Why All Men Should be Tested with the Sensitive Estradiol Test

Thread starter #1
I see everyone here reference only using the ultrasensitive test, but many others have said it is not a good test. I am just curious as to why the thought is different here. Below is a clip from Life Extension blood tests, which I assume is the same test referenced....

This test is generally NOT suggested over the regular estradiol test (LC004515).
The only difference between this test and the regular estradiol test (offered in Life Extension panels) is better detection at the lower limits of the range. For example, the lower end of the range for estradiol is 7.6 pg/mL while the lower limit for the sensitive estradiol is 3 pg/mL. This test does not provide a more accurate result at normal ranges, it is only more accurate at very low levels of estradiol.
Since Life Extension advocates higher levels of hormones, it would be very rare to use this test for its greater sensitivity at the low end of the range. Remember that men also need a certain level of estrogen (estradiol) and that studies are showing that if the estradiol level for a man is below the 18-20 pg/mL range there is increased risk for osteoporosis.


Nelson Vergel disputes this statement from the Life Extension Foundation below.
 
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Nelson Vergel

Founder, ExcelMale.com
#2
Keith will be writing a post on his experience soon. He used the two methods on the same blood sample.

Regular estradiol test result: 95 pg/ml

Ultrasensitive estradiol test result: 9 pg/ml


Regular was 10 times the value obtained from ultrasensitive.


Thread: Role of Estradiol in Men and Its Management

I was able to find the right estradiol blood test based on mass spectrometry/liquid chromatography:

Affordable sensitive estradiol test


Study: Comparison of total estradiol measured by immunoassay and LC-MS/MS (sensitive)

Of the subjects, 60 men had total estradiol measured by both the assays. The mean and median total estradiol concentrations measured by immunoassay were 3.95 ± 1.31 and 3.9 [3.1–4.8] ng/dL, respectively. In contrast, the mean and median total estradiol concentrations measured by LC-MS/MS were lower by almost half (2.16 ± 1.66 and 1.9 [0.8–3.2] ng/dL, respectively; P < 0.001 for comparison with immunoassay). The total estradiol concentrations measured by the two assays correlated only weakly (r = 0.37, P = 0.004).
Reference
 
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Thread starter #3
Thanks guys. Perhaps I will try it out (sensitive). The first thread had some head butting going on, but it is hard to argue such vast differences in results.
 
#4
Nelson,

What a huge difference since if you assumed the non-sensitive test was correct, you'd increase the dosage of an aromatase inhibitor, which in this case would put you in jeopardy of osteoporosis (or other medical conditions, since the estradiol is less than 10 pg/ml) if used long-term.
 

Nelson Vergel

Founder, ExcelMale.com
#6
I explained the latest studies that show the importance of estradiol in men and how low estradiol can be detrimental for not only for bone but also for sex drive. Low estradiol has also been linked to fat gain. So we should be careful about treating men who are obviously being over diagnosed with high estradiol due to the use of the wrong test!

RECOMMENDED ULTRASENSITIVE ESTRADIOL BLOOD TESTS FOR MEN:

Comparisons of Immunoassay and Mass Spectrometry Measurements of Serum Estradiol Levels and Their Influence on Clinical Association Studies in Men


"In conclusion, our findings suggest interference in the standard immunoassay-based E2 analyses, possibly by CRP or a CRP-associated factor. Although this interference does not seem to affect association studies between immunoassay E2 levels and skeletal parameters, we propose a reevaluation of previous association studies between immunoassay-based E2 levels and inflammation-related outcomes. In addition, MS-based assays are to be preferred for the quantification of E2 levels in men."

This is the most precise estradiol test for me provided by Labcorp:

Estradiol, LCMS (Endocrine Sciences)

Test Code: 14022


This is the test performed by Quest Diagnostics:

Estradiol, Ultrasensitive, LC/MS/MS

Test Code
30289

Methodology
Liquid Chromatography Tandem Mass Spectrometry (LC/MS/MS)


ESTRADIOL , Sensitive (LC/MS/MS)
 
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#7
I see everyone here reference only using the ultrasensitive test, but many others have said it is not a good test. I am just curious as to why the thought is different here. Below is a clip from Life Extension blood tests, which I assume is the same test referenced....

This test is generally NOT suggested over the regular estradiol test (LC004515).
The only difference between this test and the regular estradiol test (offered in Life Extension panels) is better detection at the lower limits of the range. For example, the lower end of the range for estradiol is 7.6 pg/mL while the lower limit for the sensitive estradiol is 3 pg/mL. This test does not provide a more accurate result at normal ranges, it is only more accurate at very low levels of estradiol.
Since Life Extension advocates higher levels of hormones, it would be very rare to use this test for its greater sensitivity at the low end of the range. Remember that men also need a certain level of estrogen (estradiol) and that studies are showing that if the estradiol level for a man is below the 18-20 pg/mL range there is increased risk for osteoporosis.


Nelson Vergel disputes this statement from the Life Extension Foundation below.
The above statement, by LEF, demonstrates a fundamental lack of understanding of laboratory methodology. I don't know who wrote it, but it could not be more wrong.

I stood at the kitchen counter at William Faloon's house as couple months ago (my GF and I stayed there for the night), and showed him a laboratory printout (I could have brought many of them with me) proving my point about the standard Estradiol vs. Sensitive. The patient's symptoms matched the Sensitive assay, not the standard assay.

Quest Diagnostics has proven my point as well, after I showed their Director my results, years ago. It's right on their laboratory results, IF you make the mistake of ordering the standard E2 assay.

Simply, an invalid assay is an invalid assay. Arguing about the lower range for an invalid assay is like arguing about how much you should pay for something which is worthless.

Now, just using some farmer's logic, just whom is the Sensitive assay to be used for, then?
 
#8
I explained the latest studies that show the importance of estradiol in men and how low estradiol can be detrimental for not only for bone but also for sex drive. Low estradiol has also been linked to fat gain. So we should be careful about treating men who are obviously being over diagnosed with high estradiol due to the use of the wrong test!
http://www.excelmale.com/threads/11...trozole-(Arimidex)-What-Every-Man-Should-Know
EXACTLY!

YOU should be in charge of this for the LEF!
 

Gene Devine

Super Moderator
#11
I totally agree with Kelly.

I see time and time again where the wrong E2 lab was ordered (standard default not the Sensitive lab) and when it reflects elevated E2 the Doc prescribes an AI usually in ridiculous doses like 1 mg every other day...Dear God!

If a man is on the right Testosterone dose and injects lower doses more frequently and can keep body fat to a minimum could eliminate a lot of men needing this drug.

That protocol above was the trick for me!
 
Thread starter #12
Thanks for all of the input on this. Because it was part of a panel I had the regular estradiol run the last time around and my levels were 17. I am not taking an AI although it may be low because I am currently on just Clomid and Nolva and my T levels are not great as i attempt a restart.

I assume the consensus is that my result of 17 is probably overestimated and it is truly in a much less healthy range if I were to measure by ultrasensitive? I would have thought my value was higher as I have been fighting mood swings, hot flashes, low libido, poor erectile function....although perhaps that is just from low T and the SERMs.

You guys are great.
 
#15
O.K.

Understand that standard E2 test is out....
Sensitive E2 test Item# LC140244 from LEF.ORG coat $75.00 (member pricing)
I can not find a cost for ULTRA Sensitive.
How much does the ULTRA sensitive test cost?
How big a difference is there between the SENSTIVE test and the ULTRA SENSITIVE?
If there is a substantial cost difference, is the cost difference worth the extra $$$$$$.
 
#18
Nelson,
I have not done labs in a bit and was going to go the LEF route but I am holding off till DiscountedLabs.com goes live. I hope there are some packages designed to test the minimum like free and total T, DHEA-S, SHBG, ULTA SEN E-2 at a good price:)
 
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