesbian and and an advocate of chemical castration for all men

Threres a few of those around. ...lol
After all Testosterone is evil cause all men have it.
Lol

 

[Megatron28]

I wouldn't be so quick to judge. Women have a personal understanding of how much of an influence changing Hormone levels play in one's life. Most male docs have never experienced what it is like to have Low T or high E2.

 

[tx045]

Remember, that 41 estradiol reading was at trough, correct? There's a good chance that your estradiol is much higher at peak. That was my issue. I was at around 40 at trough, and my dr. didn't want to prescribe an AI. I had to insist that I had bad high e2 symptoms 24-36 hours after my injections twice a week. She finally understood, and I got an anastrozole prescription.

What symptoms were you experiencing? I think I may be experiencing some myself. I just got bloods done yesterday so we'll see.

 

[Virginian]

She??? Oh great - probably a lesbian and and an advocate of chemical castration for all men

I assure you she is not like that. Quite the contrary.

 

[Virginian]

What symptoms were you experiencing? I think I may be experiencing some myself. I just got bloods done yesterday so we'll see.

I consistently feel great. Increased strength and stamina in gym. Increased stamina and speed biking. Leaner body. Sexual orgasms more intense.

The only negative is that I had no improvement in libido. I attributed that to being 71 years old, but perhaps it is due to excess estradiol. What do you think?