This lab was my first check of Estradiol and occurred just before I started the aromatase inhibitor Arimidex to control this strongest estrogen in men. I had just started Testim 5g/day with no HCG. Estradiol is also known as E2 and is blamed often for libido and erection issues. There is a great deal of talk about Estradiol needing to be at a certain “sweet spot” often reported as around 25 pg/mL. In this lab my value is 82 pg/ml, which is high given the lab range reported for men as less than or equal to 29 pg/mL.

Note the really important lesson here is twofold. First, the “sweep spot” theory is just that – a theory, and a bunk one at that. While it may be true in some men, and at the time of this test I thought I found the cause of my own libido issues, later when my levels were steady at a number greater than 82pg/mL functioning and sexual appetite were more than just fine. My sweet spot seems to be a range that is not too high (what that number is I do not know) or too low. Second, the real metric of interest is a stable level that is not bouncing around all over the place.

Armidex is one of those drugs that causes E2 to bounce around, especially for those on weekly Testosterone shots. Your T levels peak, then fall. One protocol has the user add in HCG the last two days prior to the day of your next shot to “bump” your T levels back up. I prefer the protocol which has the user inject every other day. Take your weekly dose and divide by 3.5. With such small doses, it is now possible to inject with an insulin needle, and there is strong evidence that these injections can be given subcutaneously as opposed to intramuscular.

For gel users, dosing twice a day can help, although gels are less likely to convert to the estrogens than shots. With stable T values, E2 control is easier and one avoids the roller-coaster ride try these out. One must be cautious that E2 does not drop too low. Low E2 for some patients, especially those with adrenal or thyroid issues, can lead to a host of problems, including severe and long-lasting – sometimes permanent – joint pain and damage. If someone tells you to drop your E2 to the floor, ignore them. Gel use does not always mean that E2 will remain in the normal range. I am an example of that as future labs will indicate. If you are insulin resistant then any exogenous T will convert to the estrogens.

The real reason estrogens should be in range for men is the tie in with increased cancer risk for males with raised estrogens. The solution to this problem is not an AI (aromatase inhibitor) but rather a good diet and exercise program to address the weight issue. There may be some men who still have estrogen issues where an AI is called for. However, keep in mind there are ways to assist estrogen problems that are natural and if these fail, then an AI can be used, with the understanding that AIs like Arimidex only reduce E2 and not the other two estrogens. In the labs below, the user will see all three estrogens are measured. This is not necessary and only Estrone and Estradiol need be tested.

Note the name of the estradiol test – ultrasensitive estradiol. For Quest diagnostics this test is still probably too sensitive for men and there is another test. Look at expert KSMan’s post on the subject over at Anabolic Minds.

I now use Labcorp and the name of the test is the Sensitive Estradiol test. Always ensure you are using the right test. Failure to do so results in wasting time and money.

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Filed under: Testosterone Replacement

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