Links between Estrogen and joint pain?
- 08-01-2007, 02:32 PM
Links between Estrogen and joint pain?
Hello to all this is my first post here. I have history of elevated estrogen, and was curious if there are any correlations between elevated estrogen and joint/ bone issues in men. Generally estrogen is looked at good as far as bone health in women, but what about an excess in men?
I have lots of blood work and a lot of background information to provide, but don't have much time at the moment.
Briefly, I am 25 yrs. old have been on hrt since 4/20/07.
200mgs depo test weekly
0.6 mgs HGH EOD (nutropin aq)
Have yet to find an armotase inhibitor to stick with. Tried Letrozole but it left me very tired no matter if I took 2.5 mgs or a quater of that. Also tried a topical AI that I bought online that worked extremely well for me, but had to discontinue due to a rash.
- 08-01-2007, 04:51 PM
is most likely too much
is not frequent enough
post your lattest known SHBG
Letrozole is a killer, topicals are useless,
try to minimize estrogen problems by proper dosing of testosteron
use Arimidex if your E2 is actually high
use other supplements for multitude of other estrogens
do good blood test for all estrogens (and everything else) and then react accordingly.
You have to be very systematic and organized otherwise you will chase your tail until you fall down.
You may want to read this when you find some time.
Jan's BloodTest April13/2007
08-02-2007, 12:59 AM
I had posted this on another board a while back:
Lets see where to start, here's an interesting rollercoaster ride I have taken in the last few years just to give some background...
Prednisone is a medication I have taken on and off since I was very young for asthma with minimal sides (atleast to my knowledge). Fast foward to 2002 I take prednisone if I recall I think it was about 30-40 mg. a little higher than I had taken in the past. To make a very long and horrific story short I had experienced the worst possible side you can get from pred. a prednisone induced psychosis.
I was rushed to the ER and what happened next was crazy. For several days I was given haldol, were I experienced all the other sides possible from it. By the time the doctors realized I wasn't really crazy and they found no drugs in my urine and blood except prednisone I was so messed up I had parkinsons like symptoms. Skipping the details on my stay in the psyc ward, I ended up in the ICU for 3 days and was given bromocriptine to negate all the other symptoms I developed. I spent a total of 13 days in the hospital.
January 2007 I was scheduled for a shoulder surgery on jan 31, 07. I decided before the surgery to get blood work. I was very curious about my test and estrogen levels. (I have had gyno since puberty, and had all the symptoms of low test) I go and with no surprise find my Test levels very low at 301, and total estrogen extremely high almost double at 244 (less than 130).
Rescheduled my shoulder surgery (June 6, 2007) and see an endo. I get several tests which thank God all come back negative MRI of Brain, ultrasound of testies, even a momogram <pseudogynecomastia with trace amount of left sided gynecomastia>. After much blood work with the endo my estradiol actually gets under control naturally, but Test levels remain low. He said sometimes the estrogen can fluctuate due to viral issues to explain why it's in range now. But did find
Cortisol (blood)27.6 (3.0-22.4)
24 hour urine Cortisol 98.8 (4.0-50.0)
I am 25 yrs old and started HRT in april, during testing my GH levels were also very low. So currently I am 200mg cyp per wk and 0.6 mg of gh daily. After the first injection I felt the difference almost instantly (it was on a friday) but by that next thursday I felt it die out and felt my nips oh boy!!! This is where I need to dicuss further with my endo next visit. We had talked about taking arimidex in the past, but he just didn't want to start that yet. I informed him on the tissue in my chest becoming much firmer and some sensitivity, but still no go on the anti-e. My BP was high and he was concerned about it being good for my surgery, and said the adex would elavate it further.
Everything was good the test was 2 wks after statring therapy total test up to 772 except estradiol as I expected it was way above level again 76 (less than 52). SHBG 13 (7-44) ACTH 16. Cortisol in range. I feel like I know my body so well now, when my test is low when my Estro is high.
I am not experiencing anything in my nips since that day, but lets just say that I have yet to have that same feeling since that first shot.
After 1 month on I have noticed a slight shrinkage in the testies, slight water retention.
Up until the middle of june I had been feeling much better, yet still felt like there was something missing in my body.
At about the last week of june I was hit with all the syptoms that I felt before starting HRT, and this is where I stand now.
As I have been reading more here I am learning the importance of all the different estrogen tests and the picking the right ones. When I first started seeing my endo (feb 24 2007) (jan 25 total E was 244) he tested my estradiol level and it was 24 (less than 52) (also just learned this isn't the best test for males). I was surprised how my estrogen had gotten so low then he mentioned the viral reasoning. When I asked about the total estrogens and esterones ect. he said all that mattered was the E2, and I believed him. unfurtunately there hadn't been a CBC done until recently by my request.
Here are some of my test from FEB 24 07:
All testing done by Shiel Laboratories in NY.
*Phosphorus 5.1 (2.5-4.8)
*Globulin 2.2 (2.3-3.7)
DHEA Serum RIA 841 (140-850)
Androsendione Serum RIA 209 (30-263)
*Growth Hormone <0.1 (less than 10)
ACTH 30 (7-50)
Testosterone, Total RIA 379 (241-824)
% Free Test 1.41 (0.95-4.30)
% Free Test (%) 0.37 (0.32-0.51)
t4 Free 1.69 (0.89-1.76)
Cortisol 27.6 (3.0-22.4)
FSH 3.4 (1.4-18.1)
LH 4.04 (1.50-9.30)
Estradiol 24 (less than 52)
Prolactin 11.9 (2.1-17.7)
*24 hr.Urine Cortisol 98.8 (4.0-50.0)
08-02-2007, 01:46 AM
Forgot to mention endo also had me do a catscan of adrenals in the begining, everything was ok.
IGF-1 339 (116-358) (most likely increased from prior TRT)
DHEA 552 (140-850)
SHBG 13 (7-44) As per my request
Testosterone Total 772 (241-827)
Tesotosterone (different lab??) 728 (241-827)
FREE TEST 2.96 (0.95-4.30)
% Free Test 0.38 (0.32-0.51)
Cortisol 15.7 (3.0-22.4)
DHT 25 (25-75)
*Estradiol 76 (less than 52)
Started GH May 7, 2007
Testing from June 14 2007
Tested Iron and CBC as per my request.
*Iron 39 (45-182)
*WBC 11.6 (4.0-11.0)
RBC 5.47 (4.20-6.00)
*Hemoglobin 16.6 (12.6-16.4)
*Neutrophils % 80.4 (40.0-70.0)
*Lymohocytes % 13.0 (20.0-40.0)
*Neutrophils, ABS 9.3 (1.6-7.8)
Lymphocytes Abs 1.5 (1.0-4.5)
MPV 8.3 (8.0-13.0)
*IGF-1 551 (116-358)
Growth Hormone 2.9 (less than 10)
DHEA Serum RIA 7.8 (1.8-12.5)
Testosterone 437 (241-827) (Took Shot on sunday test was on thursday)
*LH 0.30 (1.4-18.1)
*FSH 0.07 (1.50-9.30)
I think the highest my LH has been pre TRT was about 5.01 and FSH 3.7 which was on 3/13/07 when my endo did a screen for cushings which I passed.
July 3, 2007
*Iron 30 (45-182)
*HDL 36 (40-59)
Bence Jones Protein, Quant:
Protein total Random Urine 9 (5-25)
Free Kappa 8.01 (1.35-24.19)
Free Lamba 0.93 (0.24-6.66)
Total TEst 827 (241-827)
*Free Test 4.56 ( 0.95-4.30)
*% Free Test 0.55 (0.32-0.51)
Estradiol <10.00 (less than 52)
T4 7.4 (4.5-10.9)
T3 uptake 31.4 (2.5-37.0)
T7 (FTI) 6.9 (3.7-13.0)
TSH 3rd Generation 1.42 (0.35-5.50)
*WBC 11.6 (4.0-11.0)
*Neutophils 78.5 (40.0-70.0)
*Lymphocytes 14.5 (20.0-40.0)
*Neutrophil Abs 9.1 (1.6-7.8)
MPV 8.7 (8.0 13.0)
RBC 5.38 (4.20-6.00)
Hemoglobin 16.0 (12.6-16.4)
Hematocrit 46.2 (38.0-52.0)
Platelets 316 (150-450)
Also ran blood and urine culture to rule bacteria problem both negative.
Did ultra sound of liver and pancreas all good as well.
After this test My endo refered me to a hematologist whom I saw this past monday and will have results on thursday.
The hematologist mentioned that he used to use Testosterone to increase the WBC back in the days, and I mentioned that I thought it only effected the RBC, and he said it can to both not sure on this? I wish I had A CBC from before HRT.
My endo mentioned about going further to find out about if this is something virul and mentioned doing an endoscopy, and also examining the bone marrow to see if it producing too much estrogen. The hematologist is saying he wouldn't do that just yet with the WB cells only slightly elevated.
At the same time I am losing confidence in my endo for a few reasons.
Not enough blood work, for ex. I will not be able to see him again until september, and he will go by my blood work from july 3. I just think that we aren't stable enough to be doing that.
I had to tell him about testing my iron and to do a CBC, it gets frusrtating feeling like I have to know more if I don't i might get left behind.
He never ruled out anmeia or tried to find the cause of my estrogen elevation.
He has left me out in the world totally shut down very low LH and FSH, and low iron, and had left me with high estrogen before.
My Iron hasn't really been adressed by anybody yet, the hematologist said he would run my work for the iron, but didn't seem so concerned because of my other blood counts.
Not sure about much but I feel like I have crashed even test and estro levels look good I feel the same way i did before starting HRT which is like Sh!t.
Not sure what these tests are but had them done on 3/27/07by my endo.
Hgb A1 96.5 (95.0-100.0)
Hgb A2 3.5 (1.5-3.5)
Thank you JanSz for your reply, and for the thread! Sorry for the long read.
08-02-2007, 01:06 PM
08-02-2007, 01:35 PM
08-02-2007, 01:46 PM
08-02-2007, 02:41 PM
All I was referring to is that Dr. C's post is confusing and that it needed clarification.
Never having given it much thought, I don't have an opinion about whether a topical AI is better than A-dex. I do know, though, that I tried A-dex to lower estrone and it didn't work.
08-02-2007, 03:12 PM
08-02-2007, 03:14 PM
You need a new Dr.
Any Dr that starts a patient, especially a younger one, on injects first without trying a TD, is not a good one.
Especially one without a plan for hcG implementation.
08-02-2007, 07:29 PM
thankful indeed, and might i add.... i didnt want to even try TD.... would not stick with it....so injections are better for me... FWIW
08-02-2007, 09:27 PM
Getting turned away is no biggie, no real damage in the long run. Getting put on a bad program can have damaging effects in the long run.
Dr John, it seems like transdermals are getting a bad rap. All the countless of hours of research Im undertaking has pointed me in every direction that they are far, far superior.
I have a feeling alot are either giving up to soon on them. I also think many aren't properly cleaning application area and giving the alotted 2 hours or so to let dry before sweating.
08-02-2007, 09:35 PM
08-02-2007, 09:39 PM
Couldn't one possibly fix his thyroid with meds and become more responsive to transdermals?
One also has to remember that transdermals need to be applied in areas where androgen receptors are plentiful, like the upper body. They will not work on the legs, or at least not as good.
08-03-2007, 03:07 PM
08-03-2007, 05:30 PM
Other than the fact that TD applications are the closest thing to the natural rhythm of test production, what else makes them better than injections?
I've heard much more negative anecdotal feedback about TD's than I have about injections. Things like DHT conversion, estrogen conversion due to aromatase in the adipose tissue below the skin, inconvenience of applications, poor absorbtion in patients with thyroid disorders, and even that TD's have lowered guy's T levels somehow.
Obviously injections are more invasive and require more, i guess you could say knowledge, from the patient since he must learn how to inject properly and safely. But for the most part guys on the right dose of weekly or every third day injections seem to be very happy with the results.
I know if I start TRT, after establishing the correct dose of test from the initial run of Androgel, I'd like to switch to injections because it would be more convenient than applying a TD every day or maybe twice a day. Of course I want to ultimately end up with whichever method provides the best results, but all things equal, I think I would prefer injections.
08-03-2007, 09:53 PM
That mean your current T dose is way to high.
Additionally due to your low SHBG you have to be on frequent T injections, E2D, every other day.
I do not see anything about HCG, you should use it.
You can be with out HCG if you are not able to get script but your testicles will shrink, no big deal other than cosmetics.
I do not see much on your thyroid, get FreeT3.
When you do blood tests you have to be very consistent with timing otherwise it is difficult to use that test.
Best is to do blood tests at Quest Diagnostics, blood drawn at Quest.
Blood drawn on the day of the shot, time of the shot, before shot.
Consider the whole list that I post for testing, if cant then at least the T, E and thyroid + adrenals part.
Jan's BloodTest April13/2007
to get FreeT~250 you need
to get there you need
little less than 100mg/week of 200mg/mL testosterone.
that is 0.5cc=50 units
for E2D dose that is
14 units on insuline syringe
you need also
Do both T&hcg shots the same day the other day free of shots. Use smallest needle available, 31ga, 3/10cc, 5/16" long needle, do SubQ shots.
BD Ultrafine II U-100 Insulin Syringe 31 Gauge 3/10cc 5/16inch Short Needle--1/2 Unit Markings 100/b
BD Ultrafine II U-100 Insulin Syringe 31 Gauge 3/10cc 5/16inch Short Needle--1/2 Unit Markings 100/b Price: $25.95
Colostomy Supplies, Pet Diabetic Supplies
Easy Touch U-100 Insulin Syringe 31 Gauge 3/10cc 5/16 inch Short Needle 100/Box Sale Price: $13.99
Not sure that you realy want to spend money on GH.
08-04-2007, 12:16 AM
Added benefit of no poking holes into muscle. No risk of infections. No paying for needles.
Many guys probably aren't sticking with TD for long enough - they take time to work. One must wait 4 weeks or so for retest and adding in hcG.
E2 conversion is pointless. Maybe slightly higher. Maybe not. Easily treated with adex IF needed. Many are low on E2 anyways.
Some DHT is needed. DHT increase is minimal anyways. DHT is getting bad rap. Its FT to DHT conversion within prostate that causes issues there, as well as FT - DHT conversion on scalp that causes hair loss. Any increases, and these are minimal with TD over injects, will hardly, if at all, won't affect increases in these processes.
Remember, circulating DHT and FT - DHT conversion within skin/prostate glands aren't exactly coorelated. These are very complex conversions that involve alpha mechanisms/enzymes, and aren't necessarily going to be severally increased from a minimal increase in circulating DHT that *may* occur from TD use.
One must also consider that a once a week inject of T would increase E/DHT more so than everyday TD use anyways.
08-04-2007, 10:49 AM
DHT=29 while on one pill/day Avodart
Tcream 100mg/1gram, 1gram/day
I am now on Depo-T injections and no Avodart for long time.
It is going to be interesting experience to look at my DHT in September.
Looking for predictions.
If anything, I consider my quality of life greatly improved while on (tiny 31ga 5/16" needle SubQ E3D) shots. 10 minutes after the shot, no sorenes no after thoughts.
I can shower with out preplanning, go to pool anytime, work and sweat with out thinking that I will wash out some of the stuff off me.
Hug and kiss sweaty skin to skin, women and children no restrictions.
No worry that my acting thyroid may change my absorption rates.
08-04-2007, 05:21 PM
08-04-2007, 05:22 PM
08-05-2007, 07:59 AM
08-05-2007, 10:05 AM
TDs suck IMHO.....not convinent........much more convinient to take IM injects....
if one wants to mimic daily Test rythim a AQUAOUS TESTOSTERONE SUSPENSION for IM usage everyday with a 27g needle would be a much more convinient option in my opinion.....
08-05-2007, 01:04 PM
Or better yet,
using this test from Quest:
74 Dihydrotestosterone, Free, Serum (36168X) Dihydrotestosterone ng/dL (ADULT MALES: 25-75 )
75 /------------------------------------ DIHYDROTESTOSTERONE, FREE (DHT, Free pg/mL ADULT MALES: 1.00-6.20 )
08-05-2007, 06:20 PM
Yeah, Clockwork is an awesome movie
08-06-2007, 06:29 AM
EDIT BY DR CRISLER: Thank you, but sorry: can't promote this stuff here.
Last edited by Dr. John; 08-06-2007 at 07:46 AM.
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