t/e2 ratio off optimal ratio

[Rude]

Hello guys, been suffering with symptoms of low t even though the last test I had last year I was "in range". I have been doing research trying to figure out what could be wrong, I had originally thought I had high e2 but was in range. But while doing my research I can across these 2 threads and have questions to ask regarding that. I believe the optimal ratio of t by e2 would be 14 to 20 according to nelsons posts. On my last test my total test was 552 (range 292-1052) and my e2 (estradiol) was 20.2 (10-42). dividing them gives me 27.3 which is not in in the ratio. What would this number indicate?

This coming week I will be getting a full test over all the essentials and I will post the results. This is the thread I am referring too. I see people being under the ratio of 14 but have yet to find a post of being over the ratio of 20, so have no clue on what is wrong with me.
edit: it wont let me post links, im referring to the "should I worry about this E2 level"

Thank you guys for your time, any advice is appreciated!

 

[Vince Carter]

Typically in the T:E ratio concept you're going to see much higher E2 (sensitive LC/MS/MS method) values, technically elevated/high levels if your can believe lab ranges.
For instance my latest tests were 933:58 (or there about)...that's a rather high E2 reading, yet is a "16" in the 14-20 scale.

I was having next to no negatives with that, either, just some hot flashes the night of my HGC injection (which I was using too much and have since returned to 500iu 2x week)

 

[CoastWatcher]

I would urge you not to stress of become too anxious in regard to the T:E ratio. This is a guideline - a very, very valuable guideline - that can help you manage your estradiol levels. But don't tie yourself in knots over it. What I've found is that relying on the ratio gives me a certain freedom in allowing my estradiol to drift a bit higher than I once thought was possible. I monitor my body's response, back it up with lab work, and manage things calmly. I learned that when my E2 climbs beyond the low 40s, I am not as responsive sexually as I'd like. With my high testosterone, in excess of 1000, it should be able to go higher...according to the ratio. It can't. But it can go higher than the lab test's normal readings. Be flexible.

 

[ERO]

Your blood work shows you basically still almost have have "Low T" with a Total T of 552. Most guys do not start to feel good on TRT until they get to a Total T of 700 or more. So instead of worrying about your E2 number right now, I would look to increase your T dosage and make sure you are dosing twice weekly instead of once weekly to start.

Oh and by the way, a T:E ratio over 20 indicates low E2, not high E2. As CoastWatcher pointed out, a very reliable guideline, but a guideline none the less.

 

[Vince Carter]

Your blood work shows you basically still almost have have "Low T" with a Total T of 552. Most guys do not start to feel good on TRT until they get to a Total T of 700 or more. So instead of worrying about your E2 number right now, I would look to increase your T dosage and make sure you are dosing twice weekly instead of once weekly to start.

Oh and by the way, a T:E ratio over 20 indicates low E2, not high E2. As CoastWatcher pointed out, a very reliable guideline, but a guideline none the less.

That's a very good observation.

 

[CoastWatcher]

Your blood work shows you basically still almost have have "Low T" with a Total T of 552. Most guys do not start to feel good on TRT until they get to a Total T of 700 or more. So instead of worrying about your E2 number right now, I would look to increase your T dosage and make sure you are dosing twice weekly instead of once weekly to start.

Oh and by the way, a T:E ratio over 20 indicates low E2, not high E2. As CoastWatcher pointed out, a very reliable guideline, but a guideline none the less.

Excellent points - what is your protocol?

 

[Rude]

Thanks for all the reply's! I am not currently on a trt protocal at the moment, I have sexual issues for many now since doing a minor cycle of anavar in my early 20's. Here is what I posted on another board, copy and paste. This lab was from last year, appointment this coming week for update.
_______

Ok last year I had my labs taken and everything was "in range" but the clinic did not take a few important labs such as SBGH, Free t, T3 free and reverse, DHT. I am going back to them and redoing my labs with these additional tests to see if we can find an answer as to what is wrong. The doctor wanted to send me to a sexual therapist but it is not a mental thing, I have failed to get an adequate erection with quite a few girls and I can't even get a full erection during masturbation, last morning wood I had was maybe 5 months ago.

I live in a small town and this doctor is the only anti aging clinic in the whole area for about 4 hours. If my new labs show something questionable how would be the most reasonable way to have him allow me a run on trt before he tries to send me to a therapist again? It's been so many years since I have felt normal, its crossing my mind to do trt on my own but I know that is the wrong decision overall. Any advice would greatly be appreciated. I am placing my previous labs here from last year to see if you guys see anything I could discuss with him before our actual appointment. All symptoms are still there and some have worsened.
___________________

Im 32 years old, did a **************** when I was 21 and since then not the same sexually or mentally. I am fit, good diet, exercise regularly, social drinker.

Here is my results Expected
FSH +LH profile 5.5 MIU/ML 1.3-11.4
Luteinizing Hormone 6.1 MIU/ML 1.2-7.8
Hemoglobin 5.3% 4.0-5.6
Prolactin 5.0 NG/ML 3.0-30.0
Testosterone 552 NG/DL 292-1052
TSH 1.6 UIU/ML 0.5-4.7
Estradiol 20.2 pg/ML 10-42
Estrone 18.1 pg/ML 9-36
Total Estrogens 38.3 pg/ML 19-69
PSA 0.6 <4.0
free psa 0.30
% free psa 50
Lipid Panal
Cholesterol 190 MG/DL <200
Triglycerides 55 MG/DL <150
HDL Cholosterol 77 MG/DL >39
Calculatd LDL Chol 102 MG/DL <100
Risk Ratio LDL/HDL 1.32 Ratio <3.55

Symptoms (from other thread)
1. My balls for the first few years shrunk and fluctuate during the day to different sizes (still smaller then what they once were). When I ejaculate my balls literally disappear for a few minutes. Also if I have to do the restroom (#2) my balls will shrivel away until after I have gone to the restroom.

2. No morning wood, I rarely have morning wood, I may have it once every 2 to 3 months, obviously when I was younger had nearly everyday.

3. Weak erections that cant be maintained, poor orgasms, and lack of drive. When I ejaculate my erection litterer will be gone during orgasm

4. Very emotional! I feel like a women on PMS, I cry at movies, tv shows, etc, get moody over the littlest things.

5. Memory Fog, I will say something then forget it a minute later, same for writing things, if I go somewhere I will forget why I even went at times.

6. No facial or body hair (all though I assume this is just genetic)

7. Lack of drive, dont care to do anything.

 

[Nelson Vergel]

Rude

Your blood tests are actually pretty good. Are you sure you do not have sleep or depression issues unrelated to your hormones? You may have low dopamine and/or serotonin.

Do you have a primary care physician? I would at least consider talking about Wellbutrin with him/her.

 

[Rude]

Rude

Your blood tests are actually pretty good. Are you sure you do not have sleep or depression issues unrelated to your hormones? You may have low dopamine and/or serotonin.

Do you have a primary care physician? I would at least consider talking about Wellbutrin with him/her.

That is what baffles me the most that my labs are good, getting additional tests of sbgh, free test, dht, etc cuz I cant perform in the bedroom or even masturbate without going limp or at full erection. I dont suffer from sleep or depression issues, very happy person only thing that stresses brings me down is the ED issues.

 

[Nelson Vergel]

Rude:

These are symptoms of depression:

Very emotional! I feel like a women on PMS, I cry at movies, tv shows, etc, get moody over the littlest things.

 

[Rude]

Rude:

These are symptoms of depression:

Very emotional! I feel like a women on PMS, I cry at movies, tv shows, etc, get moody over the littlest things.

This is true but I dont feel like that is the Root cause but I can speak to a doctor about it. But why the libido issues though? What blood tests, etc could I do to see if I have any dopamine or serotonin issues? Doesn't anti depression medication create libido issues as well?

 

[Vince Carter]

Your first best option is in post #4 above, anything else should come AFTER that.

 

[Vince]

Rude, have your ever thought about using a little Cialis, if your haven't tried it already. There are many benefits of Cialis, besides helping you last longer. It may also give confidence in bed.

 

[HoustonTX]

I would urge you not to stress of become too anxious in regard to the T:E ratio. This is a guideline - a very, very valuable guideline - that can help you manage your estradiol levels. But don't tie yourself in knots over it. What I've found is that relying on the ratio gives me a certain freedom in allowing my estradiol to drift a bit higher than I once thought was possible. I monitor my body's response, back it up with lab work, and manage things calmly. I learned that when my E2 climbs beyond the low 40s, I am not as responsive sexually as I'd like. With my high testosterone, in excess of 1000, it should be able to go higher...according to the ratio. It can't. But it can go higher than the lab test's normal readings. Be flexible.

Coastwatcher, I'm glad you brought this up. I feel the same way that I am less responsive sexually with an E2 that's higher than 40 which is a huge factor in determining how I "feel". Others are huge supporters of the ratio theory. When I tried to debate it, I was given the response "The ratio holds for any level. I used to know a guy that used AAS and he once had a sensitive E2 of 172 and felt awesome, huge libido, no water retention, was killing it in the gym, etc. for the simple reason that his T was so high that an E2 of this level was likely in the sweet spot of between 14 and 20." I'm trying to dial and its been suggested that I only worry about the t/e ratio and not an e2 level, but I haven't bought into it based on past experience.

 

[CoastWatcher]

Coastwatcher, I'm glad you brought this up. I feel the same way that I am less responsive sexually with an E2 that's higher than 40 which is a huge factor in determining how I "feel". Others are huge supporters of the ratio theory. When I tried to debate it, I was given the response "The ratio holds for any level. I used to know a guy that used AAS and he once had a sensitive E2 of 172 and felt awesome, huge libido, no water retention, was killing it in the gym, etc. for the simple reason that his T was so high that an E2 of this level was likely in the sweet spot of between 14 and 20." I'm trying to dial and its been suggested that I only worry about the t/e ratio and not an e2 level, but I haven't bought into it based on past experience.

Please understand I'm not dismissing the ratio theory, not at all. It is valuable, but I believe that, if one follows it rigidly, it's as restrictive as the notion that estradiol must be maintained between 20 and 30, no exceptions. It tells us that E2 levels can, indeed, float higher than many believe. But what matters - consistently - is how you feel. I certainly don't feel well when my E2 climbs out of the low 40s. At the end of the day, our bodies, and not any single number, tell the true story.

 

[HoustonTX]

Please understand I'm not dismissing the ratio theory, not at all. It is valuable, but I believe that, if one follows it rigidly, it's as restrictive as the notion that estradiol must be maintained between 20 and 30, no exceptions. It tells us that E2 levels can, indeed, float higher than many believe. But what matters - consistently - is how you feel. I certainly don't feel well when my E2 climbs out of the low 40s. At the end of the day, our bodies, and not any single number, tell the true story.

I agree. The only thing that I would say is that when you feel good and your sexual function is great and you get your blood drawn that day with the idea that the results will tell you what your personal optimal levels should be, then my goal is to strive to find a protocol to consistently match those numbers (not exactly but within a reasonable range). The last time that happened for me, I was at a test of 1134 and a sensitive E2 of 33. The regular E2 was also run and had me at 35. So, when trying to find an optimal protocol that will find you consistently feeling good, doesn't it make sense to find one that will keep you in the range that you felt good in when you got tested...no matter what the ratio theory says? My point being that there is a correlation between numbers and how we "feel" and how well we function sexually. Personally, my test results which have varied from 900-1200 for the most part have always made me feel good. My E2 levels which have been all over the place have only made me function well sexually when in the 20-40 range, and it didn't matter what the test level was. I believe the ratio theory is very valuable, but it starts to lose it's value for me when my E2 is above 40.

 

[HoustonTX]

As Rude implied, though, you can feel good, but when your sexual function is off, you no longer feel good

 

[ERO]

There are exceptions to every rule and if one already has supporting blood work data on what feels best for him, then he should go with that data. 100%.

This segueing into an argument over semantics because when anybody replies to a question using one of the guidelines they don't always quality the information with an opening disclaimer. "This (Insert topic heading here) is a guideline that works for almost - but not every - person. There will be exceptions but those exceptions do not make the guideline invalid."

 

[Vince Carter]

You still have to apply the individualy feeling to the ratio, the ratio has never been a rule, its a guideline, but only YOU can decide where you work and feel best. Some of us like more E, some less, it's so much trial and error.

 

[CoastWatcher]

As I wrote, don't turn yourself inside out trying to match your subjective response to TRT and the ratio, or any other guideline. Use it as a tool, one of a few, that can guide you to success. Estradiol managment is the last frontier of TRT practice. There is no single, agreed upon value for what healthy levels of estradiol should be in men receiving exogenous testosterone. It is only recently that the "sensitive" assay has come to be seen as providing the most accurate measure of e2 in men - and that test can hardly be found outside the United States. Clinical judgment, insights from doctors skilled in androgen replacement, and insights gleaned from research, by thoughtful observers like Nelson, are helping clarify the issue. But the individual patient, with his unique response to therapy, is still the final judge of what works.