Question about E2 and Testosterone Percentage in the Body

[rocket man 400]

I have been on TRT for over 10 years. have always had my T in the 1200-1500 range and E2 from 12-26. I was on arrimidex at .25 mg E3D. I felt really good for the most part, then I started having issues and did something really wrong , started listening to regular doctors and lowered my T to approx 800, I stopped my AI and my E2 was 27-33. my energy dropped, my sleep worsened. I am ready to go back to approx the 1500 level again but have a question about E2. we are always hearing our E2 should be approx 20-25. I always had low libido even when my T was high and had to use ED drugs. I think the reason may have been my E2 was too low. This is the way I am thinking: correct me if I am wrong, please.
I am thinking higher E2 is acceptable such as 40 -100, when one has T of 1500. this is because say when a man has T of 400 and E2 of 20, the percentage of estradiol is greater compared to the T, right? So, when a man has T of 1500 and E2 of 20, the percentage of estradiol is much less. My point being due to the higher amount of T, perhaps a higher percentage of estradiol would make things better for me? any help would be greatly appreciated. I am trying to get as many view points as possible so I can understand this better.
1 Reply

 

[swoops36]

I think you’re correct in your thinking: higher e2 is appropriate with higher TT

 

[Vince]

I agree 100%. E follows T. The higher your testosterone, the more testosterone more you will convert into estrogen.

 

[Vince]

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[rocket man 400]

let me show you my correspondence with Life Extension. they suggest anastrozole to maintain levels of E2 between 20-30. they do not sell this product. just very curious why most everyone suggests keeping E2 under control yet am hearing on a few forums that high E2 is beneficial. I am extremely interested in trying to see if I am fine without the Al. but which is the truth.. moderate E2 using Al to control estradiol or higher E2 ? I have read all about avoiding anasrozole and it sounds good... but still confused as the majority are saying control E2 in a moderate range. And have heard that regular doctors who know nothing about TRT and prescribe T don t care about E2 either.. something seems strange?
See below:

Thank you for your recent correspondence.

We are sorry to hear about the symptoms you are experiencing, and for any confusion. We are happy to provide our viewpoints on estradiol levels in men. Life Extension views blood levels of estradiol to be 20-30 pg/mL on a reference range of 7.6-42.6 pg/mL when using the ELCIA estradiol serum test by LabCorp to be optimal. This is because estradiol levels above and below this range have been linked with an elevated risk of mortality in men. Additionally, elevated estradiol levels above the reference range and linked with cardiovascular disease and prostate enlargement men. Levels that are below the reference range are linked with increased fracture risk. All of this data points to the need for estradiol to be healthy as a male but too much or too little being detrimental to long term health.

That range does not take into account a ratio of total testosterone to estradiol. This can also be important as both hormones work in unison to support libido, erections, mood, muscle mass, muscle recovery, glucose metabolism, cognition, and overall health. Life Extension views a total testosterone to estradiol ratio of around 23-40 to be optimal using LabCorp reference ranges. This can help point us toward an optimal for total testosterone levels being around 700-900 ng/dL on a reference range of 264-916 ng/dL when using a LabCorp test to maintain an ideal ratio.

We support the use of aromatase inhibiting medications if needed to help a male maintain an optimal total testosterone to estradiol ratio and optimal estradiol levels. Please note, if one’s reference ranges differ from the listed above, then the data provided may not apply as the information above only applies to LabCorp reference ranges. We suggest discussing these optimal ranges with your doctor to evaluate what numbers may apply to you to support your overall health. We do not suggest stopping your medication without talking to your doctor first. Here are links to articles and our protocols on Lab Testing and Male Hormone Restoration you can review with your doctor:

https://www.lifeextension.com/magazine/2010/5/why-estrogen-balance-is-critical-to-aging-men

https://www.lifeextension.com/magazine/2008/11/dangers-of-excess-estrogen-in-the-aging-male

https://www.ncbi.nlm.nih.gov/pubmed/15669538

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1743-6109.2005.00075.x

https://www.lifeextension.com/protocols/appendix/lab-testing

https://www.lifeextension.com/protocols/male-reproductive/male-hormone-restoration

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[DS3]

I have been on TRT for over 10 years. have always had my T in the 1200-1500 range and E2 from 12-26. I was on arrimidex at .25 mg E3D. I felt really good for the most part, then I started having issues and did something really wrong , started listening to regular doctors and lowered my T to approx 800, I stopped my AI and my E2 was 27-33. my energy dropped, my sleep worsened. I am ready to go back to approx the 1500 level again but have a question about E2. we are always hearing our E2 should be approx 20-25. I always had low libido even when my T was high and had to use ED drugs. I think the reason may have been my E2 was too low. This is the way I am thinking: correct me if I am wrong, please.
I am thinking higher E2 is acceptable such as 40 -100, when one has T of 1500. this is because say when a man has T of 400 and E2 of 20, the percentage of estradiol is greater compared to the T, right? So, when a man has T of 1500 and E2 of 20, the percentage of estradiol is much less. My point being due to the higher amount of T, perhaps a higher percentage of estradiol would make things better for me? any help would be greatly appreciated. I am trying to get as many view points as possible so I can understand this better.
1 Reply

Higher E2 is certainly acceptable on a dose-dependent basis. If your TRT dosage puts you at 500 ng/dL and your estradiol is 60 pg/dL, you probably won’t feel good. If your TRT dosage puts you at 1500 ng/dL and your estradiol is at 60 pg/dL, your ratio of testosterone to estrogen has increased and you will likely not experience issues.

You will hear a couple of schools of thought on this forum regarding acceptable levels of estrogen. Some will give you the SHBG:E2 ratio advice, others TT:E2 advice, and yet others may say ithas to do with TT:TE, or perhaps FreeT:FreeE. At the end of the day, if you testosterone is higher you can get away with higher estrogen. If you become symptomatic then you need to decrease estrogen.

 

[rocket man 400]

why are so many saying estradiol must be in the 20-30 range as if that is embedded in stone? they are not taking into account varying doses or what?

 

[rocket man 400]

what do you think of my recent blood work, just received. I inject 46 mg T E4D, take 25 mg DHEA daily, .25 mg anastrazole every other injection or every 8th day. I want to stop the Al, what do you guys suggest?

 

[bbex2014]

why are so many saying estradiol must be in the 20-30 range as if that is embedded in stone? they are not taking into account varying doses or what?

Old myths take a lot of time to die, and this myth of keeping e2 in the 20-30 pg/ml range no matter testosterone levels is silly. Plus, estrogen is a paracrine hormone, so systemic levels might not mean much at all

 

[equel]

its based on TRT clinics observing a pattern where most men tend to feel best between 20-30. This is also the spot where the most libido is reported and general health.

And no, its not silly, and no, one should never to idiots claiming "systemic levels not mean much at all" cause he heard it on youtube, lol.

 

[rocket man 400]

what about the statement: " if you take an Al , you are blocking the conversion of testosterone to estradiol. The problem is you will have NO IDEA where it will be blocked. It could be blocked just slightly in one area and perhaps blocking all of it in the brain. Taking even the slightest amount of an Al, I don t care how small, will cause detrimental harm to your health over the course of time"

 

[Vince]

what about the statement: " if you take an Al , you are blocking the conversion of testosterone to estradiol. The problem is you will have NO IDEA where it will be blocked. It could be blocked just slightly in one area and perhaps blocking all of it in the brain. Taking even the slightest amount of an Al, I don t care how small, will cause detrimental harm to your health over the course of time"

When your estrogen is low, it's just like low testosterone. It's low throughout your whole body.

 

[Cataceous]

what about the statement: " if you take an Al , you are blocking the conversion of testosterone to estradiol. The problem is you will have NO IDEA where it will be blocked. It could be blocked just slightly in one area and perhaps blocking all of it in the brain. Taking even the slightest amount of an Al, I don t care how small, will cause detrimental harm to your health over the course of time"

When your estrogen is low, it's just like low testosterone. It's low throughout your whole body.

Both positions ignore the nuances. Estradiol is also produced in the brain, arterial walls, bone and liver. It cannot be said that aromatase inhibitors affect these areas equally. Interestingly, different aromatase inhibitors have varying abilities to affect brain aromatization. Anastrozole is said to have relatively less activity there, possibly making it safer in this regard. At the same time, it's clearly ridiculous to state that any amount of an AI must be harmful. This is not supported by the evidence. The evidence for risk from high estradiol remains contradictory, and until this is cleared up I think it's best to avoid excessive levels, especially when they are not balanced by testosterone.

 

[Vince]

First let me say I've never used an AI. As far as I know estrogen in males is secreted by the adrenal glands and by the testes.

And yes I agree it's very important for men and women.

 

[rocket man 400]

Vince, check out t nation forum on t replacement. a great piece on Estradiol, "Why measuring serum levels of E2 is pointless". they have all the documentation in the world to support the statement I copied in my previous post here: https://drive.google.com/drive/folders/1Ml3jnxdxpBTc3kKIIpW3KT5CqrwIdjuG 7

let me know what you think please. This is very interesting and I want to do the right thing. And thank you .

 

[Tommy Wall]

If a person without any TRT has, let say 1200 of TT which I believe it´s on the higher side for a mid aged person and his E2 is between 40-80. Normally he doesn´t need any AI. How come and Why? Perhaps that´s his natural levels and he is just fine with that. Maybe TRT people like myself maybe are pushing to increase ones TT artifically too high meaning well above his own nature if considering someone doesn´t know his own natural baseline levels before he became a low testo man.

 

[swoops36]

I would really love to see a study done that pits men on TRT, two groups, one with no AI and one with e2 controlled within a set range. Measure mood, energy, libido, standard labs, prostate, etc. trying to compare men on high-dose TRT to diabetics with low FT and low e2 isn’t exactly apples to apples.

 

[Cataceous]

If a person without any TRT has, let say 1200 of TT which I believe it´s on the higher side for a mid aged person and his E2 is between 40-80. Normally he doesn´t need any AI. How come and Why? Perhaps that´s his natural levels and he is just fine with that. Maybe TRT people like myself maybe are pushing to increase ones TT artifically too high meaning well above his own nature if considering someone doesn´t know his own natural baseline levels before he became a low testo man.

Even talking young men at prime age, average peak testosterone is around 600-700 ng/dL, and 1,200 ng/dL is pushing three standard deviations from there, meaning less than one percent of that population. Similarly, with estradiol 30 pg/mL is average, and even 50s is many standard deviations above that, to the point that few healthy natural men are expected to have higher levels.

I think the vast majority of guys on TRT are overdosed, sometimes to their detriment.

 

[DS3]

its based on TRT clinics observing a pattern where most men tend to feel best between 20-30. This is also the spot where the most libido is reported and general health.

And no, its not silly, and no, one should never to idiots claiming "systemic levels not mean much at all" cause he heard it on youtube, lol.

Definitely doesn’t hold true for me and from many of the reports of men on this forum. I feel best when my E2 is ~60 pg/dL.

 

[DS3]

Even talking young men at prime age, average peak testosterone is around 600-700 ng/dL, and 1,200 ng/dL is pushing three standard deviations from there, meaning less than one percent of that population. Similarly, with estradiol 30 pg/mL is average, and even 50s is many standard deviations above that, to the point that few healthy natural men are expected to have higher levels.

I think the vast majority of guys on TRT are overdosed, sometimes to their detriment.

Not many on this site are taking TRT to sit at 500 ng/dL. Most are trying to get into that 1% range of 1200 ng/dL. If any % of the population is observed to possess 1200 ng/dL then pushing TT while on TRT to those levels would still be considered physiological levels.