Help w/ labs and my E2

[LFG]

Hey all, can you help me with my test results. I’m currently on 30mg EOD of test cyp. I just changed from e3.5d to EOD 2 months ago to see if it will help me feel better. I was a little sluggish so I tried the change.

My E2 was always in the 16-22 range and now it’s jumped to 45. Nothing else really changed. How does everything else look and any tips why e2 went so high?

 

[Cataceous]

What was your previous E3.5D protocol? What was your testosterone then? Peak? Trough? If you were previously measuring trough values then it's expected to see them go up with more frequent injections at the same total weekly dose.

Your current level of estradiol is normal for your somewhat high total testosterone, about 0.5%. If it is extremely inconsistent with previous measurements then it's possible it's the test itself. The sensitive estradiol test is temperamental and is known to occasionally spit out ridiculously wrong numbers.

 

[LFG]

What was your previous E3.5D protocol? What was your testosterone then? Peak? Trough? If you were previously measuring trough values then it's expected to see them go up with more frequent injections at the same total weekly dose.

Your current level of estradiol is normal for your somewhat high total testosterone, about 0.5%. If it is extremely inconsistent with previous measurements then it's possible it's the test itself. The sensitive estradiol test is temperamental and is known to occasionally spit out ridiculously wrong numbers.

 

[LFG]

My previous e3.5d was 52 mg of cyp test. So it’s close to the 210mg every 2 weeks that I’m currently on.

When I was doing e3.5d my total test (June) was 581 with free 77. Which was honestly low. And why I switched to EOD. In March test my total test was 700 with a free test of 17 (8-25 range) and E2 of 24 (range of 8-35).

I used different lab company’s so it’s hard to compare side by side

it is extremely different than my previous test for the last three years. I never had a estradiol higher than 25 and Now it jump to 40.

 

[madman]

My previous e3.5d was 52 mg of cyp test. So it’s close to the 210mg every 2 weeks that I’m currently on.

When I was doing e3.5d my total test (June) was 581 with free 77. Which was honestly low. And why I switched to EOD. In March test my total test was 700 with a free test of 17 (8-25 range) and E2 of 24 (range of 8-35).

I used different lab company’s so it’s hard to compare side by side

it is extremely different than my previous test for the last three years. I never had a estradiol higher than 25 and Now it jump to 40.

Regarding your elevated e2, the key lies in where your FT level truly sits on such protocols and the only way to know such is to have it tested using an accurate assay such as the gold standard Equilibrium Dialysis or Ultrafiltration.

Unfortunately, you have no idea where your FT level sits on such protocols as you had it tested using different labs let alone methods the piss poor direct immunoassay (reference range LABCORP 8-25 pg/ml) and the flawed calculated linear law-mass-action ( QUEST reference range 46.0-224.0 pg/ml).

When it comes to e2 although you had it tested using LC/MS-MS it was done at Quest and keep in mind that Labcorp has been certified with the CDC HoSt program.....Quest has not!

CDC STANDARDIZED TOTAL T AND ESTRADIOL TESTS and soon to be FREE TESTOSTERONE!

How the CDC Clinical Standardization Programs Are Improving Hormone Tests - AACC.org WHAT PROGRESS HAS CDC MADE WITH STANDARDIZING TOTAL TESTOSTERONE AND ESTRADIOL TESTS? Since HoSt began in 2010, CDC has had more than 350 participants in 15 countries. Participants have shown measurable...

www.excelmale.com

Click on the PDF

Keep in mind that it is critical testing at the true trough, using the same lab, same assay (most accurate) when comparing such otherwise it is a complete waste of time!

 

[LFG]

Regarding your elevated e2, the key lies in where your FT level truly sits on such protocols and the only way to know such is to have it tested using an accurate assay such as the gold standard Equilibrium Dialysis or Ultrafiltration.

Unfortunately, you have no idea where your FT level sits on such protocols as you had it tested using different labs let alone methods the piss poor direct immunoassay (reference range LABCORP 8-25 pg/ml) and the flawed calculated linear law-mass-action ( QUEST reference range 46.0-224.0 pg/ml).

When it comes to e2 although you had it tested using LC/MS-MS it was done at Quest and keep in mind that Labcorp has been certified with the CDC HoSt program.....Quest has not!

CDC STANDARDIZED TOTAL T AND ESTRADIOL TESTS and soon to be FREE TESTOSTERONE!

How the CDC Clinical Standardization Programs Are Improving Hormone Tests - AACC.org WHAT PROGRESS HAS CDC MADE WITH STANDARDIZING TOTAL TESTOSTERONE AND ESTRADIOL TESTS? Since HoSt began in 2010, CDC has had more than 350 participants in 15 countries. Participants have shown measurable...

www.excelmale.com

Click on the PDF
View attachment 12252


Keep in mind that it is critical testing at the true trough, using the same lab, same assay (most accurate) when comparing such otherwise it is a complete waste of time!

Well shit, now I’m more confused than ever.

 

[Vince]

Hey all, can you help me with my test results. I’m currently on 30mg EOD of test cyp. I just changed from e3.5d to EOD 2 months ago to see if it will help me feel better. I was a little sluggish so I tried the change.

My E2 was always in the 16-22 range and now it’s jumped to 45. Nothing else really changed. How does everything else look and any tips why e2 went so high?

I wouldn’t be concerned with your E2, as long as you’re feeling good. The main issue with E2 is if it gets too low.

Beside your concern with your estrogen levels. How are you feeling? Do you feel better on this protocol compared your last protocol?

 

[madman]

Well shit, now I’m more confused than ever.

With a TT 900s (true trough?) and SHBG of 23 nmol/L then your FT would be on the high end.

Mind you the only way to know where it truly sits is to have it tested using an accurate assay (ED or UF) and this is critical when it comes to FT.

Although TT is important to know you should be much more concerned with where your FT level truly sits as it is the active unbound fraction of testosterone responsible for the positive effects.

Higher FT will result in higher e2.

Most men will do well with FT in the 20-30 ng/dL range and some will run higher levels as it comes down to the individual.

Some men running higher FT levels end up constantly struggling with sides.

If you feel well overall then leave it be otherwise if there are any issues then retest your FT using an accurate assay as it may very well be higher than you think and a tweak in your protocol may be needed!

 

[madman]

My previous e3.5d was 52 mg of cyp test. So it’s close to the 210mg every 2 weeks that I’m currently on.

When I was doing e3.5d my total test (June) was 581 with free 77. Which was honestly low. And why I switched to EOD. In March test my total test was 700 with a free test of 17 (8-25 range) and E2 of 24 (range of 8-35).

I used different lab company’s so it’s hard to compare side by side

it is extremely different than my previous test for the last three years. I never had a estradiol higher than 25 and Now it jump to 40.

Use Nelsons discountedlabs.

Most accurate assays for FT

Either will suffice!

1 Testosterone, Total and Free (NO Upper Limit) plus Hematocrit

2 Testosterone, Total, LC/MS and Free (Equilibrium Ultrafiltration)

 

[madman]

I wouldn’t be concerned with your E2, as long as you’re feeling good. The main issue with E2 is if it gets too low.

Beside your concern with your estrogen levels. How are you feeling? Do you feel better on this protocol compared your last protocol?

 

[LFG]

I wouldn’t be concerned with your E2, as long as you’re feeling good. The main issue with E2 is if it gets too low.

Beside your concern with your estrogen levels. How are you feeling? Do you feel better on this protocol compared your last protocol?

I’m feeling a little better but to be honest, I feel like I’m more sensitive than usual. But I’m wondering why the estrogen doubled. Maybe it was a bad test?

 

[Vince]

I’m feeling a little better but to be honest, I feel like I’m more sensitive than usual. But I’m wondering why the estrogen doubled. Maybe it was a bad test?

That’s a good idea. Why don’t you retake your E2 labs.

 

[LFG]

Yeah, and not sure if it’s useless like another member noted. I used the Test from discounted labs from this website.. so I’m not sure if it’s even worth it.

 

[madman]

I’m feeling a little better but to be honest, I feel like I’m more sensitive than usual. But I’m wondering why the estrogen doubled. Maybe it was a bad test?

Yeah, and not sure if it’s useless like another member noted. I used the Test from discounted labs from this website.. so I’m not sure if it’s even worth it.

Again to be clear when it comes to testing it is critical to use the same lab, the same assay (most accurate), and testing at the true trough.

You have no idea where your FT truly sat on your current/previous protocols as you had it tested using 2 different methods (direct immunoassay, calculated) using 2 different labs let alone we have no idea if testing was done at the true trough.

Top it off that you did not have it tested using the most accurate assays (ED or UF) so we have no idea where your FT level truly sat.

Regarding e2 you had it tested at Quest using LC/MS-MS (most accurate) and it was high because your FT is on the high end and your FT may very well be much higher than you think.

Yes you had your e2 tested using an accurate assay which was a smart move and I never stated that it was useless.....keep in mind that Labcorp has been certified with the CDC HoSt program.....Quest has not!

I was talking about your FT and unless you had it tested using the same lab, same assay (most accurate), and at the true trough then it is a waste of time to compare let alone rely upon!

Your e2 is high so no need to retest unless you want to compare.

I would be more concerned with knowing where your FT level truly sits!

 

[madman]

Very low E2 levels during menopause complicate assay use, measurement

https://www.healio.com/news/endocrinology/20201210/very-low-estrogen-levels-during-menopause-complicate-assay-use-measurement Clinicians using mass spectrometry to measure hormone levels should exercise caution when assessing data from postmenopausal women when very low estradiol levels are...

www.excelmale.com

​

Need for standardization​

Laboratory measurements are the sole source of information for diagnosis and treatment of many endocrine diseases, and hormone tests must be accurate and precise, according to Hubert W. Vesper, Ph.D., director of clinical standardization programs at the CDC’s National Center for Environmental Health. Measurements of testosterone and estradiol are two of eight laboratory measurements the CDC has worked to optimize for high accuracy and precision. Vesper said reference intervals for estradiol and other hormones are needed, especially for postmenopausal women.

“One of the main challenges with measuring low-level sex steroids is analytical specificity and sensitivity, for example, making sure that an assay measures only estradiol or testosterone and no other compound,” Vesper told Endocrine Today. “The CDC’s Clinical Standardization Programs for estradiol and testosterone are assessing the measurement accuracy and reliability of estradiol and testosterone measurements, among other biomarkers. Those laboratories and assay manufacturers successfully participating in these CDC programs are listed on the CDC website.”

If an assay manufacturer is listed on the CDC website, this means the assay is appropriately calibrated and one can see how well an assay determines these hormones in individual blood samples, Vesper said.

“The higher the individual sample pass rate, the less inaccurate measurements are on different individual blood samples,” Vesper said. “In other words, the individual sample pass rate provides some information about the specificity of an assay.”

The Endocrine Society has been actively involved with the CDC in the effort to standardize assays for more accurate hormone measurement, Wierman said.

“One mass spectrometry assay is not the same as another mass spectrometry assay,” Wierman said. “Mass spectrometry is not perfect. There still are some very sensitive immunoassays, for example, for estradiol, that actually is very good. There are situations where they are useful.”

Vesper noted that some laboratories and assay manufacturers perform extra steps to ensure and improve the quality of hormone assays by voluntarily participating in the CDC’s clinical standardization programs or by participating in accuracy-based surveys offered by the College of American Pathologists.

“It is important to support laboratories with these efforts, as standardized, high-quality measurements will improve patient care,” Vesper said.

 

[madman]

*“One mass spectrometry assay is not the same as another mass spectrometry assay,” Wierman said. “Mass spectrometry is not perfect. There still are some very sensitive immunoassays, for example, for estradiol, that actually is very good. There are situations where they are useful.”

 

[LFG]

Use Nelsons discountedlabs.

Most accurate assays for FT

Either will suffice!

1 Testosterone, Total and Free (NO Upper Limit) plus Hematocrit

2 Testosterone, Total, LC/MS and Free (Equilibrium Ultrafiltration)

Is the test I got, not this? I went thru discounted labs but maybe I picked the wrong one?

 

[LFG]

With a TT 900s (true trough?) and SHBG of 23 nmol/L then your FT would be on the high end.

Mind you the only way to know where it truly sits is to have it tested using an accurate assay (ED or UF) and this is critical when it comes to FT.

Although TT is important to know you should be much more concerned with where your FT level truly sits as it is the active unbound fraction of testosterone responsible for the positive effects.

Higher FT will result in higher e2.

Most men will do well with FT in the 20-30 ng/dL range and some will run higher levels as it comes down to the individual.

Some men running higher FT levels end up constantly struggling with sides.

If you feel well overall then leave it be otherwise if there are any issues then retest your FT using an accurate assay as it may very well be higher than you think and a tweak in your protocol may be needed!

Yes it was tested on the morning of my injection (before I did it).
from what I’m understanding is that I just did the wrong test to get a accurate result. So is it worth testing for estradiol again? Or just stick to the TT/FT in the links you provided me?

 

[madman]

Is the test I got, not this? I went thru discounted labs but maybe I picked the wrong one?

This is FT calculated (reference range 46.0-224.0 pg/ml)

)

 

[madman]

Yes it was tested on the morning of my injection (before I did it).
from what I’m understanding is that I just did the wrong test to get a accurate result. So is it worth testing for estradiol again? Or just stick to the TT/FT in the links you provided me?

Just retest FT using one of the accurate assays (ED or UF).