Very high Test/E2 ratio bad?

canatct

New Member
Hi all. I'm on Dr prescribed Test Cypionate, HCG, and Anastrozole. My last 2 labs have shown high T/E2 ratios.

From a couple months ago;

Total T 731 (348-1197)
Free T 18.9 (7.2-24)
Sensitive E2 9.5 (8.0-35)


Last week;

Total T 771
Free T 18.5
Sensitive E2 13.4


Ratios are 77/1 and 58.9/1.

Blood was drawn in the tough.
I'm scheduled for a follow up with the Dr later this week and just wanted to get some opinions on this.
I don't know if my Dr would allow me to post my protocol on here, but I'm taking less of all 3 than most people that post here.
 
I would stop or lower the dose of anastrozole (after discussing with your doctor) to see if you can get your estradiol to increase. Estradiol under 20 pg/mL has been associated with increased fat gain and bone loss.
 
I would stop or lower the dose of anastrozole (after discussing with your doctor) to see if you can get your estradiol to increase. Estradiol under 20 pg/mL has been associated with increased fat gain and bone loss.

Thanks Nelson. In Sept/2014 when my Total T was 395 my E2 was 16.5. Should one expect their base E2 to increase somewhat when on TRT? Is the T/E2 ratio important?
 
If that was your pre-TRT T level and estradiol, I do not see why any doctor would put you on anastrozole. Did he/she put you on anastrozole at the start of TRT? Or after 6-8 week follow up?

Yes, T/E2 ratio is important but E2 alone should not be low to increase that ratio. Increasing T while keeping E2 at 20-50 pg/mL should be the goal.
 
I was put on Anastrozole when labs showed my E2 got up to 54. I have never experienced nipple itch/sensitivity but my face would look bloated and ED (sometimes bad) for a few days after injecting. Does keeping E2 20-50 apply to everyone, or is it possible some are more sensitive?
 
Some can definitely be more sensitive to the effects of E2. Some people can experience issues if there E2 goes up or down just a few points. It just depends. Like Nelson said, I would definitely talk with your dr. about lowering the anastrozole dosage. It sounds like you might have just overshot the amount needed to control your E2.
 
canatct

Did you face look less puffy and/or your ED get better after starting anastrozole?

Yes the swelling in the face went away and helped with ED too. I've read that low E2 symptoms are similar to high E2, but I've been able to perform great sexually with E2 in the teens. I do notice popping in the knees and some kidney pain at times but that's it.
 
One more thing worth mentioning. I have a prescription of 1mg Anastrozole tablet from the local pharmacy that I cut into quarters and I also have a prescription of compounded .25mg capsules, and I really believe the capsules are not as potent as the pills I quarter.
 

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⚠️ 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.

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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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