Male 41, low libido for last 5 years with more than occasional ED. and other symptoms of low T. got the report. thanks to this forum, got many more tests added. here is the report. (some of the units might be different as i am not from USA)
Testosterone: 481 ng/dl,
Free T:11.52 pg/ml range given by lab 8.69-54.69. (this is free and not bioequivalnet)
cortisol A.M. : 10.48 mcg/dl
DHT: 330 pg/ml range 250-990
free T3:5.08 , free T4: 13.99, TSH: 1.052
FSH:2.51 mIu/ml -range 1.4-18.1
LH: 2.34 mIu/ml- range 1.1-7.0
Prolactin: 12.90 ng/ml (129ng/dl)- range 3.0-25.0
S.Estradiol (E2): 54.70 pg/ml - range <62
This has left me more confused. meetng the endocrinologist in a couple of days, wanted to get more info.
it is clear e2 is more, LH, FSH is low, Free T is low. not clear about total T.
What is happening? Symptoms are there, so something is definately wrong.
Any thoughts?

Your total T is only marginally low as you say. For some people your level would be ok. Your Free T is so low I think there must be some mistake. You might want to have SHBG checked too. The free T will be lower if SHBG is high but 11.2 pg/ml seems almost impossible with a total T of 481. Lets assume the Free T is a bad test for some reason. The other thing that sticks out as you also note is E2. At your level it is high enough to cause problems. It can not only cause loss of libido and ED symptoms but can lower LH (and yours is quite low) which in turn will lower total T.

I would suggest trying 30 mg - 50 mg of zinc per day which will help to reduce armoatase enzyme (if you are deficient in zinc). Aromatase enzyme converts T to Estrogen and E2. Also take 1 or 2 DIM plus by Natures Way which will help the liver remove excess estrogen and E2 from the body. Avoid grapefruit which will inhibit your liver from removing the excess estrogens.

Other ways to reduce estrongens are to lose fatty weight (which also reduces armoatase enzyme) and limit alchohol to 2 drinks per day or less.

My bet is if you bring down the E2 you will feel much better AND you T will go up. After trying this a couple weeks retest your levels and notice to see if you get a more reasonable Free T number too.

Be careful though, E2 can be too low also. The ideal level is around 20 to maybe 30. you dont want it below 10 or above 35. The way I guage how much zinc and DIM to take is if I get morning erections. Too much or too little (zinc and DIM) can make them go away or be softer.

My guess is based on your Total T your endo wont want to do anything. If your problem is estrogen (i.e. E2 also called estradiol a very potent estrogen) then that is what you want to focus on treating anyway. This is a starting point. Give it a try and re-test and if you are still not feeling well even with E2 lower then go from there and try to focus on why the free T and LH are still so low..

I see now your Free T is within the lab range. I have seen this test before. I'm not sure what the test is but it gives completely diff results than most free T tests. Anyway, I would ignore that for now. It is still at the low end of normal and you would rather be in the upper 1/3 of the range. Focus on the E2 first and see what happens.

thanks hayfrmer. i was thinking on the same lines.
i am sure, on 481 total T, my doc will not do anything.
i am also aware that high E2 is a problem as it will start "negative loop" and i will produce low LH. (i am already producing low LH). if e2 is reduced maybe LH will go up and automatically more T will be produced.
we dont get dim+ in my country (India) but have advantage of low prices of other drugs. i will also try if there is anything specific in Ayurveda (indian medicine) which specifically targets this problem.
Maybe if zinc and other things dont work i can consider aromatase inhibitor (on Docs advise)
i was wondering wheather HCG shots will help. But if extra T produced is again converted to E2 it will be a bigger problem.
The Big question remains... Why? why my body is converting Whatever T to E2? and is there a solution to this basic problem.

Arimidex is used to lower E2.

It is by prescription & expensive in the states, Use 1/2 mg tablet 3 times a week for a few weeks to see if it lowers the E2. Then adjust as needed.

For some reason you either have more armoatase than the average person or your liver is not able to remove the estrogen as good as the average person. I don't know that HCG will help much. First you would be shutting down your HPTA meaning the hypothalmus would sense the addtional T (and additional E2) and stop sending GnRH that tells the pituitary to make LH. So you would become fully dependant on HCG and would have near 0 LH. Many people whose HPTA is broken (like me) have problems with E2 being too high from using HCG. So HCG may actually make the E2 problem worse even if it does increase total T. Second as you said increasing T will also increase the E2.

Like JinL said there are Rx's you can get too but if you can solve it without an Rx thats always better. The DIM-plus by Natures Way is an extract from cruciferous vegetables (like cauliflower and brocoli) If you can not order it from the U.S. then you could eat more of these but I dont know how much it would take. Try ordering it from the U.S. The brand is Nature's Way. There are others but I know this one is good. It is not a drug but a supplement so there should not be an issue of shipping it overseas. Unfortunately I can not tell you the website I buy it from on this forum because it's against the rules. There is another name for the active ingredient in DIM, something like IC3 but I'm not sure. The DIM bottle says Diindolylmethane on it if that helps find another brand in India. It also contains 9 iu of vit E per capsule which you may need to absorb it.

You could also try losing fat, if you have too much, and/or refraining from alchohol. The high E2 can cause other problems besides sexual too by the way. My doctor thinks it is more responsible for agressive prostate cancers than T as most doctors think.

Met endo and he refused to treat. Said the readings are in range and there is "no indication". Tried to argue that the range is for 20 to 80year old people and very low free T , high e2, low LH etc and mainly symptoms are indicating something.
Nothing. Really Angry and frustrated. What am i supposed to do? see my marriage break? (It is that serious)
As i can see it. total T at 482 is just ok, free t is way too low and e2 way too high. probably this high e2 is giving negative signal and so low LH, FSH.
too much aromatase activity. liver is healthy. no alcohole, no fat.
Very inclined to try "herbal" aromatase inhibitors but dont have time to find them right away.
Found Anastrozole (Arimidex®) equivalent. Arimidex by brand is expensive (80$ for a strip of 14, 1mg). this equivalent by an indian co is 20$ for the same thing. (I am in India)
Starting it tomorrow. .5 mg twice a week. will check levels after 3 weeks.
Any idea how much time it takes to start working? (Lowering e2). Also any suggestions on the Dosage?
I plan to take it for 3-4 months, meantime try and find "herbal" equivalent. switch if i find one. if i dont then stop after 3-4 months for couple of months and start again. Meantime also try and meet another endo or a "sexologist" (Uhh).
My parents being doctors, never thought that i would be doing this on my own. But am left with no choice.
Your suggestions are welcome.

I don't know what to tell you,? I was feeling bad on Monday and failed to keep my appointment with my Heart Doctor, He had wanted to talk with me if I started taking the Androgel 5% which I stopped because of BP And weight gain.! My T was on the boderline low 281 and my free T is ok.?lower the range is 241 to 800+ I am not have any problem with my Sex drive it was the sweating at night which has stopped now for some unkown reason? I need more test and to see my Heart Doc. I wish I had advise, I am just not sure about replacement Testostrone?

Anastrozole (Arimidex®) is in my hand. Still a little apprihensive about taking it without doctors advice but going ahead. will post about the effects and blood report after 3 weeks.
Suggestions from Harryfarmer, jinL welcome.

Good luck!

I'm going to check with somone I know on another board that uses it. I think he uses 1/2 pill a day but am not sure and also not sure of the mg / pill. I know it is very powerful so I would suggest starting low and seeing what happens. Too little estradiol can ruin libido too. Ideal range is 20 - 30 pg/mL but that of course varies from person to person just like everything else when it comes to libido.

My buddy says if the arimidex is 1mg then you should cut it in quarters and use 1/4 every 3 days to start. He uses this also. He says he can judge if his level is right by his morning erections. If E2 is too high or too low he will not have them. I can't remember if you said anything about this or not but I have also noticed mine are gone or weaker when my E2 is too high. Good luck to you, I hope this works. Let us know the results.

Talked with him again and both of us feel you are likely to see a rise in both total T and free T if you can get the estradiol down with the arimidex. It amazes me that an endo can not see this connection and refuses to treat you.

The first endo that treated me said that men did not have to worry about estrogens, that it was a female hormone. I changed doctors & was tested at E2 of 84, tange 10-54, & "T" of about 200.

Everything now under control, "T" over 600 & E2 less than 30..

The first endo that treated me said that men did not have to worry about estrogens, that it was a female hormone. I changed doctors & was tested at E2 of 84, tange 10-54, & "T" of about 200.

Everything now under control, "T" over 600 & E2 less than 30.. JinL If estrogen is too high will this cause problems? I was concerned about this too.!

Thanks hayfarmer and jinl.
Yes, it is 1mg. (very small pill) took 1/2 on wednesday and 1/2 today. no effect yet (i know it is too early). will do testing in 2-3 weeks time.
being an engineer, answer seems obvious. low E2, more freeT also low E2 so no negative signal to hypothalamus, so more gnRH so more LH so more production of T. Wish it is so simple (it might not be, aware of that)