T:E Ratio: How Do I Calculate It?

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Is there really any evidence to suggest that high normal E levels are any less healthy as high normal T levels?
There's not even evidence that high normal testosterone levels are healthy; for effects on overall health they are likely less healthy than normal levels. For men not on TRT, high-normal testosterone is more likely reflecting above-average SHBG. In these cases free testosterone is probably not high. In contrast, men on TRT may generally have average or lower SHBG, in which cases high total testosterone reflects high free testosterone. The free hormone levels are usually going to be more important than the total levels in governing long-term consequences.

In sum, we lack evidence on the long-term safety of either highish testosterone or highish estradiol. We can certainly point to common side effects, such as elevated hematocrit and water retention. These may simply be the most visible warnings against running hormone levels higher than is natural for the individual.

I believe there are some data pointing to problems in males when estradiol is relatively high compared to testosterone. I think one of the issues is harm to testicular tissue. It seems likely that an imbalance in the other direction is also not going to be healthy.
 
This paper is from a mathematical model. You can see a U shape curve for total testosterone and mortality.


 
There's not even evidence that high normal testosterone levels are healthy; for effects on overall health they are likely less healthy than normal levels. For men not on TRT, high-normal testosterone is more likely reflecting above-average SHBG. In these cases free testosterone is probably not high. In contrast, men on TRT may generally have average or lower SHBG, in which cases high total testosterone reflects high free testosterone. The free hormone levels are usually going to be more important than the total levels in governing long-term consequences.

In sum, we lack evidence on the long-term safety of either highish testosterone or highish estradiol. We can certainly point to common side effects, such as elevated hematocrit and water retention. These may simply be the most visible warnings against running hormone levels higher than is natural for the individual.

I believe there are some data pointing to problems in males when estradiol is relatively high compared to testosterone. I think one of the issues is harm to testicular tissue. It seems likely that an imbalance in the other direction is also not going to be healthy.
This and Nelson’s link elucidates the lunacy of frequently using AIs to counter excess high E at excess high levels of T.

Rather than reducing T and keeping both within healthy range and in balance with one another, the first gut reaction is too often to keep the T at a likely unhealthy high level, treat the E with an AI, and then leave T and E unbalanced with one another.

Why are men and doctors so quick to freak out when E reaches high range but applaud when T reaches high range?
 
@JRos895

Why are men and doctors so quick to freak out when E reaches high range but applaud when T reaches high range?

I have been asking that question for 10 years! Very frustrating.

One doctor told me "Nelson, I prescribe anastrozole otherwise my patients will get upset as they assume all bad side effects are due to estradiol. If I don't, this will load my clinic with too many requests".

High T= Higher chances of high hematocrit, low ferritin, low HDL, high blood pressure, water retention, etc

These is a summary of lab results from Discounted Labs. The red is mostly high testosterone (over 1100 ng/dL) or what Quest considers high estradiol (29 pg/mL).

2021-11-05_10-28-30.jpg
 
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Another thing to consider is that by going on testosterone, and shutting down ur testicles, u also usually shut down most of ur progesterone production. Progesterone, to a certain degree, inhibits the conversion of test into E2 and DHT, which will keep test levels higher, from converting less into these two metabolites, and thus also improving a man’s T:E ratio. Also, since E2 is what stimulates the brain to produce prolactin, by inhibiting E2, progesterone indirectly also inhibits prolactin. So by just making sure progesterone levels are in a healthy range, while on TRT, a lot of the side effects that men report should theoretically be greatly mitigated, without the need for an ai or to lower the test dose too much and lose some of the positive benefits of TRT. Just food for thought
 

hCG Mixing Calculator

HCG Mixing Protocol Calculator

TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

ℹ️ Input Parameters

Normal range: 300-1000 ng/dL

Predicted Hormone Levels

Enter your total testosterone value to see predictions

Results will appear here after calculation

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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