question from a user
What is more important? An absolute range of estradiol, or in proper ratio with total testosterone? And what is best course of action to manage estrogen?
AlphaMD's Answer
This is very subjective and there are no studies to say one way or the other which is more important, T/E ratio or total E.
Just from clinical practice I can say that total E seems to be the most important, though high E levels don’t always lead to symptoms. This is likely because E also attaches to SHBG and some of this high level is mitigated from that.
There are no industry specific recommendations for managing high E, or what is considered optimal. But we think about it like this. When a man is at his healthiest hormone wise, is between the ages of 18-25. Average E levels at that age are 22-28. So this would be considered ideal in a patient you are trying to “optimize”.
Managing estrogen can be done with a combination of AIs and/or using higher frequency of lower dose injections.
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