I’ve read all the studies performed on lc/ms vs ECLIA and from multiple different groups and they all documented major differences between lc/ms and ECLIA. I’ve seen a few guys on here that have posted bloodwork that says otherwise but I’ve seen far more that prove eclia overstates e2 levels.
I dont have labs to prove it but I know beyond any shadow of a doubt i was crashed and my doc did eclia method. Came back at e2 49. For over a year my e2 was either <5 and no higher than like 13 or something. Then suddenly it jumps to 49? No testosterone injections. No nothing. I dont think so.
Here is another one. Ultrasensitive higher than IA, but insignificant difference. It would be really interesting if a bunch of guys would do both. I spoke to a doctor with Quest regarding both methods, pros and cons. He was non committal as to which to use, “on the fence” in his words.
Would you post links to all the studies, or maybe some of them? Thanks.
How often do you get blood work done? Feel like I would like to start getting them more than quarterly. When I go in next month I’m going to ask him to do both estrogen tests. My doc is pretty open to anything and does TRT himself.
Are you using any AI at those E2 levels? Sorry if you already answered that.
For the first one posted, 49/63, no. For the second one, 18/21, 1mg anastrozole every 3.5 days. Cannot tell a difference so I am going without right now.
I take 200mg test once a week.
Wow. Blows my mind how different people’s bodies react. I am 200mg a week as well but split every 3.5 days. If I took 1 mg anazastrol I would crash the F out of my E2. I crashed it with less than half a mg.
Over the past two years I’ve done quite a bit. Since starting trt this last January… I did my first bloodwork in February. My doc asked me to come back in September with bloodwork which my appointment is next week. Blood draw tomorrow. I did my own bloodwork 6 weeks ago due to an adjustment I made to my protocol without doctor permission.
Below is a study that reports what I have mentioned on this forum before. The biggest issue with ECLIA is that it cant distinguish between E2 and C reactive protiens. C reactive protiens are elevated when inflammation occurs in the body. If your lc/ms and eclia come back the same… that leads me to believe you dont have inflammation and that’s a good thing. It can happen to anybody at any time so why waste any time using a test that is so inefficient at drawing an accurate measurement? That’s how I look at it. Like I said I’ve seen plenty of bloodwork where people show double sometimes triple the E2 on ECLIA and totally normal E2 on lc/ms. Anyways. That’s what I believe to be true.
Thanks, I’ve read that one. What would you attribute the elevated LC/MS/MS vs the IA to? I’d just get a CRP on them, or maybe sed rate. Do you think the inflammation markers fluctuate that much? Here is another one nearly identical. What’s the largest difference you’ve had?
Here is another one showing that ECLIA is inferior to LC/MS for Testosterone testing and overstates testosterone as well.
Thanks, I’ll see if I can get the English version and read it.
Yours are so close its within tolerance and lab error. To pick that apart would be an act of futility. I’m glad it’s not an issue for you as it has been for others. Hopefully it saves you money at some point. Your numbers always seem to look great so congratulations on that.
Here’s a quote from a gentleman on another forum
“That’s been my experience. Blood drawn at the same time:
Estradiol, Standard Test: 37.6 pg/ml (8 - 43)
Estradiol, Sensitive Test: 17 pg/ml (3 - 70)”
There shouldn’t be a debate on which E2 lab to order. The major labs themselves say the standard tests should not be used for men, only the sensitive version. Honestly, this should be added to the stickies. Read the links below. If you use the standard test to explain negative symptoms, you are starting from the wrong point and pointing in the wrong direction. It’s critical to get the correct labs.
Too many guys post labs without knowing which labs they received. I would say a solid 80% receive the Roche method, without knowing, and the advice they receive is to jump on an AI. The misinformation can lead to catastrophic physical, emotional, and mental pain…most of which could be avoided had the correct lab been drawn. Guys, we’re dealing with a class III controlled substance. We have to be aware of what we’re doing, and we have to be very careful. T, AI’s, this is very serious, very powerful stuff, which can lead to great joy or great pain if not managed well.
Labcorp: 004515: Estradiol | Labcorp
Quest: https://www.questdiagnostics.com/testcenter/BUOrderInfo.action?tc=4021&labCode=PHP
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I really appreciate this info. Thank you. I have only gotten blood work done with my GP doctor. Sorry to go off topic but what does it cost to walk in to one of these labs and get all the necessary testing in one visit?
When my doctor calls in the bloodwork it cost 1300 and my insurance makes me pay 330 dollars of that cost. If I schedule the bloodwork myself it normally cost me 165. Mind you the 1300 gives us tt, ft, Roche eclia e2 and that’s pretty much it. My panel has everything tt, ft, sensitive e2, CBC, lipids, shbg ect ect. I’m having a panel done today and it cost 103. Only real difference is the testosterone test is not lc/ms. I schedule my bloodwork through discounted labs dot com.
I think it should be discussed. Some stress out because they get the “wrong test” or the “test for women”. Then there is the implication that the doctor is an “idiot” for ordering IA testing. In speaking to someone who operates immunoassay and gas/liquid chromatography equipment for a living, and another who is a doctor working for Quest, I learned there are pros and cons to each test. The labs themselves (meaning the business departments) probably would prefer use of the more expensive test as they are in business to make money. I’m sure they fund research to support that position. When I asked the doctor (again, employed by Quest) straight up, which test should be used, his response was “I’m on the fence.”
For us, and @physioLojik really made me think about this, my point is that we shouldn’t rely heavily on the lab number, regardless of which test it is. I think he said he does not treat ink on a lab report. Maybe it’s advisable to monitor E2 and react to changes in lab values if the changes correlate with E2 symptoms.
As for myself, I’ve always used anastrozole and kept E2 in the 20s, IA test method (as it turns out, ultrasensitive results pretty much match IA) and have never had an E2 issues. Based on what I’ve learned here, I decided to start testing with both methods concurrently.
Also, based on what I’ve seen here, we decided to stop anastrozole to see what happens, really, as an experiment on myself, thinking if it elevates and I have side effects, I can jump back on anastrozole. We saw E2 increase significantly. We saw LC/MS/MS results higher than IA, not the other way around, like “IA overstates your E2 and you’ll crash if you use that test” guys say here all the time.
Guess what? I feel good. Both tests showed me with elevated, significantly out of range, estradiol, and I cannot tell the difference from when E2 was in the “sweet spot” with both tests.
Bottom line, what I’m am taking from all of this, monitor E2, I don’t care how. Don’t take a drug based on a number. Don’t take anything to bring E2 down if you are feeling good, regardless of the number. I don’t know how everyone else feels about it, but I think that is very reasonable and an approach to at least consider.
If someone gets on here all stressed out because they can not, or did not, get the “correct test”, I’m going to point out that may not necessarily be true, and use myself, and my lab results, as an example. I do acknowledge the steroid metabolite, cross contamination/CRP issues, but they are not always prevalent, probably usually not.
If anyone is so inclined, get both tests next time you get labs and post the results. I’d be very interested to see them. Maybe post with your protocol as well.
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This is golden. Great post, and appreciate your contribution.
Thank you for that, and thank you and everyone else who contributes here. I learn something from everyone. I think what stands out the most is that my old age low T issues were nothing compared to what many of you deal with, and at young ages too. I had no idea.