The T:E Ratio - Evaluating My Numbers

[rhino5169]

Do you guys put credence into the ratio?
My E is 48 and listed as high.
My T is 1089 (normal).

Judging on numbers alone I should be on an AI but my E to T ratio means my E is low.
I still have all the symptoms of low E and it has remained that way since I started several months ago. I started with low E (8-10) and even though it increased along the way it increased in parallel with T, thereby still low, and as I said I have those symptoms.
I don't know what to do at this point.

 

[Vince Carter]

Low and high E symptoms are often very similar, except for joint pain being one sign of being low E, I wouldn't at all say 48 is low, it's not even really that high. Several months ago is still pretty early for things to flesh out in a new hormonal environment. Did you have the proper LC/MS/MS test for Estradiol?

 

[rhino5169]

I do.
Post # 23

https://www.excelmale.com/forum/showthread.php?10439-Labs-at-Six-Weeks-Little-Total-T-Improvement

 

[CoastWatcher]

Do you guys put credence into the ratio?
My E is 48 and listed as high.
My T is 1089 (normal).

Judging on numbers alone I should be on an AI but my E to T ratio means my E is low.
I still have all the symptoms of low E and it has remained that way since I started several months ago. I started with low E (8-10) and even though it increased along the way it increased in parallel with T, thereby still low, and as I said I have those symptoms.
I don't know what to do at this point.

I would never say that your estradiol in the situation referenced above is low, not under any circumstances. In my case, some years ago, the mid-40s was when I realized e2 was starting to challenge me. A month later I adjusted my injection schedule.

What at are your symptoms?

 

[rhino5169]

I would never say that your estradiol in the situation referenced above is low, not under any circumstances. In my case, some years ago, the mid-40s was when I realized e2 was starting to challenge me. A month later I adjusted my injection schedule.

What at are your symptoms?

No morning wood, night wood or daytime wood. I can get it going when I need to but it wont do it on its own and even when I do it's nowhere near where it should be.

 

[user_joe]

I'm kinda thinking there's a relationship, but it's not completely linear. For example, even if your tt was 1300, I'd expect symptoms with e2 of 48. If tt was much higher maybe not. E2 of 25 could be ideal at a tt of 750, but 35 is better with a tt of 1100. It's just kinda the way things have trended for me. I don't have enough blood tests to be positive.

I would experiment and treat based based on symptoms while keeping e2 in range or very close to it myself.

 

[CoastWatcher]

Erectile issues are, so often, multifaceted. They frequently persist after the rest of the benefits of a well designed TRT protocol have been realized. Estradiol levels can, and do, impede erectile function, but the issues can run deeper than your e2 levels (as many of us have found out).

 

[rhino5169]

Erectile issues are, so often, multifaceted. They frequently persist after the rest of the benefits of a well designed TRT protocol have been realized. Estradiol levels can, and do, impede erectile function, but the issues can run deeper than your e2 levels (as many of us have found out).

I totally get that, and thanks for discussing.
I want to give you a scenario that happened with me and maybe you can help me decipher the unknown.

Last summer before I was on trt I was taking supplements. My T was always in the range of 137 - 200ish.
I was taking creatine, citrulline, tribulis, Longjack from bulk supplements and a T booster I bought off amazon. I went through 3 or 4 "t boosters" before this and they were worthless.
I started taking this one along with the other things listed and felt a little something different withing a few days. Hard to explain, but since something was happening I decided to keep taking it.
I was taking basically double the amount reccomended of the t booster and the longjack.

Stuck with it for a while and I noticed I was feeling good after about a month. I have had very bad fatigue for a long time and after a month on these supplements I was doing yard work in 95* heat like I was 18 years old again. I had more energy than I knew what to do with. I was in an extremely good mood and I had wood like a lousiville slugger all throughout the day.

This lasted about 3 weeks until I ran out of the t booster then everything dissipated and went back to how I normally felt after a couple of weeks or even less.

Im not sure which supplement worked or if it was a combo of them all but it wasn't placebo effect as everything was night and day difference. You just dont go from being fatigued all the time to doing what I was doing.

Anyway, I started trt and was hoping to get back to that level but I haven't, not even close.
Im currently on thyroid meds as of 5 weeks ago. The tyroid med plus trt has me feeling a lot better than I was with more energy or I should say not so much energy as it is im just able to sustain a longer workday without being overly energetic.
I am nowhere near where I was for those 3 weeks though. It was awesome and that is actually when I realized how bad off I was and realized I was feeling like a normal person. That's when I started investigating trt seriously and proceeded to where im at now.

Im trying to figure out and get back to that 3 week awesomeness but it's a puzzle I cant seem to put together.
My T is high, my dht is high, my dhea is good, etc....now im looking at E and whether it's actually high, or not high enough.

 

[Mountain Man]

I totally get that, and thanks for discussing.
I want to give you a scenario that happened with me and maybe you can help me decipher the unknown.

Last summer before I was on trt I was taking supplements. My T was always in the range of 137 - 200ish.
I was taking creatine, citrulline, tribulis, Longjack from bulk supplements and a T booster I bought off amazon. I went through 3 or 4 "t boosters" before this and they were worthless.
I started taking this one along with the other things listed and felt a little something different withing a few days. Hard to explain, but since something was happening I decided to keep taking it.
I was taking basically double the amount reccomended of the t booster and the longjack.

Stuck with it for a while and I noticed I was feeling good after about a month. I have had very bad fatigue for a long time and after a month on these supplements I was doing yard work in 95* heat like I was 18 years old again. I had more energy than I knew what to do with. I was in an extremely good mood and I had wood like a lousiville slugger all throughout the day.

This lasted about 3 weeks until I ran out of the t booster then everything dissipated and went back to how I normally felt after a couple of weeks or even less.

Im not sure which supplement worked or if it was a combo of them all but it wasn't placebo effect as everything was night and day difference. You just dont go from being fatigued all the time to doing what I was doing.

Anyway, I started trt and was hoping to get back to that level but I haven't, not even close.
Im currently on thyroid meds as of 5 weeks ago. The tyroid med plus trt has me feeling a lot better than I was with more energy or I should say not so much energy as it is im just able to sustain a longer workday without being overly energetic.
I am nowhere near where I was for those 3 weeks though. It was awesome and that is actually when I realized how bad off I was and realized I was feeling like a normal person. That's when I started investigating trt seriously and proceeded to where im at now.

Im trying to figure out and get back to that 3 week awesomeness but it's a puzzle I cant seem to put together.
My T is high, my dht is high, my dhea is good, etc....now im looking at E and whether it's actually high, or not high enough.

Some t boosters are laced with pde5 inhibitors to give them their punch, part of the "proprietary blend." Having erections may have given you a placebo effect, and thus more energy. This is a common ploy among those that make t boosters. T boosters are a joke, they never work on their own, studies prove this. Why not add a pde5 and see how it goes?

 

[CoastWatcher]

I totally get that, and thanks for discussing.
I want to give you a scenario that happened with me and maybe you can help me decipher the unknown.

Last summer before I was on trt I was taking supplements. My T was always in the range of 137 - 200ish.
I was taking creatine, citrulline, tribulis, Longjack from bulk supplements and a T booster I bought off amazon. I went through 3 or 4 "t boosters" before this and they were worthless.
I started taking this one along with the other things listed and felt a little something different withing a few days. Hard to explain, but since something was happening I decided to keep taking it.
I was taking basically double the amount reccomended of the t booster and the longjack.

Stuck with it for a while and I noticed I was feeling good after about a month. I have had very bad fatigue for a long time and after a month on these supplements I was doing yard work in 95* heat like I was 18 years old again. I had more energy than I knew what to do with. I was in an extremely good mood and I had wood like a lousiville slugger all throughout the day.

This lasted about 3 weeks until I ran out of the t booster then everything dissipated and went back to how I normally felt after a couple of weeks or even less.

Im not sure which supplement worked or if it was a combo of them all but it wasn't placebo effect as everything was night and day difference. You just dont go from being fatigued all the time to doing what I was doing.

Anyway, I started trt and was hoping to get back to that level but I haven't, not even close.
Im currently on thyroid meds as of 5 weeks ago. The tyroid med plus trt has me feeling a lot better than I was with more energy or I should say not so much energy as it is im just able to sustain a longer workday without being overly energetic.
I am nowhere near where I was for those 3 weeks though. It was awesome and that is actually when I realized how bad off I was and realized I was feeling like a normal person. That's when I started investigating trt seriously and proceeded to where im at now.

Im trying to figure out and get back to that 3 week awesomeness but it's a puzzle I cant seem to put together.
My T is high, my dht is high, my dhea is good, etc....now im looking at E and whether it's actually high, or not high enough.

I believe you did have a response to your t-booster(s), it was unlikely to have been placebo. But I believe it may well have been, as Mountain Man said, the result of those boosters being laced with pde5 drugs (Cialis, Viagra). It's far too common a situation, and occasionally the FDA manages to test these substances and confirm their presence. In no cases has anyone ever been able to demonstrate increased testosterone levels, only some improved erectile function.

Mountain Man's advice is on point: add Cialis, Viagra, or Levitra to the protocol and see how you respond. Have you giv n any thought to Gene's nitric oxide stack?

 

[rhino5169]

I already take cialis every day / other day. Viagra sometimes before something planned.
I have done a version of genes stack for years.
So it's not a placebo effect.
I know my body well and I know that after years of chronic fatigue that pde5 inhibitors dont cause the effect I had, not on me anyway.

I do believe that its possible the booster was laced with something, it was a liquid booster so maybe a sarm. I just dont know what it was, if I did I could figure out what I could do to recreate the effect properly.

I really am stumped and dont know which direction to go in. Im not sure if I should try to raise, or lower E, or if it's something else altogether.
What I do know is that even with my conditions, it is possible for me to be 95-100% if I can find the right formula, because that's where I was at last August.
Very frustrating.

 

[madman]

I totally get that, and thanks for discussing.
I want to give you a scenario that happened with me and maybe you can help me decipher the unknown.

Last summer before I was on trt I was taking supplements. My T was always in the range of 137 - 200ish.
I was taking creatine, citrulline, tribulis, Longjack from bulk supplements and a T booster I bought off amazon. I went through 3 or 4 "t boosters" before this and they were worthless.
I started taking this one along with the other things listed and felt a little something different withing a few days. Hard to explain, but since something was happening I decided to keep taking it.
I was taking basically double the amount reccomended of the t booster and the longjack.

Stuck with it for a while and I noticed I was feeling good after about a month. I have had very bad fatigue for a long time and after a month on these supplements I was doing yard work in 95* heat like I was 18 years old again. I had more energy than I knew what to do with. I was in an extremely good mood and I had wood like a lousiville slugger all throughout the day.

This lasted about 3 weeks until I ran out of the t booster then everything dissipated and went back to how I normally felt after a couple of weeks or even less.

Im not sure which supplement worked or if it was a combo of them all but it wasn't placebo effect as everything was night and day difference. You just dont go from being fatigued all the time to doing what I was doing.

Anyway, I started trt and was hoping to get back to that level but I haven't, not even close.
Im currently on thyroid meds as of 5 weeks ago. The tyroid med plus trt has me feeling a lot better than I was with more energy or I should say not so much energy as it is im just able to sustain a longer workday without being overly energetic.
I am nowhere near where I was for those 3 weeks though. It was awesome and that is actually when I realized how bad off I was and realized I was feeling like a normal person. That's when I started investigating trt seriously and proceeded to where im at now.

Im trying to figure out and get back to that 3 week awesomeness but it's a puzzle I cant seem to put together.
My T is high, my dht is high, my dhea is good, etc....now im looking at E and whether it's actually high, or not high enough.

Those supplements you were taking the so called test boosters are supposed to enhance ones endogenous production and you are still naturally producing some testosterone let alone lh even though your natural levels were low. Exogenous testosterone is not going to mimic how you felt taking the supplements that supposedly boosts ones natural t as there are many other factors involved especially when shutting yourself down from exogenous t. Night/morning wood are the same happens during deep rem sleep and if there are some times you do not wake up with morning wood you may have waken up in a later stage of sleep. Spontaneous erections are not always related to testosterone.

 

[madman]

Some t boosters are laced with pde5 inhibitors to give them their punch, part of the "proprietary blend." Having erections may have given you a placebo effect, and thus more energy. This is a common ploy among those that make t boosters. T boosters are a joke, they never work on their own, studies prove this. Why not add a pde5 and see how it goes?

Agree with this!

 

[rhino5169]

Agree with this!

Agreed, but like I said I take pde5 meds and they help mildly, they are definitely not the reason I was feeling great though.

 

[Vince Carter]

~40 is about the spot where some say it's fine, as a number, but if there are symptoms, then it's an issue. *IF* you decided you wanted to try and bring it down, be very cautious with any AI, like .10mg once per week, perhaps. But no more than E3.5D, E is a very fickle thing and Anastrozole is rather powerful. Keep everything else static and stable so you can evaluate the AI use, if you do it.

Would you characterize your main issue as, libido/interest being poor accompanied with ED or is it just the physical ED that's a problem for you? I think the two things get lumped together when maybe they should be evaluated separately.

 

[rhino5169]

Thanks VC.

Libido and interest is about a 7.5 on a 10 scale. Im fine with that for now. I think that will go to a 10 when I get to where I should be because it was a 10 for those 3 weeks or so last august.
It's the physical part I need to work on.

You describe bringing my E down, but see that is where im confused. Do I try down or do I try to bring it up?
As a standalone number 48 is rated high, but using the ratio it is under the scale (54 - 77).

How do I know which way to go, because if I go the wrong way then im actually making things worse.

 

[rhino5169]

Im going to try and figure this out from a different direction.

Here is my question:
What causes the "smell"?
By smell, I mean not in a bad way but like a musky scent. As my wife commented during those 3 weeks last year she said I smelled more manly.

I have never had that musky scent in my life and I haven't had it since. I had it when everything lined up and I was feeling great.

Can it be testosterone as i've heard some say. I dont know now because my T is 1089.
DHT? Agian my DHT is very high, and same with DHEA.

So what is left for me to look at. I feel if I figure out what causes the smell I can then figure out what im missing.

Thoughts?

 

[Nelson Vergel]

Do you guys put credence into the ratio?
My E is 48 and listed as high.
My T is 1089 (normal).

Judging on numbers alone I should be on an AI but my E to T ratio means my E is low.
I still have all the symptoms of low E and it has remained that way since I started several months ago. I started with low E (8-10) and even though it increased along the way it increased in parallel with T, thereby still low, and as I said I have those symptoms.
I don't know what to do at this point.

Your ratio is 22
I would not do a thing.

How do you feel? Sorry to jump in late.

Is Testosterone to Estradiol Ratio Important in Men?

 

[Nelson Vergel]

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

 

[rhino5169]

Your ratio is 22
I would not do a thing.

How do you feel? Sorry to jump in late.

Is Testosterone to Estradiol Ratio Important in Men?

Thanks for jumping in Nelson, was hoping you would.
So if you wouldn't do a thing with E, what do I look at next.

How do I feel?
See post # 5 and i'll add this:
Pre trt was horrible, was a 1 on a 10 scale.
On trt for a while and felt / feel better, maybe a 4-5. Then we added natural thyroid and that made me feel even better, energy wise. Not that im running a marathion but more like my day is extended. Instead of dragging my ass from 3pm on, and in bed at 7pm, im fine all day and up until 10pm without any real fatigue like I used to have.

There is definitely room for improvement though as im eating and gaining weight instead of losing weight and building muscle. That is more related to diet but I feel I should be better. Mood wise im better than I was but not where I should be.
Libido is ok, but could be better.
Spontaneous wood is non existent, and when it is there (with help) nowhere as hard as should be and was last august.