Are there any conditions which cause extremely low estradiol levels in men?

[Brenda E]

Title says it all.  What on earth could cause extremely low estradiol levels in a male?  Like well below the low point of the normal range for guys, low enough that it's barely even measurable.  (And this is with taking estradiol too - can't mention dose, and while it's not a proper transitioning dose, it's not particularly small either.)

What's weirder is that even with such low levels, I'm experiencing reasonable feminization - tits, fat redistribution, etc.

Utterly confused about this.

Something genetic?  A medical issue that might need attention?  Or just unusual sensitivity to estradiol?

[Jenna Marie]

According to my endo, E levels fluctuate so much that they're not worth testing anyway. But my understanding is that the test typically checks for either circulating estrogen in the blood or excreted estrogen in the urine - the key is that in both cases it's *unused* estrogen being registered, as that which is bound to the receptors isn't testable. So it's entirely possible that what's happening is that your body is simply using 99% of it up before it hits the test.

And as my endo says, if the results are good, the method is working, even if the lab wants to disagree.

[Randi]

You can measure total estrogens (E1, E2, and E3) or each separately.  You can also measure "free and weakly bound" estrogens.

SHBG (Sex Hormone Binding Globulin) binds to estrogen (and testosterone) which makes it biologically inert.  If you measured free estrogen, the bound estrogen isn't included in that.

A high dose of any sex steroid can cause SHBG to increase in an attempt to achieve stasis.

Randi

[Alexis2107]

You get better from HRT through very high dose of T blockers and low dose of estrogen through my research.  Just like Jenna said, E levels very time to time.  If you get too much E, anyways, it just turns into T which is something a M2F don't want.  My next appointment I am going to see about upping the T blockers. 

[Beverly]

Because E fluctuates you have to be consistent when you take it and when you measure it. I attend a GIC that bills itself as the world's largest so I suspect my endo knows what he is taking about as he manages hundreds - maybe thousands - of people each year.

He told me to take my E (pills) in one dose at the same time every day. My blood tests where to be taken 4 hours after no ingestion (no sublingual).

I have done exactly what he said and my blood levels are in step with my dosage. If my dosage goes up then my blood levels go up, if he decreases my doasge, my blood levels go down. So it is measuarable and predictable.

If you take your E and get measured too soon afterward then your results will be misleading. Similarly, if you leave it too late. Ask your endo when the blood should be taken and then stick with that. Be consistent.

[Stephe]

Title says it all.  What on earth could cause extremely low estradiol levels in a male?  Like well below the low point of the normal range for guys, low enough that it's barely even measurable.  (And this is with taking estradiol too - can't mention dose, and while it's not a proper transitioning dose, it's not particularly small either.)

What's weirder is that even with such low levels, I'm experiencing reasonable feminization - tits, fat redistribution, etc.

Utterly confused about this.

Something genetic?  A medical issue that might need attention?  Or just unusual sensitivity to estradiol?

I gave up with blood test readings for me. My T started out before any HRT at 200 (baseline, whatever the measurement type is) and on full bore spiro + estrogen + p it never changed at all. Finasteride did nothing to the t levels either, just made me feel weird. It was 200 the last test before I had my orchi, my e levels were very low, yet I have 36C boobs and my body femed out nicely, I felt -different- that before HRT etc etc. The doctor was like "whatever, clearly these blood tests are a waste of time on you". We are going to test my T three months post-op just out of curiosity. I won't be shocked if it is still 200 lol.

[Stephe]

If you get too much E, anyways, it just turns into T which is something a M2F don't want.

I don't believe this is true or even scientifically possible.

[Beverly]

I don't believe this is true or even scientifically possible.

It is wrong. T is converted to E via the Aromatise Enzyme. There is no reverse pathway for converting E to T. If anybody thinks otherwise then they should name the enzyme that does it. I suspect that it will be a long wait ....

[Alexis2107]

It is wrong. T is converted to E via the Aromatise Enzyme. There is no reverse pathway for converting E to T. If anybody thinks otherwise then they should name the enzyme that does it. I suspect that it will be a long wait ....

On my paper work from the doctor, where I had to sign off about the effects of taking HRT... it states:

"I understand that I am strongly advised not to take more medication than I am prescribed, as this increases health risks.  I have been informed that taking more than I am prescribed will not make feminization happen more quickly or increase the degree of change: Extra estrogen can be converted to testosterone, which may slow or stop feminization"

Now I have something to research.  I'll let you know when I find out

[Alexis2107]

On my paper work from the doctor, where I had to sign off about the effects of taking HRT... it states:

"I understand that I am strongly advised not to take more medication than I am prescribed, as this increases health risks.  I have been informed that taking more than I am prescribed will not make feminization happen more quickly or increase the degree of change: Extra estrogen can be converted to testosterone, which may slow or stop feminization"

Now I have something to research.  I'll let you know when I find out

Found it!!

"Taking more hormones than the dose you were prescribed is not a good
way to try to speed up changes. Taking a higher dose can actually slow
down the changes you want: extra estrogen in the body can be converted
to testosterone by an enzyme called aromatase. "


http://www.camh.ca/en/hospital/care_program_and_services/hospital_services/Documents/hormones-MTF.pdf

[Indoctrinated]

I don't believe this is true or even scientifically possible.

Well... In theory too much E2 in the liver may lead to higher conversion rate to E3.

In practise... Who tests E3 anyway?

[Beverly]

Found it!!

"Taking more hormones than the dose you were prescribed is not a good
way to try to speed up changes. Taking a higher dose can actually slow
down the changes you want: extra estrogen in the body can be converted
to testosterone by an enzyme called aromatase. "


http://www.camh.ca/en/hospital/care_program_and_services/hospital_services/Documents/hormones-MTF.pdf

Your leaflet is incorrect.  Aromatase alters the electron structure of testosterone by aromatising the benzene-like ring at the end of the molecule.  That is how the enzyme gets its name.

http://en.m.wikipedia.org/wiki/Aromatase#/editor/1


Google the words "aromatase estrogen  testosterone" and read the summaries.  They are all T to E

[Alexis2107]

Your leaflet is incorrect.  Aromatase alters the electron structure of testosterone by aromatising the benzene-like ring at the end of the molecule.  That is how the enzyme gets its name.

http://en.m.wikipedia.org/wiki/Aromatase#/editor/1


Google the words "aromatase estrogen  testosterone" and read the summaries.  They are all T to E

Yes, there are a few that all point T to E.  There are also from E to T including articles written by those in medical profession.  I am not an expert, I just research and go by what professionals tell me including my own doctor.  I'll ask his opinion and let you know, but by the paper work, he suggests E can go T... I'll see if he can explain or direct me where to find the information. 

[Brenda E]

Some very interesting info.

So...the fact that my serum levels are extremely low (despite taking a reasonable dose of estradiol) means that all of the estradiol is being used up, and not that I don't have any in my system to do any work in the first place?  That would make sense: I'm definitely seeing some feminization - these are real boobs, not moobs.  Low E levels are thus not necessarily a bad thing?

And would it follow that if the estradiol levels in my blood are very high, it's because I've exceeded the threshold of what my body can actually cope with?

[Indoctrinated]

And would it follow that if the estradiol levels in my blood are very high, it's because I've exceeded the threshold of what my body can actually cope with?

Could be but the only 100% sure thing is that sensitivity to estrogens matches your genetics and so what's ideal to you may be too low to someone else... or too high. SHBG seems to be the best way to measure it.

I had my E2 checked weeks after starting HRT. It was 44 pg/ml. My SHBG was very low though... But still I'm getting wider hips and breast growth.

[HughE]

Yes, there are a few that all point T to E.  There are also from E to T including articles written by those in medical profession.  I am not an expert, I just research and go by what professionals tell me including my own doctor.  I'll ask his opinion and let you know, but by the paper work, he suggests E can go T... I'll see if he can explain or direct me where to find the information.

Just because a doctor said it doesn't necessarily mean it's true. Medicine is largely based around "expert opinion", and a lot of the time that expert opinion later turns out to be wrong. At one time doctors said that bloodletting was the cure for all ills, and that there was no need for them to wash their hands in between seeing patients or practice any kind of hygiene. They were wrong, and a lot of their patients died as a result! Everything I've read in the scientific literature says that the aromatase reaction only goes in one direction, and that's from T to E. My guess is that a doctor somewhere made up a story about excess E turning into T as a way of discouraging his trans patients from overdosing on E, and people have taken it as gospel and spread the myth.

Overdosing on E (especially oral forms of E) is a very bad idea, but that's because of the risk of blood clots, not because it converts into T.

[Randi]

http://ceri.com/steroid.gif

This simplified diagram shows how hormones are created.  There is no pathway to convert estrogen to testosterone.  It's just not biochemically possible.

Randi

[Allyda]

My E levels were never above 168 pg/ml on tablets however I have been since switched over to injections as my Endo thinks I have a problem absorbing the tablets. I too have had excellent development despite these lower E levels. However, I haven't had my levels checked tho since I've been on injections but I will be having blood taken this week, and I see my Endo again first week in December where I'll find out what my levels are now.

Being on injections I don't feel that much different, so I don't expect much change. However I will keep y'all informed of what happens with my bloodwork.

Having said all that, regarding Estradiol you should never ever take more than your Endo/Doctors prescribe. Not just because there may be a possibility too much E may be converted to T(if possible which I dunno), many other health risks, very serious ones can arise from doing so.

Be safe everyone!

Ally

[Stephe]

Overdosing on E (especially oral forms of E) is a very bad idea, but that's because of the risk of blood clots, not because it converts into T.

Right and if this -was- true, over dosing on E wouldn't be dangerous because it would simply turn any excess into T. I'm -sure- some doctor figured out it was a good idea to tell trans patients this story, to scare them from taking more E than prescribed.

[KayXo]

You can measure total estrogens (E1, E2, and E3)

But my understanding was that serum total estrogen testing only included Estradiol (E2) and Estrone (E1). Correct if I'm wrong.

You can also measure "free and weakly bound" estrogens.

Extremely rare. When serum estradiol is tested, it is most often total estradiol including that which is bound weakly to albumin and strongly to SHBG.

A high dose of any sex steroid can cause SHBG to increase

My understanding was that estrogen as opposed to androgen increased SHBG and that is why it is higher in women who have higher estrogen and lower androgen.

Right and if this -was- true, over dosing on E wouldn't be dangerous because it would simply turn any excess into T. I'm -sure- some doctor figured out it was a good idea to tell trans patients this story, to scare them from taking more E than prescribed.

Unethical to do this and take advantage of patients' ignorance to feed them lies. I've had high levels of E (pregnancy levels) for quite some time and my total T is quite low, 10-20 ng/dl...and I noticed decreased androgenization...thicker scalp hair, less body hair, etc. If indeed E converted to T, many transgirls would notice this, trust me you! Think of the pregnant women who have very high levels of E...do they suddenly turn into men?