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.