Should Men on Testosterone Test Their Free Estradiol ?

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Gman86

Member
We really only care about free T levels, and don’t really even need the total level. So why is E2 different? Shouldn’t we only care about the free E2 level?
 
Defy Medical TRT clinic doctor
In my opinion (for how little that is worth) yes we should only care about free E2. Total E2 is only clinically important after we factor in the effect of SHBG levels. I have come to the conclusion after digesting this site that those of us who have a decently high SHBG are the lucky ones as we can run high total E2 numbers with little concern. I would like to see more people post their free E2 results. I know it costs but I would rather have people do that then go on an AI because they "think" they have high E2 and crash their estrogen. There could easily be an entire forum on here devoted to guys who have disastrous results because of their irrational fear of E2 and (sometimes) unwarranted use of AIs.

I once worried that I had an E2 problem but a free E2 test showed me that my numbers are in the normal range. My last labs had a SHBG of 44.5, TT 1008, FT 24.2 and a sensitive E2 of 36.7. Many guys on here have jumped feet first into AI dosing with numbers like that and had disastrous results. My serum free estradiol was 0.8 (Range 0.2-1.5) with a percent of 1.9% (Range 1.7%-5.4%) which is actually on the low end of the range.

It is a very informative test. I'd like to see more people post their results if for no other reason than to get more accurate ranges on the test as they are derived from all of the subjects who take it. I think that number might be rather small at this point.
 
Wow very well said! Thanks for the response. The only thing I disagree with is that i don’t think anyone would of thought about an ai if they had a SHBG 44.5 and a sensitive E2 of 36.7. No offense obviously. Years ago guys might of thought this, or maybe guys on different forums, but almost every guy on excel, at this point, would know that they shouldn’t be messing with an ai with a SHBG and E2 like yours. In fact, I think that’s right around the exact E2 that they would be striving for with a SHBG on the higher end.

Thank you very much for posting your free E2 level. I completely agree with you that more guys should be getting their free E2 tested, regardless of cost, and posting their results. I think once more guys start doing that, we will see a HUGE decrease in men having any sort of E2 related issues. It will also hopefully decrease the amount of debates over E2, which will then allow for more discussions on other aspects of HRT that get less focus, such as DHEA, DHT and pregnenolone, for a couple examples.
 
Stx359, what is your current protocol, including compounds, doses, frequencies, and did you have these labs drawn at trough? And how do you feel? I ask because we have the exact same SHBG level, and to me your numbers look just about perfect on paper, including your free E2. Do you feel optimal? Thanks.
 
Stx359, what is your current protocol, including compounds, doses, frequencies, and did you have these labs drawn at trough? And how do you feel? I ask because we have the exact same SHBG level, and to me your numbers look just about perfect on paper, including your free E2. Do you feel optimal? Thanks.

My last labs were for the following regimen:
Test Cyp 80 mg q 3.5
HCG (Pregnyl) 150 IU daily
DHEA 75 mg a day, 50 in the morning and 25 at night.
I always have blood drawn on injection morning before injecting to get a trough.

I feel optimal in every way except for libido, but I suspect that may be because I am 50 not for any other reason. Even so I am trying to improve that with the addition of 25 mg of testosterone cream applied to the scrotum. I am expecting my first labs on that any day now and will adjust doses after that. I experienced a dramatic increase in libido which tailed off and may have been a honeymoon effect. I never adjust anything until after 40 days on a new dosing schedule because of the 5 half lives rule. Finally I am under the care of Dr. Crisler. I do not come up with the HCG and DHEA doses on my own and I realize they are high compared to what is discussed on here.
 
My last labs were for the following regimen:
Test Cyp 80 mg q 3.5
HCG (Pregnyl) 150 IU daily
DHEA 75 mg a day, 50 in the morning and 25 at night.
I always have blood drawn on injection morning before injecting to get a trough.

I feel optimal in every way except for libido, but I suspect that may be because I am 50 not for any other reason. Even so I am trying to improve that with the addition of 25 mg of testosterone cream applied to the scrotum. I am expecting my first labs on that any day now and will adjust doses after that. I experienced a dramatic increase in libido which tailed off and may have been a honeymoon effect. I never adjust anything until after 40 days on a new dosing schedule because of the 5 half lives rule. Finally I am under the care of Dr. Crisler. I do not come up with the HCG and DHEA doses on my own and I realize they are high compared to what is discussed on here.

Thanks for mentioning who you doctor is. I know it's personal info, but I wish more guys would include this info.
 
Here is my Free E2 labs from yesterday,
Free Serum Estradiol, Serum, MS 16 pg/mL 01 Reference Range: Adult Males: 8.0 - 35
Percent 2.2 % 01 Reference Range: Adult Males: 1.7 - 5.4
Free Estradiol, Serum 0.35 pg/mL 01 Reference Range: Adult Males: 0.2 - 1.5
E2 Sensitive = 8 Range 8-35
SHBG = 39.9
Total Testosterone = 900
All comments welcome and why is Free E2 important?
 
It affects guys with low shbg. Guys with low shbg have issues with estrogen and free estrogen. Something you don't need to worry about. Not having low shbg makes your trt treatment much easier to manage.
 
My last labs were for the following regimen:
Test Cyp 80 mg q 3.5
HCG (Pregnyl) 150 IU daily
DHEA 75 mg a day, 50 in the morning and 25 at night.
I always have blood drawn on injection morning before injecting to get a trough.

I feel optimal in every way except for libido, but I suspect that may be because I am 50 not for any other reason. Even so I am trying to improve that with the addition of 25 mg of testosterone cream applied to the scrotum. I am expecting my first labs on that any day now and will adjust doses after that. I experienced a dramatic increase in libido which tailed off and may have been a honeymoon effect. I never adjust anything until after 40 days on a new dosing schedule because of the 5 half lives rule. Finally I am under the care of Dr. Crisler. I do not come up with the HCG and DHEA doses on my own and I realize they are high compared to what is discussed on here.

Thanks for replying with your protocol, appreciate it. Your HCG dose isn't that high. 500iu-1000iu is the norm. DHEA, ya that's the highest dose I think I've ever seen. Just goes to show that DHEA doesn't always convert at a high rate into E2. Clearly if you're not experiencing much E2 conversion at 75mg/ day, it's definitely an individual thing. So good to know. As far as your issues with libido, it's definitely a tough one. Your numbers look pretty much perfect. Don't give up though. I personally don't think your age is the reason for the lack of libido. I mean it could be, but I personally just don't think that's the reason. 50 isn't very old at all, plus I've read many stories of guys in their late 70's getting their libido back, after not having it for 10+ years, in some guys. Definitely don't give up on it, I think you will definitely figure out how to get your libido back if you keep trying different things, especially considering you saw a spike in libido initially with the testosterone cream to your testicles. That alone basically tells you it has little to do with your age, which is an awesome sign. You'll get it back for good. Hopefully sooner than later.
 
Here is my Free E2 labs from yesterday,
Free Serum Estradiol, Serum, MS 16 pg/mL 01 Reference Range: Adult Males: 8.0 - 35
Percent 2.2 % 01 Reference Range: Adult Males: 1.7 - 5.4
Free Estradiol, Serum 0.35 pg/mL 01 Reference Range: Adult Males: 0.2 - 1.5
E2 Sensitive = 8 Range 8-35
SHBG = 39.9
Total Testosterone = 900
All comments welcome and why is Free E2 important?

This is awesome. Really appreciate you guys posting your free E2 levels. Even just comparing the 3 of our free E2 levels is giving me some good reference data. Just imagine if more men had it done. My last labs had SHBG at 45, E2 sens at 10, and free E2 at 0.33 (0.2-1.5). So although my SHBG is slightly higher than yours Diverdown2, we have almost identical sens E2 results, and therefore pretty much identical free E2 results. It's obviously not an exact science, but can give someone with a SHBG level around ours a decent idea of where his free E2 might sit. So again, thank you very much for posting this.

And with hormones, there is usually a total serum level, which is how much of that hormone is in the blood, and then there is a free level usually, which is the actual amount that is active and ready to work on a cellular level. It is usually the free form of the hormone that is what matters, because this is the form that is actually doing the work. For instance, with testosterone, your free T is what is giving you the benefits of testosterone. You could have a high total testosterone, but if you have a low free testosterone, there's not much testosterone getting into the cells and giving you the benefits of testosterone. If you have low free testosterone, your body reacts as if there is very little testosterone in your body, regardless of how high your total is. Same with thyroid. You could have all the total T3 in the world, but if your free T3 is low, you're going to experience hypothyroid symptoms. It's the same with E2, I would imagine. The free E2 is what's activating your E2 receptors. So I would imagine it doesn't matter where your total E2 sits. It's the free E2 that you want to keep in a healthy range and focus on.
 
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Here are some of my E2 levels to compare total E2 to free E2, if it will help anybody. I'll also put my SHBG in as well.

E2 NOT Sensitive - 71
E2 Free - 1.88 (0.2-1.5)
SHBG 44 (10-50)

E2 Sensitive - 8
E2 NOT Sensitive - 13
E2 Free - 0.28 (0.2-1.5)
SHBG 51 (10-50)

E2 Sensitive - 9
E2 NOT Sensitive - 13
E2 Free - 0.28 (0.2-1.5)
SHBG 36 (10-50)

E2 Sensitive - 46
E2 NOT Sensitive - 27
E2 Free - 0.58 (0.2-1.5)
SHBG 47 (10-50)

E2 Sensitive - 57
E2 NOT Sensitive - 56
E2 Free - 1.35 (0.2-1.5)
SHBG 41 (10-50)

E2 Sensitive - 58
E2 NOT Sensitive - 68
E2 Free - 1.48 (0.2-1.5)
SHBG 44 (10-50)

E2 Sensitive - 10
E2 NOT Sensitive - 15
E2 Free - 0.33 (0.2-1.5)
SHBG 45 (10-50)
 
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Wow very well said! Thanks for the response. The only thing I disagree with is that i don’t think anyone would of thought about an ai if they had a SHBG 44.5 and a sensitive E2 of 36.7. No offense obviously. Years ago guys might of thought this, or maybe guys on different forums, but almost every guy on excel, at this point, would know that they shouldn’t be messing with an ai with a SHBG and E2 like yours. In fact, I think that’s right around the exact E2 that they would be striving for with a SHBG on the higher end.

Thank you very much for posting your free E2 level. I completely agree with you that more guys should be getting their free E2 tested, regardless of cost, and posting their results. I think once more guys start doing that, we will see a HUGE decrease in men having any sort of E2 related issues. It will also hopefully decrease the amount of debates over E2, which will then allow for more discussions on other aspects of HRT that get less focus, such as DHEA, DHT and pregnenolone, for a couple examples.
wow. I might be one of "those guys" who have not learned just yet. I have SHBG of 53 and E2 (sensitive) of 39. I take 0.125mg anastrozole twice a week. I almost increased my AI dosage to 0.250 mg thinking that my AI was a bit high. I am glad I did not. I will go ahead and test my free E2. I wonder why my Defy doctor hasn't recommended this test. Maybe because it is a bit expensive? I just learned about this test in this thread. I know my Defy doctor has told me a few times that my E2 was not high considering that my SHBG is high. He is right of course. I will test next week.
 
My last labs were for the following regimen:
Test Cyp 80 mg q 3.5
HCG (Pregnyl) 150 IU daily
DHEA 75 mg a day, 50 in the morning and 25 at night.
I always have blood drawn on injection morning before injecting to get a trough.

I feel optimal in every way except for libido, but I suspect that may be because I am 50 not for any other reason. Even so I am trying to improve that with the addition of 25 mg of testosterone cream applied to the scrotum. I am expecting my first labs on that any day now and will adjust doses after that. I experienced a dramatic increase in libido which tailed off and may have been a honeymoon effect. I never adjust anything until after 40 days on a new dosing schedule because of the 5 half lives rule. Finally I am under the care of Dr. Crisler. I do not come up with the HCG and DHEA doses on my own and I realize they are high compared to what is discussed on here.
Hi. Just curious on why you inject HCG daily ? I am also under Dr. Crisler's care and he has me on 500 IUs twice a week. What is the rationale to switch to a daily injection?
 
Here are some of my E2 levels to compare total E2 to free E2, if it will help anybody. I'll also put my SHBG in as well.

E2 NOT Sensitive - 71
E2 Free - 1.88 (0.2-1.5)
SHBG 44 (10-50)

E2 Sensitive - 8
E2 NOT Sensitive - 13
E2 Free - 0.28 (0.2-1.5)
SHBG 51 (10-50)

E2 Sensitive - 9
E2 NOT Sensitive - 13
E2 Free - 0.28 (0.2-1.5)
SHBG 36 (10-50)

E2 Sensitive - 46
E2 NOT Sensitive - 27
E2 Free - 0.58 (0.2-1.5)
SHBG 47 (10-50)

E2 Sensitive - 57
E2 NOT Sensitive - 56
E2 Free - 1.35 (0.2-1.5)
SHBG 41 (10-50)

E2 Sensitive - 58
E2 NOT Sensitive - 68
E2 Free - 1.48 (0.2-1.5)
SHBG 44 (10-50)

E2 Sensitive - 10
E2 NOT Sensitive - 15
E2 Free - 0.33 (0.2-1.5)
SHBG 45 (10-50)
hi Gman86. Why do you have such fluctuations on your E2 levels? Is this based on different AI dosages? On what of all these ranges did you feel best?
 
My last labs were for the following regimen:
Test Cyp 80 mg q 3.5
HCG (Pregnyl) 150 IU daily
DHEA 75 mg a day, 50 in the morning and 25 at night.
I always have blood drawn on injection morning before injecting to get a trough.

I feel optimal in every way except for libido, but I suspect that may be because I am 50 not for any other reason. Even so I am trying to improve that with the addition of 25 mg of testosterone cream applied to the scrotum. I am expecting my first labs on that any day now and will adjust doses after that. I experienced a dramatic increase in libido which tailed off and may have been a honeymoon effect. I never adjust anything until after 40 days on a new dosing schedule because of the 5 half lives rule. Finally I am under the care of Dr. Crisler. I do not come up with the HCG and DHEA doses on my own and I realize they are high compared to what is discussed on here.
Adding a little testosterone cream to the scrotum can boost libido for patients.

I usually ask my patients to have their blood drawn a few hours after they apply their cream or take a pill. That way I can compare what the labs say to what the patient says about how they feel.
 
Hi. Just curious on why you inject HCG daily ? I am also under Dr. Crisler's care and he has me on 500 IUs twice a week. What is the rationale to switch to a daily injection?
The best way to take HCG is a smaller daily dose, as we are attempting to provide a similar profile as the LH which the body is used to seeing, but is now suppressed.
 
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