Which E2 test is more reliable (Sensitive or Roche)?

croaker24 · Nov 4, 2014

My last test showed my total T at 758. The E2 sensitive assay was 19 pg/mL (3-79 reference range), while the Roche ECLIA was 41.9 pg mL (7.6 - 42.6) reference range.

Compared to a test performed 2 months ago, the sensitive was 14, while the Roche was 23.2 where
the total T was 560.

I have yet to take any anti-aromatase medications since starting shots over 3 months ago. Going by the Roche it seems I should consider it?

Nelson Vergel · Nov 4, 2014

The E2 sensitive assay by MS (mass spectrometry) is the most sensitive for men compared to ECLIA (immunoassay).

You do not need an aromatase inhibitor. It will only tank your estradiol. For some men, estradiol recovers very slowly once tanked.

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."

croaker24 · Nov 4, 2014

Thanks Nelson. I purchased your book a while back and keep it handy at all times, and while it does state that the range should be 20-30 pg/mL I did not see any clarification as to which test was appropriate for that range. Maybe the next edition??

Gene Devine · Nov 4, 2014

croaker24 said:
My last test showed my total T at 758. The E2 sensitive assay was 19 pg/mL (3-79 reference range), while the Roche ECLIA was 41.9 pg mL (7.6 - 42.6) reference range.

Compared to a test performed 2 months ago, the sensitive was 14, while the Roche was 23.2 where
the total T was 560.

I have yet to take any anti-aromatase medications since starting shots over 3 months ago. Going by the Roche it seems I should consider it?

The non-sensitive E2 lab tends to over estimate serum levels as you can see in your comparison.

As Nelson stated, you are not a candidate for an AI or E2 management...good news for you

croaker24 · Nov 5, 2014

Thanks Gene. I'm very lean - an urologist I saw a while ago for a different issue told me that I was very unlikely to have to worry about my estradiol as long as I stayed lean. Is this generally true? If so - it sure is a motivation to stay the course as far as exercise and diet.

Nelson Vergel · Nov 5, 2014

Lean or not, 100-200 mg per week of testosterone does not raise estradiol blood levels over 45 pg/mL (measured by ultrasensitive test using mass spectrometry) in most men unless they have liver issues and genetic predisposition.

When I wrote my book, the study that compared estradiol tests had not been published.

Which E2 test is more reliable (Sensitive or Roche)?

croaker24

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Nelson Vergel

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Gene Devine

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