When you inject T there is some available for immediate use. The more we inject at once the more of a spike we create.
Now go inject 200mg and take a test 2 days out and you will have what’s called peak levels.
Now go take 30mg daily and take a test at anytime and you will see a more stable level.
The body can only process so much T at once. Meaning naturally it’s built to handle whatever your body naturally produced.
We want to avoid symptoms and this is why most suggest daily injections.
Yup I never saw a big difference it’s when we have super low levels does it work and I think higher is more accurate as well
This is what the first graph in this thread tries to illustrate.
It puts injection frequency and variability (spikes) into context. Admittedly for the ‚average‘ person.
Yes agreed. It’s just a terrible assay and one should not base too many decisions on the results of this assay.
What is your take on the LC/MS/MS results consistently coming back 25-35% higher than the immunoassay?
How many data points do you have? And was it always the same sample (from the same blood draw)? It would be very interesting to see the data as you mentioned you have many of these examples.
But unfortunately I don’t have an answer to your question.
Generally speaking it’s always difficult to compare methods, that’s why different methods for the same analyte have different reference ranges.
Ideally one compares only values from the same lab using the same method.
I that sense I agree with a previous comment from another member that it can easily lead to the conclusion that ‚labs frequently screw up‘.
Especially the IA E2 assay is really bad.
In the US regulatory bodies have realized this problem and at least for T there are now standards available to ensure that value can be compared also between labs.
Check out this document here
I also have to admit that I may not have the most recent insights as I left this business more than 10 years ago to head into Pharma. Considering the time I spent now on this topic because of TRT during my working day I should actually change again 
.
This what I found also:
Since HoSt began in 2010, CDC has had more than 350 participants in 15 countries. Participants have shown measureable improvements for both total testosterone (TT) and estradiol (E2). Specifically, the among-laboratory bias has decreased from 16.5% in 2007 to 2.8% in 2017 for TT and from 54.8% in 2012 to 13.9% in 2017 for E2. Not only has bias improved, but data from proficiency testing programs also show that standardized testosterone assays are more accurate and consistent compared to non-standardized assays.
This is what I have quickly available:
IA LC/MS/MS
-
15 21
18 21
21 18
23 23
26 21
28 27
37 49
38 52
41 53
49 63
50 71
55 79
About half of those are from me. There are one or two women in this sample.
No sorry, don’t have an answer for this.
I am however surprised how well IA and MS agree with each other, expected way lower degree of correlation.
Interesting, eg LabCorp participated in the CDCs hormone standardization program initiated in 2014 for E2 with their LC MS Method.
Update June 2019
The following laboratories have successfully met the performance criteria of ±12.5% mean bias (for samples >20 pg/mL) and ±2.5 pg/mL absolute bias (for samples ≤20 pg/mL) when compared to the CDC reference measurement procedure for estradiol for 80% of samples.
Yes. I was just responding overall to some comments by others.
Found another interesting study. MS was compared to 5 different available immunoassays.
On average all 5 immunoassays reported higher levels than the MS method.
Good stuff, appreciate it.
Here’s my take, test however you test. If your E2 is 30 and you feel great, fine. If it goes to 60 and you feel great, fine. If it goes to 60 and you feel like crap, try lowering it. If it goes to <15 (IA) or 5 LC/MS?MS and you feel like crap, stop the AI.
Focus less on the number and more on symptom response relative to any significant change in levels.
Yes, especially with the lower levels, very close. Once you get into the high 30s, not so much.
If high frequency shots are better, why Dr Rand Mclain who is one of the most popular TRT experts in the world prescribed 200mg test once a week with 1mg or more Anastrazole a week?. This Doctor has thousands of customers.
When you try one way and after enough time conclude that way is not producing ideal results you try another way. Everyone is different and what’s better for one may not be true for another.
I’m sure Dr Rand is great but he is just going to prescribe testosterone and after enough time ask how you are doing, compare that to labs and adjust dose. He doesn’t have a secret that no one else has. He has experience which is better than no experience. For some folks having a doc take control of them gives the peace of mind needed to have an effective treatment. Many times those people on their own or with a not so caring doc will come here and complain about symptom after symptom and always second guess everything before it has time to work. Those people need to give up control. Similar to how AA works for alcoholics.
Popular based on what? Who is this? There are lots of TRT docs with thousands of patients. There are apparently also a lot of people that are Justin Bieber fans, that doesn’t mean he makes good music.
All the TRT clinics in AZ prescribed one shot a week. How come the only people that do more than once a week injections are the ones on the forums?.Anyways, I won’t follow the instructions of the mainstream TRT, I will go head and do EOD injections. On TRT you are on your own
How many guys have gone from defy; rand and that Florida clinic to my doctor Nichols
And other doctors on the group is profound. Everyday they get calls and the simple fix is remove ai, increase free t and stop being a bitch about your symtoms. After 3-4 months they come to our group on face bag and all say thank you so much doctor for making me feel so great.
How many guys have gotten off an ai; given it time; raised estrogen and came back saying “I lowered my estrogen to 20-30 and got back in an ai?” I am talking about guys who do this right. Go on daily. Increase free t and give it 1/3 months max.
I have not had one guy who asked me for help return to ai and low e2. Their symtoms resolved: blood pressure libido and well being is ten fold better.
These arguments are based on inaccurate One sided information . The people who make these comments aren’t looking at both sides with open eyes: it’s confirmation bias. They want to believe something and therefore find content that backs up their beliefs. Critical thinking has left the world of internet researchers.
I hope you are right. I will do EOD first, if doesn’t work, I will do ED. You guys are great