Is Testosterone to Estradiol Ratio Important in Men?

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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?
 
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.
 
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.
 
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?
 
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.
 
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.
 
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.
 
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