Mass spectrometry the same as LC-MS?

[DiegoG]

Hello,

I tried searching the forum and web and can't seem to find a direct answer. Is mass spectrometry the same as LC-MS? (Liquid chromatography mass spectrometry)

My fiance (biological female) just completed blood work at a hospital and she got her results in.

Total t - 255, free t - 25. The test method said it was completed by mass spectrometry. Shouldn't it have been LC-MS? Liquid chromatography mass spectrometry or are they the same? Trying to interpret if her results are correct and reliable.

Thanks,

 

[DiegoG]

@Nelson Vergel

@madman

 

[madman]

Hello,

I tried searching the forum and web and can't seem to find a direct answer. Is mass spectrometry the same as LC-MS? (Liquid chromatography mass spectrometry)

My fiance (biological female) just completed blood work at a hospital and she got her results in.

Total t - 255, free t - 25. The test method said it was completed by mass spectrometry. Shouldn't it have been LC-MS? Liquid chromatography mass spectrometry or are they the same? Trying to interpret if her results are correct and reliable.

Thanks,

Yes this is the gold standard testing method for TT.

Depending on the lab some will just state MS.

Look over the methodology as it is always coupled with liquid or gas chromatography (LC or GC).




*MS-based assays remain the gold standard for the quantification of total testosterone levels.

*MS involves the ionization of serum compounds and subsequent measurement of their mass-to-charge ratios or molecular weight. Preanalysis extraction or chromatography (gas or liquid) prior to MS can be performed to separate hormones and proteins that could otherwise affect the accurate measurement of testosterone.

*The MS subtype, LC-MS/MS, which couples the liquid chromatography technique of chemical separation to the MS technique, has been an increasingly adopted high-throughput and accurate testosterone assay in clinical practice and research.19

Testosterone Assays

Testosterone Assays (2022) Brendan King, MD, Caleb Natale, MD, Wayne J.G. Hellstrom, MD The accurate detection and quantification of serum testosterone levels are necessary for the diagnosis of hypogonadism in men, evaluation of endocrine abnormalities, and monitoring and titration of...

www.excelmale.com

Mass Spectrometry

MS-based assays remain the gold standard for the quantification of total testosterone levels. Despite higher costs, MS has become increasingly more utilized in clinical practice in part due to its higher sensitivity and specificity at both low and high testosterone levels compared to IAs, which have been shown to vary significantly, particularly at low testosterone levels.19,20 From 2012 to 2015, nearly a fivefold increase in the use of MS-based assays was reported by the College of American Pathologists.14

Additional advantages of MS include the ability to measure multiple steroid levels simultaneously, simple sample preparation wherein nonderivatized steroids can be analyzed directly; high recovery with improved signal-to-noise ratio; and lower interference.17

In contrast to IA, MS involves the ionization of serum compounds and subsequent measurement of their mass-to-charge ratios or molecular weight. Preanalysis extraction or chromatography (gas or liquid) prior to MS can be performed to separate hormones and proteins that could otherwise affect the accurate measurement of testosterone. The MS subtype, LC-MS/MS, which couples the liquid chromatography technique of chemical separation to the MS technique, has been an increasingly adopted high-throughput and accurate testosterone assay in clinical practice and research.19 Although considerable interlaboratory variability exists with MS, this remains a significant improvement from the variability inherent to commercially available IAs.21 The high complexity of laboratory equipment required and the relatively high expense of running MS remain the predominant obstacles to its widespread adoption.22

Testosterone, Total, LC/MS-MS​

070001: Testosterone, Total, Women, Children, and Hypogonadal Males, LC/MS-MS | Labcorp

Labcorp test details for Testosterone, Total, Women, Children, and Hypogonadal Males, LC/MS-MS

www.labcorp.com

Methodology​

Liquid chromatography/tandem mass spectrometry (LC/MS-MS)

Testosterone, Total, MS​

Quest Diagnostics: Test Directory

testdirectory.questdiagnostics.com

Methodology​

Chromatography/Mass Spectrometry

 

[madman]

THE IMPORTANCE OF ACCURATE HORMONE TESTS

https://www.hormoneassays.org/ Watch our video to learn about the importance of accurate hormone testing. Tests to measure the level of a specific hormone in the body are the third most common diagnostic in medicine today yet some current hormone tests are not sufficiently accurate or...

www.excelmale.com

 

[DiegoG]

Yes this is the gold standard testing method for TT.

Depending on the lab some will just state MS.

Look over the methodology as it is always coupled with liquid or gas chromatography (LC or GC).




*MS-based assays remain the gold standard for the quantification of total testosterone levels.

*MS involves the ionization of serum compounds and subsequent measurement of their mass-to-charge ratios or molecular weight. Preanalysis extraction or chromatography (gas or liquid) prior to MS can be performed to separate hormones and proteins that could otherwise affect the accurate measurement of testosterone.

*The MS subtype, LC-MS/MS, which couples the liquid chromatography technique of chemical separation to the MS technique, has been an increasingly adopted high-throughput and accurate testosterone assay in clinical practice and research.19

Testosterone Assays

Testosterone Assays (2022) Brendan King, MD, Caleb Natale, MD, Wayne J.G. Hellstrom, MD The accurate detection and quantification of serum testosterone levels are necessary for the diagnosis of hypogonadism in men, evaluation of endocrine abnormalities, and monitoring and titration of...

www.excelmale.com

Mass Spectrometry

MS-based assays remain the gold standard for the quantification of total testosterone levels. Despite higher costs, MS has become increasingly more utilized in clinical practice in part due to its higher sensitivity and specificity at both low and high testosterone levels compared to IAs, which have been shown to vary significantly, particularly at low testosterone levels.19,20 From 2012 to 2015, nearly a fivefold increase in the use of MS-based assays was reported by the College of American Pathologists.14

Additional advantages of MS include the ability to measure multiple steroid levels simultaneously, simple sample preparation wherein nonderivatized steroids can be analyzed directly; high recovery with improved signal-to-noise ratio; and lower interference.17

In contrast to IA, MS involves the ionization of serum compounds and subsequent measurement of their mass-to-charge ratios or molecular weight. Preanalysis extraction or chromatography (gas or liquid) prior to MS can be performed to separate hormones and proteins that could otherwise affect the accurate measurement of testosterone. The MS subtype, LC-MS/MS, which couples the liquid chromatography technique of chemical separation to the MS technique, has been an increasingly adopted high-throughput and accurate testosterone assay in clinical practice and research.19 Although considerable interlaboratory variability exists with MS, this remains a significant improvement from the variability inherent to commercially available IAs.21 The high complexity of laboratory equipment required and the relatively high expense of running MS remain the predominant obstacles to its widespread adoption.22

Testosterone, Total, LC/MS-MS​

070001: Testosterone, Total, Women, Children, and Hypogonadal Males, LC/MS-MS | Labcorp

Labcorp test details for Testosterone, Total, Women, Children, and Hypogonadal Males, LC/MS-MS

www.labcorp.com

Methodology​

Liquid chromatography/tandem mass spectrometry (LC/MS-MS)

Testosterone, Total, MS​

Quest Diagnostics: Test Directory

testdirectory.questdiagnostics.com

Methodology​

Chromatography/Mass Spectrometry

Thanks for the detailed response. I contacted the lab and confirmed it was LC-MS. So we are good and your right it was to determine the labs were accurate and not in error. She is on trt replacement and has been experiencing a lot of agitation and anger issues. Assuming it's from the elevated testosterone.

 

[DiegoG]

THE IMPORTANCE OF ACCURATE HORMONE TESTS

https://www.hormoneassays.org/ Watch our video to learn about the importance of accurate hormone testing. Tests to measure the level of a specific hormone in the body are the third most common diagnostic in medicine today yet some current hormone tests are not sufficiently accurate or...

www.excelmale.com

I'll be watching this tonight. Thank you.

 

[DiegoG]

@madman

Can I get your opinion on these labs below? They are from my fiancé whos trying to get dialed in feeling her best. We are lowering her Testosterone Cypionate based on these results and symptoms she was having of anger and agitation. She's on thyroid medication but from the blood results her T3 & T4 seem low still. What do you think?

Lab Results	Value
Total T	227 ng/dL
Free T	25.1 pg/mL
Progestrone	0.32 ng/mL
Estradiol	103 pg/mL
SHBG	71 nmol/L
DHEA	218 ug/dl
Ferritin	210 ng/mL
Iron and TIBC	Low Transferrin
TSH, 3rd Gen	1.010 u[IU]/mL
T3 Free	2.70 pg/mL
T4 Free	0.81 ng/dL
T3 Reverse	8.4 ng/dL
Thyroid Antibody	196 <34 [IU]/mL

 

[madman]

@madman

Can I get your opinion on these labs below? They are from my fiancé whos trying to get dialed in feeling her best. We are lowering her Testosterone Cypionate based on these results and symptoms she was having of anger and agitation. She's on thyroid medication but from the blood results her T3 & T4 seem low still. What do you think?

Lab Results	Value
Total T	227 ng/dL
Free T	25.1 pg/mL
Progestrone	0.32 ng/mL
Estradiol	103 pg/mL
SHBG	71 nmol/L
DHEA	218 ug/dl
Ferritin	210 ng/mL
Iron and TIBC	Low Transferrin
TSH, 3rd Gen	1.010 u[IU]/mL
T3 Free	2.70 pg/mL
T4 Free	0.81 ng/dL
T3 Reverse	8.4 ng/dL
Thyroid Antibody	196 <34 [IU]/mL

Post reference ranges.

Her TT and more importantly FT are sky-high even with a high SHBG of 71 nmol/L.

*Normal ranges for total T is 15-70 ng/dl and free T is 0.5-6.5 pg/ml.

What method (assay/cFT) was used for free testosterone?

You would need to have tested her FT using the most accurate assay Equilibrium Dialysis to know where it truly sits.