My experience- high v low E plus Ferritin

My intent with this post is to share my experience with symptoms so that others may avoid my mistakes. Unfortunately every trt issue I’ve had, I had to figure out on my own. TLDR - estrogen is as important as T to dial in and much harder to do so. Don’t let doctors blame physical problems on your mental health.

I began TRT 5 years ago at 120mg plus HCG no AI. I felt a lot of benefits but was pretty anxious and breathless. Didn’t think much of it but after looking back my E was high. Continued this for a year or so and then wanted kids. Urologist had me drop T and go on high dose clomid and HCG w an AI. This was my first time using and AI. This combo shot my estrogen through the roof. My symptoms for high E:

-complete inability to control intrusive thoughts

-mental anxiety (as compared to guttural adrenaline type anxiety) this anxiety stemmed from my thought patterns.

-breathlessness

-bloat

Figured out my E2 was high and upped AI. Felt better but not good until I froze sperm and went back to TRT. After restarting TRT the urologist kept me on an AI and advised me to donate blood regularly to keep Hcrit down. At this point I’m on 120mg t cyp MWF, HCG 500iu, and .5 Anastrozole 1x per week. This went well for awhile but never really truly dialed in.

Fast forward a year or so and VA kicked me off community care so went from urologist to my PCM who was willing to oversee TRT. However he had no idea what he was doing. I went to him with severe fatigue regardless of sleep. (My sleep apnea is treated well and I was regularly getting 8 hours). He put me on a GLP1 bc he thought it was just excess weight and had me drop HCG without lowering AI.

I lost 20lbs and felt much worse. Extreme fatigue, brain fog, low libido, guttural/physical anxiety (like a real fight or flight response), dick kept wanting to hide inside my body lol, leg weakness and lastly bad joint pain.

I suggested maybe my E2 was low but he didn’t agree. Turns out I was right. Dropping weight and HCG without a corresponding lowering of AI tanked my E2.

I lowered the AI and felt a bit better but still fatigued and foggy. Doctors didn’t care and said it was stress (admittedly I am in a stressful time going to law school with an infant at home). I ordered my own labs. Guess who has crashed his ferritin by doing regular double red donations. You guessed it- THIS GUY! I’ve just begun supplementing iron and praying that finally solves this fatigue.

I am confident this will solve the problem though it may mean higher h-crit. I’ve read anything below 55 is ok for trt patients as long as platelets are fine. I never went above 52 so I probably never needed to donate but listened to the doc.

I had read about all these issues before but always told myself not to be a hypochondriac. Listen to the doc and all will be well. DO NOT be like me! If you don’t feel right there’s a reason! Don’t let the regular shitty medical system tell you it’s all in your head.

Apologies for the long post/rant. Godspeed