Conflicting Numbers From Labs

I am currently taking liquid anastrozole for high estradiol due to TRT with transdermals. I am getting some crazy lab readings between LabCorp and Quest Diagnostics.

11-1-07 LabCorp (anastrozole: 10 drops EOD)

Estradiol 20 pg/mL

12-9-07 LabCorp (anastrozole: 10 drops EOD)

Estradiol <15 pg/mL

At this point I reduced my anastrozole and retested.

12-31-07 Quest Diagnostics (anastrozole: 6 drops EOD)

Estradiol 53 pg/mL

What the heck is going on here? Which is the more reputable lab? I don’t understand this. Anyone else experienced this?

Both labs are totally and completely reputable. They are the #1 and #2 labs in the US.

However, they can and do make mistakes. Usually, however, for quality control, they perform tests multiple times to make sure that there’s not a problem with the calibration of the equipment and things like that.

So… it might not be a problem with the lab but actual fluctuations in your Estradiol levels for some reason.

You don’t say if YOU believe these numbers. I’d expect to see noticeable changes in how I felt with swings like these.

When my E2 is too low, I feel it in my joints and my libido crashes. When my E2 is too high, I get depressed and my erections get softer. Does your dick believe these results?

Lab Tests Online has some relevant information about E2 testing:

NOTE: A standard reference range is not available for this test. Because reference values are dependent on many factors, including patient age, gender, sample population, and test method, numeric test results have different meanings in different labs. Your lab report should include the specific reference range for your test.

[quote]Raw Power wrote:
I am currently taking liquid anastrozole for high estradiol due to TRT with transdermals. I am getting some crazy lab readings between LabCorp and Quest Diagnostics.

11-1-07 LabCorp (anastrozole: 10 drops EOD)

Estradiol 20 pg/mL

12-9-07 LabCorp (anastrozole: 10 drops EOD)

Estradiol <15 pg/mL

At this point I reduced my anastrozole and retested.

12-31-07 Quest Diagnostics (anastrozole: 6 drops EOD)

Estradiol 53 pg/mL

What the heck is going on here? Which is the more reputable lab? I don’t understand this. Anyone else experienced this? [/quote]

Many insist that from Quest, you need their high sensitivity E2 test, and that the non high sensitivity test is useless for some reason. The basic serum E2 test from LabCorp works well for TRT. Some transfer the need for a high sensitivity E2 test onto LabCorp from Quest, but such statements seem groundless. If LabCorp does not report E2 levels less than 15, that should not be an issue once you have your dose dialed in.

Do not switch labs, this only introduces uncertainty into everything. You want to be able to correlate lab numbers with dose changes and how you feel. You can’t do that with different labs.

Lab numbers can be off the wall some times. Even with a large apparent change, you do not want to make large dose changes like that when a known dose had you at 20 at one point, which for many would seem to be an ideal level. You reduced your dose by 40%. I that happened to me and I felt great, I would not have changed my dose.

With all of the above that you reported; how did your libido, mood and engorge respond to the dose change? How you feel is more important than the lab numbers.

[quote]Raw Power wrote:
I am currently taking liquid anastrozole for high estradiol due to TRT with transdermals. I am getting some crazy lab readings between LabCorp and Quest Diagnostics.

11-1-07 LabCorp (anastrozole: 10 drops EOD)

Estradiol 20 pg/mL

12-9-07 LabCorp (anastrozole: 10 drops EOD)

Estradiol <15 pg/mL

At this point I reduced my anastrozole and retested.

12-31-07 Quest Diagnostics (anastrozole: 6 drops EOD)

Estradiol 53 pg/mL

What the heck is going on here? Which is the more reputable lab? I don’t understand this. Anyone else experienced this? [/quote]

Anastrozole is powerful stuff. I’ve read also (possibly here) that there is a belief that in response to aromatase inhibition, your body will kick up the production of the aromatase enzyme a bit to attempt a new equilibrium. So, 10 drops every other day was a little too much in the beginning, then a couple months later, fewer drops was not enough to counter the new equilibrium.

Also, were you shaking up that stuff really well each time? It might have been losing its potency over those few weeks.

[quote]happydog48 wrote:
You don’t say if YOU believe these numbers. I’d expect to see noticeable changes in how I felt with swings like these.

When my E2 is too low, I feel it in my joints and my libido crashes. When my E2 is too high, I get depressed and my erections get softer. Does your dick believe these results?

[/quote]

No, I didn’t believe the numbers from Quest because I was feeling fine or so I thought. No, my dick sure didn’t believe those numbers because my libido and erections are stronger than ever. I haven’t been experiencing any of the side effects of high E2 that I know about. My total T has gone down several hundred points (1749 to 978) after switching from exemestane to anastrozole.

When I was taking exemestane my starting E2 levels were 34. After several months of tweeking that and taking upwards of up to 20 drops per day I could only get my E2 down to 28.

I switched to anastrozole and kept getting the “<15 pg/mL” on my E2 readings from LabCorp through LEF so I kept reducing the amount I was taking. I started to experience what I was thought was too low E2 so I reduced down to just 6 drops EOD. I figured I would be in range. When I saw the lab from Quest showing 53 (range 0-54), yes, I couldn’t believe it!

I don’t know which lab to believe. I only know how I feel, but I am concerned about the consequences physically of high E2 so it would be nice to know if that really is a good number.

[quote]KSman wrote:

Do not switch labs, this only introduces uncertainty into everything. You want to be able to correlate lab numbers with dose changes and how you feel. You can’t do that with different labs.

Lab numbers can be off the wall some times. Even with a large apparent change, you do not want to make large dose changes like that when a known dose had you at 20 at one point, which for many would seem to be an ideal level. You reduced your dose by 40%. I that happened to me and I felt great, I would not have changed my dose.

With all of the above that you reported; how did your libido, mood and engorge respond to the dose change? How you feel is more important than the lab numbers.[/quote]

I was finally able to convince my doctor to check my E2 through my insurance so it went through Quest. I’ve always been checking it on my own through LabCorp via LEF. I guess your saying I should stay with LabCorp since that it was I have been using mainly? LabCorp has only one type of E2 test. I’ve never heard of the high sensitivity test for E2. I can’t imagine Quest screwing it up this big.

I guess I have already made that mistake about taking a large dose. When I saw that 53 pg/mL I came home and immediately front loaded 1 mL (24 drops) which equals 1mg of anastrozole. I’ve since been taking 12 drops every day since last Monday. I guess I overreacted on the numbers instead of how I feel which is fine. Heck, I have sex on my mind constantly it seems and am a “walking hard-on” all the time around my wife so it just seems hard to believe that an estradiol reading of 53 could be accurate. I don’t know.

[quote]bigdawg011 wrote:

Anastrozole is powerful stuff. I’ve read also (possibly here) that there is a belief that in response to aromatase inhibition, your body will kick up the production of the aromatase enzyme a bit to attempt a new equilibrium. So, 10 drops every other day was a little too much in the beginning, then a couple months later, fewer drops was not enough to counter the new equilibrium.

Also, were you shaking up that stuff really well each time? It might have been losing its potency over those few weeks.[/quote]

Yes sir, you’re right about the anastrozole. That is why I switched from exemestane to anastrozole. It’s stronger, takes less to get the job done and is cheaper. I was shaking the bottle up before dosage. I’ve had this bottle for 7 months now and have just a little bit left at the bottom. I thought maybe it’s become ineffective or something else. I don’t know what to think or do now. I guess I should pay attention to the symptoms from now on and quit worrying about the numbers.

I’ve been screwing around with anastrozole for many months trying to find the right dosage. I thought I had it when I hit 20 pg/mL on my E2 testing last Fall. When I retested again weeks later and it came back “<15” I thought I should back off some more.

I appreciate all the feedback! Thank you!

Not trying to make this a thread hijack, just trying to educate myself further…

Question - was this from the same blood draw? I mean - isn’t the only fair comparison to consider one that’s from samples taken at the same time??

WRT hormones / HRT - doesn’t blood chemistry have the ability to peak & valley rather quickly?

A personal experience FWIW, in my mid-20’s (circa 1986) I was an Orderly in an ER. I was in good with the lab folks because I chummed around with them all the time (11-7 shift, 110 bed hospital). I used to get blood work done all the time, mainly my cholesterol. Because I had read that fluctuations in diet (vs fasting) and caffeine/alcohol consumption could greatly affect cholesterol tests, I asked to be tested every day for a week, after ingesting various amount of food and coffee, and upon returning to work from a weekend (which typically found me rather hammered) all prior to having the draw done. The numbers swung by over a 50 points, my “theoretical ‘good’ base number” being about 187…

This is one of my concerns over starting to pay for blood work to observe my own hormone levels - consistency. How critical are factors like this for hormonal levels? I mean - I’ve read that testosterone can literally change minute to minute… I personally don’t have an “immediate need” or present health concerns, it’s more for personal edification - so I question whether or not I should start testing because of issues like those stated in this thread…

[b]All that being said -[/b] I recently learned I am a full 2 inches shorter than I was a decade ago - and that really freaked me out. My family has a rather demonstrated history of knee/hip joint deterioration. I have not measured my height upon waking or with any consistency, so maybe I should do that before getting too alarmed, I may just have been at the Docs on a day when life “beat me down” particularly hard…

TIA
Don

Raw Power: something I forgot to mention, and this is important, is that hormone levels fluctuate from day to day, and throughout a single day. A blood draw several minutes after the one they measured could have led to a different result. That’s why there are ranges. That’s why labs PLUS your symptoms/feeling are important to look at together.

How did you feel when your E2 was measured to be 53?

Don, there’s no such thing as too much information. Having your levels checked when you feel fine is perfect for later on down the road when/if you don’t feel fine. If I had a blood test from my twenties that showed my T at 800, then my doctor would have had a hard time telling me that I was “normal” at 300, even though both are “in range.” On the other hand, if I had the symptoms of low T and my blood came back with high levels, then I’d look elsewhere for the problem, like maybe high E or thyroid issues. The more you know, the better off you are.

Numbers aren’t the be all and end all, but the alternative is total ignorance. I’d rather know something than nothing. I’m doing the best I can with what’s available to me and I’m taking advantage of every bit of information I can get. Even less than perfect information.

[quote]bigdawg011 wrote:
Raw Power: something I forgot to mention, and this is important, is that hormone levels fluctuate from day to day, and throughout a single day. A blood draw several minutes after the one they measured could have led to a different result. That’s why there are ranges. That’s why labs PLUS your symptoms/feeling are important to look at together.

How did you feel when your E2 was measured to be 53?[/quote]

Is that true to the same extend when one is on TRT? I would not have expected that. Have studies been done on men with TRT, HPTA shutdown for things like that?