Speaker A
If I had an 800 nanogram per deciliter total test level, I would want to see at least—what's up, guys? Derek for playsmartdates.com. Today, we're going to be talking about the ideal testosterone-estrogen ratio. So after I put out my estrogen videos on, you know, why inhibiting aromatase is neurotoxic and the examples showing this and that, like all the benefits of estrogen and why it is such an important regulator of, you know, cardiovascular health, neurological health, libido, [expletive], dick function—literally, very, very important things—a lot of people ask me, "Well, how do you know what the optimal ratio is of testosterone and estrogen in your blood work?" So I had to extrapolate a bit to actually come to some sort of, like, actual way to interpret this because it's not like the units of measurements in blood tests are even the same units. Like when you have, when you measure total testosterone, it's usually in nanograms per deciliter. When you get your estradiol, it's usually in micrograms per milliliter. And testosterone, that's your total testosterone, whereas estradiol is only your E2. It's not even total estrogen, so we're just talking about a component, a fraction of the total estrogens in your entire body. So there's a bit of, like, finagling I had to do to figure out what is, like, a reasonable, you know, ratio to expect based on averages and based on the clinical data, and I sort of, you know, came to a good framework to go by. So typically, just in general, the ratio is a hundred to one, but let me explain before you, you know, just go check your blood work and see if it's times 100 of your estradiol because it's not exactly how it works. So approximately 40 to 50 micrograms of estradiol is produced per day in men. So micrograms, that's like the actual concentration of the hormone produced. So like, you know, how men produce three to ten milligrams per day of testosterone—that's not, you know, in nanograms, that's an actual milligram equivalent. So you produce approximately 40 to 50 micrograms of estradiol, of E2, per day. So that's about 280 to 350 micrograms per week. So about 5 to 10 micrograms of the estradiol daily produced is in the testes, approximately 10 to 20 percent of it, and the remaining 40 to 45 micrograms, 80 to 90 percent of it, in peripheral tissues like adipose tissue, muscle, breast, brain, liver, and bone, in which the aromatase enzyme is expressed. So this is also why inhibiting aromatase can be so deleterious because in tissue-specific hormones that need more estrogen, if you're just indiscriminately inhibiting aromatase in these tissues, it doesn't really matter what's in your blood. If the actual tissues themselves are deprived just because your blood might say you're in range, it doesn't necessarily mean your brain is getting enough estrogen, your bones, or whatever. So you produce on average, at like low to high end—this is very, you know, individual-specific—but three to ten milligrams of testosterone per day. So five milligrams is kind of like the average. Then five milligrams is a hundred times the 50 micrograms of estradiol produced per day, which is, so roughly, 40 to 50 milligrams per week is how much actual test the average man produces, which is exactly a hundred times the 40 to 50 micrograms of estradiol that they produce. So as far as, like, why, you know, estrogen is important and stuff, I actually recommend you go check out my videos on testosterone is not neuroprotective, estrogen is, and all those videos and whatnot. So as far as the estradiol to testosterone ratio at supraphysiological doses, the E2, the estradiol to testosterone ratio starts to decrease, and the 100 to 1 ratio does not stay static throughout a blast phase for most individuals, as seen here in the graph of graded dose response to supraphysiological dosages of testosterone up to 600 milligrams per week. So you see the ratio slowly declining, implying that aromatase does not function in a dose-dependent manner where it just, you know, spits out an exactly proportional estradiol to testosterone ratio or spits out equivalent estradiol for the amount of testosterone administered for all dosage groups, and the ratio becomes more and more skewed the higher the dose of testosterone. But just in general, we're talking about in, like, a therapeutic context first, and in an ideal world, your ratio would stay the same, like the physiologic homeostasis that your body wants to stay at. You would ideally be at that regardless of your dose. Obviously, there's limiting factors on aromatase expression and whatnot, but anyways, therapeutic levels, like where a healthy man would be at 101, and this is how you would interpret your blood work, and this is like the extrapolation part. So the average male is going to have about 30 picograms per milliliter estradiol blood test result in their serum. The average testosterone level is around 600 nanograms per deciliter, depending on which study you look at because, you know, some will show a 531 nanogram per deciliter median, other sample sizes will show as high as a 679 nanogram per deciliter median, but in general, it's about 600 nanograms per deciliter total testosterone. So in general, the ratio of estradiol in the actual units of measurement that we use in our blood work, picograms per milliliter, relative to the units of measurement we use for our testosterone levels in nanograms per deciliter, results in about five percent of the estradiol in picograms per milliliter relative to total testosterone in nanograms per deciliter. I'm not even going to get into free estrogen relative to free testosterone because that's like a whole nother level of extrapolation, but anyways, so that's a rough guideline. So in general, if a man produces 600 nanograms per deciliter of testosterone, he will, if he's healthy and not indiscriminately inhibiting aromatase and doing things that are going to, you know, inhibit physiologic processes, he will probably have about 30 picograms per milliliter of estradiol in his serum, which is 5. So, you know, you could do the math on that for other things, and frankly, this is more of, like, a very, very rough framework based on averages that I just pulled out of, like, sample size data. So it's like, you know, don't take this as some concrete rule where it's like, "Oh, like a healthy free, just also two to three percent of your total." That's not what—this isn't as concrete as that. But in general, from what I can see, it's about like the hundred to one ratio applies for the actual milligram amount that you produce relative to the microgram amount that your body, like, pumps out. But as far as actual serum concentrations reflected in a unit of measurement in your blood on a lab test, that's what you're seeing, and the hundred to one doesn't apply for that because you're seeing estrogen estradiol in picograms per milliliter, you're seeing total tests in nanograms per deciliter. So for that, the picogram per milliliter estradiol is about five percent of the nanogram per deciliter total T from what I can tell. But anyway, so that's a general framework. A lot of people ask me that, and that is sort of what I would look for in a blood test. So like, for example, if I had an 800 nanogram per deciliter total test level, I would want to see at least a 40 picogram per milliliter estradiol in the blood. Now obviously, you can say it's just a number and like, who cares? Like, what about the tissues? We want to know tissue-specific levels. It's okay, bro, like we don't have biopsies of your [expletive] bones, your head, your [expletive] heart, your everything, your brain. So we have serum. That's what we can go off of right now. So just in general, for the people getting blood work, that's all we're talking about. We're not talking about like next-level [expletive], intra-current hormone and whatnot. There's all these like new, you know, arguments and, you know, TRT and whatnot that I'm totally on board with and totally makes sense, by the way. Like obviously, it matters how much aromatase expression is occurring in the tissues that actually need the estrogen.
