question from a user
I just had 6 week bloods done. e2 was 48. SHBG must be crashed because my free T was 255. Obviously an e2 of 48 is unlikely to cause any puff or itching. I read about HCG in women and how it can increase fatty built up in the breast. Could that be what happened to me? I know it likely spiked my e2. But is there zero chance HCG itself is responsible for these symptoms? Also, how likely would it be to develop gyno 6 weeks in? I know I'm probably overanalyzing, but when I woke today my nips and chest just looked way perkier and more "boob" shaped than I've ever seen. Again, been on for 6 weeks and ONLY after doing HCG did this happen.
AlphaMD's Answer
Well, to break things down, when starting TRT you should generally not be adjusting your routine or adding medications until the 7-8 week mark when your body's hormones balance out for exactly this reason: It can be hard to tell what's causing what.
Until weeks 7 or 8, you can expect ups/downs/side effects. Then you can expect yourself to be somewhat stable. Any changes from there to routine make it easier to pin point which change may have caused what.
It's not impossible that HCG is causing some trouble here, it's simply much more likely that your Estrogen is causing the problem. For reference, 48 is not incredibly high but it's elevated & something to watch. Some men we work with sit at 10-12 for example. Each man is also going to react a different way to each hormone with no set values being 100% definitive.
If you wanted to be absolutely sure, this is what you can do:
-Stop HCG. Retest your Estrogen in 2-4 weeks. See how you feel. This could show that the HCG or the elevated E from the HCG was contributing.
-Start an AI or increase your AI immediately & continue all other doses at the same levels. This would show that if symptoms stop or significantly reduce, it was your Estrogen.
6 Weeks in and seeing strong symptoms like that may be a bit abnormal, but the best course of action is not to guess about the cause & instead start systematically eliminating potential causes until the side effect is removed.
Personally, if you really feel like the HCG was causing the issue, I'd just stop it pure and simple. HCG doesn't need to be started with TRT & can always be added back in later. Get rid of the symptoms first then add/adjust things back in after.
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