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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Sensitive E2 in the 100’s
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<blockquote data-quote="TRTARNP" data-source="post: 198714" data-attributes="member: 42356"><p>Do you generally favor not using HcG when starting TRT, in the context of a non-fertility desiring patient? I am starting to think perhaps this is more desirable in this patient base. </p><p></p><p>The E2 issue continues to be challenging, it is good to at least get some input that perhaps, it is not crazy to consider letting patients ride in the 60-120 range, assuming they are tolerating that well, therapy is going well and achieving the identified goals of therapy, etc. As you eluded to, there is lacking justification that AI use is a better long-term solution, especially if the use is strictly to control a number versus side effect management. </p><p></p><p>Interestingly, the clinic's standard E2 assessment is the immunoassay. I don't use this for Ai considerations, and always assess LC/MS if there are issues. I would estimate 25% of the time the LC/MS has read higher than the immunoassay. And in both of these individuals, the LC/MS read between 20-30 point higher than the immunoassay. These were run by Quest. </p><p></p><p>I have also seen many immunoassay levels measure anywhere from 8-120 points lower than the LC/MS. So the levels are all over the place. Lab assessment of these hormone values can be maddeningly frustrating at times.</p></blockquote><p></p>
[QUOTE="TRTARNP, post: 198714, member: 42356"] Do you generally favor not using HcG when starting TRT, in the context of a non-fertility desiring patient? I am starting to think perhaps this is more desirable in this patient base. The E2 issue continues to be challenging, it is good to at least get some input that perhaps, it is not crazy to consider letting patients ride in the 60-120 range, assuming they are tolerating that well, therapy is going well and achieving the identified goals of therapy, etc. As you eluded to, there is lacking justification that AI use is a better long-term solution, especially if the use is strictly to control a number versus side effect management. Interestingly, the clinic's standard E2 assessment is the immunoassay. I don't use this for Ai considerations, and always assess LC/MS if there are issues. I would estimate 25% of the time the LC/MS has read higher than the immunoassay. And in both of these individuals, the LC/MS read between 20-30 point higher than the immunoassay. These were run by Quest. I have also seen many immunoassay levels measure anywhere from 8-120 points lower than the LC/MS. So the levels are all over the place. Lab assessment of these hormone values can be maddeningly frustrating at times. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Sensitive E2 in the 100’s
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