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Ultrasensitive Estradiol results

Thebigone

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Dr. Crisler wrote about how standard E2 testing isn’t a good value for men and they need ultrasensitive Estradiol for testing. I’ve always just done E2 but recently did ultrasensitive to compare. My last blood work is here
http://www.professionalmuscle.com/f...cle-forum/139996-everyday-im-trt-results.html

Since then I’ve had a few more tests using the 25mg IM TRT protocol. Total and free test are around 1100-1200 and free test around 280-320. I wanted to see how low I could go with arimidex to control estrogen. At .5mg 2x per week my E2 was around 20 or so. Then I went to .25mg 3x per week and E2 was 35 range <=39 but I had ultrasensitive Estradiol done as well to compare and it was 10. Range <=29. So that surprised me. I don’t want estro that low so my last test was I switched to .125mg Adex 3x per week. It’s a bitch splitting the tabs that low but I just used a .01g scale and it would always be around .12-.15mg so a total of around only .36-.45mg/wk of total Adex. I figured this would be too low but I just got my ultrasensitive Estradiol results back and it’s 20. Same range <=29. I wouldn’t even mind being closer to 29 since my test is in the high range the ratio would be equal. I figure .10mg Adex 3x per week will be my sweet spot. I recommend anyone who gets estrogen tested to get ultrasensitive Estradiol done instead of standard E2. Much more accurate.
 
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heavyhitter

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Very interesting. thanks for doing all the leg work on that
 

Knight9

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Ultrasensitive? I thought it was Estradiol(sensitive).

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suppdude

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Ultrasensitive? I thought it was Estradiol(sensitive).

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Negative, it’s ultra. Just got it myself.


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dale338

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Much more accurate, but sheesh, how could it be 10 on the ultra and 30 on the standard? That is ridiculously inaccurate. Thanks for sharing! I run my basic labs every 6 weeks , but always go the low budget route. Standard E2. Based on how I feel, I alway felt it was accurate. Now I'm rethinking this.
 

Thebigone

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Thebigone

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Dr. Crisler wrote about how standard E2 testing isn’t a good value for men and they need ultrasensitive Estradiol for testing. I’ve always just done E2 but recently did ultrasensitive to compare. My last blood work is here
http://www.professionalmuscle.com/f...cle-forum/139996-everyday-im-trt-results.html

Since then I’ve had a few more tests using the 25mg IM TRT protocol. Total and free test are around 1100-1200 and free test around 280-320. I wanted to see how low I could go with arimidex to control estrogen. At .5mg 2x per week my E2 was around 20 or so. Then I went to .25mg 3x per week and E2 was 35 range <=39 but I had ultrasensitive Estradiol done as well to compare and it was 10. Range <=29. So that surprised me. I don’t want estro that low so my last test was I switched to .125mg Adex 3x per week. It’s a bitch splitting the tabs that low but I just used a .01g scale and it would always be around .12-.15mg so a total of around only .36-.45mg/wk of total Adex. I figured this would be too low but I just got my ultrasensitive Estradiol results back and it’s 20. Same range <=29. I wouldn’t even mind being closer to 29 since my test is in the high range the ratio would be equal. I figure .10mg Adex 3x per week will be my sweet spot. I recommend anyone who gets estrogen tested to get ultrasensitive Estradiol done instead of standard E2. Much more accurate.

Sorry guys I had the numbers wrong. When using the .25adex 3x per week E2 was 22 not 35. Range <=39. Ultrasensitive was 10 range <=29. Then dropping Adex to .125mg 3x per week ultrasensitive was 20 range <=29

So from calculating it having an E2 of 22 with range <=39 means my E2 was approx 57% of max value(39x.57). When calculating ultrasensitive I was approx 35% of max value(29x.35).

So pretty significant difference about 20% difference. Although both tests measure in pg/mL

Now with Adex at .125mg 3x/wk ultrasensitive is 20 range <=29

I think this is a decent range to stay at I might drop the Adex a tad more to let’s say .10mg 3x/wk and check again in a few weeks. The goal would obviously be to not use Adex at all and if I dropped the testosterone just a little bit like maybe from 25mg ED to 20mg ED that alone may let me avoid using any anti estrogens. I found it interesting my estrogen was higher when doing every day subQ shots vs shallow IM. But then I read the following article by Dr. Crisler.

http://www.allthingsmale.com/word_docs/TRT.doc

Under the transdermal topic he states:

“Gels and creams, like all transdermal delivery systems, provide a greater boost in DHT levels, compared to injectable testosterone preparations. As DHT is responsible for all the things of manhood--literally, AllThingsMale--the transdermals are better at treating sexual dysfunction than are injectables. However, issues of hair loss (which I treat with a compounded topical DHT blocking mixture) and possible prostate morbidity (a contentiously debatable point, to be sure, but resolved in the negative to my mind) then come into play. This might be a good time to mention I vehemently oppose adding finasteride or similar medication.

To end the debate on this topic, transdermal T gels/creams are more likely to elevate estrogen than injections, as long as the shots are properly administered once per week. That is because aromatase lives in the skin, along with higher concentrations of 5-AR, which converts T to E. Even so, the benefits of TD TRT outweigh the weekly convenience of shots.”

So this leads me to believe that perhaps subQ increases estrogen more than shallow IM.

P.S. during this entire testing protocol I have also implemented 200mg/day DIM and 500mg/day calcium D-glucarate.
 
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Thebigone

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Here is an interesting update. So I ended up switching to only .1mg Adex 3x per week. Kept everything else the exact same. Same 25mg Cyp ED, got blood drawn the exact same timing, etc. after about 2 1/2 weeks. This time I decided to get E2 with test AND Ultrasensitive Estradiol At the same time this way it would be an easy comparison of both estrogen types.

Results:

Total test:
1072 Range 250-1100

Free test:
288 Range 35-155


E2 was 26 Range <=39

BUT........

Ultrasensitive Estradiol was HIGH at 37. Range <=29

This was really surprising. Now this actually proves how important ultrasensitive Estradiol is versus standard E2.

So from calculating it having an E2 of 26 with range <=39 means my E2 was approx 67% of max value(39x.67) When calculating ultrasensitive I was approx 128% of max value(29x1.28).

That’s a 60% difference!

As for .1mg Adex being too low I actually don’t think that’s the case. I think the reasoning is the prescribed tablets are 1 mg and they are already really small so trying to divide that into tenths was very hard. I used a .01 scale but just the coating on the tabs could have had an effect. But regardless we can conclude the importance of ultrasensitive estradiol now since there is a direct comparison at the exact same time, etc.
 
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Thebigone

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Since I haven’t been training much lately I decided to drop my T from 25mg ED to 20mg ED and drop Adex completely. I’ll get bloods in 2 weeks.
 

Knight9

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Ultrasensitive? I thought it was Estradiol(sensitive).

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Negative, it’s ultra. Just got it myself.


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“On the subject of laboratory testing, many years ago I realized the standard assay for Estradiol, known as “E2” (the major player in estrogen evaluation, so it’s the first one we test), by a laboratory technique called immunoassay, is not valid for adult males. That means we can draw NO conclusions from its result whatsoever. NONE. Instead, estrogen in males MUST be tested by the LC/MS technology. Here is a list of the major labs, and the correct E2 test to order:

Quest Diagnostics “Ultrasensitive Estradiol” # 30289
LabCorp “Sensitive Estradiol” #140244
Mayo Clinic “Enhanced Estradiol” #EEST
ARUP “Estradiol TMS” #93247

IF you run the incorrect standard estradiol assay on an adult male patient, each of these labs will include a paragraph straightening you out. For the Quest Diagnostics laboratory, that paragraph appears because of my work with them, many years ago. I had run both standard and LC/MS assays on many patients: their clinical response matched the better testing methodology. I was widely attacked for that position at the time. The science is now well-accepted.

The reason the standard E2 assay (made for women) is not valid for adult males is because the concentration of estrogen is just too low in men for this more crude methodology to be reliable. Also, numerous things like CRP, progesterone, and even a form of AI falsely elevate its result. That means the doctor who relies on it—and treats solely by the numbers on a piece of paper, instead of how the patient actually feels—may mistakenly add in an AI. Since estrogen would then be lowered in a patient whose estrogen was not high to begin with, that tanks the estrogen level. Low estrogen is ALWAYS bad for you: bones are demineralized, the Lipid Profile is blown, joints begin to ache (as they dry out), headaches, and loss of libido. The emotional component of a man’s sexual being comes from estrogen.”


BTW, a little over a month ago, I got labs and elected to add an estradiol sensitive(labcorp version) along with regular E2.
Results:
E2= 34.1(estradiol)
Estradiol Sensitive= 19.4
 

Kaladryn

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The "range" is just something they make up and stick on there, it's based on the lab company more than anything else usually, they have different ranges for different demographics.
 

Thebigone

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DIM and calcium D-Gluc won’t show much on E2 but they should help lower negative estrogens from what Dr. Crisler says. DIM is cheap and a great antioxidant as well.
 

LATS

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DIM and calcium D-Gluc won’t show much on E2 but they should help lower negative estrogens from what Dr. Crisler says. DIM is cheap and a great antioxidant as well.

Yep.. I don't think dim does much for e2.. But it did do great for my PSA numbers.. So I take 200mgs for my psa.. Any ESTRo benefit is incidental and not what I'm after..
 

Knight9

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BTW, a little over a month ago, I got labs and elected to add an estradiol sensitive(labcorp version) along with regular E2.
Results:
E2= 34.1(estradiol)
Estradiol Sensitive= 19.4

BTW,

E2=34.1 [RANGE 7.6-42.6]
Estradiol Sensitive=19.4 [RANGE 8.0-35.0]
 
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Thebigone

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Update:

Dropped cyp from 25mg IM ED to 20mg
Dropped Adex completely

Total test:
696 Range 250-1100

Free test:
157 Range 35-155

Ultrasensitive Estradiol

42 range <20mg




Previous results on 25mg Cyp IM ED with .125mg Adex 3x/wk

Total test:
1203. Range 250-1100

Free test:
331. Range 35-155

Ultrasensitive Estradiol
20 range <29

I will be going back to my original 25 mg protocol as it yielded far better results.
 

Kaladryn

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I would guess the AI is suppressing E2 enough to cause some natty test production and that is why you are getting a much higher level on just 5mg more.
 

Fitraver

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BTW,

E2=34.1 [RANGE 7.6-42.6]
Estradiol Sensitive=19.4 [RANGE 8.0-35.0]



So on both of them you were in range then. Wouldn’t this go opposite of your point that the sensitive is needed? Not tying to question, more so just trying to understand. I’ve feed regular for years and so does my doc. I wanna tell her about this.
 

Fitraver

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Is it more so that sometimes just estradiol could
Come back in range and sensitive out of range? And that’s why you always want to do the sensitive? I saw that was the case with one of the OPs posts above. Looks like sometimes they can both be accurate and sometimes not so worth getting sensitive to be sure. This was very informative.
 

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