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[K45]

Hi ladies

I was just wondering if anyone knows what oestradiol 758 on blood test means? I'm on 2 pumps oestrogel daily.

Thanks in advance x

[JS79]

It depends on age.
After menopause it can be fairly accurate but in perimenopause it's really not useful as only takes a snapshot of that day, hormones can fluctuate daily.
Mines was 306 pmol/l recently, currently perimenopause and on 3 pumps of oestrogel daily. Dr at Newson happy. The blood tests were to check testosterone levels but they just checked lots at same time.

[K45]

Thanks - I just thought it sounded quite high. It would be just so much easier if it wasn't all based on symptoms and there was a definitive way of knowing whether it's perimenopause or something else and whether the oesteogel or progesterone were at the right level...

[JS79]

Exactly. HRT has helped with some of my symptoms but lots remain. I've only been searching for 1yr for answers but I feel I'm ruling out lots of things and doing my GPs job. I've went private for a lot of tests. Spent almost a Yr getting my vit d into normal range and now away to focus on b12, folate and ferritin as all technically in normal NHS range but very low.
Sometimes it trial and error

[K45]

Interesting that you should say about levels being very low but classed as normal in the NHS range as I just had blood results and other than bilirubin being too high (32) everything else says normal range. Have you found a site that lists different ranges to what GPs use?

[JS79]

My GP result shows me the guide they use but that's only for my region. Using their ranges I can see where my levels are in their range.

[Mary G]

758 pmol is a very good level and for most women it's enough to be symptom free.

Re the high bilirubin level, you have probably inherited Gilbert's syndrome.  It's very common and unfortunately levels increase at menopause and in pregnancy.  My sister found out she had it when she was pregnant but I have never been pregnant and found out post menopause.  My bilirubin level had been right at the upper limit before that.

It's harmless and interestingly it protects you from some cancers but it's not always symptom free and a lot of people have IBS and fatigue.

[bombsh3ll]

With gel there is a transient high spike in estradiol as it is absorbed, then plasma levels decline over the next 24 hours, so it can be quite difficult to interpret levels with this method as they vary greatly depending on when you last dosed.

[K45]

Thanks for the responses - Bombsh3ll, I had bloods at 8am and used gel at 10 pm the night before so 10 hrs after using it. That makes sense that the time would impact result.
    Mary - yes, have GS, diagnosed at 17 (bilirubin levels peaked at 81) as mixed with glandular fever I was rather sick for about a year. Apparently most people have no symptoms. I find it's manageable unless I'm menstruating, sick or stressed which causes tiredness, brain fog, anxiety & stomach pain. Did you find it improved after menopause as I read that hormome fluctuations in perimenopause can affect bilirubin levels?

[JS79]

I have Gilbert's also, diagnosed this year however when they checked back all my results they can see it was high 25yrs ago but no one noticed. It's only been this year as been having regular blood tests that they csn see it is consistently high, well between 20 and 38.
Got told it is nothing to worry about and won't effect me but just need to tell Dr's if I'm getting bloods done so they don't panic.

[Mary G]

That's interesting, two more GS sufferers!
 
I also had glandular fever aged (nearly) 12 and it was dreadful.  I also felt ill for at least a year, l lost loads of weight, completely lost my appetite for ages and had bad depression afterwards too.  It was confirmed in a blood test but GS didn't flag up then.  I caught glandular fever from sharing canned drinks with a school friend but we later discovered that she was wrongly diagnosed with tonsillitis - she didn't have a blood test. 

Bilirubin levels do fluctuate quite a bit and mine go from 1.20 to 1.50 mg/dL but have stayed roughly the same since I was diagnosed in 2007.  Looking back at my records, they were 20 (in your money!) in 2000 when I was 39.  Stress affects me badly and causes a GS flare up which includes IBS, fatigue and it also triggers my silent migraines.

Re fluctuating hormone levels and blood tests, I agree it's not always exact but on the other hand, you are unlikely to have an oestrogen blood level of 700 in the morning and then sink to the depths of 200 in the afternoon.  Obviously there is a margin of fluctuation but it's going to be there or thereabouts.  My blood tests have always been pretty consistent but I always had low reading with patches because of poor absorption which correlated with symptoms.

[K45]

Sounds like you had a very similar experience with glandular fever. It's definitely an unpleasant illness! So many drs seem to dismiss GS as asymptomatic but the symptoms are very real when you're having a high bilirubin episode. I agree that stress is a big trigger as when work is manic I often get unwell.

That makes sense re the blood levels unlikely to change hugely from morning to afternoon. I've done a bit if reading today and it seems that progestetone can elevate bilirubin (results in more enzymes needed to break it down) so am hoping that now I'm not on 200 anymore it will help with GS.

Apparently GS is much less common in females so I'm guessing there's not a lot of research into how this is affected by hrt/menopause.

[Seasidegirl]

Re the estradiol level it also depends when in your cycle you were tested, if you have a cycle.

Also check your SHBG  mine is really high so whilst I had an estradiol reading of 600 on day 6 which looks high, that seems to translate to a "free estradiol" figure of 128 which is a huge difference.   

With my testosterone my serum T was 1.48 which is flagged as out of high regerence range but the free T is 0.01!!!   

[K45]

Thanks - I was day 17 when got tested. My GP didn't do SHBG. I will ask about it at my next appointment. Now I know my bilirubin is high I'm feeling less worried about the hrt as this explains a lot of the symptoms I thought were down to perimenopause. It's strange in all 4 of my appointments about hrt not once has testosterone been even mentioned. I really wonder whether GPs get .much training at all in this area...

[Seasidegirl]

I'm going to try to post a screenshot,  I'm not sure if I can,  this shows the ranges my private tests (Lola via Eurofins lab) use for estradiol.  **I can't,  I'll type the figures in a post below...)

I'm still trying to understand this,  like you,  what I thought were pure peri symptoms look to be being caused by something else.   HRT has resolved many of my issues but has revealed what looks like an underlying issue.   

SHBG can be key, you can see the impact on my levels between total levels and free levels.   I'd been taking T for 5 or 6 weeks at the time of these tests.    Neither of the GPs I have seen have any understanding of the effect of SHBG.   I suspect they would try to stop my T currently given the total figure whilst not understanding the free figure is 0.01!    Whereas from my reading increasing T can act to lower SHBG.

Potentially my issues are high thyroid levels which may be making my SHBG high which is binding up the other hormones T, estradiol) which might explain my symptoms  (fatigue, palpitations)

I would recommend a full set of bloods including vitamins, minerals,  SHBG, T etc (I also wanted to see Progesterone to get a feel for whether that was generally high or low against range as i seen to have an issue with it. 

 Sub optimal Folate, B12, D, ferritin, iron can make a huge difference to how we feel.   The NHS ranges are really wide and your GP will only be interested in whether you are in range which I've learnt isn't the same as being optimal.

I hope this gives you food for thought!