Hormone Panel Results advice please

happybunny63

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I am a 62 y/o female and I have suffered from chronic fatigue/low energy/ low mood.
I finally started taking hormones for longstanding rock bottom hormone levels (since my 40's).

I started on 4.5mg/wk of Test E and an Estrogen 25ug patch 2x/wk in May.
3 months later in August: Total testosterone level (LC/MS) = 17.8 ng/dL; Free (direct) testosterone level = 0.5 ng/dL; Estradiol level (LC/MS) = 6.1; Total Estrogen = 409 *; Progesterone (LC/MS) = 0.1; SHBG = 98.7

I continued to titrate up the Test E to 15mg/wk and added Progesterone 100mg daily.
In Dec: Total testosterone level (LC/MS) in Dec = 18.6 ng/dL; Free (direct) testosterone level = 1.7 ng/ Estradiol level (LC/MS) = 28; Total Estrogen = 422 *. My Progesterone (LC/MS) = 25
I have now titrated up my Test E to 21mg because I still do not have any side effects of acne, oily skin or facial hair.

My questions:

(1) What is a good goal target for my free direct testosterone level?
I currently feel better with more energy but I would like to increase my lean muscle mass (Dexa scan showed that I was slightly below average.)

(2) Should I be concerned enough with a sustained Total Estrogen level above 400 that I should start on Arimidex? Does Arimidex selectively lower Estradiol or does it lower Total Estrogen levels?

(3) Is there anything I can do to lower my SHBG level?
 
Last edited:
I am a 62 y/o female and I have suffered from chronic fatigue/low energy/ low mood.
I finally started taking hormones for longstanding rock bottom hormone levels (since my 40's).

I started on 4.5mg/wk of Test E and an Estrogen 25ug patch 2x/wk in May.
3 months later in August: Total testosterone level (LC/MS) = 17.8 ng/dL; Free (direct) testosterone level = 0.5 ng/dL; Estradiol level (LC/MS) = 6.1; Total Estrogen = 409 *; Progesterone (LC/MS) = 0.1; SHBG = 98.7

I continued to titrate up the Test E to 15mg/wk and added Progesterone 100mg daily.
In Dec: Total testosterone level (LC/MS) in Dec = 18.6 ng/dL; Free (direct) testosterone level = 1.7 ng/ Estradiol level (LC/MS) = 28; Total Estrogen = 422 *. My Progesterone (LC/MS) = 25
I have now titrated up my Test E to 21mg because I still do not have any side effects of acne, oily skin or facial hair.

My questions:

(1) What is a good goal target for my free direct testosterone level?
I currently feel better with more energy but I would like to increase my lean muscle mass (Dexa scan showed that I was slightly below average.)

(2) Should I be concerned enough with a sustained Total Estrogen level above 400 that I should start on Arimidex? Does Arimidex selectively lower Estradiol or does it lower Total Estrogen levels?

(3) Is there anything I can do to lower my SHBG level?
SHGB looks pretty high. You're taking a lot of test just to get to a low-normal level of free test. My guess would be you're taking too much estrogen which is elevating SHGB. You could probably drop the dose of both T and E and end up with more free test. YMMV but I'd certainly ask your doctor if that's a fair assumption.

Arimidex can be unpredictable enough that I wouldn't use it without regular blood work and a doctor's guidance. But I think you'll be better off just getting your levels dialed in with the minimum number of medications necessary.
 

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