Sorry I missed this question for a long time - still getting used to this platform not sending me notifications for all communications. If both tests report the same units they should yield very similar results or else one of them should not be on the market. Small differences are not a big deal because the exact numbers don't matter that much anyway. These levels change all the time and we should not get too caught up in the numbers themselves. How similar were your estrogen levels between the two tests? One problem is that hormone levels fluctuate constantly and if you had your blood drawn hours apart they could be different because of that. You would need to run both tests on the same blood sample to compare, which you apparently did - it helps to be a scientist yourself, gold star. Estrone and Estradiol levels can be very different and that's why you have to check both forms of estrogen every time. Most men will maintain the same ratio between those two, but it can change some within the same individual. There is no "usual" for this, everyone is different and should check both forms to get the best results. I don't see any value in looking at the ratio between E1 and E2. If Estrone runs consistently high even after pushing the Estradiol level down lower than you need, I suggest taking Iodine (Lugol's solution or an equivalent formula in a tablet - I made a video about iodine with all those details) 12.5-25mg per day along with 2,000mg vitamin C each time to ensure good absorption. Iodine help promote the clearance of Estrone and the last steps of estrogen elimination.

This is why labs have to have reference ranges really, because tests have different margins of error - but levels that far off means one of the tests was performed incorrectly in one step along the way. There is no way that both tests were run correctly and had results that far apart. I see spurious erroneous lab results fairly often and if they don't make sense with the person's symptoms and story I either have the test rerun or just treat them based on my clinical suspicion, ignoring that lab result.

Normal saline (same salt concentration as our blood) is 0.9% salt. That's 9 grams per liter (similar to a quart). So taking 2g salt per day accounts for just over 7 ounces of water or blood volume. The heart association and entire medical community has been telling people for decades to avoid salt and that 2 grams per day is the most you should consume - but that is nonsense and was based on the DASH Diet study where they made all kinds of lifestyle and dietary changes that led to decreased blood pressure. There was no direct link between that result and the salt restriction, but that's the one thing they pushed on the public. At the same time everyone is chronically salt deficient, they teach doctors that the first class of blood pressure drugs we should prescribe for most people is the diuretics. Those cause salt wasting and worsened deficiency. Then we are taught to keep adding more drugs when the person might normalize their blood pressure by ignoring all of that and getting their body fully re-salinated. I think supplementing with salt and then just letting your body tell you when it wants water is the best way to go. Our brain has all sorts of signal inputs regarding our blood chemistry and nutrient needs, directing us to salt or water or food when we need it. Just don't make drinking water a "health habit" because it most certainly isn't. Don't drink extra water just because you think it's healthy. Water loading is a common method for MMA fighters to cut weight for a fight. They pound down a ton of water for 2-3 days to flush a lot of the salt out of their body, then drop that excess water through sweating. They can suck 20# of water out of their bodies in a few days doing that, and some of them end up in the ER with serious electrolyte deficiencies. The people out there in public following the chronic salt restriction while drinking lots of water suggestions are doing the same thing over a much longer stretch of time. Our bodies can adapt for a long way before totally de-compensating, but people develop a lot of progressive symptoms along the way.

Those tests are assessments of kidney function and a couple adrenal steroids that need to be put into clinical perspective to make any sense. Serum osmolality is more used to asses for inappropriate production of anti-diuretic hormone and don't reflect salt concentration. Lots of other things contribute to blood osmolality. Blood levels don't become abnormal until people are quite dehydrated and will look normal in the vast majority of people until they end up in the hospital due to complications. The blood test shows a concentration of salt ions in the blood, but the concentration can stay the same until you're 25% dehydrated because your life depends on keeping serum sodium and potassium within their narrow ranges. Unlike the testosterone lab ranges, which are based on nonsense, taking stock of a rapidly declining population and repeatedly lowering the ranges to fit where people seem to be rather than where they should be - those blood chemistry ranges are based on what is needed for basic survival. The best test to verify if a person is low on salt and their adrenals are working overtime to try and retain as much salt as possible is a "Fractional Excretion of Sodium". You can find the formula online and probably a handy little calculator program you can just plug numbers into. You need to collect urine samples for sodium and creatinine levels and also have a basic chemistry panel done with sodium and creatinine in the blood. Then there is a simple math equation to calculate what percentage of blood sodium is being excreted into the urine. If sodium excretion is less than 1% the person is definitely deficient in salt and therefore water. We can't keep plain water in our bodies without a matching amount of salt to keep it 0.9% sodium chloride, so we just urinate all of it out and lose a little more salt in the process. I recorded a video a couple weeks ago discussing a few cases I've seen recently with unexplained chronic headaches, fatigue, poor stamina, vertigo in one case - all resolved within a week simply be taking extra salt every day. They'd had their problems for years. I did the FeNa calculation with the two older women (ages 69 and 78) and they were both excreting less than 0.75%. The woman with chronic vertigo was even put on a diuretic because the general medical community has this completely backwards. The diuretic made her worse to where she could only tolerate it once per week instead of every day, but she was still taking it three years later like a good patient when I spoke to her.

Louis, you've been nominated for chief research assistant in this group. I've never been that organized in my life.

Wonderful to have you! We are doing a live Q&A Sunday morning at 8am Hawaii time, which is around 5am Monday morning for you? It will be recorded and posted for anyone to watch later as well. I'm open to other days and times for our Q&A's too, if we have international people in way off time zones.

Hi Andrezej, I will attach my TRT handout for men and it should answer most of your questions about whether to try it or not, the common concerns people have, and other issues surrounding TRT. If you still have questions after reading that, please post them in the community forum where everyone may benefit from the discussion and information. Thanks!

Hi Bailey, That is an extremely high estradiol level, considering it's best to keep your E1/E2 total under 100. You don't even know your Estrone level and it could be just as high. I will say, I have a hard time believing it's really that high if you are only injecting 150mg T per week. Did you have it checked more than once? Measuring steroid hormones is a complicated laboratory process with multiple steps and places for errors to occur. It seems reasonable to think your estrogen is higher than it should be, and that can ruin the potential benefits of your TRT even if you were taking an optimal dose. Estrogen conversion is the most important thing to manage, the main reason it would be useful to be managed by a doctor. But I have hardly ever seen other practitioners order both Estrone and Estradiol levels and control them in a logical manner. It's usually some one size fits some people protocol that isn't right for many men. I'll attach my TRT handout here for you, and you can let us know if you have any more questions after that. I would get new labs with both Estrone and Estradiol, and check a Total Estrogens level too just to help calibrate things so they make sense. In my opinion, you should be using a lot more testosterone too, but figure out the estrogen thing before increasing your dose.