Newbie w/Hypogonadism questions

[galloglass]

Thanks to all the posters here, I've learned a ton of new info. I just turned 37, I'm 5'6 158lbs and for the last year or so I noticed a big drop in virility and libido. I was pretty sedentary for the last year and put on about 15lbs. Just started lifting and cardio again but see no results after a month, not even a pound lost or added mass. Erections are barely vertical, whereas they used to be vertical. I need some insight on my bloodwork. CBC was fine, Metabolic fine, TSH fine, but I had to push for the T test, the doc seemed to think it was mental.(She's the MD @ the university clinic and is clueless)
Here are the results from quest. (I know the ranges aren't always useful.)
Total T 175, 224 (241-800)
LH: 2.4 (1.5-9.3) low end
Prolactin 13.9 (2.0-18.0)
E2:32pg/ML >29
Should I ask the doc to have me do the Clomid test?? HCG? TRT? Thanks. By the way, my twin brother also has low T.

 

[T800]

You look like a good candidate for TRT. Your T levels are in the tank, but I don't quite understand the range on E2. For men, it's usually a "less than x amount" kind of reading.

Is your doc open to running Dr John's tests stickied above?

Sonny

 

[galloglass]

You look like a good candidate for TRT. Your T levels are in the tank, but I don't quite understand the range on E2. For men, it's usually a "less than x amount" kind of reading.

Is your doc open to running Dr John's tests stickied above?

Sonny

Sorry, I may have put the greater than sign rather than the less than sign, never was any good with them. The level for E2 is under 29 pg/ML.

My doc's open to the test, but I don't have insurance @ the moment so I have to find a cost-effective lab that runs a test panel like that.

 

[hardasnails1973]

Sorry, I may have put the greater than sign rather than the less than sign, never was any good with them. The level for E2 is under 29 pg/ML.

My doc's open to the test, but I don't have insurance @ the moment so I have to find a cost-effective lab that runs a test panel like that.

That test is wrong test that for a woman not a male. They had me that less then crap and I actually ended up with high e2 instead. Plain old e2 is one you want

You know you have low T thats a given goto lef.org and become a member and get the right e2 test. Dr john also has a urine test that is good for helpig to find abnormalites and is available at reasonable price. Check thyroid /adrenals first before messing with testosterone. But I bet your e2 is high 33 bucks will tell you if it is or not

 

[galloglass]

That test is wrong test that for a woman not a male. They had me that less then crap and I actually ended up with high e2 instead. Plain old e2 is one you want

You know you have low T thats a given goto lef.org and become a member and get the right e2 test. Dr john also has a urine test that is good for helpig to find abnormalites and is available at reasonable price. Check thyroid /adrenals first before messing with testosterone. But I bet your e2 is high 33 bucks will tell you if it is or not

Hardasnails:
Are you sure?? Don't Dr. John and Dr. Shippen ask for the extraction method? The test report/code says Estradiol,Ultrasensitive,LC/MS/MS #30289 from Nichols Lab in CA.
Here's the page.
Quest Diagnostics Nichols Institute
33608 Ortega Highway
San Juan Capistrano, CA 92690-6130
Clinical Significance: Estradiol is the major estrogenic hormone secreted by the
ovaries. Measurement of estradiol may be useful in women
to assess ovarian function in patients with menstrual
disorders, precocious or delayed puberty, and menopause and
useful in men to assess gynecomastia.
Reference Ranges: Estradiol, LC/MS/MS pg/mL
Adult Reference Ranges for Estradiol,
Ultrasensitive, LC/MS/MS:

Males: < or = 29 pg/mL

 

[hardasnails1973]

Hardasnails:
Are you sure?? The test report/code says ultrasensitive estradiol Estradiol,Ultrasensitive,LC/MS/MS from Nichols Lab in CA.

I did ultrasensative and it was the one that funked me up royally its showed less the 29 as the range when really i was high

 

[galloglass]

How did the 2 scores differ? (E2 ultrasensitive and regular).

 

[hardasnails1973]

How did the 2 scores differ? (E2 ultrasensitive and regular).

Utrasentiive was <4 from scale of <29
Given this information I figure my e2 was into the ground so I came off estrogen blocker 4 weeks later it tested at e2 = 73. I have heard this from several other people as well

 

[plymouth city]

It might be the right one.

Quest recently changes their ranges.

Under 30 would be more ideal for an adult male, the <50 is outdated..........

 

[JanSz]

Hardasnails:
Are you sure?? Don't Dr. John and Dr. Shippen ask for the extraction method? The test report/code says Estradiol,Ultrasensitive,LC/MS/MS #30289 from Nichols Lab in CA.
Here's the page.
Quest Diagnostics Nichols Institute
33608 Ortega Highway
San Juan Capistrano, CA 92690-6130
Clinical Significance: Estradiol is the major estrogenic hormone secreted by the
ovaries. Measurement of estradiol may be useful in women
to assess ovarian function in patients with menstrual
disorders, precocious or delayed puberty, and menopause and
useful in men to assess gynecomastia.
Reference Ranges: Estradiol, LC/MS/MS pg/mL
Adult Reference Ranges for Estradiol,
Ultrasensitive, LC/MS/MS:

Males: < or = 29 pg/mL

post link to where you copied these words from.

 

[hardasnails1973]

post link to where you copied these words from.

WTF does <29 mean
Does that mean its being compared to regular e2 10-54 or what ?
And what does a result of <4 actually mean doe that mean i have low estrogen or what and what is it being compared with?
So what is a good range when top end is <29

 

[galloglass]

post link to where you copied these words from.

Quest Diagnostics: Test Menu

So what appears to be causing the low T? Is it the prolactin? It's @ 12.9 (2.0-18.0)
Could it be E2 @ 32pg/ML? How much of a role does exercise/weight training play in T levels?

 

[JanSz]

Quest Diagnostics: Test Menu

Yours done in California:
Ultrasensitive, LC/MS/MS:

Males: < or = 29 pg/mL

Mine done in NJ:

Estradiol, Ultra-sensitive (10-50) pg/mL
Code: 30289T ESTRADIOL,ULTRA-SENSITIVE
they do not do the LC/MS/MS
-----------------------------------------------
They do different tests and ranges in different parts of country.

And in that link you posted, if you change laboratory to NJ and search on estradiol
the listing you get back talks only about specimen, no Reference Ranges.

 

[hardasnails1973]

Yours done in California:
Ultrasensitive, LC/MS/MS:

Males: < or = 29 pg/mL

Mine done in NJ:

Estradiol, Ultra-sensitive (10-50) pg/mL
Code: 30289T ESTRADIOL,ULTRA-SENSITIVE
they do not do the LC/MS/MS
-----------------------------------------------
They do different tests and ranges in different parts of country.

And in that link you posted, if you change laboratory to NJ and search on estradiol
the listing you get back talks only about specimen, no Reference Ranges.

SO its was useless and invalid yes and it was sent out to cali to get tested and there was no reference range it looks like it was part of fractural estrogen test for post menopausal women

 

[JanSz]

Yours done in California:
Ultrasensitive, LC/MS/MS:

Males: < or = 29 pg/mL

Mine done in NJ:

Estradiol, Ultra-sensitive (10-50) pg/mL
Code: 30289T ESTRADIOL,ULTRA-SENSITIVE
they do not do the LC/MS/MS
-----------------------------------------------
They do different tests and ranges in different parts of country.

And in that link you posted, if you change laboratory to NJ and search on estradiol
the listing you get back talks only about specimen, no Reference Ranges.

SO its was useless and invalid yes and it was sent out to cali to get tested and there was no reference range it looks like it was part of fractural estrogen test for post menopausal women

LC/MS/MS
is the best ever way of testing as of now, cat's meow.

uless you see
UPLC/MS/MS

HPLC and UPLC™.
============================================================================================
Problem is on how to figure out the desirable levels for this (I think new and more accurate) test.
============================================================================================
Introduction to Liquid Chromatography/Mass Spectrometry/Mass Spectrometry (LC-MS/MS)

Introduction to Liquid Chromatography/Mass Spectrometry/Mass Spectrometry (LC-MS/MS)
==============================================
LCMS page

LIQUID CHROMATOGRAPHY MASS SPECTROMETERY
BACKGROUND MATERIAL for the SUCCESSFUL OPERATION of LC-MS
==============================================
Liquid chromatography-mass spectrometry - Wikipedia, the free encyclopedia

Liquid chromatography-mass spectrometry

 

[hardasnails1973]

LC/MS/MS
is the best ever way of testing as of now, cat's meow.

uless you see
UPLC/MS/MS

HPLC and UPLC™.
============================================================================================
Problem is on how to figure out the desirable levels for this (I think new and more accurate) test.
============================================================================================
Introduction to Liquid Chromatography/Mass Spectrometry/Mass Spectrometry (LC-MS/MS)

Introduction to Liquid Chromatography/Mass Spectrometry/Mass Spectrometry (LC-MS/MS)
==============================================
LCMS page

LIQUID CHROMATOGRAPHY MASS SPECTROMETERY
BACKGROUND MATERIAL for the SUCCESSFUL OPERATION of LC-MS
==============================================
Liquid chromatography-mass spectrometry - Wikipedia, the free encyclopedia

Liquid chromatography-mass spectrometry

Yes i realize that but whats do the results actually mean of being <2 on <29 scale..and the scale is not measured or even idetifies if its a female or male representation..Should i call and find out what those results indicated..Because to my dr they looked incredible low and thats what we went by as probably any dr would have so he told me to come off the armidex and 4 weeks later BAM e2 in 70's..No one is at fought just want to understand what the test really means is all because it was a big clue to what has been going on with my hormones..

 

[JanSz]

Yes i realize that but whats do the results actually mean of being <2 on <29 scale..and the scale is not measured or even idetifies if its a female or male representation..Should i call and find out what those results indicated..Because to my dr they looked incredible low and thats what we went by as probably any dr would have so he told me to come off the armidex and 4 weeks later BAM e2 in 70's..No one is at fought just want to understand what the test really means is all because it was a big clue to what has been going on with my hormones..

Double check of what tests you had, go to your report, study the details.

The first time you most likely had the lattest test because of the <29 range

What range have you got the second time.

(You may have had two different tsts done, cannot compare them.
---------------------------------------------------------
This is actually driving me nuts.
At first to post my results I retyped them into one concise file.
Next time I tink I will do the same but there is a value in scanning the pages (all 22 of them in my case).
----------------------------------------------------------
galloglass & HAN
please look at you report page and, re-type the complete name of E2 test you had, value, units and range, and the LC/MS/MS if they are there. Also important, performing laboratory information.
----

In my case:

ESTRADIOL, ULTRA-SESITIVE 27 (10-50) pg/mL

Performing Laboratory Information:
Quest Diagnostics One Malcon Avenue Teterboro NJ 07608
----------------------------------------------------------

Fun with Estrodial.
The letters LC/MS/MS next to the test name are very important,
I have them only on very few items in my last test.

 

[hardasnails1973]

Double check of what tests you had, go to your report, study the details.

The first time you most likely had the lattest test because of the <29 range

What range have you got the second time.

(You may have had two different tsts done, cannot compare them.
---------------------------------------------------------
This is actually driving me nuts.
At first to post my results I retyped them into one concise file.
Next time I tink I will do the same but there is a value in scanning the pages (all 22 of them in my case).
----------------------------------------------------------
galloglass & HAN
please look at you report page and, re-type the complete name of E2 test you had, value, units and range, and the LC/MS/MS if they are there. Also important, performing laboratory information.
----

In my case:

ESTRADIOL, ULTRA-SESITIVE 27 (10-50) pg/mL

Performing Laboratory Information:
Quest Diagnostics One Malcon Avenue Teterboro NJ 07608
----------------------------------------------------------

Fun with Estrodial.
The letters LC/MS/MS next to the test name are very important,
I have them only on very few items in my last test.

Check email ,,,this was sent to cali beucase it too almost 10 days to get back vs 2 normal days

 

[JanSz]

Check email ,,,this was sent to cali beucase it too almost 10 days to get back vs 2 normal days

Nothing in my e-mail box
Nothing in my PM box

 

[hardasnails1973]

Nothing in my e-mail box
Nothing in my PM box

sent to same email address you sent to me before

 

[JanSz]

sent to same email address you sent to me before

Got it.

You had two E2 tests done, one very low other very high, you have send me only one test.
The one that you send me is
ESTRADIOL, ULTRASENSITIVE LC/MS/MS

I am missing the name of laboratory that did the testing,
probably on next page.

But I noted right left column and compared to my test.
They do different tests at different labs.

For example your and mine DHT test was done at lab designated AMD.

There is performing laboratory information, and my tests were done at
AMD--Chantily VA
TBR--Teterboro NJ

Mine Estradiol Ultra-sensitive was done at TBR
Yours Estradiol Ultra-sensitive LC/MS/MS done at EZ

bet your other Estodial test was done somewhere else.

Is there a way to have more control over those tests????

The pull down under menu REGIONAL LABORATORY in this link:
Quest Diagnostics: Test Menu

contains list of Quest laboratories, including three leter codes for each lab. Unfotunately I cannot match them.
Fot my Teterboro NJ lab they have (QTE) but on my test report I see (TBR)
================================================================
Tell you what HAN.
Your more accurate test shows that you basically have absent E2 (<2)
then after less accurate E2 test you kill the remnatns of any E2 that you had,
no wonder you do not feel good.

Just my guess based on your tests and actions you have taken.

Unless Quest screw up your test, after all it is new technology for them.
===================================================================

 

[galloglass]

Here are my results:
Estradiol, Ultra-Sensitive
Testing performed at: Quest Diagnostics/Nichols, 33608 Ortega Hwy, San Juan Capistrano, CA 92675,
Laboratory Director: R.E. Reitz, MD
Test Name: Estradiol, Ultra-sensitive, LC/MS/MS
32 pg/ML (abnormal) reference range < OR = 29

32 pg/ML doesn't seem that high, of course it should be around 20, I'm thinking the Clomid test won't work for me since 32pg/ML doesn't seem like it would displace a lot of Testosterone...or could it?

 

[JanSz]

Here are my results:
Estradiol, Ultra-Sensitive
Testing performed at: Quest Diagnostics/Nichols, 33608 Ortega Hwy, San Juan Capistrano, CA 92675,
Laboratory Director: R.E. Reitz, MD
Test Name: Estradiol, Ultra-sensitive, LC/MS/MS
32 pg/ML (abnormal) reference range < OR = 29

32 pg/ML doesn't seem that high, of course it should be around 20, I'm thinking the Clomid test won't work for me since 32pg/ML doesn't seem like it would displace a lot of Testosterone...or could it?

Watch out, do not miss the whole crux of discussion.

We are walking on thin ice here.

We are talking different ways of measuring E2.

Your test was done using the lattest and greatest method.

Your results are almost on the mark, I would not mess with it.
Most likely little DIM and TMG and calcium glutharate for the other estrogens.
We do not use Clomid.
-------
My test was done using less accurate method but at E2=27 I do ok, in the past I tried Arimidex and did not liked.

===========================================

What bothers me about HAN is that his
Estradiol, Ultra-sensitive, LC/MS/MS show no E2 (<2)

and his

Estradiol, Ultra-sensitive shows excessive E2

============================================

 

[galloglass]

Watch out, do not miss the whole crux of discussion.

We are walking on thin ice here.

We are talking different ways of measuring E2.

Your test was done using the lattest and greatest method.

Your results are almost on the mark, I would not mess with it.
Most likely little DIM and TMG and calcium glutharate for the other estrogens.
We do not use Clomid.
-------
My test was done using less accurate method but at E2=27 I do ok, in the past I tried Arimidex and did not liked.

===========================================

What bothers me about HAN is that his
Estradiol, Ultra-sensitive, LC/MS/MS show no E2 (<2)

and his

Estradiol, Ultra-sensitive shows excessive E2

============================================

Was he on a SERM or aromatase inhibitor when he took the
1st test? He could have gone too low, then gone off and the E2 levels went too high...I've got low T, so I was going to run the Clomid test...why don't we want to use clomid? DIM/TMG, etc. won't raise my T, will they?

 

[hardasnails1973]

Was he on a SERM or aromatase inhibitor when he took the
1st test? He could have gone too low, then gone off and the E2 levels went too high...I've got low T, so I was going to run the Clomid test...why don't we want to use clomid? DIM/TMG, etc. won't raise my T, will they?

I was using some 2 pills DIM and 2000 mgs TMG when the <2 was taken and yes I could have had a nasty rebound effect from cold turkey stopping which makes the most sense to me..

So jansz <2 identified that I had almost zero estrogen then according to the <29 range on ultrasensitive estrodial ..and the low estrogen could have explained the low homocysteine levels and also the elevated Lp(a) levels. then second reading was from the bad ass rebound effect from stoping every thing. I was just following drs orders is all, but how could low estrogen explain high esterone levels unless it was the progesterone pushing estrone : estrodial ratio up un eveningly, but on the other hand a guy has estrodial ultrasenitive <4 and he retested almost 35 on standard e2 test. This is what makes it so confusing for dr to know how to treat it properly..If the correct test was given the first time I know WTF was really happening..

when looking where the labs were sent to in PA when its identified as ultrasentiative it goes to california so I will not identify it as ultrasentiative and just use estrodial for my location

 

[plymouth city]

I was using some 2 pills DIM and 2000 mgs TMG when the <2 was taken and yes I could have had a nasty rebound effect from cold turkey stopping which makes the most sense to me..

So jansz <2 identified that I had almost zero estrogen then according to the <29 range on ultrasensitive estrodial ..and the low estrogen could have explained the low homocysteine levels and also the elevated Lp(a) levels. then second reading was from the bad ass rebound effect from stoping every thing. I was just following drs orders is all, but how could low estrogen explain high esterone levels unless it was the progesterone pushing estrone : estrodial ratio up un eveningly, but on the other hand a guy has estrodial ultrasenitive <4 and he retested almost 35 on standard e2 test. This is what makes it so confusing for dr to know how to treat it properly..If the correct test was given the first time I know WTF was really happening..

when looking where the labs were sent to in PA when its identified as ultrasentiative it goes to california so I will not identify it as ultrasentiative and just use estrodial for my location

2000mg of TMG could explain low homocystein levels.

Who ever told you to take that much? Its 4 times the amount LEF recommends!

 

[JanSz]

I was using some 2 pills DIM and 2000 mgs TMG when the <2 was taken and yes I could have had a nasty rebound effect from cold turkey stopping which makes the most sense to me..

So jansz <2 identified that I had almost zero estrogen then according to the <29 range on ultrasensitive estrodial ..and the low estrogen could have explained the low homocysteine levels and also the elevated Lp(a) levels. then second reading was from the bad ass rebound effect from stoping every thing. I was just following drs orders is all, but how could low estrogen explain high esterone levels unless it was the progesterone pushing estrone : estrodial ratio up un eveningly, but on the other hand a guy has estrodial ultrasenitive <4 and he retested almost 35 on standard e2 test. This is what makes it so confusing for dr to know how to treat it properly..If the correct test was given the first time I know WTF was really happening..

when looking where the labs were sent to in PA when its identified as ultrasentiative it goes to california so I will not identify it as ultrasentiative and just use estrodial for my location

HAN,
you have to slow down making all this changes.
You will newer figure out what is going on.

Measure your blood twice make adjustment once.

And do not do good blood test more often than once every two months.

If that helps you, it is policy of the doctor that Phil is with.

 

[hardasnails1973]

HAN,
you have to slow down making all this changes.
You will newer figure out what is going on.

Measure your blood twice make adjustment once.

And do not do good blood test more often than once every two months.

If that helps you, it is policy of the doctor that Phil is with.

If I knew what the first reading meant I could have saved alot of trouble thats for sure, but no one could have told me what it really distinguish..MY dr using common sense assumed it was low so he suggested the proper thing to do stop the adex and retest. All varaibles stayed the same nothing changed one bit..

Something is screwing up methyation my homocysteine levels were low with out TMG and TMG, folinic acid, methycobalin are used to increase methyation. Its going back to estrogen and its altered metabolism. I have used same protcol for months and homocysteine levels never budged and even droped the TMG for 2-3 monthsand homocysteine still the same under 5 what ever i do.