Dr. Jen Gunter

There's no low level of testosterone.

We would say you need to do something about that.

One thing that people forget with both estrogen and testosterone, and these are the only ones I know, so I can't speak about the others, is a very complex intracraniology.

So what's going on inside the cell may not be what's happening in the blood.

And so we have to be really careful about making

reaching for making far-reaching conclusions when we don't have clinical trial data to back that up so for example if you talk about estradiol levels people like oh maybe i should get my estradiol level to see how i'm doing on my menopause hormone therapy well no first of all we go by symptoms but secondly because of the you know intertest variability and how

estradiol is converted into estrone and then back into ester goes back and forth, back and forth is converted.

Your levels can change throughout the day.

So it could be higher in the morning and lower in the afternoon and higher again in the evening.

So what are we really measuring?

Also, if you're taking a patch, well, we have to make sure we're measuring at exactly the same time each time you're getting it done, right?

So there's that variable.

If you're using a cream, we know that there can actually be contamination to the other site.

So that's also a variable.

And finally, if your estradiol levels are lower, is it because your blood levels are lower or because it's entered the cell more quickly?

Right.

So until we have clinical trial data that says a level means this, we should not be doing them.

And that's kind of the next level that I see unintended, I guess, with disinformation is just not enough to be on estradiol.

Now you have to push your levels up into, you know, the what would be a normal range for somebody who is menstruating.

Oh, I imagine, you know, I. What's one mechanism that that.