Estradiol E2 Testing in Men: Comparison Between Regular and Sensitive E2 Assays

[Mcgiver54]

Since this question is always a hot topic on here, I did both tests at the same time to see how far apart they were, Royal paid for the non-sensitive and I paid cash for the sensitive in the same blood draw:
ESTRADIOL, SENSITIVE 22.6 PG/ML 8.0-35.0 02
Methodology: Liquid chromatography tandem mass spectrometry(LC/MS/MS)

Estradiol 20.9 pg/mL 7.6 - 42.6 01
Roche ECLIA methodology

Pretty close, I expected to see more of a difference but am happy I did not. I feel my E2 is still too low in relation to my T of 1200 so I am working to get it higher. This was a response on another thread but I thought it warranted its own discussion.

 

[antelopers]

Thanks for sharing. I ran both the standard and sensitive test about 3 years ago and here were my readings:

Standard Estradiol: 22
Sensitive Estradiol: 21.5

Basically same as you, no notable difference.

 

[Nelson Vergel]

Thanks for sharing. I ran both the standard and sensitive test about 3 years ago and here were my readings:

Standard Estradiol: 22
Sensitive Estradiol: 21.5

Basically same as you, no notable difference.

You probably have low CRP

 

[Nelson Vergel]

Guys with low inflammation (measured by CRP) don't show much of a difference between ECLIA and LC/MS estradiol testing methods.

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



J Clin Endocrinol Metab (2013) 98 (6): E1097-E1102.

Immunoassay-based techniques, routinely used to measure serum estradiol (E2), are known to have reduced specificity, especially at lower concentrations, when compared with the gold standard technique of mass spectrometry (MS). Different measurement techniques may be responsible for the conflicting results of associations between serum E2 and clinical phenotypes in men.

Objective:

Our objective was to compare immunoassay and MS measurements of E2 levels in men and evaluate associations with clinical phenotypes.

Design and Setting:

Middle-aged and older male subjects participating in the population-based Osteoporotic Fractures in Men (MrOS) Sweden study (n = 2599), MrOS US (n = 688), and the European Male Aging Study (n = 2908) were included.



Main Outcome Measures:

Immunoassay and MS measurements of serum E2 were compared and related to bone mineral density (BMD; measured by dual energy x-ray absorptiometry) and ankle-brachial index.

Results:

Within each cohort, serum E2 levels obtained by immunoassay and MS correlated moderately (Spearman rank correlation coefficient rS 0.53–0.76). Serum C-reactive protein (CRP) levels associated significantly (albeit to a low extent, rS = 0.29) with immunoassay E2 but not with MS E2 levels. Similar associations of immunoassay E2 and MS E2 were seen with lumbar spine and total hip BMD, independent of serum CRP. However, immunoassay E2, but not MS E2, associated inversely with ankle-brachial index, and this correlation was lost after adjustment for CRP.

Conclusions:

Our findings suggest interference in the immunoassay E2 analyses, possibly by CRP or a CRP-associated factor. Although associations with BMD remain unaffected, this might imply for a reevaluation of previous association studies between immunoassay E2 levels and inflammation-related outcomes.

 

[Nelson Vergel]

Comparing my Estradiol Standard & Sensitive Labs

 

[wondering]

The midpoint on the first test is 21.5 and the second is 25.6. So you are slightly higher on the first, but probably not statistically significant.

Curious about your common on thinking it is too low and you are trying to raise.

 

[MarcoFL]

Guys with low inflammation (measured by CRP) don't show much of a difference between ECLIA and LC/MS estradiol testing methods.

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



J Clin Endocrinol Metab (2013) 98 (6): E1097-E1102.

Immunoassay-based techniques, routinely used to measure serum estradiol (E2), are known to have reduced specificity, especially at lower concentrations, when compared with the gold standard technique of mass spectrometry (MS). Different measurement techniques may be responsible for the conflicting results of associations between serum E2 and clinical phenotypes in men.

Objective:

Our objective was to compare immunoassay and MS measurements of E2 levels in men and evaluate associations with clinical phenotypes.

Design and Setting:

Middle-aged and older male subjects participating in the population-based Osteoporotic Fractures in Men (MrOS) Sweden study (n = 2599), MrOS US (n = 688), and the European Male Aging Study (n = 2908) were included.



Main Outcome Measures:

Immunoassay and MS measurements of serum E2 were compared and related to bone mineral density (BMD; measured by dual energy x-ray absorptiometry) and ankle-brachial index.

Results:

Within each cohort, serum E2 levels obtained by immunoassay and MS correlated moderately (Spearman rank correlation coefficient rS 0.53–0.76). Serum C-reactive protein (CRP) levels associated significantly (albeit to a low extent, rS = 0.29) with immunoassay E2 but not with MS E2 levels. Similar associations of immunoassay E2 and MS E2 were seen with lumbar spine and total hip BMD, independent of serum CRP. However, immunoassay E2, but not MS E2, associated inversely with ankle-brachial index, and this correlation was lost after adjustment for CRP.

Conclusions:

Our findings suggest interference in the immunoassay E2 analyses, possibly by CRP or a CRP-associated factor. Although associations with BMD remain unaffected, this might imply for a reevaluation of previous association studies between immunoassay E2 levels and inflammation-related outcomes.

interesting! this would be my case lower CRP and both E2 about the same. Thank you for bringing this up.

 

[Mcgiver54]

The midpoint on the first test is 21.5 and the second is 25.6. So you are slightly higher on the first, but probably not statistically significant.

Curious about your common on thinking it is too low and you are trying to raise.

Wondering, I am struggling with ED that was brought on after my first month on TRT, the only thing I can come up with is to get my E2 higher, I am stopping the AI next month and will see how I do with higher E2.

Nelson, I appreciate the info on the CRP, I will study it.

 

[Nelson Vergel]

I believe no man should be put on an AI at the start of TRT.

Effect of Estradiol on Men's Libido

 

[wondering]

I believe no man should be put on an AI at the start of TRT.

Effect of Estradiol on Men's Libido

Dr. Mariano said it was responsible for sex drive. He always cautioned about everyone blaming E2 for their problems.

 

[Mcgiver54]

I am learning the hard way about the AI. I started with 1mg of anastrozole that crashed my e2, then it was lowered to .5mg, now I will switch to pills with the idea of adjusting dose frequency to keep the levels from getting too high, I will take then pills as a last resort. I am interested to see if my ED remains or get fixed with an e2 level of 30 or higher.
Shbg is 29.5 currently.

 

[TorontoTRT]

Guys witH ED or low libido on TRT seem to all be on AI. If you’re pumping out 1000+ testosterone levels why would one think that the normal E2 range would be suitable for them? It’s like RDI vitamin recommendations. All these ranges are for NORMAL people. Yeah if your testosterone is 450-500, E2 of 25 is ok. But at 1000+ your E2 needs to be over 60 even. The body requires a ratio at TT->E2->DHT. let it do it’s thing. My best libido is at E2 70+.

 

[VDD]

Vivo en España, hice un análisis estándar de estradiol y me drogué, 47'02 pg / ml, luego hice la prueba de estradiol ultrasensible, pero no es por cromatografía de masas, creo que es por inmunoensayo y me dio 8 pg / ml muy bajo.
Es una gran diferencia.

 

[Mcgiver54]

Parece que algunos hombres tienen lecturas cercanas y otros grandes diferencias entre los dos, Nelson menciona CRP

It appears that some men have close readings and others large differences between the two, Nelson mentions CRP

 

[Mcgiver54]

But at 1000+ your E2 needs to be over 60 even. The body requires a ratio at TT->E2->DHT. let it do it’s thing. My best libido is at E2 70+.

Thanks Toronto, I am trying to get to that range to see how I feel, I go off the AI in the next 2 weeks as soon as i get my new prescription.

 

[wondering]

Guys witH ED or low libido on TRT seem to all be on AI. If you’re pumping out 1000+ testosterone levels why would one think that the normal E2 range would be suitable for them? It’s like RDI vitamin recommendations. All these ranges are for NORMAL people. Yeah if your testosterone is 450-500, E2 of 25 is ok. But at 1000+ your E2 needs to be over 60 even. The body requires a ratio at TT->E2->DHT. let it do it’s thing. My best libido is at E2 70+.

I am not on any AI and still have massive libido/ED issues.

 

[jcmaxwell]

Guys with low inflammation (measured by CRP) don't show much of a difference between ECLIA and LC/MS estradiol testing methods.

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



J Clin Endocrinol Metab (2013) 98 (6): E1097-E1102.

Immunoassay-based techniques, routinely used to measure serum estradiol (E2), are known to have reduced specificity, especially at lower concentrations, when compared with the gold standard technique of mass spectrometry (MS). Different measurement techniques may be responsible for the conflicting results of associations between serum E2 and clinical phenotypes in men.

Objective:

Our objective was to compare immunoassay and MS measurements of E2 levels in men and evaluate associations with clinical phenotypes.

Design and Setting:

Middle-aged and older male subjects participating in the population-based Osteoporotic Fractures in Men (MrOS) Sweden study (n = 2599), MrOS US (n = 688), and the European Male Aging Study (n = 2908) were included.



Main Outcome Measures:

Immunoassay and MS measurements of serum E2 were compared and related to bone mineral density (BMD; measured by dual energy x-ray absorptiometry) and ankle-brachial index.

Results:

Within each cohort, serum E2 levels obtained by immunoassay and MS correlated moderately (Spearman rank correlation coefficient rS 0.53–0.76). Serum C-reactive protein (CRP) levels associated significantly (albeit to a low extent, rS = 0.29) with immunoassay E2 but not with MS E2 levels. Similar associations of immunoassay E2 and MS E2 were seen with lumbar spine and total hip BMD, independent of serum CRP. However, immunoassay E2, but not MS E2, associated inversely with ankle-brachial index, and this correlation was lost after adjustment for CRP.

Conclusions:

Our findings suggest interference in the immunoassay E2 analyses, possibly by CRP or a CRP-associated factor. Although associations with BMD remain unaffected, this might imply for a reevaluation of previous association studies between immunoassay E2 levels and inflammation-related outcomes.

Lab Corp standard E2: 88.5
Lab Corp LC/MS/MS E2: 10

 

[Nelson Vergel]

Lab Corp standard E2: 88.5
Lab Corp LC/MS/MS E2: 10

Wow...thanks for sharing.
I bet your CRP is high. I assume both were taken the same day/time.

 

[Cataceous]

Lab Corp standard E2: 88.5
Lab Corp LC/MS/MS E2: 10

I would redo them. More than once I've had the mass spectrometry test result be half of what it should have been. It's not a reliable test.

Are you on TRT? An AI? Which result is more plausible? Your CRP would have to be very high to account for such a big difference.

 

[antelopers]

I'll run both on my next test again to compare and post it here as well as my CRP.