Good afternoon!
53YO, been on TRT for almost 10 years. I switched to a local provider for my TRT.
My E2 has spiked and I'm dealing with the usual ED, zero libido, no focus and indifferent on everything (again). But this round of ED is so much worse and I'm hoping an AI would bring the E2 down.
I'm not getting any answers from my clinic but my E2 only dropped 7 points from Oct 2025 labs. I'm now injecting every 2.5 days. I get another panel in a week but I'd like y'alls input on my Jan2026 labs.
Many thanks!
Not sure why you would test your LH/FSH as your HPG-axis will be suppressed when using exogenous T.
Even though your critical blood markers RBCs, hemoglobin and hematocrit are in range you are missing iron/ferritin which is important to know.
Have you been donating blood and if so how often?
Big mistake here getting caught up on just testing your TT as the most critical fraction is your free testosterone which is responsible for the positive effects.
You are injecting every 2.5 days but what is your weekly dose?
Seeing as you are injecting very frequently chances are you had your blood work done at the true trough (lowest point) before your next injection.
Your estradiol is high because your trough FT is still very high!
With a top-end trough TT 954 ngdL and somewhat lowish SHBG 20.3 nmol/L it is a given that your trough FT will be high.
The only way to know where your FT truly sits would be testing it using the most accurate assay the gold standard Equilibrium Dialysis especially in cases of altered SHBG.
If you do not have access to such which is highly unlikely unless you live outside of the US than you can use the next best testing method which is the calculated linear law-of-mass action Vermeulen (cFTV) as it will give a good approximation mind you it tends to overestimate slightly.
You can easily figure out where your FT sits using the online calculator which is. available to the general public for free.
Just need to plug in your TT, SHBG and Albumin.
With a top-end trough TT 954 ng/dL, somewhat lowish SHBG 20.3 nmol/L and Albumin 4.2 g/dL your trough FT 29 ng/dL is high!
Your peak TT, FT and estradiol would be higher.
FT <5 ng/dL would be considerd low.
FT 5-9 ng/dL would be considered the grey zone where some men may experience symptoms of low-T.
FT 10-15 ng/dL would be healthy.
FT 20-25 ng/dL would be high-end/high!
The majority of men will do well with a trough FT 15-25 ng/dL depending on the injection frequency.
You easily have room to lower your weekly dose and bring down your trough FT before even considering if you would need to micro dose an AI!
