T:E Ratio - What is a Good Number?

[tomas]

Is there a range or ratio that the Estradiol Sensitive should be in?

Free Testosterone 11 pg/ml
Estradiol Sensitive 26.6 pg/ml
DHT 315 ng/dl

Test cream applied to arm 8 hrs before blood draw.

I looked elsewhere but could not find the answer but it is probably somewhere obvious.

 

[CoastWatcher]

There is NO magic number. One size does not fit all in the world of androgens. Your e2, as referenced in the example above, is in a comfortable position. The t:e ratio is a guideline, not a hard and fast value, and is one metric a good doctor considers. What is your total testosterone?

 

[Vettester Chris]

Everyone is different, but for me somewhere in the 25 to 35 range tends to work best.

 

[johndoesmith]

Dunno. How do you feel?

 

[tomas]

There is NO magic number. One size does not fit all in the world of androgens. Your e2, as referenced in the example above, is in a comfortable position. The t:e ratio is a guideline, not a hard and fast value, and is one metric a good doctor considers. What is your total testosterone?

Total was 475 ng/dl (both free and total were done almost 24hrs since testosterone cream was applied.)

 

[rhino5169]

Everyone is different, but for me somewhere in the 25 to 35 range tends to work best.

Chris, at 25-35 E, what is your total T?

 

[Vince]

Nelson has some good videos on estradiol. Estradiol in Men: Myths and Facts.

 

[Vince Carter]

21-30 is a good spot as a baseline but you have to work towards what is best for you the individual, E is s fickle thing and it's not the same for every guy in that you can aim for a number on a test.

 

[CoastWatcher]

Total was 475 ng/dl (both free and total were done almost 24hrs since testosterone cream was applied.)

This result, total and free testosterone, were obtained 24 hours after application of your topical cream, just before the next application was due? Typically, with gels and creams, unlike injections, blood is drawn a few hours after administration of the testosterone.

 

[tomas]

This result, total and free testosterone, were obtained 24 hours after application of your topical cream, just before the next application was due? Typically, with gels and creams, unlike injections, blood is drawn a few hours after administration of the testosterone.

I was hoping it would give me more of a baseline since I apply the cream to my arms and did not want it to interfere with the test.

 

[Vettester Chris]

Chris, at 25-35 E, what is your total T?

Usually in the 750 to 850 range, free around 21 to 24

 

[tomas]

Dunno. How do you feel?

Not very good. The cream makes me heady, I sometimes nap in the afternoon now, I really don't feel like working out either. Mood has normalized but not enthusiastic to do things and libido is hit or miss too. It seems I feel better if I miss a dose right now.

 

[simeoni]

Are you sure you posted the DHT reading in the right units? If it truly is 315 ng/dl, then you are at a supraphysiological level and that reading might explain some of your symptoms.

 

[Nelson Vergel]

T/E has to be at least 10 for fertility (in a small study, so this is not cast in stone)

Total T in ng/dL divided by E2 in pg/ml

Is Testosterone to Estradiol Ratio Important in Men?

 

[Nelson Vergel]

I am trying to set up an interview with the doctor who presented this study.

AUA 2017: Calculated Free T and T:E Ratio but not Total Testosterone and Estradiol Predict Low Libido

Boston, MA (UroToday.com) Libido is thought to be influenced by hormonal milieu, particularly testosterone. The knowledge about the role of estradiol in male sexual function has been found to be more important than originally thought. The estradiol cut-off point of 5 ng/dL in hypogonadal men is thought to directly affect libido. Dr. Gupta presented a study assessing the impact of sex hormones on libido specifically in a cardiac patient population.

The study focused on 200 men in a cardiology practice who completed the IIEF-15, ADAM, and previous ED treatment questionnaires. Additionally all patients had serum total testosterone (T), estradiol (E), and sex hormone binding globulin (SHBG) levels measured via morning lab draws. Their free testosterone (CFT) was calculated using an online ISSM calculator. Patients that were diagnosed for hypogonadism in the past or who were currently on medications possibly affecting T levels were excluded. Hormonal levels were correlated to responses to the IIEF questions 11 and 12 (IIEF11, IIEF12), focusing on libido.

Results demonstrated the mean total T level to be 310 ng/dL with CFT of 5.4 ng/dL. Mean E levels were 4.4 ng/dL and mean T:E ratio was 8.2. Importantly, 55% of patients had T levels less than 300 ng/dL and 74% of patients had a CFT < 6.5 ng/dL. Negative correlation was found between estradiol and IIEF11 and IIEF12, but was not statistically significant. However, a positive correlation was found between IIEF11 and IIEF12 and CFT and T:E ratio (p=0.007, p=0.009, respectively). At a cutoff of E=5ng/dL, no difference was found for either hypogonadal or eugonadal men on the IIEF11 or IIEF12.

In summary, CFT and T:E ratio were predictive of positive libido response on IIEF11 & 12 questions in the IIEF questionnaire. Estradiol, even at a cutoff of 5 ng/dL, was not independently associated with improved libido. Surprisingly, no correlation was found between total testosterone and IIEF11 (desire frequency). The effect of testosterone and estradiol on libido requires further research with prospective studies.

Presented By: Nikhil Gupta, Springfield, IL

Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 &#8211; Boston, Massachusetts, USA

 

[Nelson Vergel]

Very little data on T/E2 ratios (that actually use LC/MS for both parameters).

My hypothesis is that, like all hormones, there is an inverted U-shaped curve (for benefits vs T/E2 ratio). Some studies hint at T/E2 above 14, but we have no data on the upper range since very high T/E2 may be indicative of low estradiol.

Post #12: Is Testosterone to Estradiol Ratio Important in Men?

Since 0.3 percent of TT is normally aromatized into E2 in healthy men, then it makes sense that

1/0.03= 33 should be used as a benchmark

Estradiol tends to plateau as T dose increases (probably also due to increased DHT that acts as an estradiol blocker). Aromatization was shown to be higher for older men here:

Effect of Testosterone Injections on Estradiol and DHT in Young and Older Men - ExcelMale

I think 0.25 mg per week of anastrozole makes sense for men whose conversion is above 0.3 percent (I think we should monitor estradiol like we do free T. Free T percent should be 2% of TT or above). DHT should be 10% of TT or above.​

 

[Nelson Vergel]

Role of T:E ratio in predicting the efficacy of recombinant HCG and T treatment in male hypogonadism

ABSTRACT Objective: We aimed to investigate the role of testosterone to estradiol ratio in predicting the effectiveness of human chorionic gonadotropin and testosterone treatments in male hypogonadism. Materials and methods: Thirty-six male patients with hypogonadotropic hypogonadism were...

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