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Testosterone Replacement, Low T, HCG, & Beyond
Blood Test Discussion
Why All Men Should be Tested with the Sensitive Estradiol Test
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<blockquote data-quote="DragonBits" data-source="post: 102948" data-attributes="member: 18023"><p>I agree with you that the LC-MS/MS method is more accurate, and especially so for lower levels of E2. Though in my case it’s a moot point.</p><p> </p><p>Partly I asked the question because I was wondering if there any value to knowing if my E2 was 2 pg/ml or 4 pg/ml or even 10 pg/ml?</p><p> </p><p>I don’t see any value to knowing that, and the only reason at this time I wanted to know was intellectual curiosity. </p><p> </p><p>Moot point because I do not have any exogenous testosterone in my system, and my free testosterone measured 5.5 pg/ml (Roche ECLIA methodology) and my TT was 390 ng/dl (LC/MS-MS method). Which would explain my low E2. (LH 3.6 mIU/mL)</p><p> </p><p>If I were ordering testosterone independent of a doctor/clinic I would do so based on the evidence I have right now. But I already know my medical history for the past 8 years, while a doctor tends to treat a new patient as if they were a newly created human. Meaning they want to start from ground zero.</p><p> </p><p>My reason for getting on this forum was to determine the best method to restart TRT. I had previously been on Nebido for 5 years, but it was mostly independent of a doctor. A doctor in Asia gave me my first injection, he didn’t do any hormone tests before hand, though he did run a PSA and EKG test. And I knew my TT level was likely low normal ~ 376 ng/dl from a test I had done a few years ago. Sure, I know it can change, but it didn’t feel like it changed. After that I pretty much went my own way.</p><p> </p><p>BTW, I had contracted Defy and your intake specialist also repeated the need for the sensitive E2 test giving the same reasons as you stated. </p><p> </p><p>I don’t have a problem with getting the panel Defy needs, and I have never measured IGF-1, so that at least would be new information for me. The rest of the panel, I could pretty much predict what it will indicate. But I have recently been taking Boron, it is reported to raise free T by 28% by lowing SHBG. In the past my SHBG ranged from 37-42 nmol/L. Any significant change in those two measurements I would attribute to the boron supplement. Though it’s not going to be enough of a change to bring me up to the level I would like to be at.</p><p> </p><p>I have learned something new about the E2 standard Vs sensitive test. I had thought sensitive meant the test would measure lower levels of E2 than the standard, but I didn’t know the standard test was error prone. </p><p> </p><p>BTW, I didn’t order the E2 test, an urologist I went to for a prostate exam and to request TRT for me ordered the test. His feelings were that the Low level of E2 was not clinically significant, the low level of free T he ignored and went by the level of Total T as being within normal limits. Talking to his nurse I disagreed, he then wanted to order another test that would include SHBG. I haven’t done the test as I assume it wouldn’t change his mind. And likely my insurance which is Medicare wouldn’t pay for TRT and for the same reason, so I lost interest in that route. He said he wasn't a numbers guy, my first hint that he was a numbers guy, so he would probably be difficult to deal with in any case. <img src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" class="smilie smilie--sprite smilie--sprite3" alt=":(" title="Frown :(" loading="lazy" data-shortname=":(" /></p><p> </p><p></p><p>(Honestly, bottom line is that everyone is a numbers guy, just some are more flexible about the numbers.)</p><p></p><p></p><p>In order to get Medicare to pay for TRT, I would probably have to get my TT down to 264.0 ng/dl, which would be nearly impossible to achieve without some sort of drug. So I also have abandoned the idea that maybe Medicare would pay for it.</p><p> </p><p>After reading “Challenges to the Measurement of Estradiol: An Endocrine Society Position Statement”, I can see why this is the case.</p><p><a href="https://academic.oup.com/jcem/article/98/4/1376/2536715" target="_blank"></a></p><p><a href="https://academic.oup.com/jcem/article/98/4/1376/2536715" target="_blank">https://academic.oup.com/jcem/article/98/4/1376/2536715</a></p></blockquote><p></p>
[QUOTE="DragonBits, post: 102948, member: 18023"] I agree with you that the LC-MS/MS method is more accurate, and especially so for lower levels of E2. Though in my case it’s a moot point. Partly I asked the question because I was wondering if there any value to knowing if my E2 was 2 pg/ml or 4 pg/ml or even 10 pg/ml? I don’t see any value to knowing that, and the only reason at this time I wanted to know was intellectual curiosity. Moot point because I do not have any exogenous testosterone in my system, and my free testosterone measured 5.5 pg/ml (Roche ECLIA methodology) and my TT was 390 ng/dl (LC/MS-MS method). Which would explain my low E2. (LH 3.6 mIU/mL) If I were ordering testosterone independent of a doctor/clinic I would do so based on the evidence I have right now. But I already know my medical history for the past 8 years, while a doctor tends to treat a new patient as if they were a newly created human. Meaning they want to start from ground zero. My reason for getting on this forum was to determine the best method to restart TRT. I had previously been on Nebido for 5 years, but it was mostly independent of a doctor. A doctor in Asia gave me my first injection, he didn’t do any hormone tests before hand, though he did run a PSA and EKG test. And I knew my TT level was likely low normal ~ 376 ng/dl from a test I had done a few years ago. Sure, I know it can change, but it didn’t feel like it changed. After that I pretty much went my own way. BTW, I had contracted Defy and your intake specialist also repeated the need for the sensitive E2 test giving the same reasons as you stated. I don’t have a problem with getting the panel Defy needs, and I have never measured IGF-1, so that at least would be new information for me. The rest of the panel, I could pretty much predict what it will indicate. But I have recently been taking Boron, it is reported to raise free T by 28% by lowing SHBG. In the past my SHBG ranged from 37-42 nmol/L. Any significant change in those two measurements I would attribute to the boron supplement. Though it’s not going to be enough of a change to bring me up to the level I would like to be at. I have learned something new about the E2 standard Vs sensitive test. I had thought sensitive meant the test would measure lower levels of E2 than the standard, but I didn’t know the standard test was error prone. BTW, I didn’t order the E2 test, an urologist I went to for a prostate exam and to request TRT for me ordered the test. His feelings were that the Low level of E2 was not clinically significant, the low level of free T he ignored and went by the level of Total T as being within normal limits. Talking to his nurse I disagreed, he then wanted to order another test that would include SHBG. I haven’t done the test as I assume it wouldn’t change his mind. And likely my insurance which is Medicare wouldn’t pay for TRT and for the same reason, so I lost interest in that route. He said he wasn't a numbers guy, my first hint that he was a numbers guy, so he would probably be difficult to deal with in any case. :( (Honestly, bottom line is that everyone is a numbers guy, just some are more flexible about the numbers.) In order to get Medicare to pay for TRT, I would probably have to get my TT down to 264.0 ng/dl, which would be nearly impossible to achieve without some sort of drug. So I also have abandoned the idea that maybe Medicare would pay for it. After reading “Challenges to the Measurement of Estradiol: An Endocrine Society Position Statement”, I can see why this is the case. [URL="https://academic.oup.com/jcem/article/98/4/1376/2536715"] https://academic.oup.com/jcem/article/98/4/1376/2536715[/URL] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Blood Test Discussion
Why All Men Should be Tested with the Sensitive Estradiol Test
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