TRT & 24-Hour Urine

[Michael Scally MD]

Here is some crazy therapy I was PM. According to this “expert,” the use of transdermal testosterone is best monitored or followed by the use of a 24-hour urine. This is absolutely nuts/quacko!!! It seems to me like this person has a financial interest in urine testing. Does this guy even know how testosterone is metabolized? Is anyone really falling for this kind of testing? Once again, I would love to see support for this craziness?

QUOTE: “The best matrix for following transdermal TRT is the 24 hour urine panel. Graphing the serum levels status post application shows why. The best time to draw a serum sample is two hours after application—even that is highly variable. However, a 24 hour urine panel catches all (for practical purposes) the T absorbed, and its metabolites, thus basically providing the area under the curve. Thus we are not merely taking snapshots on a roller coaster of serum T levels.

The astute practitioner must keep in mind proper assay evaluation in TD BID regimen. Serum T levels will appear artificially low with same because only half the daily dose is being measured. Of course, 24 hour urines are free of this, as they catch the area under the curve for the entire day.” END QUOTE

 

[rburgandy]

seems pretty dead on to me.

 

[hardasnails1973]

What the body shows in blood and actually metabolized can be to seperate things that is a scientific fact. So for finacial gain in this I disagree becuase there are numerous labs that offer it, If there was no data behind it then quest or lab corrp would not participate in such test.

 

[Michael Scally MD]

What the body shows in blood and actually metabolized can be to seperate things that is a scientific fact. So for finacial gain in this I disagree becuase there are numerous labs that offer it, If there was no data behind it then quest or lab corrp would not participate in such test.

that is what I call impeccable reasoning and analysis! NOT. Is that really the best you can come up with? And, further, just what Quest test are you talking about? Anyone who uses this as a measure of treatment is nuts and the person who has them as their doctor is a fool. Every time I make a challenge to support this kind of crap, I get mumbo-jumbo. This does not serve people in need well. We can do better.

 

[Michael Scally MD]

seems pretty dead on to me.

I suppose you would just about believe anything! I am not so quick as to allow others control of my health and life. Good Luck.

 

[rburgandy]

I suppose you would just about believe anything! I am not so quick as to allow others control of my health and life. Good Luck.

Just my thoughts. Not to get in between your catfight.

You 2 really need to get over that stuff.

People are on these boards to learn and get better. Not to get in between 2 grown men acting like children.

 

[Bigkarch]

we dont need a controversy...I respect each of you....both of you have extreme knowledge...

 

[ProfBush]

Did I miss something? I think you left out the reasons why you think that this particular test is ill-advised.

You can't get away with name-calling a particular procedure or testing protocol without being asked to support your position. If you have formation we can use, please enlighten us. If, on the other hand, this is just another volley in your feud, spare us, and get over it.

 

[hardasnails1973]

Just because there is no "clincal"evidence on testosterone urinary analysis does not discount the fact that by using an"out of the box principle" people do not get better. Many people that I deal with personal that have been to traditional endos without success depsite optimal T levels and levels.when we use the urinary test it shows us the rate at which testosterone is metabolized. Then from this data modifications in protocols are made then symptoms improves. Urinary testosterone is just another tool which can be used to give more information to the clincian to better treat the patient. If more dr's would think out side the box out from trasditional medicine healh care system costs would be signifcantly reduced. Not trying to start anything I just want to see the clincal evidence to support his claim.

Any one
Please support claims or provide clincial studies that disprove or "debunk" the use of 24 hour testosteorne as measurement.

 

[cumkwakka]

lol

dr thierry hertoghe uses it to make assessments about testosterone

i'll stick with his judgement, thanks

 

[cvictorg]

Here is some crazy therapy I was PM. According to this ?expert,? the use of transdermal testosterone is best monitored or followed by the use of a 24-hour urine. This is absolutely nuts/quacko!!! It seems to me like this person has a financial interest in urine testing. Does this guy even know how testosterone is metabolized? Is anyone really falling for this kind of testing? Once again, I would love to see support for this craziness?

QUOTE: ?The best matrix for following transdermal TRT is the 24 hour urine panel. Graphing the serum levels status post application shows why. The best time to draw a serum sample is two hours after application?even that is highly variable. However, a 24 hour urine panel catches all (for practical purposes) the T absorbed, and its metabolites, thus basically providing the area under the curve. Thus we are not merely taking snapshots on a roller coaster of serum T levels.

The astute practitioner must keep in mind proper assay evaluation in TD BID regimen. Serum T levels will appear artificially low with same because only half the daily dose is being measured. Of course, 24 hour urines are free of this, as they catch the area under the curve for the entire day.? END QUOTE

Dr. Marianco, Urine more accurate then Blood?

Originally Posted by marianco
When a person has unexpected problems with a treatment, it may be useful to do a comprehensive 24-hour urine test covering all the steroid hormones and their metabolites, thyroid hormones, growth hormone, etc. It is an expensive test.

Meridian Valley Lab in Renton, Washington State is probably the best at the job. It is run by Jonathan Wright, M.D. (who has been doing hormone replacement therapy for about 30 years - more experience than anyone I know) who convinced me in a meeting this past weekend of their usefulness.

With the comprehensive 24-hour urine test, one can tell better how a treatment affects the various hormone metabolic pathways. Given how variable these pathways are between individuals, this lab test is useful to clarify how a person is responding to treatment - particularly when unexpected or unusual things are happening.

For example, Finasteride in a few men can cause an increase in Estrone levels - which may not be caught in when blood testing alone is done. Thus it is not only DHT that is affected - but the levels of other steroid hormones also - in some cases, in unexpected ways. For example, perhaps the increase in Estrone can affect overall anabolism

Watching an expert - such as Jonathan Wright, MD - who has done this for over 20 years and his staff - read a 24-hour urine test can be breathtaking by the amount of detail he can extract from the test. Luckily, he and his staff help others are very happy to help other physicians interpret their lab tests.

 

[Michael Scally MD]

Where's the beef?

This is not a debate or argument between myself and others. This is to provide an impetus to find what is the source for these practices. While many of these stated practices appear to have some reasoning or foundation, they actually do not. I challenged anyone to cite a single article to support the use of urine testing in TRT. Whether anyone goes chasing treatments with no scientific support is their decision. I am only pointing out that to do so is based on mumbo-jumbo. Do so knowing it is a risk.

Where's the beef?

 

[hardasnails1973]

one needs to look at benefit to risk ratio in anythng, but personal, clincally and over whelm majority of improved QOL men have recieved from these gambles I tihnk it is obvious the benefits are well worth the risk. What ever we do in our practice is documented down and we have to support the reasoning behind it because one never knows when some patientsis going to come back on you for what ever the resaon. If you have sound medical reasoning for ones action that is not quackery or voo-doo medicine. Since we take insurance we have to be incredible careful about decisions we make are medical sound. If you want to refer to it as "experimental" medicine fine, but I refer it to cutting edge medicine that in the next 20-30 years will be foundarion of what will be taught in medical school.

 

[Michael Scally MD]

one needs to look at benefit to risk ratio in anythng, but personal, clincally and over whelm majority of improved QOL men have recieved from these gambles I tihnk it is obvious the benefits are well worth the risk. What ever we do in our practice is documented down and we have to support the reasoning behind it because one never knows when some patientsis going to come back on you for what ever the resaon. If you have sound medical reasoning for ones action that is not quackery or voo-doo medicine. Since we take insurance we have to be incredible careful about decisions we make are medical sound. If you want to refer to it as "experimental" medicine fine, but I refer it to cutting edge medicine that in the next 20-30 years will be foundarion of what will be taught in medical school.

HAN: I am unable to refute your circular method of reasoning and analysis! ROTFLMFAOPIMP

 

[cvictorg]

Re: Where's the beef?

This is not a debate or argument between myself and others. This is to provide an impetus to find what is the source for these practices. While many of these stated practices appear to have some reasoning or foundation, they actually do not. I challenged anyone to cite a single article to support the use of urine testing in TRT. Whether anyone goes chasing treatments with no scientific support is their decision. I am only pointing out that to do so is based on mumbo-jumbo. Do so knowing it is a risk.

Where's the beef?

Gilad S, Chayen R, Tordjman K, Kisch E, Stern N. Assessment of 5 alpha-reductase activity in
hirsute women: comparison of serum androstanediol glucuronide with urinary androsterone and
aetiocholanolone excretion. Clin Endocrinol (Oxf). 1994 Apr;40(4):459-64

Urinary testosterone in women
98. Doberne Y, New MI. Urinary androstanediol and testosterone in adults. J Clin Endocrinol Metab.
1976 Jan;42(1):152-4
99. Karila T, Kosunen V, Leinonen A, Tahtela R, Seppala T. High doses of alcohol increase urinary
testosterone-to-epitestosterone ratio in females. J Chromatogr B Biomed Appl. 1996 Dec
6;687(1):109-16
100. Borts DJ, Bowers LD. Direct measurement of urinary testosterone and epitestosterone
conjugates using high-performance liquid chromatography/tandem mass spectrometry. J Mass
Spectrom. 2000 Jan;35(1):50-61
101. Makino H, Kobegawa A. Radioimmunoassay of urinary testosterone. Horumon To Rinsho. 1974
Jul;22(7):893-6
102. Bezverkhaia TP. Method of determining urinary testosterone levels. Lab Delo. 1981;(5):285-8
103. Osada H, Osawa K, Makino T, Kandogawa A. Proceedings: Determination of urinary
testosterone by radioimmunoassay. Nippon Naibunpi Gakkai Zasshi. 1974 Feb 20;50(2):190
104. Tresguerres JA, Tamm J. Urinary and plasma testosterone glucosiduronate measurement by a
simple RIA method. J Steroid Biochem. 1979 Jul;11(1A):143-6
105. Sayo H, Hosokawa M. Spin immunoassay of urinary testosterone. Yakugaku Zasshi. 1980
Jan;100(1):56-60

Urinary 7-ketosteroids in men
316. Hamilton JB, Bunch LD, Mestler GE. Urinary 17-ketosteroids in castrated vs. noncastrated men.
J Clin Endocrinol Metab. 1959 Dec;19:1680-2
317. Furman RH, Howard RP. Urinary 17-ketosteroid excretion in castrated and intact men. J Clin
Endocrinol Metab. 1959 Nov;19:1510-2
318. Dorfman RI, Hamilton JB. Concerning the metabolism of testosterone to androsterone. J Biol
Chem. 1940;133:753-60
319. Callow, Nancy H. The isolation of two transformation products of testosterone from urine.
Biochem J. 1939; 33: 559-64
320. Dehennin L, Matsumoto AM. Long-term administration of testosterone enanthate to normal men:
alterations of the urinary profile of androgen metabolites potentially useful for detection of
testosterone misuse in sport. J Steroid Biochem Mol Biol. 1993;44 (2):179-89
321. Harrison LM, Martin D, Gotlin RW, Fenessey PV. Effect of extended use of single anabolic
steroids on urinary steroid excretion and metabolism. J Chromatogr. 1989;489(1):121-6
322. Motta E, Rosciszewska D, Buntner B, Sliwa P. Total serum testosterone levels and urinary 17-
ketosteroids of men with epilepsy and decreased sexual activity. Psychiatr Pol. 1987;21(3):251-
5
323. Maroulis GB, Manlimos FS, Abraham E. Comparison between urinary 17-ketosteroids and
serum androgens in hirsute patients. Obstet Gynecol 1977;49:454-8
324. Maynar M, Caballero MJ, Mena P, Rodriguez C, Cortes R, Maynar JI. Urine excretion of
androgen hormones in professional racing cyclists. Eur J Appl Physiol. 1994; 68(3):200-4
325. Robinson A. The excretion of 17-ketosteroids in men of different age groups, with special
reference to prostatic cancer. Brit J Cancer. 1948;2:13-6
326. Kirk E. The urinary excretion of neutral 17-ketosteroids in the middle-aged and old men. J
Gerontol. 1949;5:222-6
327. Pincus G, Romanoff L, Carlo J. Excretion of urinary steroids by men and women of various
ages. J Gerontol. 1954;9:113-32

24-hour urine androgen tests in men
Urinary testosterone in men
257. Ooi LS, Panesar NS, Masarei JR. Within- and between-subject variation in, and associations
between, serum concentrations and urinary excretion of testosterone and estradiol in Chinese
men. Clin Chim Acta. 1995 Apr 30;236(1):87-92
258. Borts DJ, Bowers LD. Direct measurement of urinary testosterone and epitestosterone
conjugates using high-performance liquid chromatography/tandem mass spectrometry. J Mass
Spectrom. 2000 Jan;35(1):50-61
259. Choi MH, Kim KR, Chung BC. Simultaneous determination of urinary androgen glucuronides by
high temperature gas chromatography-mass spectrometry with selected ion monitoring.
Steroids. 2000 Jan;65(1):54-9
260. Makino H, Kobegawa A. Radioimmunoassay of urinary testosterone. Horumon To Rinsho. 1974
Jul;22(7):893-6
261. Bezverkhaia TP. Method of determining urinary testosterone levels. Lab Delo. 1981;(5):285-8
262. Osada H, Osawa K, Makino T, Kandogawa A. Proceedings: Determination of urinary
testosterone by radioimmunoassay. Nippon Naibunpi Gakkai Zasshi. 1974 Feb 20;50(2):190
263. Tresguerres JA, Tamm J. Urinary and plasma testosterone glucosiduronate measurement by a
simple RIA method. J Steroid Biochem. 1979 Jul;11(1A):143-6
264. Sayo H, Hosokawa M. Spin immunoassay of urinary testosterone. Yakugaku Zasshi. 1980
Jan;100(1):56-60
85
265. Rudd BT, Rosenfield RL, Bongiovanni AM, Eberlein WR. The measurement of urinary
testosterone glucuronide by competitive protein binding and validation by a double isotope
derivative assay. Steroids. 1969 Feb;13(2):227-45
266. Futterweit W, Eng Y, Griboff SI. Gas chromatographic determination of urinary testosterone and
epitestosterone glucuronide. Mt Sinai J Med. 1971 May-Jun;38(3):281-3
267. Venturelli E, Cavalleri A, Secreto G. Methods for urinary testosterone analysis. J Chromatogr B
Biomed Appl. 1995; 671 (1-2): 363-80
268. Vermeulen A. A study of the urinary excretion of testosterone. Verh K Vlaam Acad Geneeskd
Belg. 1966;28(5):461-519
269. Doberne Y, New MI. Urinary androstanediol and testosterone in adults. J Clin Endocrinol Metab.
1976 Jan;42(1):152-4
270. Andino N, James VH, Parker V, Rippon AE. Excretion of non-conjugated androstenedione and
testosterone in human urine. Steroids. 1976 Dec;28(6):837-46
271. Callow, Nancy H. The isolation of two transformation products of testosterone from urine.
Biochem J. 1939;33:559-64
272. Wilkins RB, Carlson L. Qualitative studies of neutral 17-ketosteroids in normal subjects. J Clin
Endocrinol Met. 1952; 12: 647-3
273. Vestergaard P, Raabo E, Vedso S. Determination of urinary testosterone in men, women and
children. Clin Chim Acta. 1966 Oct;14(4):540-52
274. Krawczynska H, Zachmann M, Prader A. Urinary testosterone glucuronide and sulphate in
newborns and young infants. Acta Endocrinol (Copenh). 1976 Aug;82(4):842-50
275. Yamaguchi T, Konno K, Kawabe K, Yasuda K, Mori H, Suzuki T, Yanaihara T, Nakayama T.
Simultaneous determination of five androgens in early neonatal urine by selected ion monitoring
GC-MS using 19-d3 steroids as internal standards. Endocrinol Jpn. 1985;32(2):279-85
276. Raynaud E, Audran M, Pages JC, Fedou C, Brun JF, Chanal JL, Orsetti A. Determination of
urinary testosterone and epitestosterone during pubertal development: a cross-sectional study in
141 normal male subjects. Clin Endocrinol (Oxf). 1993 Apr;38(4):353-9
277. Raynaud E, Audran M, Pages JC, Brun JF, Fedou C, Chanal JL, Orsetti A. Study of urinary
excretion of testosterone and epitestosterone glucuronides in children and adolescents Pathol
Biol (Paris). 1993 Feb;41(2):159-63
278. Dehennin L, Delgado A, Peres G. Urinary profile of androgen metabolites at different stages of
pubertal development in a population of sporting male subjects. Eur J Endocrinol. 1994
Jan;130(1):53-9
279. Gleispach H, Fauster R, Borkenstein M, Wendler H. Urinary testosterone excretion in boys in
relation to other parameters of somatic maturity (a longitudinal study). Wien Klin Wochenschr.
1981 Feb 6;93(3):89-93
280. Popa M, Ciocirdia C, Florea I, Tache A, Dimitriu V. Clinical assessment of cryptorchid boys by
determination of urinary testosterone glucuronide following large doses of human chorionic
gonadotropin (hCG). Endocrinologie. 1976 Oct-Dec;14(4):313-7
281. Mauvais-Jarvis P, Charransol G, Bobas-Masson F. Simultaneous determination of urinary
androstanediol and testosterone as an evaluation of human androgenicity. J Clin Endocrinol
Metab. 1973 Mar;36(3):452-9
282. Demichenko AN, Serdechnaia LI. Excretion of testosterone in men with various forms of
hypogonadism. Probl Endokrinol (Mosk). 1975 Jul-Aug;21(4):31-4
283. Demchenko AN, Serdechnaia LI. Urinary excretion of testosterone and androstenedione in
hypogonadism in men. Probl Endokrinol (Mosk) 1977 Mar-Apr;23(2):43-7
284. Marenich LP. Excretion of testosterone, epitestosterone, androstenedione and 7-
ketodehydroepiandrostenedione in healthy men of different ages. Probl Endokrinol (Mosk). 1979
Jul-Aug;25(4):28-31
285. Deslypere JP, Wiers PW, Sayed A, Vermeulen A. Urinary excretion of androgen metabolites,
comparison with excretion of radioactive metabolites after injection of [4-14C]testosterone.
Influence of age. Acta Endocrinol (Copenh). 1981 Feb;96(2):265-72
286. Favino A, Cavalleri A, Tilli M. Relations between urinary excretion of 17-ketosteroids,
androsterone, etiocholanolone, testosterone and epitestosterone in adult and aged male
subjects. Folia Endocrinol 1967 Jun;20(3):331-44
287. Wright F, Poizat R, Bongini M, Bozzolan F, Doukani A, Mauvais-Jarvis P. Decreased urinary 5
alpha-androstane-3 alpha,17 beta-diol glucuronide excretion in patients with benign prostatic
hyperplasia. J Clin Endocrinol Metab. 1985 Feb;60(2):294-8
86
288. Niermann H, Lenau H, Ayi-Bonte G, Schulz H. Excretion of urinary testosterone in Klinefelter's
syndrome. Humangenetik. 1975;26(1):61-70
289. Yunda IF, Imshinetskaya LP. Testosterone excretion in chronic prostatis. Andrologia. 1977 Jan-
Mar;9(1):89-94
290. Pedersen-Bjergaard K, Tonnesen M. Sex hormone analyses. II. The excretion of sexual
hormones by normal men, impotent males, polyarthritics and prostatics. Acta Med Scand. 1948;
213: 284-97
291. Oka M, Nakashima K. Endocrine therapy and serum and urinary testosterone levels, as a
monitoring, in patients with carcinoma of the prostate Nippon Gan Chiryo Gakkai Shi. 1977 Sep
20;12(3):336-42

292. Kisliakova ND, Luntovskaia VA. Testosterone, epitestosterone and total estrogen excretion in
men with cancer of certain localizations] Vopr Onkol. 1979;25(5):12-4
293. Zumoff B, Rosenfeld RS, Friedman M, Byers SO, Rosenman RH, Hellman L. Elevated daytime
urinary excretion of testosterone glucuronide in men with the type A behavior pattern.
Psychosom Med. 1984 May-Jun;46(3):223-5
294. Guilland JC, Moreau D, Malval M, Morville R, Klepping J. Evaluation of sympathoadrenal
activity, adrenocortical function and androgenic status in five men during a Himalayan
mountaineering expedition (ascent of Mt Pabil, 7,102 m, 23,294 ft). Eur J Appl Physiol Occup
Physiol. 1984;52(2):156-62
295. Yap BK, Kazlauskas R, Elghazi K, Johnston GA, Weatherby RP. Profiling of urinary testosterone
and luteinizing hormone in exercise-stressed male athletes, using gas chromatography-mass
spectrometry and enzyme immunoassay techniques. J Chromatogr B Biomed Appl. 1996 Dec
6;687(1):117-25
296. Bandelow B, Sengos G, Wedekind D, Huether G, Pilz J, Broocks A, Hajak G, Ruther E.Urinary
excretion of cortisol, norepinephrine, testosterone, and melatonin in panic disorder.
Pharmacopsychiatry. 1997 Jul;30(4):113-7
297. Gode JD, Singh RH, Settiwar RM, Gode KD, Udupa KN. Increased urinary excretion of
testosterone following a course of yoga in normal young volunteers. Indian J Med Sci. 1974 Apr-
May;28(4-5):212-5
298. Yamamoto A, Ito M. Sebaceous gland activity and urinary androgen levels in children. J
Dermatol Sci. 1992 Sep;4(2):98-104
299. Loewit K, Schwarz S, Hussl B, Richter E. Urinary androgen- and estrogen excretion in men with
pachydermia laryngis and cancer of the larynx. Endokrinologie. 1979 Apr;73(2):151-6
300. Tokar' VI, Gurovich AA. Mechanism of a decrease in urinary testosterone excretion in chronic
fluoride Poisoning. Gig Tr Prof Zabol. 1979;(1):37-9
301. Shackleton CH, Phillips A, Chang T, Li Y. Confirming testosterone administration by isotope
ratio mass spectrometric analysis of urinary androstanediols. Steroids. 1997 Apr;62(4):379-87
302. Borts DJ, Bowers LD. Direct measurement of urinary testosterone and epitestosterone
conjugates using high-performance liquid chromatography/tandem mass spectrometry. J Mass
Spectrom. 2000 Jan;35(1):50-61
303. Dehennin L. Detection of simultaneous self-administration of testosterone and epitestosterone in
healthy men. Clin Chem. 1994 Jan;40(1):106-9
304. Carlstrom K, Palonek E, Garle M, Oftebro H, Stanghelle J, Bjorkhem I. Detection of testosterone
administration by increased ratio between serum concentrations of testosterone and 17 alphahydroxyprogesterone.
Clin Chem. 1992 Sep;38(9):1779-84
305. Southan GJ, Brooks RV, Cowan DA, Kicman AT, Unnadkat N, Walker CJ Possible indices for
the detection of the administration of dihydrotestosterone to athletes. J Steroid Biochem Mol
Biol. 1992 Mar;42(1):87-94
306. Dehennin L, Scholler R. Detection of self-administration of testosterone as an anabolic by
determination of the ratio of urinary testosterone to urinary epitestosterone in adolescents.
Pathol Biol (Paris). 1990 Nov;38(9):920-2
307. Aguilera R, Catlin DH, Becchi M, Phillips A, Wang C, Swerdloff RS, Pope HG, Hatton CK.
Screening urine for exogenous testosterone by isotope ratio mass spectrometric analysis of one
pregnanediol and two androstanediols. J Chromatogr B Biomed Sci Appl. 1999 Apr 30;727(1-
2):95-105
308. Bosy TZ, Moore KA, Poklis A. The effect of oral dehydroepiandrosterone (DHEA) on the urine
testosterone/epitestosterone (T/E) ratio in human male volunteers. J Anal Toxicol. 1998
Oct;22(6):455-9
87
309. Babar A, Kaachy A, Cutie AJ, Plakogiannis FM. Gas chromatographic method for simultaneous
analysis of urinary testosterone, androsterone and etiocholanolone. Determinations after a
single dose of testosterone. Pharm Acta Helv. 1988;63(9-10):278-81
310. Aguilera R, Becchi M, Casabianca H, Hatton CK, Catlin DH, Starcevic B, Pope HG Jr. Improved
method of detection of testosterone abuse by gas chromatography/combustion/isotope ratio
mass spectrometry analysis of urinary steroids. J Mass Spectrom. 1996 Feb;31(2):169-76
311. Aguilera R, Becchi M, Grenot C, Casabianca H, Hatton CK. Detection of testosterone misuse:
comparison of two chromatographic sample preparation methods for gas chromatographiccombustion/
isotope ratio mass spectrometric analysis. J Chromatogr B Biomed Appl. 1996 Dec
6;687(1):43-53
312. Becchi M, Aguilera R, Farizon Y, Flament MM, Casabianca H, James P. Gas
chromatography/combustion/isotope-ratio mass spectrometry analysis of urinary steroids to
detect misuse of testosterone in sport. Rapid Commun Mass Spectrom. 1994 Apr;8(4):304-8
313. Dehennin L, Peres G. Plasma and urinary markers of oral testosterone misuse by healthy men
in presence of masking epitestosterone administration. Int J Sports Med. 1996 Jul;17(5):315-9
314. Uralets VP, Gillette PA. Over-the-counter anabolic steroids 4-androsten-3,17-dione; 4-
androsten-3beta,17beta-diol; and 19-nor-4-androsten-3,17-dione: excretion studies in men. J
Anal Toxicol 1999 Sep;23(5):357-66
315. van de Kerkhof DH, de Boer D, Thijssen JH, Maes RA. Evaluation of
testosterone/epitestosterone ratio influential factors as determined in doping analysis. J Anal
Toxicol. 2000 Mar;24(2):102-15

 

[HeadDoc]

have you read these studies? Do they favorably or unfavorably compare results? I looked and found an old study that would suggest the value of serum over urine assays for gonadotropic hormones.

http://jcem.endojournals.org/cgi/content/abstract/52/2/225?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&fulltext=24+hour+urine&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT (Interrelationship of Plasma and Urinary Gonadotropins: Correlations for 24 Hours, for Sleep/Wake Periods, and for 3 Hours after Luteinizing Hormone-Releasing Hormone Stimulation -- CHIPMAN et al. 52 (2): 225 -- Journal of Clinical Endocrinology & Met)

 

[Millard]

have you read these studies? Do they favorably or unfavorably compare results?

Bingo! The existence of studies examining this relationship and the mere existence of laboratory tests doesn't automatically provide scientific justification for a given treatment over another.

 

[gettingold]

https://thinksteroids.com/community/threads/134250246

Originally Posted by marianco
When a person has unexpected problems with a treatment, it may be useful to do a comprehensive 24-hour urine test covering all the steroid hormones and their metabolites, thyroid hormones, growth hormone, etc. It is an expensive test.

Meridian Valley Lab in Renton, Washington State is probably the best at the job. It is run by Jonathan Wright, M.D. (who has been doing hormone replacement therapy for about 30 years - more experience than anyone I know) who convinced me in a meeting this past weekend of their usefulness.

With the comprehensive 24-hour urine test, one can tell better how a treatment affects the various hormone metabolic pathways. Given how variable these pathways are between individuals, this lab test is useful to clarify how a person is responding to treatment - particularly when unexpected or unusual things are happening.

For example, Finasteride in a few men can cause an increase in Estrone levels - which may not be caught in when blood testing alone is done. Thus it is not only DHT that is affected - but the levels of other steroid hormones also - in some cases, in unexpected ways. For example, perhaps the increase in Estrone can affect overall anabolism

Watching an expert - such as Jonathan Wright, MD - who has done this for over 20 years and his staff - read a 24-hour urine test can be breathtaking by the amount of detail he can extract from the test. Luckily, he and his staff help others are very happy to help other physicians interpret their lab tests.

This was written almost 3 years ago. Dr. Mariano has used urine testing in a while, if ever.

 

[gettingold]

This was written almost 3 years ago. Dr. Mariano has used urine testing in a while, if ever.

Sorry can't type.

Should say .......Dr. Mariano hasn't used urine testing in a while, if ever.

 

[ProfBush]

Bingo! The existence of studies examining this relationship and the mere existence of laboratory tests doesn't automatically provide scientific justification for a given treatment over another.

No, but the point is that Scally used his "preference" for serum testing as an excuse to ridicule both a licensed medical practitioner who sometimes uses this procedure and a forum member who simply thought urine testing made sense. Ridicule is the tool of a bully.

Further, he refused to support his "preference" when I explicitly asked. I didn't even ask him to support it with studies, i just wanted to know why he thought the 24 hour urine test in the case of TD application was ill-advised.

He not only refused to explain, but threw the burden of disproving his statements back on the members of this forum. Well, studies have been provided. Will he respond now?