Ultrasensitive Estradiol test

[atsaaa]

Comrades, last Monday I had some blood testing done before the follow up with my Dr. today. They test blood in house and they use most likeley the standard E2 test (range 20-75). Becase of that I tested my self privately for Total, Free T and Estradiol using the ultrasensitive LC/MS/MS from Quest D.

The clinic's E2 test came back high 86 (20-75) and the Ultrasensitive from Quest came back 101 with normal range <29. Is it usual to see the opposite effect with the ultrasensitive? I thought that the regular one overestimates E2.

On the same note, TT was measured in clinic at 925 (300-1000) and at Quest 812 (250-1100), so not a big difference here. On the other hand, FT was measured in clinic at 2.08 (0.87-5.47) and at Quest 202 (35-155) which is too high. SHBG was tested normal in clinic 24 (20-60) and prolactin 14.4 (3.3-20.8).

Dr. prescirbed arimidex. I haven't gotten the prescription yet but when I asked him about the dose he said 1mg per day. From what I read here, that's too high of a dose. I've read a paper posted by nelson in an estradiol thread that one study cohort was also given 1mg per day. What are your thoughts?

 

[CoastWatcher]

Pay attention to the ultra-sensitive test; the standard test is unreliable. While it typically inflates the estradiol level, we have a number of members who report results similar to yours. The standard test is not a reliable vehicle for measuring e2 in men. It is flawed. Your Anastrozole dose is just fine...if you are a woman dealing with breast cancer. It's a disaster waiting to happen if any man follows that regimen. You will crash and be in a world of agony within 72 hours.

What is your protocol like? Are you injecting multiple times a week? You will want to lower that estradiol reading, but a little AI goes a long way. It would be reasonable to take .25, or possibly .50, milligrams twice a week. Be very careful...

 

[johndoesmith]

Comrades, last Monday I had some blood testing done before the follow up with my Dr. today. They test blood in house and they use most likeley the standard E2 test (range 20-75). Becase of that I tested my self privately for Total, Free T and Estradiol using the ultrasensitive LC/MS/MS from Quest D.

The clinic's E2 test came back high 86 (20-75) and the Ultrasensitive from Quest came back 101 with normal range <29. Is it usual to see the opposite effect with the ultrasensitive? I thought that the regular one overestimates E2.

On the same note, TT was measured in clinic at 925 (300-1000) and at Quest 812 (250-1100), so not a big difference here. On the other hand, FT was measured in clinic at 2.08 (0.87-5.47) and at Quest 202 (35-155) which is too high. SHBG was tested normal in clinic 24 (20-60) and prolactin 14.4 (3.3-20.8).

Dr. prescirbed arimidex. I haven't gotten the prescription yet but when I asked him about the dose he said 1mg per day. From what I read here, that's too high of a dose. I've read a paper posted by nelson in an estradiol thread that one study cohort was also given 1mg per day. What are your thoughts?

Were both of these tests done at the same time relative to injection? As in, did you do the in house day 5 after injection, then do the sensitive test day 6?

Also always post your full results. It's hard to make sense of them when you only post certain ones and not all next you each to other.

 

[ERO]

1mg a day of arimidex is insane - that is a comon dosing regimen used for women undergoing breast cancer treatment.

0.25 mg twice a week is a safe starting dose for a man on TRT.

 

[atsaaa]

Thanks CoastWatcher. I use HCG 1000IU x3 per week. Since my guess is that's too high of AI dose I will start lower (i.e. 0.25 x2 per week) for two weeks, get the ultra sensitive E2 done (ouch, that's 108 bucks) and then adjust either to 0.5 x2 per week or stay at 0.25 x2.

 

[atsaaa]

Johndoessmith, that's a good catch. I inject 1000IU HCG 3x (M, W, F). The in house lab tests were done on a Monday before I even injected. The Quest labs were done on Tuesday morning. I don't believe that this should make such a big difference on E2.

 

[Vince Carter]

Ive had a sensitive test that was higher than the standard, same blood draw on the same day.

 

[atsaaa]

Thanks ERO. That's my plan. To start 0.25 x2 and see how it goes.
Does anybody has a recommendation on what time of day is best for AI? I inject HCG M-W-F in the morning.

 

[johndoesmith]

Johndoessmith, that's a good catch. I inject 1000IU HCG 3x (M, W, F). The in house lab tests were done on a Monday before I even injected. The Quest labs were done on Tuesday morning. I don't believe that this should make such a big difference on E2.

It absolutely will. HCG is absorbed pretty quickly, so if you injected monday morning, then 24 hours later tested, a significant amount has been absorbed.

You cannot compare tests done under different conditions. I see you're new so you probably didn't know this, but these test results aren't proof of anything at this point.

AI dosing I'm not super familiar with, but I think standard starting dose is .25mg twice a week. If anyone else says I'm wrong with AI dose, listen to them instead of me lol.

 

[Vettester Chris]

Thanks ERO. That's my plan. To start 0.25 x2 and see how it goes.
Does anybody has a recommendation on what time of day is best for AI? I inject HCG M-W-F in the morning.

Agree, 1mg/day would be serious bad news! I knew a guy that was literally bed ridden for months because of a dosage like that. It prompted some sort of autoimmune disorder, and even put him in the hospital. It's a serious subject and I hope some of these doctors that just throw darts for dosage amounts get held accountable!! I personally don't think that anything above 1.5mg/week of Anastrozole is ever needed for men & TRT purposes, regardless of E2 serum results. AI's are potent and effective, and if it takes a month or two (or three) to get it really dialed in, then that's fine by me. If you crash your E2, just wait to see what estrogen rebound is like and the time frame with getting it all back in order (I was there once upon a time, no fun, won't do again!!).

The .25mg idea is good IMO, and it can be titrated up if needed. IMO, the most effective protocol is taking the AI the following day after you administer cypionate. That will usually be an effective intersection with the Peak Value of cypionate and the half life of the AI

 

[Vince Carter]

If taking it twice per week, the half life is about 50hrs so E3.5D is a fair compromise.

 

[atsaaa]

Thank you all guys. I did started AI yesterday night with 0.5mg as the initial dose. From now on I will continue with 0.25mg E3.5D and have labs done at two weeks from yesterday. I will keep you posted.

This morning I already had a decent erection. Is it possible for AI to have worked that fast or it was just the placibo effect?

 

[Weasel]

Thank you all guys. I did started AI yesterday night with 0.5mg as the initial dose. From now on I will continue with 0.25mg E3.5D and have labs done at two weeks from yesterday. I will keep you posted.

This morning I already had a decent erection. Is it possible for AI to have worked that fast or it was just the placibo effect?

Yes it is very possible for an AI to work that quickly.

It is my understanding that the standard test can match the sensitive/ultrasensitive test. It is certainly levels of CRP that can mess up the standard test. I believe it was elevated CRP that can cause a false elevated reading on the standard E2 test. Don't quote me on that though.... Nelson???

 

[atsaaa]

Comrades, I run the same ultra sensitive LC/MS/MS test two weeks after I started anastrozole. I've been taking 0.25mg twice per week. Before AI my E2 was 101 (ref <29) and with the last test was 50 (ref<29). Do you think I should stick with this dose or go to 0.25mg three times per week and retest? I haven't seen much difference to be honest except that very first day that I took my initial dose of AI.

As a note, both times I drew blood ~24 hours after an HCG injection. The only difference was that the second time I took 0.25mg of AI with the injection.

As a second note, my TRT regimen is 1000IU of HCG three times per week. With this dose I am well into the top range of total testosterone. I also take 0.25mg of AI every 3.5 days. Is it worth trying to take 0.25mg of AI with each injection so as to hopefully get in the 20-30 range of the sensitive test?

 

[Vince Carter]

Comrades, I run the same ultra sensitive LC/MS/MS test two weeks after I started anastrozole. I've been taking 0.25mg twice per week. Before AI my E2 was 101 (ref <29) and with the last test was 50 (ref<29). Do you think I should stick with this dose or go to 0.25mg three times per week and retest? I haven't seen much difference to be honest except that very first day that I took my initial dose of AI.

As a note, both times I drew blood ~24 hours after an HCG injection. The only difference was that the second time I took 0.25mg of AI with the injection.

As a second note, my TRT regimen is 1000IU of HCG three times per week. With this dose I am well into the top range of total testosterone. I also take 0.25mg of AI every 3.5 days. Is it worth trying to take 0.25mg of AI with each injection so as to hopefully get in the 20-30 range of the sensitive test?

WHile you're working this issue, don't change anything. A small change like I highlighted above can skew a result. Stay consistent. I would add a third dose perhaps M/W/F .25mg for at least two weeks.

 

[atsaaa]

Thanks Vince. The 0.25mg with the injection is part of the treatment. I didn't take any extra so as to do the test. I do injections M/W/F mornings and take AI Monday evening and Friday morning. Both tests were done on a Saturday.

 

[Vince Carter]

If you're shooting T M/W/F you should only be testing on Monday morning, not on Saturday.

 

[atsaaa]

Guys, new results are in after I started 0.75mg Anastrozole per week. The whole picture is:

I am on HCG monotherapy at the moment shooting 1000IU x3 weekly. Before I started AI my labs were:

11/15/16| Estradiol Ultrasensitive 101 (<=29), Total T 812 (250-1100), Free T 202 (35-155)*

I started taking 0.25mg of AI twice per week on 11/16/16 (0.5mg weekly total). After 18 days I got tested and the results were:

12/03/16| Estradiol Ultrasensitive 50 (<=29), Total T 1114 (250-1100), Free T 338.7 (35-155)*

On 12/08/16 I started 0.25mg of AI three times per week (0.75mg weekly total) on the day that I am injecting HCG. I got tested ~20 days after I started the 0.75mg weekly and the results just came in as:

12/29/16| Estradiol Ultrasensitive 60 (<=29), Total T 991 (250-1100), Free T 262 (35-155)*

*Blood was drawn a day after injecting HCG injection and taking 0.25mg AI.

Estradiol is still high. Should I go to 1mg weekly? What's your opinion?

My symptoms, subjectively improved, i.e. I started seeing some improvement in erections but I am not up there yet, if ya know what I mean.

I have a Dr's appointment in two weeks and I will discuss the T+HCG+AI option with him. To give a bit of background information, I chose HCG mono, to start with, because there are reports about exogenous administartion of T and retinopathies. I myself suffer from Central Serous Retinopathy (CSR). I chose to start with HCG to see whether endogenous T has an effect on it. I'm on HCG since 7/6/16 and so far so good. No problems with my eyes and I have the impression that treatment helps me with my condition. There is a very strong link with CSR and stress. Personality A people are more susceptible to it and also high cortisol levels can cause it. In the past 3 years I got tested at least 10-15 times for cortisol with three different methods and I was never high on cortisol, but I am still a personality A person. However, since I started HCG, I feel that I cope much better with stressful events. Is there any link with T and stress? If there is, there you go, it helps me at least.

Now that I figured that endogenous T doesn't affect my eyes, and knowing that exogenous and endogenous T are bioidentical (or am I wrong here?), I would like to try the trifecta regimen (T+HCG+AI).

Any commenst and help are appreciated.

 

[Vince Carter]

You should have only been tested right before your next HCG shot, not the day after, which makes this test rather useless in planning a dose change. We say this time after time after time...test right before your next shot.

 

[atsaaa]

Why is that? From the moment that all tests were done at the same time interval there should be comparable.