Should we monitor free estradiol E2 in men on TRT?

Gman86

Member
I'll keep this simple. What matters is free test, not total. Free T3, not total. Free (active) Vitamin D, not total. Magnesium RBC, not serum total. I feel like the more we learn, the more we realize that the free, or active, form of hormones/ minerals is what matters. So is free E2 what really matters, and not even the all mighty Ultrasensitive E2 assay?

To me, it just seems like all this E2 talk might be a waste of time, because soon we're most likely just going to be testing Free E2 as the "gold standard" and will have to have all these conversations and debates all over again, but will now be about the best Free E2 range.

Obviously I understand that free E2 might be more expensive, and this might not be realistic in 2018, or even 2019, but shouldn't we all just be testing free E2? I mean that would eliminate the whole correlating your E2 level with your SHBG. Also, SHBG is a decent way to factor how much free E2 you might have, but it's far from ideal due to the fact that two men can have the same exact SHBG level, but one of the guy's SHBG might be stickier and bind more to hormones than the other guy, resulting in different free E2 levels, even if they both have the exact same Ultrasensitive E2 level. If everyone just checked free E2, we wouldn't have to speculate. I think we would learn a lot, in a quick amount of time, in regards to optimal E2 range, if everyone just checked their free E2. And I think there would be less confusion, less discrepancies between men, and not as many doctors having to pick sides. Just my opinions obviously. But this just very clearly seems like the future to me, but I could obviously be wrong.
 
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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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