Methods to measure estradiol

[robertin75]

Hi:

Does anyone knows why Dr. Crisler recommends Extraction or Ultra-Sensitive methods to measure estradiol?

My local lab uses the chemiluminescence method and I wonder if I wasted my money with this particular method.

Thanks,
Roberto

 

[zaarel2]

I thought I read somewhere that the ultrasensitive assay was a more accurate measure in the lower range where mens E levels were. Not postiive though.

 

[SWALE]

If you just run the assay they usually do for females it will give the result, for instance, "<25". Well, there is a huge difference between 25 and 4. Realistically interpreting this result means the true concentration could be anywhere form 0 to about 35--not much use to us.

The bottom of normal range for females is the top for males.

 

[robertin75]

Thanks SWALE and zaarel2 for the explanations. They really malke a lot of sense now.

As I said before, I got my E2 levels measured by chemiluminescence and it was 55 pg/ml.

The report has all the ranges for both women (according to cycle) and men, and for men it says 25.0-107.0 pg/ml (Now I understand why this particular method would not tell me if my levels are between 0 and 24).

From what I have been reading on the web, even with the chemiluminescence method, the top range for men never goes beyond 100 pg/ml.

I wonder if my lab ranges for men are flawed or why are they soooo wide.

I really feel like crap and I suspect that is because of my E2 levels. My Testosterone levels are in the low-normal range by the way and I'm 29 years old.

I was reading the symptoms of high E2 in men, and I have most of them, but sadly, no one has ever told me why I feel this way. The only things that all doctors that I have consulted with have to offer me are antidepressants and tranquilizers.

Thanks and any comments are greatly appreciated,
Roberto

 

[SWALE]

There are different ranges for different labs and laboratory protocols. By the reference range you list, you did indeed have an appropriate assay done.

 

[pmgamer18]

SWALE my Dr. uses Biotech there range is <20 to 56 I don't have a problem knowing how far below 20 my E2 is because if it is under 25 I feel bad. They also give ranges for women and men. I also have my Total E checked that range is for an Adult Male <200. Most men I have talked to have a problem when there E2 goes below 25. It takes a longer time to get the result of a ASSAY that goes below 20 or 25 so using Biotech works for me.
Phil

 

[SWALE]

You need an assay with a reference range in low single digits or zero.

 

[bigmark]

I was reading the symptoms of high E2 in men, and I have most of them, but sadly, no one has ever told me why I feel this way. The only things that all doctors that I have consulted with have to offer me are antidepressants and tranquilizers.

Welcome to the club, been there done that now I am finally on the right track.
It's NOT a nice feeling is it.

 

[robertin75]

Hi bigmark:

Did you have high E2 or low T?

Thanks,
Roberto

 

[bigmark]

High E2, T was slightly high but I am still getting tuned in. Looking forward to new labs soon.
Still felt like CRAP despite higher t.

 

[DavidZ]

Does anyone knows why Dr. Crisler recommends Extraction or Ultra-Sensitive methods to measure estradiol?

My local lab uses the chemiluminescence method and I wonder if I wasted my money with this particular method.

There seems to be quite a bit of confusion on this topic. Hopefully, I'll clarify the situation, rather than adding to the confusion.

The "regular" E2 test will give you a numerical result if your E2 is above the limit of sensitivity of the test. For example, my lab (Quest Diagnostics) gives me a specific number if my E2 is at or above 20 pg/mL. But if my E2 is less than 20, the result they give is simply "<20." That result is not very good because you don't know if your E2 is 0 or 19 or somewhere in between. OTOH, if your E2 test result comes in less than 20, the ultrasensitive assay will give you a specific number between 0 and 19.

But if your lab gives you a specific result of 20 or more, then the test that's been done is a good one and you can rely on it.

I actually prefer the "regular" E2 test because my E2 virtually never comes in less than 20 (it happened only once in about 50 blood tests over 5 or 6 years) and the results are available in about a day or 2, whereas the ultrasensitive test takes about a week to report out.

 

[pmgamer18]

My lab has the same range and I don't feel all that good <20 so if my test comes back that low I back off on my Indolplex/DIM. Right now I am doing very good on 1/4 of a pil.
Phil

 

[mranak]

There seems to be quite a bit of confusion on this topic. Hopefully, I'll clarify the situation, rather than adding to the confusion.

The "regular" E2 test will give you a numerical result if your E2 is above the limit of sensitivity of the test. For example, my lab (Quest Diagnostics) gives me a specific number if my E2 is at or above 20 pg/mL. But if my E2 is less than 20, the result they give is simply "<20." That result is not very good because you don't know if your E2 is 0 or 19 or somewhere in between. OTOH, if your E2 test result comes in less than 20, the ultrasensitive assay will give you a specific number between 0 and 19.

But if your lab gives you a specific result of 20 or more, then the test that's been done is a good one and you can rely on it.

I actually prefer the "regular" E2 test because my E2 virtually never comes in less than 20 (it happened only once in about 50 blood tests over 5 or 6 years) and the results are available in about a day or 2, whereas the ultrasensitive test takes about a week to report out.

Do you find the the sensitive and ultrasensitive results correlate well?

I have read a medical article that mentions less sensitive estradiol assays can give a 'normal' result for men when in fact the estradiol is high. If this is true, then the standard estradiol test is totally inappropriate.

 

[DavidZ]

Do you find the the sensitive and ultrasensitive results correlate well?

I have no data comparing these two tests. However, I have lots of data confirming what raises and lowers my E2. Before using Indolplex my E2 was consistently in the 70 to 80 range. Now, with Indolplex, my E2 is consistently in the 35 to 40 range.

I have read a medical article that mentions less sensitive estradiol assays can give a 'normal' result for men when in fact the estradiol is high. If this is true, then the standard estradiol test is totally inappropriate.

For my purposes, the regular test is clearly sufficient.

 

[pmgamer18]

I think the only diff. is on goes to 20 and the other goes to 10 or 0. But if the test was an ASSAY for men then that is the only diff.
Phil

 

[robertin75]

Hi Davidz:

I have no data comparing these two tests. However, I have lots of data confirming what raises and lowers my E2.

Can you tell us what raises and lowers your E2 levels?

Thanks,
Roberto

 

[DavidZ]

Hi Davidz: Can you tell us what raises and lowers your E2 levels?

As I said above, I use Indolplex/DIM to lower my E2 from about the 70 to 80 range to the 35 to 40 range.

Also, of course, my T raises and lowers my E2. That's why keeping T from going too high is really the best E2 management method.

 

[SWALE]

An answer of "<20" does not mean you can count on it being 19 or less. It means the test is not sensitive enough to determine where it is at. I'll say it again: you need an ultrasensitive estradiol assay. Quest provides the Extraction Method. This is precisely why they recommend it for males.

Having to wait a few days for labs to come back is of no consequence when it comes to tuning you up properly.