How to Predict Estradiol and DHT at Different Testosterone Doses

[Nelson Vergel]

Spyro didn't work

Spyro? What is it?

 

[Cataceous]

Spyro? What is it?

He's a spammer. He copied the post from a trans thread here and tacked on a link, which I had deleted. Probably best to just ban him and delete his and our posts 40-43, which are not helpful to the thread...

 

[Nelson Vergel]

Lol ah ok. Remember it is an androgen blocker.

I prefer chlorthalidone twice per week.

 

[Nelson Vergel]

Relation of Testosterone, Dihydrotestosterone, and Estradiol With Changes in Outcomes Measures in the Testosterone Trials - PubMed

Change in estradiol level was the best predictor not only of the change in vBMD and sexual desire but also of the changes in hemoglobin and HDL cholesterol. Consideration of testosterone, estradiol, and DHT together offers a superior prediction of treatment response in older hypogonadal men than...

pubmed.ncbi.nlm.nih.gov

 

[jacb]

Thanks for catching that. Table is OK though. There is something else no one has noticed but I will see who does first.

Would it be the percentage values of E2 to TT?

EG: at 275 TT the "Percent E2 of TT" is shown as 0.79%, should that not be 7.9% etc?

Maybe I am being crazy ... not sure about this?

 

[Cataceous]

Would it be the percentage values of E2 to TT?

EG: at 275 TT the "Percent E2 of TT" is shown as 0.79%, should that not be 7.9% etc?

Maybe I am being crazy ... not sure about this?

You must make the units match before calculating the ratio in percent. Testosterone of 275 is measured in ng/dL. Estradiol of 21.8 is measured in pg/mL. To convert pg/mL to ng/dL you divide by 10. So total estradiol is 2.18 ng/dL, and the E2/T ratio is 0.0079, or 0.79%.

 

[MDavidW76]

Hmm
My E2 is quite high 96pg/dL with Total T is 1012ng/dL, my Free T is 26.7pg/mL, SHBG 20.4nmol/L.

Math: (9.6/1012) x 100 = 0.968

So I’m aromatizing almost 1% of my total T into Estradiol…

My doctor has given me a blank slate for blood tests to be run, I’m looking for the whole package… I’m going to search around the posts to see what all I can cram into a list for him.

 

[Nelson Vergel]

My E2 is quite high 96pg/dL

Is this sensitive (LC/MS) estradiol or ECLIA-based?

My doctor has given me a blank slate for blood tests to be run, I’m looking for the whole package… I’m going to search around the posts to see what all I can cram into a list for him.

Here are a few possibilities depending on how much out-of-pocket you are willing to pay the clinic or as a insurance copay:

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[MDavidW76]

Is this sensitive (LC/MS) estradiol or ECLIA-based?


Here are a few possibilities depending on how much out-of-pocket you are willing to pay the clinic or as a insurance copay:

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Shop for male hormone tests online, bodybuilder test panels, other blood tests and much more. For more information on testing specifics, browse the full DiscountedLabs.com catalogue today!

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This year (01/15/22 10:30 am)
96 pg/mL (H)
Methodology: Roche ECLIA methodology
Performed at: SPOWA - Labcorp Spokane

Last year (05/22/21 7:58 am)
83.7 pg/mL (H)
Methodology: Liquid chromatography tandem mass spectrometry(LC/MS/MS)
Performed at: SPOWA - LabCorp Spokane

I forgot to remind my Dr to order the LC/MS - that’s part of why I’m going to do new labs.

 

[Nelson Vergel]

 

[Ribeye]

I was able to come up with a table using the predictive model equation derived from data in this study:

The Effects of Injected Testosterone Dose and Age on the Conversion of Testosterone to Estradiol and Dihydrotestosterone in Young and Older Men

The graphs shown in the study (They injected several doses of testosterone enanthate in young and older men) show sensitive estradiol and DHT at different total testosterone blood levels. The curves reach a pseudo plateau at higher TT levels. Older men tended to produce more estradiol and DHT than younger men.

View attachment 9467

The equation I used was based on a mathematical model shown in this study that included variables calculated from Michaelis-Menten kinetics.

For older men:

E2 (regular immunoassay- not sensitive)= 138.3xTT/(1470.1+TT)

DHT = 269.4xTT/(2389.6+TT)

TT= Total Testosterone

Here is the table I came up with for older men

Of course, as you can see from the graphs above, there is a lot of variability in values, so these predicted numbers are just representing the curve.

View attachment 9472
Since these estradiol values were immunoassay-based, sensitive (LC/MS) values would be lower. How much lower? We don't know since CRP values were not measured. I would multiply the estradiol numbers in the above table by 0.80 to arrive at a guess for sensitive estradiol values.


These were the baseline characteristics of both groups before they received testosterone enanthate injections. Both groups seemed relatively lean to me.

View attachment 9470

Treatment protocol:

View attachment 9471


MAIN MESSAGE: ESTRADIOL AND DHT "NORMAL RANGES" SHOWN BY LABCORP OR QUEST ARE DERIVED FROM MEN WHO DO NOT HAVE HIGH TESTOSTERONE. MANY MEN ON TRT USUALLY HAVE "HIGHER" TESTOSTERONE THAN "NORMAL", SO THOSE RANGES DO NOT APPLY TO THEM. STOP OBSESSING!

So, I am wondering why my estradiol numbers are so far above the reference, considering and test report confirms the sensitive test used. While I didn't get DHT measured, I would assume with topical cream applied to the scrotum, a substantial rate of conversion directly to DHT. It would seem, that having fairly robust free and total T, that I may be getting some aromatization occurring changing T over to Estradiol. But not sure that can account for the amount of estradiol? On the other hand, it appears that estradiol in the face of higher T and free T, doesn't cause gynecomastia, can't find it in the literature. If it does not interfere with erectile function, isn't giving me any other symptoms, should I be that concerned?

 

[Ribeye]

High Estradiol in Men: Myths and Realities

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this really adds clarity! thank you.

 

[Nelson Vergel]

this really adds clarity! thank you.

You are welcome.

It saddens me that week after week during the past 14 years we get posts from men who are concerned that their estradiol is high since the LabCorp and Quest ranges really apply for men not on TRT who usually do not have "high" testosterone levels.

 

[tareload]

You are welcome.

It saddens me that week after week during the past 14 years we get posts from men who are concerned that their estradiol is high since the LabCorp and Quest ranges really apply for men not on TRT who usually do not have "high" testosterone levels.

@Nelson Vergel that is a good point and quite different than stating that healthy young men not on TRT would often/typically run an E2 70 pg/ml or higher. As shown below, if many of these guys on TRT/TOT have a TT/fT AUC much higher than their counterparts inside the physiologic range, then there's no reason why they wouldn't also have E2 levels above the physiologic range.





Summary of information from director of “popular/leading” TRT/TOT clinic. This ellipse covers vast majority of the patients (>10,000 patients). Median dosing is 140 mg/week (range is 100 to 180 mg/week for most). You can see what that means in terms of mean TT levels (about half in range and the other half above range for mean TT). This graph collapses all the dosing strategies (E7D, E3.5D, EOD, ED) onto one plot using approach I shared previously:

	mean/trough ratio	peak/trough ratio	peak/mean ratio	check math
q7d	1.60	2.13	1.33	1.33
q3.5d	1.20	1.40	1.10	1.17
qod	1.09	1.14	1.05	1.05
qed	1.03	1.05	1.02	1.02

After a lot of argue with Danny Bossa (and to be fair and unbiased once I had the data) I wanted to share this plot as it shows many many guys are running supra at some point or all of the week and seeming to do well. Long term who knows. I respect the MD I got this info from so you can see the median is very close (140 mg/week) to Danny’s touted starting dosage of 150 mg/week. This provider is not running his patients to fT levels of 30-50 or 50+ ng/dl but there are a good fraction running up to 30 ng/dl.

 

[Jerajera]

What am I missing here?

If you take a TT of 1,000ng/dL, the formula for young men gives an E2 of approximately 33pg/mL, while the formula for older men gives an E2 of ~55pg/mL, almost double that of young men.

Has anyone actually run those numbers and compared them?

To me this could be evidence that the much higher ratio of E2 to TT is a significant reason older men don't feel as good as younger men. Actually if you look at the table in the OP, the older men's ratio of E2 to TT is double that of younger men's, 0.8 vs 0.4.

An obvious culprit could be the significant bodyfat percentage difference between old and young men. But that assumes a specific causal relationship in the direction of higher BF -> higher E2.

I'm not sure that's completely accurate. What if it was higher E2 -> higher BF -> higher E2 -> ...

I don't know about you but when I was 20yo I didn't have to work out or watch my diet to be lean. Now I have to work out like an animal to stay around 12% BF even on TRT.

I'm not sure I understand how the message here is "don't worry about E2". To me, the message looks more like "younger men have half the E2 of their older counterparts at equivalent TT levels, and that's probably the reason they feel a million times better on average"

 

[Nelson Vergel]

Responses of different doses of testosterone injections on body composition, strength, etc.

Comment: 125 mg per week was the lowest dose that provided statistically significant changes in lean body mass and fat mass. PAPER ATTACHED Testosterone dose-response relationships in healthy young men. Bhasin S, et al. Am J Physiol Endocrinol Metab. 2001 Dec;281(6):E1172-81. Full paper...

www.excelmale.com

 

[JessicaWalker]

Thanks for the tabla)