Question:
Male 41, low libido for last 5 years with more than occasional ED. and other symptoms of low T. got the report. thanks to this forum, got many more tests added. here is the report. (some of the units might be different as i am not from USA)
Testosterone: 481 ng/dl,
Free T:11.52 pg/ml range given by lab 8.69-54.69. (this is free and not bioequivalnet)
cortisol A.M. : 10.48 mcg/dl
DHT: 330 pg/ml range 250-990
free T3:5.08 , free T4: 13.99, TSH: 1.052
FSH:2.51 mIu/ml -range 1.4-18.1
LH: 2.34 mIu/ml- range 1.1-7.0
Prolactin: 12.90 ng/ml (129ng/dl)- range 3.0-25.0
S.Estradiol (E2): 54.70 pg/ml - range <62
This has left me more confused. meetng the endocrinologist in a couple of days, wanted to get more info.
it is clear e2 is more, LH, FSH is low, Free T is low. not clear about total T.
What is happening? Symptoms are there, so something is definately wrong.
Any thoughts?
Answer:
Your total T is only marginally low as you say. For some people your level would be ok. Your Free T is so low I think there must be some mistake. You might want to have SHBG checked too. The free T will be lower if SHBG is high but 11.2 pg/ml seems almost impossible with a total T of 481. Lets assume the Free T is a bad test for some reason. The other thing that sticks out as you also note is E2. At your level it is high enough to cause problems. It can not only cause loss of libido and ED symptoms but can lower LH (and yours is quite low) which in turn will lower total T.
I would suggest trying 30 mg - 50 mg of zinc per day which will help to reduce armoatase enzyme (if you are deficient in zinc). Aromatase enzyme converts T to Estrogen and E2. Also take 1 or 2 DIM plus by Natures Way which will help the liver remove excess estrogen and E2 from the body. Avoid grapefruit which will inhibit your liver from removing the excess estrogens.
Other ways to reduce estrongens are to lose fatty weight (which also reduces armoatase enzyme) and limit alchohol to 2 drinks per day or less.
My bet is if you bring down the E2 you will feel much better AND you T will go up. After trying this a couple weeks retest your levels and notice to see if you get a more reasonable Free T number too.
Be careful though, E2 can be too low also. The ideal level is around 20 to maybe 30. you dont want it below 10 or above 35. The way I guage how much zinc and DIM to take is if I get morning erections. Too much or too little (zinc and DIM) can make them go away or be softer.
My guess is based on your Total T your endo wont want to do anything. If your problem is estrogen (i.e. E2 also called estradiol a very potent estrogen) then that is what you want to focus on treating anyway. This is a starting point. Give it a try and re-test and if you are still not feeling well even with E2 lower then go from there and try to focus on why the free T and LH are still so low..
Answer:
I see now your Free T is within the lab range. I have seen this test before. I'm not sure what the test is but it gives completely diff results than most free T tests. Anyway, I would ignore that for now. It is still at the low end of normal and you would rather be in the upper 1/3 of the range. Focus on the E2 first and see what happens.
Answer:
thanks hayfrmer. i was thinking on the same lines.
i am sure, on 481 total T, my doc will not do anything.
i am also aware that high E2 is a problem as it will start "negative loop" and i will produce low LH. (i am already producing low LH). if e2 is reduced maybe LH will go up and automatically more T will be produced.
we dont get dim+ in my country (India) but have advantage of low prices of other drugs. i will also try if there is anything specific in Ayurveda (indian medicine) which specifically targets this problem.
Maybe if zinc and other things dont work i can consider aromatase inhibitor (on Docs advise)
i was wondering wheather HCG shots will help. But if extra T produced is again converted to E2 it will be a bigger problem.
The Big question remains... Why? why my body is converting Whatever T to E2? and is there a solution to this basic problem.
Answer:
Arimidex is used to lower E2.
It is by prescription & expensive in the states, Use 1/2 mg tablet 3 times a week for a few weeks to see if it lowers the E2. Then adjust as needed.