Is Testosterone to Estradiol Ratio Important in Men?

[TucsonJJ]

No, I would just start with dhea and see how it goes.

10-4, thanks!

 

[rayrock1]

vince, thank you for posting labs.

 

[Nelson Vergel]

The association between testosterone, estradiol and their ratio and mortality among US men - PubMed

While studies have suggested that testosterone is associated with a man's health, the relationship with other sex steroids remains uncertain. The current study aimed to investigate the association between sex steroids (i.e. testosterone, estradiol and the testosterone:estradiol ratio) and...

pubmed.ncbi.nlm.nih.gov

 

[Nelson Vergel]

https://archrazi.areeo.ac.ir/article_125244.html

 

[jobshopper]

My latest labs. I’m having new ones on September 15.


Testosterone, Serum 1118 Reference Range: 264-916 ng/dL
Free Testosterone(Direct) 27.3 Reference Range: 6.6-18.1 pg/mL
Estradiol, Sensitive 19.8 Reference Range: 8.0-35.0 of/mL
SHBG 47.7 Reference Range: 19.3-76.4 nmol/L
DHEA-Sulfate 424.8 Reference Range: 30.9-295.6 ug/dL (age adjusted)
Albumin 4.3 Reference Range: 3.6-4.8 g/dL
Tru T 38.46 range 16-31 ng/dL

Hey Vince,
I am so confused about this whole E2 vs. T/E2 ratio thing. I am hoping you can help me understand this. So, if your TT is 1118 and your E2 is 19.8, is that a good thing or a bad thing? The reason I ask is because it would seem that your T/E2 ration would be something like 56.5! Is that a good thing or a bad thing? What if hypothetically your sensitive E2 was something like 58? That would put your T/E2 ratio around 19. So which is it, should a person treat the E2 at 58 with AI to bring it down to 19? Or should they leave the E2 at 58 because it's a better ratio?

 

[jobshopper]

Hey Vince,
I am so confused about this whole E2 vs. T/E2 ratio thing. I am hoping you can help me understand this. So, if your TT is 1118 and your E2 is 19.8, is that a good thing or a bad thing? The reason I ask is because it would seem that your T/E2 ration would be something like 56.5! Is that a good thing or a bad thing? What if hypothetically your sensitive E2 was something like 58? That would put your T/E2 ratio around 19. So which is it, should a person treat the E2 at 58 with AI to bring it down to 19? Or should they leave the E2 at 58 because it's a better ratio?

Anyone care to weigh in on this? All thoughts and input are welcome. I sure would like to understand this better.

 

[Vince]

Hey Vince,
I am so confused about this whole E2 vs. T/E2 ratio thing. I am hoping you can help me understand this. So, if your TT is 1118 and your E2 is 19.8, is that a good thing or a bad thing? The reason I ask is because it would seem that your T/E2 ration would be something like 56.5! Is that a good thing or a bad thing? What if hypothetically your sensitive E2 was something like 58? That would put your T/E2 ratio around 19. So which is it, should a person treat the E2 at 58 with AI to bring it down to 19? Or should they leave the E2 at 58 because it's a better ratio?

I personally believe higher e2 levels are good as long as you're not having any issues with the higher levels. Estrogen has so many benefits to a man, it help keeps a good libido., good joints and build muscles.

My estrogen runs on the lower level. Thankfully it's not causing me any issues so I leave my levels alone.

 

[jobshopper]

I personally believe higher e2 levels are good as long as you're not having any issues with the higher levels. Estrogen has so many benefits to a man, it help keeps a good libido., good joints and build muscles.

My estrogen runs on the lower level. Thankfully it's not causing me any issues so I leave my levels alone.

Thank you for your reply Vince.
Can high E2 also cause libido and sexual functions to crash? I am waiting for the rest of my labs to come in but I do know that my sensitive E2 came back at 58 (I've never had the sensitive test done before). I am 70 years old. I've been on Test C (mono) for 4 years and have enjoyed a raging libido until several weeks ago when my libido crashed and I developed other sexual function issues, ie, no morning or nocturnal erections, no interest in sex or women, soft erections, delayed ejaculation... etc. My TT normally runs 1050 to 1250. I've recently cut back my T to 60mg E3.5D from 80mg E3.5D. I am trying to figure out if my elevated E2 is the issue. I also plan to try HCG. Any thoughts on this?

 

[Vince]

Thank you for your reply Vince.
Can high E2 also cause libido and sexual functions to crash? I am waiting for the rest of my labs to come in but I do know that my sensitive E2 came back at 58 (I've never had the sensitive test done before). I am 70 years old. I've been on Test C (mono) for 4 years and have enjoyed a raging libido until several weeks ago when my libido crashed and I developed other sexual function issues, ie, no morning or nocturnal erections, no interest in sex or women, soft erections, delayed ejaculation... etc. My TT normally runs 1050 to 1250. I've recently cut back my T to 60mg E3.5D from 80mg E3.5D. I am trying to figure out if my elevated E2 is the issue. I also plan to try HCG. Any thoughts on this?

HCG may help. I've been using it throughout my TRT journey. I inject 500 IU twice a week now for over 8 years.

 

[JimGainz]

FWIW my Urologist who has been treating TRT patients for 15 years says he likes to see E2 in the 30-40 range. He said that generally that’s a good level to get estrogen benefits without worrying about any gyno, bloating ,acne, etc. He targets Testosterone in the 700-1000 ng/dl so its a decent ratio.

i have to take 1/4 Aromasin per week to keep E2 at 45 (with a 900 total T). Without any AI my E2 would shoot up to 80 or 90. My Uro said that’s too high for a man. I also felt weird at that level, very itchy, irritable, etc.

I never followed the logic of having E2 get to what ever level it wants without controlling it. Seems Dr Rouzier put out some info on YouTube asking to show one study that demonstrated harm with estrogen in males - and TRT people took that and threw away the AI. Well, I haven't seen a study showing higher estrogen is better either so I’ll try to keep things in physiological ranges for a male.

 

[tcmi]

FWIW my Urologist who has been treating TRT patients for 15 years says he likes to see E2 in the 30-40 range. He said that generally that’s a good level to get estrogen benefits without worrying about any gyno, bloating ,acne, etc. He targets Testosterone in the 700-1000 ng/dl so its a decent ratio.

i have to take 1/4 Aromasin per week to keep E2 at 45 (with a 900 total T). Without any AI my E2 would shoot up to 80 or 90. My Uro said that’s too high for a man. I also felt weird at that level, very itchy, irritable, etc.

I never followed the logic of having E2 get to what ever level it wants without controlling it. Seems Dr Rouzier put out some info on YouTube asking to show one study that demonstrated harm with estrogen in males - and TRT people took that and threw away the AI. Well, I haven't seen a study showing higher estrogen is better either so I’ll try to keep things in physiological ranges for a male.

So the challenge is determining the “physiological ranges” for estradiol in a healthy older male, at a healthy weight, with healthy testosterone levels.

 

[Nelson Vergel]

DISTRIBUTION OF TESTOSTERONE TO ESTRADIOL RATIOS IN FERTILE AND SUBFERTILE MEN: A LARGE COHORT ANALYSIS​

https://www.fertstert.org/article/S0015-0282(23)01462-0/fulltext

 

[Nelson Vergel]

Metabolic benefits afforded by estradiol and testosterone in both sexes

Enjoyed this one! As we very well know T s metabolites estradiol and DHT are needed in order to reap full beneficial effects of testosterone. Ts metabolites estradiol and DHT are needed in healthy amounts to experience the full spectrum of testosterones beneficial effects on (cardiovascular...

www.excelmale.com

 

[_CTI_]

Couple months ago Nelson had a take on E management and understanding E follows T makes perfect sense and treating symptoms vs numbers on bloodwork.

There was alot of conversation about a ratio of keeping E2 (14-20) using the math of T÷E2.

I recently moved to Nashville from So Cal and starting to interview doctors in the area and wanted to go in with some added info as I feel fantastic and keep my E2 ratio around 18 on Nelsons scale. In reality its total T: 740 and E2 ultra sensitive is 39. (740÷39=18)

Im in the process of compiling all the questions regarding my treatment, and want to back up my E2 management. Its taken over a year to get to this point and I dont want to go backwards.

Question: is this an educated belief about ratios or is there a study out there that was used to come up with the math.

I want to stay on the same protocal Im currently on without having to fly back to CA yearly, just not sure what Im going to run in to out here.

(Yes, I could go to Defy, but right now its an insurance issue.( i know someone will suggest that. Lol)

I used to frequent this site years ago when I first started TRT. I chased numbers for a long time until I got in contact with a doc that used test cream with a scrotal application.
Been on this protocol since 2018 and have never thought about my labs or my estrogen since. I know thats not ideal for everyone but I just wanted to come back and see where the consensus was on things.