Imbalance of testosterone/estradiol promotes male CHD development

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I recently came across this article. It's not new, but the search function doesn't turn up previous discussions about it on ExcelMale.

Imbalance of testosterone/estradiol promotes male CHD development​

Abstract
Objective: Testosterone is either neutral or has a harmful effect on the male cardiovascular system. But the role of imbalance of testosterone (T) and estrogen (E2) (T/E2 ratio) in male CHD has been less studied. This study was carried out with the purpose of evaluating the relationship between T/E2 ratio and CHD.​
Methods: Fifty-five male CHD patients (aged 61.25 ± 3.44) and 60 age-matched controls (aged 59.54 ± 1.44) were selected in this research.​
Results: Compared with control group, levels of both serum T and E2 decreased, but only E2 had statistical significance (P=0.001). The normal testosterone (T)/estradiol (E2) ratio is 1.7 ± 0.12, but the ratio of T/E2 (3.28 ± 0.58) changed significantly in men with CHD group (P<0.05). With the imbalance of T/E2 ratio in CHD group, we further used a linear and multiple regression methods to analyze the correlation between sex hormones and CHD risk factors. The results showed serum T was positively associated with TG (r=0.439, P<0.01) and D-dimer (r=0.258, P<0.05), but negatively associated with HDL-C (r=-0.267, P<0.05) and Hs-CRP (r=-0.214, P<0.05). However, E2 was highly positive associated with TG (r=0.783, P<0.01) and HDL-C (r=0.515, P<0.01), but was negative related with LDL-C (r=-0.219, P<0.05), TC/LDL (r=-0.236, P<0.05) and D-dimer. Multiple linear regression method also showed the same results between E2 and HDL-C (P=0.020), LDL-C (P=0.000), which showed E2's protective role in cases. However, T/E2's effect is more significative than E2's, and the values between T/E2 and index are HDL-C (r=-0.624, P<0.01), LDL-C (r=0.348, P<0.01), TC/HDL (r=0.237, P<0.05), Hs-CRP (r=0.248, P<0.05) and D-dimer (r=0.249, P<0.05). Multiple linear regression method also showed the positive relationship between T/E2 and HDL-C (P=0.000), D-dimer (P=0.000), and negative relationships between T/E2 and TC (P=0.000), TG (P=0.000) or HDL/LDL (P=0.000).​
Conclusion: The balance of T/E2 ratio, rather than the absolute levels of androgens, is crucial in modulating the effect of androgens on CHD in males.​

It's some food for thought for guys with high testosterone who might use AIs to push estradiol down to "normal".
 
Defy Medical TRT clinic doctor
I recently came across this article. It's not new, but the search function doesn't turn up previous discussions about it on ExcelMale.

Imbalance of testosterone/estradiol promotes male CHD development​

Abstract
Objective: Testosterone is either neutral or has a harmful effect on the male cardiovascular system. But the role of imbalance of testosterone (T) and estrogen (E2) (T/E2 ratio) in male CHD has been less studied. This study was carried out with the purpose of evaluating the relationship between T/E2 ratio and CHD.​
Methods: Fifty-five male CHD patients (aged 61.25 ± 3.44) and 60 age-matched controls (aged 59.54 ± 1.44) were selected in this research.​
Results: Compared with control group, levels of both serum T and E2 decreased, but only E2 had statistical significance (P=0.001). The normal testosterone (T)/estradiol (E2) ratio is 1.7 ± 0.12, but the ratio of T/E2 (3.28 ± 0.58) changed significantly in men with CHD group (P<0.05). With the imbalance of T/E2 ratio in CHD group, we further used a linear and multiple regression methods to analyze the correlation between sex hormones and CHD risk factors. The results showed serum T was positively associated with TG (r=0.439, P<0.01) and D-dimer (r=0.258, P<0.05), but negatively associated with HDL-C (r=-0.267, P<0.05) and Hs-CRP (r=-0.214, P<0.05). However, E2 was highly positive associated with TG (r=0.783, P<0.01) and HDL-C (r=0.515, P<0.01), but was negative related with LDL-C (r=-0.219, P<0.05), TC/LDL (r=-0.236, P<0.05) and D-dimer. Multiple linear regression method also showed the same results between E2 and HDL-C (P=0.020), LDL-C (P=0.000), which showed E2's protective role in cases. However, T/E2's effect is more significative than E2's, and the values between T/E2 and index are HDL-C (r=-0.624, P<0.01), LDL-C (r=0.348, P<0.01), TC/HDL (r=0.237, P<0.05), Hs-CRP (r=0.248, P<0.05) and D-dimer (r=0.249, P<0.05). Multiple linear regression method also showed the positive relationship between T/E2 and HDL-C (P=0.000), D-dimer (P=0.000), and negative relationships between T/E2 and TC (P=0.000), TG (P=0.000) or HDL/LDL (P=0.000).​
Conclusion: The balance of T/E2 ratio, rather than the absolute levels of androgens, is crucial in modulating the effect of androgens on CHD in males.​

It's some food for thought for guys with high testosterone who might use AIs to push estradiol down to "normal".
The ratio has me confused.

Looking at one of my tests, Total T = 1067ng/dl: E2 25.2 pg/ml so how do I calc the ratio?
 
The ratio has me confused.

Looking at one of my tests, Total T = 1067ng/dl: E2 25.2 pg/ml so how do I calc the ratio?
This is a little frustrating, i have come across 3 different T/E units/scales, and the studies never show the formula.

For example here ideal ratio 12:

And then there are calculators online that give in your case a number of around 400
 
The ratio has me confused.

Looking at one of my tests, Total T = 1067ng/dl: E2 25.2 pg/ml so how do I calc the ratio?
Personally I prefer the E2/T ratio, either by weight or molar concentration. In any case, this study appears to use T in ng/dL divided by (10 times E2 in pg/mL). No explanation why—perhaps just to make nice numbers. Controls had T = 611.42 and E2 = 36.35. CHD cases had T = 522.44 and E2 = 20.73. I assume the ratios were calculated before averaging, so the ratio of the averages is not equal to the average of the ratios. That is, in the CHD group 522.44 / 10 / 20.73 = 2.52, which is different from the stated ratio of 3.28.

Looking at their results as E2/T, the control is 0.59%, while the CHD group is 0.30%. I've been giving a normal range for E2/T as something like 0.3-0.6%, so their control does seem to be on the high side. It's probably best not to focus too hard on the absolute numbers. Instead the message is that less estradiol relative to testosterone is associated with CHD.

Your T/E2 ratio by the study method is 4.23, worse than the CHD average. Your E2/T ratio is 0.24%. Either way your ratio is skewed towards testosterone, possibly increasing your risk. You might check the same lab markers they used, and worry less if they are ok.

Full study attached for your viewing pleasure.
 

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The only
Personally I prefer the E2/T ratio, either by weight or molar concentration. In any case, this study appears to use T in ng/dL divided by (10 times E2 in pg/mL). No explanation why—perhaps just to make nice numbers. Controls had T = 611.42 and E2 = 36.35. CHD cases had T = 522.44 and E2 = 20.73. I assume the ratios were calculated before averaging, so the ratio of the averages is not equal to the average of the ratios. That is, in the CHD group 522.44 / 10 / 20.73 = 2.52, which is different from the stated ratio of 3.28.

Looking at their results as E2/T, the control is 0.59%, while the CHD group is 0.30%. I've been giving a normal range for E2/T as something like 0.3-0.6%, so their control does seem to be on the high side. It's probably best not to focus too hard on the absolute numbers. Instead the message is that less estradiol relative to testosterone is associated with CHD.

Your T/E2 ratio by the study method is 4.23, worse than the CHD average. Your E2/T ratio is 0.24%. Either way your ratio is skewed towards testosterone, possibly increasing your risk. You might check the same lab markers they used, and worry less if they are ok.

Full study attached for your viewing pleasure.
Thanks, you would think they would spell that out, but I haven't read the full study yet.

The only way I could get my E2 higher would be to supplement E2. My E2 has been been very high vs T.
 
The only

Thanks, you would think they would spell that out, but I haven't read the full study yet.

The only way I could get my E2 higher would be to supplement E2. My E2 has been been very high vs T.
Are you saying your ratio has changed to be less estrogenic than before? Are you still on 1000mg undecanoate and how long after the shot were those numbers taken?
On the last trt run i also seemed to have problems aromatizing, even though i have fat, pretty fucked up. Makes you wonder if the body is regulating for some reason, or would dhea or straight estradiol valerate be cardio protective if you're not making enough...
 
Last edited:
Beyond Testosterone Book by Nelson Vergel
Are you saying your ratio has changed to be less estrogenic than before? Are you still on 1000mg undecanoate and how long after the shot were those numbers taken?
On the last trt run i also seemed to have problems aromatizing, even though i have fat, pretty fucked up. Makes you wonder if the body is regulating for some reason, or would dhea or straight estradiol valerate be cardio protective if you're not making enough...
After looking at my post, I should have said my E2 has always been low in comparison to the amount of T. This is true no matter what protocol, TC, cream or undecanoate.

In all the tests I have ever done, only once has my E2 been over range. In 2018 I had a tot T of 1389 and E2 of 56.2. That was so unusual for me, I thought it might be a lab error. A year after that another test when my T was 1492 my E2 was 32.6.

Basically I am at 2-3% of total T showing up as E2.

Only clomid raised my E2 higher than expected, but still under the top of the range.

EDIT: This also includes when my weight at 190 - 140, fat didn't seem to change anything about E2.
 
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