The RIGHT Estradiol test?

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    The RIGHT Estradiol test?


    Going in for labs - QUEST. The last 2 times they did not do the ultrasensitive test. Dr isn't happy :-)

    What do I ask for? I saw a lot of lab test numbers floating around - is there something I can do to make it idiot proof for them? Seems that they should able to read instructions - oviously not.

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    Quote Originally Posted by AnotherOldGuy View Post
    Going in for labs - QUEST. The last 2 times they did not do the ultrasensitive test. Dr isn't happy :-)

    What do I ask for? I saw a lot of lab test numbers floating around - is there something I can do to make it idiot proof for them? Seems that they should able to read instructions - oviously not.
    Depending on your location the lab dictates on where it goes. For example mine in hatboro PA goes to cali and ranges they use there are <29 but jansz from nj goes to some other place and it gives a range of 10-54 which is correct one. Now I just mark estrodial on the test and that I am a male and no problemo. What where your last testing results just curious ?

    Mine was <2 stopped AI and BAM 4 week it was 73 I was likeWTF !! Alot of people have also been miss lead by the results..
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    Quote Originally Posted by AnotherOldGuy View Post
    Going in for labs - QUEST. The last 2 times they did not do the ultrasensitive test. Dr isn't happy :-)

    What do I ask for? I saw a lot of lab test numbers floating around - is there something I can do to make it idiot proof for them? Seems that they should able to read instructions - oviously not.
    That is a very good question, to make test request idiot proof.
    And we are dealing with best laboratory available.
    Other are less or no transparent at all.

    The system lends it self to screw ups.
    Large part of request if not all is written on all kind of forms provided by Quest, each different.
    I went thru three different forms before I got request that I went with to Quest.

    Some tests are bundled so when checking a box with a name of some panel nobody really know for sure what is selected

    We here discuss all kind of tests and while discussing them we discover that Quest is doing tests at lest three different ways while testing the same item.

    At the moment I think we can divide tests into two groups

    Testosterone and Estrogene testing
    everything else

    Use available form for everything else
    Use doctor's script for Testosterone and Estrogene
    ============================== ===============

    Tests at Quest can be done three different ways

    1. The undesirable way, low sensitivity (do not know the name)(dialysis method???)
    2. RIA, Radioimmunoassay
    Radioimmunoassay - Wikipedia, the free encyclopedia

    3. (LC/MS/MS) The newest and greatest

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

    Quest have a number of laboratories thru out USA.
    Each laboratory have a list of tests that they do.
    If nearest laboratory is not performing certain reaquest it can be send out to laboratory that is able to do it. Hence waiting time up to 3 or 4 weeks to complete some tests.

    No easy way to look at the list, but get Test Menu:
    Quest Diagnostics: Test Menu
    Type (partial) name of test
    use pulldown menu and select one of the laboratories
    result will show available tests (most of the time).




    ============================== ================
    I think script should include request that only complete report should be send to a requesting doctor. That is, do not send partial reports.
    I ended up with over 20 pages of gibberish that had to be decoded latter. Report that would normally fit on 2 or 3 loosely written pages.
    ============================== ================
    Quest have does bussiness in other countries;
    Quest Diagnostics: International Facilities & Operations
    ============================== ==============
    ============================== ==============
    Use available form for everything else
    Use doctor's script for Testosterone and Estrogene
    Here is a list of estrogen and testosterone tests as done at three different Quest labs.
    CA -San Juan Capistrano (Nichols Institute)(SJC)
    NJ- Teterboro (QTE)
    VA-Chantily (Nichols Institute) (AMD)
    =====
    CA -San Juan Capistrano (Nichols Institute) (SJC)
    • ESTRADIOL & ESTRONE - (9299)
    • Estradiol, Free, LC/MS/MS (36169X) - (41772N)
    Estradiol, Ultrasensitive, LC/MS/MS (30289X) - (30289N)
    • Estriol, Amniotic Fluid - (6568X)
    • Estriol, Serum (34883X) - (22517P)
    • Estrogen Receptor (ER), IHC with Interpretation (36160X) - (13011N)
    • Estrogen Receptor (ER-IHC) with Photomicrograph (10736X) - (10736N)
    • Estrogen, Total, Serum (439X) - (22541P)
    • Estrogens, Fractionated, LC/MS/MS (36742X) - (5314N)
    • Estrone Sulfate (37104X) - (153551P)
    • Estrone, Amniotic Fluid - (15067X)
    • Estrone, LC/MS/MS (23244X) - (22582P)
    • FSH & ESTRADIOL - (85670N)
    • Lepidoglyphus destructor (D71) IgE (2723X) - (61606N)
    /============================== ============================== =
    • Dihydrotestosterone (204X) - (67751P)
    • Dihydrotestosterone, Free, Serum (36168X) - (12997N)
    • Testosterone, Free and Total, LC/MS/MS - (36170X)
    Testosterone, Free, Bioavailable, and Total, LC/MS/MS - (14966X)
    • Testosterone, Total - (873X)
    • Testosterone, Total & Free and Sex Hormone Binding Globulin - (54502N)
    • Testosterone, Total (Women and Children), LC/MS/MS - (15983X)
    • Testosterone, Urine (874X) - (29892P)
    /============================== ============================== =

    NJ- Teterboro (QTE)
    • 17-OH-PROGESTRN RESP,ACTH - (17682X)
    • COMPMETPNL/CBD/T3/ESTR/IGF-1/PROG/TESTOS/DHEA/PREG/TSH/T4/HCY - (P12450)
    • ESTRADIOL - (22434R)
    • ESTRADIOL,FREE,LC/MS/MS - (41772N)
    • ESTRADIOL,ORAL HRT,RIA - (429T)
    ESTRADIOL,ULTRA-SENSITIVE - (30289T)
    • ESTRIOL,FREE - (22509W)
    • ESTRIOL,SERUM - (22517P)
    • ESTROGENS,FRACT,LC/MS/MS - (36742X)
    • ESTROGENS,FRACT,LC/MS/MS - (5314F)
    • ESTROGENS,TOTAL,SERUM - (22541P)
    • ESTRONE SULFATE - (153551P)
    • ESTRONE,LC/MS/MS - (22582P)
    • IGF-I/SHBG/TESTOS T+F/DHEA/ESTRAD,EXTRAC/CBD - (P2213)
    /============================== ============================== =

    • COMPMETPNL/CBD/T3/ESTR/IGF-1/PROG/TESTOS/DHEA/PREG/TSH/T4/HCY - (P12450)
    • DIHYDROTESTOSTERONE - (67751P)
    • FREE TESTOSTERONE(EIA) - (K57003)
    • IGF-I/SHBG/TESTOS T+F/DHEA/ESTRAD,EXTRAC/CBD - (P2213)
    • TESTOS/FSH/LH - (P435)
    • TESTOSTERON,FR/TOT,LCMSMS - (36170X)
    • TESTOSTERONE 3 TEST - (K40752)
    • TESTOSTERONE,24HR URINE - (29892P)
    TESTOSTERONE,FREE,BIO/TOT - (14966X)
    • TESTOSTERONE,TOTAL - (29868W)
    • TESTOSTERONE,TOTAL/FREE - (4960A)
    • TESTOSTERONE,TOTAL/PROLACTIN - (P5555)
    /============================== ============================== =

    VA-Chantily (Nichols Institute) (AMD)
    • Apple (Malus sylvestris) IgG* [38257X] - (38257)
    • Estradiol [4021X] - (3062)
    • Estradiol, Free, LC/MS/MS [36169X] - (118162)
    • Estradiol, Rapid [15577X] - (21882)
    Estradiol, Ultrasensitive, LC/MS/MS [30289X] - (30289)
    • Estriol [34883X] - (34883)
    • Estrogen Receptor (ER), IHC without Interpretation [19197X] - (19197)
    • Estrogens, Fractionated, LC/MS/MS [36742X] - (36742)
    • Estrone & Estradiol, Serum - (70652)
    • Estrone Sulfate [37104X] - (61772)
    • Estrone, LC/MS/MS [23244X] - (1272)
    • Total Estrogen [439X] - (28032)
    /============================== ============================== =
    • DIHYDROTESTOSTERONE [204X] - (69962)
    • Dihydrotestosterone, Free, Serum [36168X] - (36168)
    • Testosterone [873X] - (4412)
    • Testosterone, Free and Total, LC/MS/MS [36170X] - (15988)
    Testosterone, Free,Bioavailable,and Total [14966X] - (15985)
    • Testosterone, Total, (Women and Children) LC/MS/MS [15983X] - (15983)
    • TESTOSTERONE, URINE [874X] - (15401)
    • Total Testosterone,Baseline - (441500)
    /============================== ============================== =



    ============================== ===============
    •   
       

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    Quote Originally Posted by hardasnails1973 View Post
    Depending on your location the lab dictates on where it goes..... What where your last testing results just curious ?.
    on my pretreatment labs, they did not do ultrasensitive, but I got

    Estradiol, Free, LC/MS/MS (36169X) -
    it was done in SanJuan, CA

    Dr requested UltraSensitive, but the lab note said it was duplicate, so it was not done.


    the results were:

    Estradiol free 0.41 (<=0.45)
    %free 1.87 (1.25-1.85)
    Estradiol 22 (<=29)
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    Quote Originally Posted by AnotherOldGuy View Post
    on my pretreatment labs, they did not do ultrasensitive, but I got

    • Estradiol, Free, LC/MS/MS (36169X) -
    it was done in SanJuan, CA

    Dr requested UltraSensitive, but the lab note said it was duplicate, so it was not done.


    the results were:

    Estradiol free 0.41 (<=0.45)
    %free 1.87 (1.25-1.85)
    Estradiol 22 (<=29)
    Interesting, UltraSensitive is a part of Estradiol, Free.
    You have got good, the lattest and greatest testing.

    I am changing my test list to account for this new information.
    When testing for E2 do:
    Estradiol, Free, LC/MS/MS (36169X)

    Question is where we want our numbers to fall.
    My theory, we want lots of all hormones, we want to be close to the top range, usually top 25%.
    Your test Estradiol test looks good to me, you could even raise it tiny bit.
    Most likely (Estradiol free) is more important than (total) Estradiol. Question is, will we have future discussions about accuracy of the test, similar to what we have with FreeT.

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


    From the link I posted on my post above:

    Quest Diagnostics: Test Menu

    and CA San Juan Capisrano (SJC)
    they make following Estrodial tests:

    • ESTRADIOL & ESTRONE - (9299)
    • Estradiol, Free, LC/MS/MS (36169X) - (41772N)
    • Estradiol, Ultrasensitive, LC/MS/MS (30289X) - (30289N)

    • FSH & ESTRADIOL - (85670N)

    ============================== ===============
    Estradiol, Free, LC/MS/MS (36169X)
    Clinical Significance: Much of Estradiol is bound to proteins. The unbound
    portion and Estradiol bound to proteins with low affinity
    reflect the Free concentration. The Free Estradiol may
    better correlate with medical conditions than the Total
    Estradiol concentrations.

    Males (Adult): < or = 0.45 pg/mL
    Estradiol, % Free %
    Males (Adult): 1.25-1.85 %
    Estradiol pg/mL
    Males (Adult): < or = 29 pg/mL

    ============================== ===============
    Estradiol, Ultrasensitive, LC/MS/MS (30289X)
    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.

    Estradiol, LC/MS/MS pg/mL
    Adult Reference Ranges for Estradiol,
    Ultrasensitive, LC/MS/MS:

    Males: < or = 29 pg/mL
    ============================== ===============

    ADDITIONAN NOTE

    Best testing is done at Nichols Institute.
    Nichols Institute have two locations

    CA San Juan Capistrano (SJC)
    VA Chantilly AMD)

    when looking at the T & E testing the
    CA San Juan Capistrano (SJC)
    does advanced testing.
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    So with this "<= 29 pg/mL" is the new "standard" for males? For years, the range on every Estradiol test that I've taken has been "13-54 pg/mL".

    <= 29 pg/mL seems pretty good if that is the case since most guys seem to do well in that range.

    Sonny
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    Quote Originally Posted by T800 View Post
    So with this "<= 29 pg/mL" is the new "standard" for males? For years, the range on every Estradiol test that I've taken has been "13-54 pg/mL".

    <= 29 pg/mL seems pretty good if that is the case since most guys seem to do well in that range.

    Sonny
    Short answer, NO.

    Longer answer,
    there are three Estradiol tests available from Quest, and people have somewhat litle to say on what test they are going to get.

    useless
    good, older test
    good, lattest and greatest

    Looking at blood test
    first
    figure out what test are you dealing with

    proceed accordingly.
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    Quote Originally Posted by T800 View Post
    So with this "<= 29 pg/mL" is the new "standard" for males? For years, the range on every Estradiol test that I've taken has been "13-54 pg/mL".

    <= 29 pg/mL seems pretty good if that is the case since most guys seem to do well in that range.

    Sonny
    I hate this scale because if its less < what ever How the hell can you tell where you are at ? <20 does that mean you are at 10,12,5, it does not give you a specific number which makes the results confusing to intepret.

    1. .So where is the optimal range at is the question on range <29 ?
    I have seen guys test <16 and then get standard e2 test and test e2 at 40..I like standard testing alot better then ultrasensnitive <29 reference range..

    2. what doe these results really mean and are they some how related to the standard range of e2 testing 10-54 but just a narrow down version of stanard e2 from say using range (10-30 ) vs (10-54)
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    Quote Originally Posted by hardasnails1973 View Post
    I hate this scale because if its less < what ever How the hell can you tell where you are at ? <20 does that mean you are at 10,12,5, it does not give you a specific number which makes the results confusing to intepret.

    1. .So where is the optimal range at is the question on range <29 ?
    I have seen guys test <16 and then get standard e2 test and test e2 at 40..I like standard testing alot better then ultrasensnitive <29 reference range..

    2. what doe these results really mean and are they some how related to the standard range of e2 testing 10-54 but just a narrow down version of stanard e2 from say using range (10-30 ) vs (10-54)
    I think with this test ideal value is E2=28 (<29)
    but on my next test I am asking for
    Estradiol, Free, LC/MS/MS (36169X)

    that should give me:
    Quest Diagnostics: Test Menu


    Estradiol, Free (Males (Adult): < or = 0.45 pg/mL )
    Estradiol (Males (Adult): < or = 29 pg/mL)

    and then (I think) I want my Free~0.45 or 0.44

    I am guessing that it is same as with FreeTestosterone,
    we want lots of it but not too much.

    Dont you guys think that we could use help of

    Dr John
    or
    Dr Delgado

    in this conversation??????????????
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    hen I went in for blood draw today, I took Dr Johns advice and had a talk with them. I told them the last 2 times i got the wrong estradiol test.

    I told them the Dr asked for ultrasensitive. They first said "I don't know if our lab does it" to which I replied, "Your hormone tests go to San Juan, and they perform this test". They looked it up, and said that they were all set.

    I really got the impression that they were just not used to using this specific test. I also got the impression that they really wanted to do the proper test. Unfortunately, i suspect it is just not the norm, so they are just a bit ignorant.

    It could have still gotten screwed up - I won't know until i see the results.
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    Quote Originally Posted by AnotherOldGuy View Post
    hen I went in for blood draw today, I took Dr Johns advice and had a talk with them. I told them the last 2 times i got the wrong estradiol test.

    I told them the Dr asked for ultrasensitive. They first said "I don't know if our lab does it" to which I replied, "Your hormone tests go to San Juan, and they perform this test". They looked it up, and said that they were all set.

    I really got the impression that they were just not used to using this specific test. I also got the impression that they really wanted to do the proper test. Unfortunately, i suspect it is just not the norm, so they are just a bit ignorant.

    It could have still gotten screwed up - I won't know until i see the results.
    If ultrasenstive goes to san juan then you get <29 range. Is this what the range you wanted ? or standard 10-54 ? Which does dr wants?
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    I was told to get the ultrasensitive from Quest.
  

  
 

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