Peak Testosterone Forum

General Category => Testosterone, Hormones and General Men's Health => Topic started by: Kierkegaard on February 24, 2015, 07:24:19 pm

Title: Still Symptoms? Maybe It's Not Just Estradiol
Post by: Kierkegaard on February 24, 2015, 07:24:19 pm
Here's an interesting thing I noticed.

When I was on intramuscular shots my estradiol (obviously) was a good deal higher (absolutely and relative to my T) than since I've started subq shots.  While on IM I got my estradiol up to about 60 pg/ml with obvious symptoms, but not bad enough that I was unable to work.  Since being on subq, a few months ago I could get to around 25 pg/ml before I started having symptoms, and any higher would result in the same approximate symptoms as when I had my estradiol at 60 pg/ml while IM.

About a month ago, for whatever reason (finding my right dosage that isn't too high, starting turmeric, etc.) my SHBG dropped by about 20 points and my free T shot up compared to my old number.  So now I can get free T to around 18-20 pg/ml with about 50 mg a week of test (with E2 levels at around 20 pg/ml), whereas a month ago (again, for whatever reason) 77 mg per week resulted in about 16-18 pg/ml of free T.

My "aha" moment came when I started noticing that even when my estradiol number got lower (but not too low) and I was having the same symptoms (intermittent fatigue, bloating, water retention, sleepiness, head fog, insomnia, etc.), my free T was getting higher.  What does this mean?  That my free T is the most likely candidate between it and estradiol for causing problems.

Which got me thinking.  What else can higher free T levels screw with?  That led me to thoughts on aldosterone, a stress hormone (given that this hormone involves water retention/bloating problems).  But what happens when you look up aldosterone on a hormone tree?  It ultimately goes back to progesterone and pregnenolone.  What else is connected to pregnenolone?  Cortisol!  Okay, so maybe there's a connection with cortisol or another hormone. 

I don't know what the connection is.  I know my DHEA is very high, which should mean my cortisol is relatively low.  Low cortisol could mean that my ACTH and other stress hormones are higher than they should be. (My understanding is that cortisol is a glucocorticoid, which works in response with primary stress hormones such as epinephrine, norepinephrine, and others, such that low cortisol might mean that these primary stress hormones are more likely to run amuck without cortisol moderating them.)  I also know that Dr. Gordon and Dr. Crisler talk about "backfilling" DHEA and pregnenolone because these hormones tend to get lower as people are on TRT.  So I'm planning on checking my pregnenolone and progesterone soon and seeing what could be up.  My sense, though, is it might be a cortisol problem during those intermittent times when I'm having symptoms.  Again, the conclusion is that it probably isn't estradiol by itself that's causing problems, like I used to think, but the increasing free T levels; another bit of evidence is that the best two weeks of my life involved low doses of IM injections (30 mg every four days), meaning free T around 10-12 pg/ml, at which time I felt the best ever: best sleep, best clarity, best sex, etc.  This realization with the stuff above is making me think that maybe, given my biology (and lack of knowledge of other hormones, such as cortisol, growth hormone, etc.), having lower levels of free test is really the best, not so much estradiol, and could be a reason for why IM injections might be better for me: lower T but not too low estradiol like you get on subq injections.

Anyone have experience with getting pregnenolone, progesterone, and/or cortisol tested before and/or after TRT?

ETA: Peak has mentioned the mystery of some guys having higher blood pressure when they're on TRT.  I have this problem, but only for half a day or a day with slight elevations after my injection.  I also have a higher pulse and sometimes a sense of being ramped up.  All of these can be determined by cortisol.
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: euphorixx1 on February 24, 2015, 07:35:43 pm
This is exactly what I am experimenting for the past 2 weeks or so I switched my injection protocol to be:

60mgT E3d with 250IU HCG, IM.

Between 1/9 and 2/3 My T and E came up to 949(tt) 32.5(FreeT) and 29(ultrasensitive E2)

I slowly, began waking up with more and more anxiety.  Caused by nothing.  Yesterday I could barely sit still at work, everything drove me nuts, every email, every person.... I felt so god damn anxious...

I too have DHEA in the 500s, so cortisol should be low...but I still have weird anxiety.

Today was supposed to be another injection, but I skipped it... I already feel much calmer.  This is fantastic information, but I think you are right... freeT might cause issues in guys that have high DHEA.
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: euphorixx1 on February 24, 2015, 07:37:31 pm
TO note.  I am going to go a few more days without injecting and see how I feel..I think I am going to find out that I need very low test doses to feel OK... maybe 80mg a week or so...
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: Kierkegaard on February 24, 2015, 07:49:24 pm
The question for me is whether it's my cortisol that's too low or it gets too high around injections.  Your symptoms, euphorix, sound like they could be cortisol-related.  The biggest question of all might be whether estradiol has anything to do with this elevation in nervous-like symptoms. 

An experiment could pretty easily figure this out.  Get a 4x/day salival test, but instead of taking it at four different times in the day, take it four days in a row relative to your injection at the same time and after relaxing yourself (deep breathing, meditation, etc.) for a little to make sure no extraneous stressors confound anything.  If you see a significant change on the day of or following your injection, you can bet cortisol is the issue after all. 

I also would like to know the influence pregnenolone and possibly progesterone have on things.  Preg is the master hormone of the body, so it's pretty important, so checking it could be helpful and supplementing as needed. 
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: euphorixx1 on February 24, 2015, 07:55:10 pm
Well I incorporate HCG into my protocol, not sure what that does besides keeps my testicles full.

I will know if its E2/freeT related in a few days, since I am skipping my injection. My E2 and FT will drop, so if I feel less anxious I know those are the cause.

THe funny thing is for most of the time on TRT I Have had ZERO anxiety.  Its only when my T gets over 900 and stays there, that anxiety comes back...the two have to be related.
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: PeakT on February 24, 2015, 08:29:08 pm
Well I incorporate HCG into my protocol, not sure what that does besides keeps my testicles full.

I will know if its E2/freeT related in a few days, since I am skipping my injection. My E2 and FT will drop, so if I feel less anxious I know those are the cause.

THe funny thing is for most of the time on TRT I Have had ZERO anxiety.  Its only when my T gets over 900 and stays there, that anxiety comes back...the two have to be related.

What's your SHBG right now.  Any idea?
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: euphorixx1 on February 24, 2015, 08:32:00 pm
Well I incorporate HCG into my protocol, not sure what that does besides keeps my testicles full.

I will know if its E2/freeT related in a few days, since I am skipping my injection. My E2 and FT will drop, so if I feel less anxious I know those are the cause.

THe funny thing is for most of the time on TRT I Have had ZERO anxiety.  Its only when my T gets over 900 and stays there, that anxiety comes back...the two have to be related.



What's your SHBG right now.  Any idea?

16
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: PeakT on February 24, 2015, 09:19:03 pm
using the calculator, you come out to

28.7 ng/dL  =  3.19 %

that's pretty beefy...
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: euphorixx1 on February 24, 2015, 09:25:53 pm
Thats my what, freeT?
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: SumTingWong on February 24, 2015, 09:40:21 pm
Do these changes coincide with you changing your DIM dosage?
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: Kierkegaard on February 24, 2015, 10:24:10 pm
Do these changes coincide with you changing your DIM dosage?

No influence. I've kept my DIM dosage the same.
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: electrify on February 25, 2015, 12:53:48 am
I have been wondering about cortisol too. On HCG mono I just had it tested and it came out to 13.3 which is not that much of an increase from a baseline of 11. Ideally should be 17-20 right?
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: Kierkegaard on February 25, 2015, 02:28:57 am
I have been wondering about cortisol too. On HCG mono I just had it tested and it came out to 13.3 which is not that much of an increase from a baseline of 11. Ideally should be 17-20 right?

Not sure. One brilliant poster on another board said that HCG can be helpful in increasing cortisol because perhaps LH and FSH are involved in cortisol production, and these two hormones shut down when your body is on testosterone but not HCG.
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: euphorixx1 on February 25, 2015, 02:46:45 am
One interesting thing to note, is that before I had some anxiety symptoms I did 2 injections of 50mgT and 500 IU HCG... so that likely shot up my estradiol(these injections were last week)  In the meantime I ran out of HCG... SO i havent been getting my HCG... I wonder if suddenly dropping this caused some issues.

Regardless I am going back to HG subQ 125IU ED.
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: Kierkegaard on February 25, 2015, 03:20:20 am
Another interesting find: apparently cortisol can bind (albeit weakly) to aldosterone receptors, meaning any bloating you feel from testosterone can be due (whether or not estradiol is a player or if it's "just" T) to cortisol increase rather than aldosterone.
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: kquad on February 25, 2015, 03:29:10 am
Another interesting find: apparently cortisol can bind (albeit weakly) to aldosterone receptors, meaning any bloating you feel from testosterone can be due (whether or not estradiol is a player or if it's "just" T) to cortisol increase rather than aldosterone.

Wow, maybe I should skip the HCG for a while. Of coarse that would effect my estradiol. I think after I get that drawn, I will stop it for a week or two. Because I retain water regardless of estradiol levels on testosterone therapy.
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: Kierkegaard on February 25, 2015, 03:41:19 am
Another interesting find: apparently cortisol can bind (albeit weakly) to aldosterone receptors, meaning any bloating you feel from testosterone can be due (whether or not estradiol is a player or if it's "just" T) to cortisol increase rather than aldosterone.

Wow, maybe I should skip the HCG for a while. Of coarse that would effect my estradiol. I think after I get that drawn, I will stop it for a week or two. Because I retain water regardless of estradiol levels on testosterone therapy.

See, I'm actually thinking of starting HCG so that I can decrease my testosterone level, leading to lower free T relative to estradiol; when I try to lower my free T now too much I hit the wall of too low E2 and get symptoms. 

Either that or go back to IM injections for the same reason. 

Best thing might be just to check pregnenolone and progesterone first, though.
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: electrify on February 25, 2015, 03:57:41 am
I have been wondering about cortisol too. On HCG mono I just had it tested and it came out to 13.3 which is not that much of an increase from a baseline of 11. Ideally should be 17-20 right?

Not sure. One brilliant poster on another board said that HCG can be helpful in increasing cortisol because perhaps LH and FSH are involved in cortisol production, and these two hormones shut down when your body is on testosterone but not HCG.

Yea thats true. It happened for me with Clomid due to the increase in LH/FSH but HCG mono at least so far does not seem to be giving the same increase. I might need to give it more time though, lately my E2 is the most difficult thing to manage though. If fixing that doesn't work then its probably the cortisol for me.
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: Sighalot on February 25, 2015, 06:07:58 am
Because I retain water regardless of estradiol levels on testosterone therapy.
Perhaps a diuretic would help?
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: kquad on February 25, 2015, 06:50:19 am
Because I retain water regardless of estradiol levels on testosterone therapy.
Perhaps a diuretic would help?

No, I tried lasix. It came back after about 8 hours. Something in my body wants that water and it will not be deterred.
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: Kierkegaard on February 25, 2015, 02:59:46 pm
Because I retain water regardless of estradiol levels on testosterone therapy.
Perhaps a diuretic would help?

For me the very moment my ring is loose and I have no water retention, I feel better.  It's a stretch, but maybe the water retention itself causes the foggy feelings I have at times.  My doc has been on me about starting a low dose blood pressure med, and agreed to try a diuretic BP med, so maybe this will be a double whammy. 
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: theturducken on February 25, 2015, 04:16:10 pm
I'd say the water retention, if not E2, is aldosterone since it is a mineralocorticoid.  Likewise aldosterone and cortisol supposedly oppose each other or fight for the same resources.

Progesterone, which is a precursor to these, is supposed to work great as a diuretic when supped.

Just adding in what I've read/heard/think.
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: kquad on February 25, 2015, 04:33:45 pm
I have worked in the medical field as an RN for 20 years and this is getting far too complicated. However, I have to admit, if it did not make me feel poorly at times, it would be fun to figure out. I think the effect on thyroid hormones can not be ruled out, especially in my case. Hypothyroid causes water retention and it seems all the high E2 symptoms.
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: Kierkegaard on February 25, 2015, 05:10:50 pm
I'd say the water retention, if not E2, is aldosterone since it is a mineralocorticoid.  Likewise aldosterone and cortisol supposedly oppose each other or fight for the same resources.

Progesterone, which is a precursor to these, is supposed to work great as a diuretic when supped.

Just adding in what I've read/heard/think.

Interesting!  Especially the progesterone.  If true this could mean I'm progesterone deficient/estrogen dominant. 
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: Kierkegaard on February 25, 2015, 05:36:25 pm
I have worked in the medical field as an RN for 20 years and this is getting far too complicated. However, I have to admit, if it did not make me feel poorly at times, it would be fun to figure out. I think the effect on thyroid hormones can not be ruled out, especially in my case. Hypothyroid causes water retention and it seems all the high E2 symptoms.

I don't think it's too incredibly complicated.  A lot of this comes down to whether things like thyroid or estradiol "cause" water retention; my thinking is by themselves they don't, but things like aldosterone, cortisol, and possibly too-low vasopressin might be the sufficient causes, although estradiol, thyroid, etc., might be necessary ones.  There are only a few possible culprits, and if we know these we can know where to aim our guns to try and change things. 
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: Sighalot on February 25, 2015, 08:49:52 pm
My doc has been on me about starting a low dose blood pressure med, and agreed to try a diuretic BP med, so maybe this will be a double whammy.
Im using hydrochlorothiazide and dont have  any definitive side effects, up'ed the dose last friday from 12.5mg to 25mg, had to use the bathroom 2-3 times more then usual but not felt any other effects yet but hoping, estradiol probably on the low side at the moment.

I think the effect on thyroid hormones can not be ruled out, especially in my case. Hypothyroid causes water retention and it seems all the high E2 symptoms.
You mean high estradiol causes temporary hypothyroidism?
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: Kierkegaard on February 25, 2015, 10:01:49 pm
My doc has been on me about starting a low dose blood pressure med, and agreed to try a diuretic BP med, so maybe this will be a double whammy.
Im using hydrochlorothiazide and dont have  any definitive side effects, up'ed the dose last friday from 12.5mg to 25mg, had to use the bathroom 2-3 times more then usual but not felt any other effects yet but hoping, estradiol probably on the low side at the moment.

Keep us updated as your estradiol gets up there.  My hope is it's "just" the water retention that's causing other symptoms such as slight fatigue or head fog, and that getting the water retention down will take care of those things.  Probably not, but we'll see.  I just know what the moment my urine is getting clear and my ring feels not tight that I feel great: no head fog, fatigue, etc. 
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: kquad on February 26, 2015, 05:58:45 am
Well I hope someone figures it out soon. I ballooned up again. Even a patient who saw me two weeks ago was concerned. My urine is concentrated again.  I did take the tiny dose of arimedix (1/8) a day late, but am doubtful that can do it. I will force fluids again

. The good news, with the extra thyroid meds, I feel good. Just a little tight in the lungs. It is crazy and may not be related, but when I get my TSH near normal, I retain water. Or maybe it is just a delayed response to earlier hypothyroid. Since starting TRT, I have been on a roller coaster with my TSH. I popped a lasix, it is maddening!!
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: kquad on February 26, 2015, 06:42:04 am
OK K. I am reading through this again, The water retention, if caused by cortisol, would be because of high cortisol. Correct? In that case lowering or stopping the HCG might lower cortsol.
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: theturducken on February 26, 2015, 01:06:50 pm
In theory, HCG added to TRT is a great idea.  Especially for any younger guys who still want to have children (myself included).  However, anytime I add hcg, it triggers so many other mechanisms in the body that the roller coaster ride begins. 

I'm going back to basics and getting my TRT dose dialed in without hcg and see where my e2, preg, prog, dhea is after a month. 

Keep in mind hcg increaes the conversion of CHOL to Preg, and then everything else down the line.  This is a big line that is being changed and could trigger a multitude of symptoms.

Just saying, HCG could be doing more harm than help.
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: kquad on February 26, 2015, 05:45:58 pm
In theory, HCG added to TRT is a great idea.  Especially for any younger guys who still want to have children (myself included).  However, anytime I add hcg, it triggers so many other mechanisms in the body that the roller coaster ride begins. 

I'm going back to basics and getting my TRT dose dialed in without hcg and see where my e2, preg, prog, dhea is after a month. 

Keep in mind hcg increaes the conversion of CHOL to Preg, and then everything else down the line.  This is a big line that is being changed and could trigger a multitude of symptoms.

Just saying, HCG could be doing more harm than help.

That seems to make sense. I have a friend, he has no issues, but is not taking HCG. Seems there is no harm in dropping it for a while.
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: kquad on February 26, 2015, 06:08:53 pm
Does anyone have a link to all the effects of HCG? All I really find is weight loss links
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: PeakT on February 26, 2015, 08:58:11 pm
I split out some estrone testing questions here:

http://www.peaktestosterone.com/forum/index.php?topic=6629.0
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: Kierkegaard on February 26, 2015, 10:41:33 pm
OK K. I am reading through this again, The water retention, if caused by cortisol, would be because of high cortisol. Correct? In that case lowering or stopping the HCG might lower cortsol.

Cortisol or aldosterone, and if the former because it's clogging up aldosterone receptors. 
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: PeakT on February 27, 2015, 02:58:00 am
Split out some (negative) commentary on HCG:

http://www.peaktestosterone.com/forum/index.php?topic=6632.0
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: euphorixx1 on February 27, 2015, 03:23:42 am
Hmmm, maybe I should drop my HCG... idk, what about fertility tho?  There has to be some benefits to HCG?
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: kquad on February 27, 2015, 03:47:04 am
I took the HCG yesterday. I plan on stopping it for now. My only real outstanding issues now are oily skin (minor) and facial swelling. I hope it helps with both. I am done having kids. This may be good. Since I am broke, I may not have to pay for HCG!
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: PeakT on February 27, 2015, 02:16:56 pm
I took the HCG yesterday. I plan on stopping it for now. My only real outstanding issues now are oily skin (minor) and facial swelling. I hope it helps with both. I am done having kids. This may be good. Since I am broke, I may not have to pay for HCG!

So why would HCG help with these?  Not sure where you are headed with that...
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: theturducken on February 27, 2015, 02:22:37 pm
I took the HCG yesterday. I plan on stopping it for now. My only real outstanding issues now are oily skin (minor) and facial swelling. I hope it helps with both. I am done having kids. This may be good. Since I am broke, I may not have to pay for HCG!

So why would HCG help with these?  Not sure where you are headed with that...

I think he is saying that "quitting Hcg" will help reduce these symptoms.
Title: Re: Still Symptoms? Maybe It's Not Just Estradiol
Post by: PeakT on February 27, 2015, 03:16:51 pm

I think he is saying that "quitting Hcg" will help reduce these symptoms.

Gotcha.  Now I'm with ya...