E2 labs Quest vs Labcorp Insanely different results!

[Oldpowerlifter]

I've been having libido issues after many successful years on HRT. I want to narrow it down if it's an E2 issue or dopamine desensitization.

Anyhow few months ago Quest labs my E2 was 36 which is way high for me! I thought it may be a fluke. Then I recently did Labcorp and it says my E2 is LESS THAN 6 and doesn't even register! Same protocol. Same day blood draw. How on earth could it change that much. And i imagine I'd have more than just libido issues if my E2 was so low it doesn't even register !!

What the hell is going on? The Quest E2 was part of their "male panel" and Labcorp was Roche (which I've read is no good by some and fine by others).

 

[johndoesmith]

I've been having libido issues after many successful years on HRT. I want to narrow it down if it's an E2 issue or dopamine desensitization.

Anyhow few months ago Quest labs my E2 was 36 which is way high for me! I thought it may be a fluke. Then I recently did Labcorp and it says my E2 is LESS THAN 6 and doesn't even register! Same protocol. Same day blood draw. How on earth could it change that much. And i imagine I'd have more than just libido issues if my E2 was so low it doesn't even register !!

What the hell is going on? The Quest E2 was part of their "male panel" and Labcorp was Roche (which I've read is no good by some and fine by others).

So you have labs done months apart, and you think the change in labs is what caused the differences?

You'll need to add more details, time taken relative to injection, protocol, lab ranges, and your other labs.

Roche is the standard test, which is not intended for men.

If your E2 is <6 then that'd explain your libido problems.

 

[Oldpowerlifter]

Tomorrow I will explain in more detail as I have a post on this forum in another section covering many of your questions.

So is the Labcorp Roche accurate? That's my big question, seems impossible it would be less than 6 and not even register. Especially if a few months ago on a lab with Quest it was 36. Same protocol since the Quest lab, got blood drawn on exact same day of week so same timing with any injections, and morning fasted state. All was exact same.

So a few months ago on Quest:
TT 826 (range 250-1100)
FT 225.6 (35-155)
Estradiol 36

Now with LabCorp
TT 826 (264-916)
FT 22.7 (6.8-21.5)
Estradiol less than 6

Literally exact same TT numbers but E2 results opposite end of the Spectrum!

No changes in protocol:
200mg Test a week
1mg adex 3x week
250iu HCH 3x week
3iu HGH daily

 

[Oldpowerlifter]

https://www.excelmale.com/forum/sho...good-pre-post-TRT-Years-later-crashes&p=79428

There is orher thread that has
Details about my situation. If further info is needed just ask. I appreciate any help.

I want to get labs done again next week with Quest as that's who I've used mostly over the years. Thing is I'm confused as hell what E2 test to ask doc to specifically mark on lab sheet. If my E2 was/is 36 then I need to increase my adex dose. If it's less than 6 holy Balls I need to drop my adex for a period of time and adjust to a smalller dose. And then my damn libido would probably come back!!!

Maybe I don't have a dopamine desensitization issue...but I think I likely do given my symptoms even when my E2 was 21-26 on previous labs and my libido was still not good. I'm guessing the T and Xyrem (both that boost dopamine and could cause desensitization) combined with vicadin (that blunts dopamine output) probably made my pecker obsolete. And if my E2 is really low just piling it on, and may explain my increase in tendonitis pain in my elbows and shoulders in past year. Hell I just thought it was from getting old.

Or is it possibly my E2 was high a few months ago and is low now...solely because I finally want back to low carb after a 4 year Hiatus where I was eating lots of carbs and desserts almost every night. I'm sure it wasn't good for my estrogen. But just two months basically of going back to meat and veggies, with maybe one or two nights a week a baked potatoe or smoothie full of berries, and been pounding coconut and olive oil. gonna lower my E2 from 36 to less than 6?

 

[Vince]

What's your protocol and can you post the range for the estradiol test.
The Labcorp Roche is not accurate, you need the sensitive Estradiol, LCMS for men.

 

[johndoesmith]

I'd say your E2 is crashed. You strike me as a low E2 guy, and you're on 3 MILLIGRAMS OF ANASTROZOLE PER WEEK.

That is an ENORMOUS dose. Period.

The other problem is that you're on vicodin, xyrem, and monstrous doses of AI.

I assume the xyrem is because you have Narcolepsy, so you're never sleeping properly.

Point is, you have multiple comorbidities, multiple drugs, and probably 10 different lifestyle changes in the time that your labs have changed. Guys constantly think libido is E2 and E2 only, but they NEVER mention how their workplace is, their homelife, schedule, or social life is. If you're doing 60 hours a week with a deadline over your head, yeah your libido is going to be low.

You just cannot attribute low libido to a sole cause like E2(which you aren't even testing properly).

 

[madman]

https://www.excelmale.com/forum/sho...good-pre-post-TRT-Years-later-crashes&p=79428

There is orher thread that has
Details about my situation. If further info is needed just ask. I appreciate any help.

I want to get labs done again next week with Quest as that's who I've used mostly over the years. Thing is I'm confused as hell what E2 test to ask doc to specifically mark on lab sheet. If my E2 was/is 36 then I need to increase my adex dose. If it's less than 6 holy Balls I need to drop my adex for a period of time and adjust to a smalller dose. And then my damn libido would probably come back!!!

Maybe I don't have a dopamine desensitization issue...but I think I likely do given my symptoms even when my E2 was 21-26 on previous labs and my libido was still not good. I'm guessing the T and Xyrem (both that boost dopamine and could cause desensitization) combined with vicadin (that blunts dopamine output) probably made my pecker obsolete. And if my E2 is really low just piling it on, and may explain my increase in tendonitis pain in my elbows and shoulders in past year. Hell I just thought it was from getting old.

Or is it possibly my E2 was high a few months ago and is low now...solely because I finally want back to low carb after a 4 year Hiatus where I was eating lots of carbs and desserts almost every night. I'm sure it wasn't good for my estrogen. But just two months basically of going back to meat and veggies, with maybe one or two nights a week a baked potatoe or smoothie full of berries, and been pounding coconut and olive oil. gonna lower my E2 from 36 to less than 6?

Its the insane dose of adex you are taking weekly that is more than likely crashing your e2. You have asked numerous times and in numerous posts as everyone has said you need the sensitive assay when testing e2 and it has to be used consistently with your protocols.....................diet is not lowering your e2. As jds stated too many get caught up on e2 and libido when in fact many other factors can affect ones libido.

 

[Oldpowerlifter]

Thanks guys. I was not thinking E2 was the sole issue with my libido. I was more leaning towards it being dopamine related UNTIL this Labcorp test that freaked me out.

As for it being a "massive dose" of adex, I've been on that dose of adex for years and my E2 regularly being in the range of 21-27 on labs and my libido being sky high. Just the last 2 years it's been awful.

Xyrem is for chronic pain and insomnia in my case, not narcolepsy. Vicadin is for chronic pain as well. Been on the Xyrem as long as I've been on HRT. that stuff used to actually make me super horny. Vicadin I've not been on the entire time, just recent years which makes sense it's related to killing my libido. And yes I've had major amounts of stress the last 4 years which is what my docs attribute the libido crash to. But If my E2 can be dialed in, and there is a way to deal with dopamine desensitization obviously it may improve my life. Stress has recently gone down and I'm doing lots of self care to manage the stress.

Going to ask doc next week to do labs with Quest and the sensitive assay.

Only lifestyle change between the two different labs was going back on low carb. That's it. And I've been on same low carb diet (even stricter keto and cyclical anabolic diet aka DiPasquale) while on this same HRT protocol for the first four years I was on.

For Vince :
Estradiol range 7.6 to 42.6

Protocol
200mg Test per week
3x1mg adex per week
3x250iu HCG per week
3iu HGH daily

My E2 normally comes in anywhere between 21 to 27, and even past two years when E2 is spot on my libido still dead. At certain points I knew it was high stress, but just stumpled onto reading about the dopamine densensitization with TRT for some, then started digging about Vicadin and found it reduces dopamine, and I know my doc has said Xyrem boosts dopamine.

Hopefully I can get a blood draw this week with Quest and at least get an idea of where E2 really is so I can adjust my adex dose accordingly.

 

[johndoesmith]

Thanks guys. I was not thinking E2 was the sole issue with my libido. I was more leaning towards it being dopamine related UNTIL this Labcorp test that freaked me out.

As for it being a "massive dose" of adex, I've been on that dose of adex for years and my E2 regularly being in the range of 21-27 on labs and my libido being sky high. Just the last 2 years it's been awful.

Xyrem is for chronic pain and insomnia in my case, not narcolepsy. Vicadin is for chronic pain as well. Been on the Xyrem as long as I've been on HRT. that stuff used to actually make me super horny. Vicadin I've not been on the entire time, just recent years which makes sense it's related to killing my libido. And yes I've had major amounts of stress the last 4 years which is what my docs attribute the libido crash to. But If my E2 can be dialed in, and there is a way to deal with dopamine desensitization obviously it may improve my life. Stress has recently gone down and I'm doing lots of self care to manage the stress.

Going to ask doc next week to do labs with Quest and the sensitive assay.

Only lifestyle change between the two different labs was going back on low carb. That's it. And I've been on same low carb diet (even stricter keto and cyclical anabolic diet aka DiPasquale) while on this same HRT protocol for the first four years I was on.

For Vince :
Estradiol range 7.6 to 42.6

Protocol
200mg Test per week
3x1mg adex per week
3x250iu HCG per week
3iu HGH daily

My E2 normally comes in anywhere between 21 to 27, and even past two years when E2 is spot on my libido still dead. At certain points I knew it was high stress, but just stumpled onto reading about the dopamine densensitization with TRT for some, then started digging about Vicadin and found it reduces dopamine, and I know my doc has said Xyrem boosts dopamine.

Hopefully I can get a blood draw this week with Quest and at least get an idea of where E2 really is so I can adjust my adex dose accordingly.

Yeah man, I understand where you're coming from, but chronic pain, stress, opiates, and anastrozole are probably the world's biggest libido killers with only Mom's voice being more effective at killing libido.

Dopamine Desensitization is broscience speculation without any real sources, evidence or science to back it up. A quick google search gives me just forum posts from weed, steroid and porn forums.

Just because you've been on a dose of 3mg per week doesn't mean it's not a high dose. Most guys on anastrozole don't take 3mg per MONTH.

 

[Oldpowerlifter]

Thanks JDS. hilarious comment about mom's voice hah.

And the dopamine desensitization I read on posts by Dr Romeo Mariano. do a quick search on "dopamine desensitization" and "Dr. Mariano" and some of the forum threads should pop up.

Hopefully new Quest labs will let me see where my E2 really is so I can adjust adex in right direction. And obviously I'm gonna have to do the battle with tapering off the vicadin. I'm actually gonna hope my E2 is low so I can lower the adex dose rather than be in a position wondering why E2 is so high even with so much adex.

 

[user_joe]

If you really require an ai dose that high at 200/wk you gotta question the reason. I've "heard" certain pain killers reduce the effectiveness of anastrozole, but I've got no idea if it is true or to what extent. You liver is what converts the test to estrogen. I'd be looking into that and interactions. With e2 sensitive dialed in I'd expect to fall somewhere in range on other estradiol tests rather than below range or at the bottom.

 

[Oldpowerlifter]

Thanks Joe. That certainly is something to look into if the pain killer reduces effectiveness of AI.

I'll need to ask to review my records....i can't recall the timing of when I had to bump up
My AI dose. I think I only did .5mg 3x week for a number of years and then got a high E2 readings so had to adjust up to the 1mg eventually. If it turns out that occurred sometime near when I started using vicadin regularly, what you heard about painkillers influence on AI might be true. And just another reason I'm gonna have to grab my balls and battle to get off vicadin.

 

[johndoesmith]

Thanks JDS. hilarious comment about mom's voice hah.

And the dopamine desensitization I read on posts by Dr Romeo Mariano. do a quick search on "dopamine desensitization" and "Dr. Mariano" and some of the forum threads should pop up.

Hopefully new Quest labs will let me see where my E2 really is so I can adjust adex in right direction. And obviously I'm gonna have to do the battle with tapering off the vicadin. I'm actually gonna hope my E2 is low so I can lower the adex dose rather than be in a position wondering why E2 is so high even with so much adex.

You're obsessing over E2 results that you don't even have yet.

The liver is not the sole source of aromatization.

 

[Oldpowerlifter]

True. Not having a strong libido for a few years is frustrating.

Any other suggestions on what to do labs wise or speak to doctors about I'm all ears.

Will try to get Quest labs done this week and see where the ol E2 comes in at this time.

 

[johndoesmith]

True. Not having a strong libido for a few years is frustrating.

Any other suggestions on what to do labs wise or speak to doctors about I'm all ears.

Will try to get Quest labs done this week and see where the ol E2 comes in at this time.

How is TRT managing your other hypogonadal symptoms?

Personally I suspect the opiate having the strongest impact on your libido then the anastrozole induced menopause.

 

[Oldpowerlifter]

Other than libido and lack of sexual pleasure and barely even feeling orgasms just for past two years....TRT is and has been a life saver over 8-9 years whenever it is I started. My energy, cognitive function, mood, bodyfat, fitness and strength levels are all awesome. I haven't got dunk tank or dexa scanned lately but I'm 5'10, 230ish (normally 240ish but going low carb and upping interval training I've dropped ~10 pounds recently) no more than 10-12% BF, and possibly lower since I went back to low carb.

Just this week I cranked 1000 feet on the Versa Climber in 7:30 (not world class but Versa Climber is a bear) and last set of deadlifts was 455x 3 no problem slow and controlled both concentric and eccentric. Again it's not world class and I've certainly done much heavier than that but for training more generally for fitness in last two years and not heavy lifting, to feel good one day and run it up to 455 no issues in my 40s made me satisfied. Especially since I've been doing so much conditioning lately. If it is dopamine related it may explain why heavy lifting doesn't excite me anymore either. For decades I drove to gym foaming at the mouth, and left feeling like I had 20 orgasms. Past few years that I haven't had libido, going to gym has also been unmotivating but it's always been a lifestyle for me so I force it, plus want to keep my health in order.

So all in all life is good. But being in this flat state in which even if the Swedish bikini team walked into my home I'd not be aroused, or maybe unable to perform even if I did slightly get aroused, or even if I performed not feel any pleasure from it...is a mind f--k.

 

[johndoesmith]

Other than libido and lack of sexual pleasure and barely even feeling orgasms just for past two years....TRT is and has been a life saver over 8-9 years whenever it is I started. My energy, cognitive function, mood, bodyfat, fitness and strength levels are all awesome. I haven't got dunk tank or dexa scanned lately but I'm 5'10, 230ish (normally 240ish but going low carb and upping interval training I've dropped ~10 pounds recently) no more than 10-12% BF, and possibly lower since I went back to low carb.

Just this week I cranked 1000 feet on the Versa Climber in 7:30 (not world class but Versa Climber is a bear) and last set of deadlifts was 455x 3 no problem slow and controlled both concentric and eccentric. Again it's not world class and I've certainly done much heavier than that but for training more generally for fitness in last two years and not heavy lifting, to feel good one day and run it up to 455 no issues in my 40s made me satisfied. Especially since I've been doing so much conditioning lately. If it is dopamine related it may explain why heavy lifting doesn't excite me anymore either. For decades I drove to gym foaming at the mouth, and left feeling like I had 20 orgasms. Past few years that I haven't had libido, going to gym has also been unmotivating but it's always been a lifestyle for me so I force it, plus want to keep my health in order.

So all in all life is good. But being in this flat state in which even if the Swedish bikini team walked into my home I'd not be aroused, or maybe unable to perform even if I did slightly get aroused, or even if I performed not feel any pleasure from it...is a mind f--k.

Have you considered depression?

 

[Oldpowerlifter]

Been there done that long time ago. Not depression at all. Moods and feelings are good to go other than lack of pleasure with sex and lifting.

 

[Vince]

I have used 200mg of T weekly, now 20mg of T daily. Being on TRT for over 2 1/2 years never needed or used an AI. I know we are all different, luckily my doctor did labs to check my estradiol levels after starting TRT. Instead of just starting me on an AI with no labs.

 

[Vince Carter]

One, stop using both labs, use one or the other. You cannot compare results from multiple labs, you need the repeatability of ONE lab doing your tests. And use the correct one as has been said, you need the (ultra) Sensitive Estradiol LC/MS/MS, any other test is for females.

You need to throw out those other labs and all this up and down E2, you wasted your time and money on things that are basically useless for this purpose.