T:E Ratio: How Do I Calculate It?

[Cataceous]

...
Is there really any evidence to suggest that high normal E levels are any less healthy as high normal T levels?

There's not even evidence that high normal testosterone levels are healthy; for effects on overall health they are likely less healthy than normal levels. For men not on TRT, high-normal testosterone is more likely reflecting above-average SHBG. In these cases free testosterone is probably not high. In contrast, men on TRT may generally have average or lower SHBG, in which cases high total testosterone reflects high free testosterone. The free hormone levels are usually going to be more important than the total levels in governing long-term consequences.

In sum, we lack evidence on the long-term safety of either highish testosterone or highish estradiol. We can certainly point to common side effects, such as elevated hematocrit and water retention. These may simply be the most visible warnings against running hormone levels higher than is natural for the individual.

I believe there are some data pointing to problems in males when estradiol is relatively high compared to testosterone. I think one of the issues is harm to testicular tissue. It seems likely that an imbalance in the other direction is also not going to be healthy.

 

[Nelson Vergel]

This paper is from a mathematical model. You can see a U shape curve for total testosterone and mortality.

Testosterone, DHT and Estradiol and Mortality in Older Men

Testosterone Is Associated With Reduced All-Cause Mortality and Higher Dihydrotestosterone With Reduced Ischemic Heart Disease Mortality, While Estradiol Levels Do Not Predict Mortality- In older men, having total T levels in the middle two quartiles at baseline predicted reduced incidence...

www.excelmale.com

In Older Men an Optimal Plasma Testosterone Is Associated With Reduced All-Cause Mortality and Higher Dihydrotestosterone With Reduced Ischemic Heart Disease Mortality, While Estradiol Levels Do Not Predict Mortality

Context:. Testosterone (T) levels decline with age and lower T has been associated with increased mortality in aging men. However, the associations of its

academic.oup.com

 

[JRos895]

There's not even evidence that high normal testosterone levels are healthy; for effects on overall health they are likely less healthy than normal levels. For men not on TRT, high-normal testosterone is more likely reflecting above-average SHBG. In these cases free testosterone is probably not high. In contrast, men on TRT may generally have average or lower SHBG, in which cases high total testosterone reflects high free testosterone. The free hormone levels are usually going to be more important than the total levels in governing long-term consequences.

In sum, we lack evidence on the long-term safety of either highish testosterone or highish estradiol. We can certainly point to common side effects, such as elevated hematocrit and water retention. These may simply be the most visible warnings against running hormone levels higher than is natural for the individual.

I believe there are some data pointing to problems in males when estradiol is relatively high compared to testosterone. I think one of the issues is harm to testicular tissue. It seems likely that an imbalance in the other direction is also not going to be healthy.

This and Nelson’s link elucidates the lunacy of frequently using AIs to counter excess high E at excess high levels of T.

Rather than reducing T and keeping both within healthy range and in balance with one another, the first gut reaction is too often to keep the T at a likely unhealthy high level, treat the E with an AI, and then leave T and E unbalanced with one another.

Why are men and doctors so quick to freak out when E reaches high range but applaud when T reaches high range?

 

[Nelson Vergel]

@JRos895

Why are men and doctors so quick to freak out when E reaches high range but applaud when T reaches high range?

I have been asking that question for 10 years! Very frustrating.

One doctor told me "Nelson, I prescribe anastrozole otherwise my patients will get upset as they assume all bad side effects are due to estradiol. If I don't, this will load my clinic with too many requests".

High T= Higher chances of high hematocrit, low ferritin, low HDL, high blood pressure, water retention, etc

These is a summary of lab results from Discounted Labs. The red is mostly high testosterone (over 1100 ng/dL) or what Quest considers high estradiol (29 pg/mL).

 

[JRos895]

 

[Gman86]

Another thing to consider is that by going on testosterone, and shutting down ur testicles, u also usually shut down most of ur progesterone production. Progesterone, to a certain degree, inhibits the conversion of test into E2 and DHT, which will keep test levels higher, from converting less into these two metabolites, and thus also improving a man’s T:E ratio. Also, since E2 is what stimulates the brain to produce prolactin, by inhibiting E2, progesterone indirectly also inhibits prolactin. So by just making sure progesterone levels are in a healthy range, while on TRT, a lot of the side effects that men report should theoretically be greatly mitigated, without the need for an ai or to lower the test dose too much and lose some of the positive benefits of TRT. Just food for thought

 

[Nelson Vergel]

Correlation between libido and testosterone: Estradiol ratio in men with sexual dysfunction

Sexual desire drives men to seek sexual activity, positively impacting cognitive function, emotional affective state and affecting the quality of life…

www.sciencedirect.com