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Thread: Estradiol "sensitive" assay

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    Lockout888 is offline Associate Member
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    Estradiol "sensitive" assay

    Is the Estradiol "sensitive" assay more accurate than the standard test?

    Are the standard test results not useful?

    Both the Labcorp standard E2 test (004515 CPT Code: 82670) and the E2 "sensitive" test (140244 CPT Code: 82670) measure pg/mL and have ranges for adult Men:

    Sensitive 3-70 pg/mL
    Standard 7.6-42.6 pg/mL

    The main difference I can see is the "sensitive" assay is a test where low levels of E2 are expected.

    Has anyone had labs, testing both to see if the numbers are close?

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    These are someone else's results:
    I recently had all three of their e2 tests done; two that came back with results in line with each other and on the total opposite end of the spectrum.

    Estradiol, LCMS, Endo Sci
    Labcorp test# 500108
    result: <1.0 pg/mL

    Estradiol- Roche ECLIA methodology
    Labcorp test# 004515
    result: 15.9 pg/mL

    Estradiol, Sensitive
    Labcorp Test# 140244
    result: 227 pg/mL
    I've recently read a thread on another forum where they think the labs are frequently screwing up with the sensitive so they just using the standard.

    Labcorp more or less told me to go with one of their tests and then use that same test for comparison in the future.

    Here's a recent thread on E2 test:
    http://forums.steroid.com/hormone-re...some-help.html
    Last edited by flyrs; 06-04-2013 at 12:23 PM.

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    Quote Originally Posted by flyrs View Post
    These are someone else's results:


    I've recently read a thread on another forum where they think the labs are frequently screwing up with the sensitive so they just using the standard.
    yup read that too..although the threads ive looked at were old, are yours old?
    im just grateful my uro will order me the estradiol...not gonna fight to get sensitive..my e2 is very low anyway

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    Quote Originally Posted by powerlifterty16 View Post
    yup read that too..although the threads ive looked at were old, are yours old?
    im just grateful my uro will order me the estradiol...not gonna fight to get sensitive..my e2 is very low anyway
    The thread I posted is older, don't remember how old.
    The thread I mentioned about them screwing up in the lab on the sensitive is new. I'll have to try to send you the link by PM since the crappy filter will delete it.

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    Lockout888 is offline Associate Member
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    Here is someone who did both:

    I ordered a pre-created panel from one of the online sites. The panel I bought gave me Estradiol. So, I ordered Estradiol, Sensitive in addition to the panel

    Estradiol, Sensitive 3.0 - 70.0 pg/mL 66
    Estradiol 7.6 - 42.6 pg/mL 73.9

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    Lockout888 is offline Associate Member
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    From the LEF dot org website:

    Estradiol, Sensitive

    Item Catalog Number: LC140244

    This test is generally NOT suggested over the regular estradiol test (LC004515).

    The only difference between this test and the regular estradiol test (offered in Life Extension panels) is better detection at the lower limits of the range. For example, the lower end of the range for estradiol is 7.6 pg/mL while the lower limit for the sensitive estradiol is 3 pg/mL. This test does not provide a more accurate result at normal ranges, it is only more accurate at very low levels of estradiol.
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    xcraider37 is offline Associate Member
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    Quote Originally Posted by flyrs View Post
    These are someone else's results:

    I've recently read a thread on another forum where they think the labs are frequently screwing up with the sensitive so they just using the standard.

    Labcorp more or less told me to go with one of their tests and then use that same test for comparison in the future.

    Here's a recent thread on E2 test:
    http://forums.steroid.com/hormone-re...some-help.html
    I've read that in the past also, but I believe labcorp has fixed this issue. I have been doing the sensitive test with very consistant results, I think the test results that were posted in this thread are wrong and poster needed to be retested. If you use the regular e2, test its going to take longer to get dialed in.

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    Lockout888 is offline Associate Member
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    From the sticky:
    Unless your Doctor specifically requests a ‘Sensitive’ assay the lab will default to the standard Estradiol assay designed specifically for women, which is useless for men. The reason for the difference between the two assays is the bell curve from which the test was designed sits within the “normal” range for women and not men.
    I don't think this is the case. The Labcorp "standard" test has ranges for women, men and children. Isn't pg/mL = pg/mL regardless of the range?

    Adult male: 7.6-42.6 pg/mL

    Adult female:
    • Follicular: 12.5-166.0 pg/mL
    • Ovulation: 85.8-498.0 pg/mL
    • Luteal: 43.8-211.0 pg/mL
    • Postmenopausal: <6.0-54.7 pg/mL

    Pregnancy:
    • First trimester: 215.0 to >4300.0 pg/mL

    Children (1-10 years):
    • Male: <6.0-20.0 pg/mL
    • Female: 6.0-27.0 pg/mL
    Last edited by Lockout888; 06-11-2013 at 02:57 PM.

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    bass's Avatar
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    I've done both at the same time and the results were pretty close percentage wise, however another member did the same thing and his numbers were drastically different. I guess the reason sensitive assay is recommended because its more repeatable that the whole serum test. when I order the e2 serum test I could never get my e2 to stay in one place, but checking it with sensitive assay was more stable and consistent readings.

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    imom is offline Banned
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    Quote Originally Posted by Lockout888 View Post
    Are the standard test results not useful?
    My understanding is that the sensitive test becomes more accurate as the E2 levels become lower.

    If a test yields a result of 200 +/-5 then it is accurate to within 2.5%. However a result of 10 +/-5 is only accurate to within 50%. (These numbers were purely for illustrative purposes and don't represent the reality of the E2 tests. )

    If your E2 is high (for a man) then the standard assay is probably accurate enough. If your levels are low then the sensitive assay will be more useful. Just my understanding of the issue...

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    Quote Originally Posted by bass View Post
    I've done both at the same time and the results were pretty close percentage wise, however another member did the same thing and his numbers were drastically different. I guess the reason sensitive assay is recommended because its more repeatable that the whole serum test. when I order the e2 serum test I could never get my e2 to stay in one place, but checking it with sensitive assay was more stable and consistent readings.
    ive heard the sensitive assays have large errors too. It's hard enough finding a dr who will check estradiol, so if iget a dr to agree to that, i dont push sensitivie..especially because they have no idea what it is and will argue with me.

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    Quote Originally Posted by Lockout888
    From the LEF dot org website:
    X2 - if in normal range (pretty broad), I feel the standard test is fine.

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    I've had both tests a few months apart. Results, percentage wise, were similiar enough to have me believe I don't need to pay on my own for the sensitive assay.

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    I don't believe in the female bell curve theory any more. I think it was true but now most testing range and accuracy has improved so much. If you look at the non sensitive test on labcorp clearly can be used for males or females. You can also estimate what a sensitive test results would be with this calculation. Not exact but close
    Sensitive E2 Test Range 3-70------- Standard E2 Test Range 7.6 – 46
    So Sensitive 70 is the SAME as Standard 46 high end
    33.5 is the SAME as - 27 middle- and 3 is the SAME as -7.6 low

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    Lockout888 is offline Associate Member
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    Quote Originally Posted by 100% View Post
    You can also estimate what a sensitive test results would be with this calculation. Not exact but close
    Sensitive E2 Test Range 3-70------- Standard E2 Test Range 7.6 – 46
    So Sensitive 70 is the SAME as Standard 46 high end
    33.5 is the SAME as - 27 middle- and 3 is the SAME as -7.6 low
    Doesn't pg/mL = pg/mL regardless of the range?

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    Think of range like looking threw a microscope with different magnification.

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    Quote Originally Posted by Lockout888 View Post
    Doesn't pg/mL = pg/mL regardless of the range?
    i agree with you on this one.

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    Quote Originally Posted by powerlifterty16 View Post
    i agree with you on this one.
    Gallon=128oz sensitive
    Gallon=16 cups non sensitive
    unit does not change just method of measurement

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    yes but what he was asking is if the measurements are the same but ranges are diff arent they equal...

    for instance..
    quest is 240-1020 or so ng/dl
    labcorp is 348-1197 ng/dl

    348 should be the same on both unless im misunderstanding what ur saying

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    Quote Originally Posted by powerlifterty16 View Post
    yes but what he was asking is if the measurements are the same but ranges are diff arent they equal...

    for instance..
    quest is 240-1020 or so ng/dl
    labcorp is 348-1197 ng/dl

    348 should be the same on both unless im misunderstanding what ur saying
    Method they use to test is different so no. lab corp uses Methodology: Radioimmunoassay (RIA) for there sensitive.
    and Roche ECLIA methodology for standard test

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    Lockout888 is offline Associate Member
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    Quote Originally Posted by powerlifterty16 View Post
    for instance..
    quest is 240-1020 or so ng/dl
    labcorp is 348-1197 ng/dl

    348 should be the same on both unless im misunderstanding what ur saying
    348 should be the same if they are both using the same measurement (pg/mL). Are the ranges different due to what each Lab thinks is a "normal" range should be for a male?

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    100%'s Avatar
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    These guy do a pretty good job of explaining it
    We at Life Extension understand your concerns andf rustration. We have the same ones when we review scientific studies dealingwith hormones. Unfortunately, hormone testing is problematic due to a lack of standardization across different laboratories. Even within the same laboratory there are different ways (methodologies) to test the same hormone. For example, total testosterone can be tested via ECLIA gen 1 or gen 2(electrochemilluminescene immunoassay) and LC - MS/MS (liquid chromatography tandem mass spec). These issues with hormone testing have lead to frustration among doctors, researchers and us here at Life Extension. We would like nothing more than to be able to provide you with concerete answers, unfortunately we cannot because of the all the variables and lack of standardization in hormone testing as it exist today.
    In fact the CDC in the US has been spearheading a program to address issues in hormone testing. However, it is moving along slowly. Here is a link to the program for more details:

    CDC - Laboratory Standards - Hormone Standardization

    This site goes further into the problems and details we all face trying to make sense of hormone results.
    Your question of the conversion factor for estradiol is agood one; however, as much as we would like to give you a definite answer, we can't because the conversion factor alone is not enough. It also depends on which lab did the test and what was the exact methodology they used for the your test. There are no conversion factors that take those variables into account.

    Thus, the best way we have found over the years is to make educated approximations using the reference range of the lab that did the test.

    The LabCorp reference range for estradiol using the Roche ECLIA methodology for men is:

    Adult male: 7.6-42.6 pg/mL

    The LEF suggested optimal range for this specific test from LabCorp is:

    Adult male: 20-30 pg/mL

    Rather than trying to convert it (which doesn’t work well because of methodology differences), take a proportional approach. For example, our optimal range is basically right in the middle ofLabCorp’s reference range for estradiol, give or take a little on each side of the average of 25 pg/ml. Thus, we would suggest targeting the same using the reference range from your lab (not our lab). You should be around the average of your lab’s reference range, give or take a little. This approach is consistent with studies showing that for a man you don’t want estradiol too high or too low.

    Is this a perfect approach? Of course not. Do we wish it could be more accurate and precise? Yes, but until such time as all labs start using the same methodologies, units and reference ranges this approach has been the most helpful.
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    Everything I have read says that LCMS is the preferred assay, followed by ECLIA and then RIA.

    Quest uses RIA for their standard test, and LC/MS/MS method for their "ultrasensitive" test.

    Female
    Follicular Phase 19-144 pg/mL
    Mid-Cycle 64-357 pg/mL
    Luteal Phase 56-214 pg/mL
    Postmenopausal ≤31 pg/mL
    Male ≤39 pg/mL

  24. #24
    100%'s Avatar
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    Quote Originally Posted by Lockout888 View Post
    Everything I have read says that LCMS is the preferred assay, followed by ECLIA and then RIA.

    Quest uses RIA for their standard test, and LC/MS/MS method for their "ultrasensitive" test.

    Female
    Follicular Phase 19-144 pg/mL
    Mid-Cycle 64-357 pg/mL
    Luteal Phase 56-214 pg/mL
    Postmenopausal ≤31 pg/mL
    Male ≤39 pg/mL
    This what Dr Crisler said to me about Quest "ultrasensitive" test. "BTW, the Quest Ultrasensitive is now quite unreliable. They just aren't fixing it, as LabCorp did a while back when they had problems with their Sensitive E2. They even sent their Rep to my office to explain it. Nice folks."

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