E2 vs Sensitive E2 test

[Luke717]

My Dr ordered just a regular estradiol test. I asked him if he could do a sensitive estradiol instead... I assume it is the same only more sensitive... Is that correct?

I am looking at switching over to Defy. As this guy seems slightly incompetent comparatively

Thanks,

Luke

 

[Nelson Vergel]

You may want to read this
Why All Men Should be Tested with the Sensitive Estradiol Test

 

[Cataceous]

Standard test
• Idiot-proof
• Highly repeatable
• Somewhat prone to cross-reactivity, e.g. to high levels of CRP
• Higher detection threshold, e.g. 5 pg/mL minimum
• Lower cost

Sensitive test
• Temperamental and prone to huge errors when not done perfectly
• Very accurate
• High specificity
• Lower detection threshold, e.g. 2.5 pg/mL minimum
• Higher cost

 

[Vince Carter]

I advocate if it's affordable to run both but still it's indisputable...Quest Diagnostics, for one, prints it right on the test results for the Standard test that if you're a male its the wrong test.

 

[slicktop]

The code for the liquid chromatic test (sensitive) through Quest is 30289, FYI. If that code doesn't show on the order, it probably wasn't the sensitive test. Although, Quest may have up to three different codes for the non-sensitive test in some areas. No one knows why.

 

[Cataceous]

...Quest Diagnostics, for one, prints it right on the test results for the Standard test that if you're a male its the wrong test.

The supposed "right" test has been wildly inaccurate for me 30% of the time—off by a factor of two. Others have reported similar problems. Until these reliability issues are resolved the sensitive test cannot be fully trusted.

 

[slicktop]

The supposed "right" test has been wildly inaccurate for me 30% of the time—off by a factor of two. Others have reported similar problems. Until these reliability issues are resolved the sensitive test cannot be fully trusted.

Out of curiosity, how are you judging the accuracy of the liquid chromatic test?

 

[Vince Carter]

The code for the liquid chromatic test (sensitive) through Quest is 30289, FYI. If that code doesn't show on the order, it probably wasn't the sensitive test. Although, Quest may have up to three different codes for the non-sensitive test in some areas. No one knows why.

The correct one has the lab range of < or = 29

 

[slicktop]

I think that's right, Vince. I got the code off my own bloodwork before I knew to ask my doctor to order it for me specifically, back in my dark days of TRT (pre-Defy).

 

[Cataceous]

Out of curiosity, how are you judging the accuracy of the liquid chromatic test?

The last time it was blatantly wrong I retested with both ECLIA and LC/MS. On the retest both agreed with each other and disagreed with the previous LC/MS. This was after only a short time lapse and no change in protocol.

In this thread on calculating free estradiol, somebody crunched Gman86's results and found excellent agreement between measured free estradiol and that calculated from the standard estradiol test. He also had sensitive test results which were much less consistent.

Also check out AWesker's recent thread over at PeakT documenting results of simultaneous standard and sensitive estradiol tests at both Quest and LabCorp.

This criticism of LC/MS seems to still be relevant:
It needs to be noted that mass spectrometry assays are highly complex and require both a high degree of manual adjustments and controlling of operational conditions. Therefore, a high level of skill and knowledge is required to properly set up and operate these methods. Inappropriately operated mass spectrometry methods can lead to profoundly incorrect and inconsistent results. To facilitate the implementation of mass spectrometry in the clinical laboratory, the Clinical and Laboratory Standards Institute (www.CLSI.org) is developing a series of guidance documents, with one specifically addressing methods for steroid hormones. Furthermore, organizations such as the American Association of Clinical Chemistry (www.AACC.org) are offering training opportunities on mass spectrometry for the clinical laboratory.

 

[Appassionato]

Also, labs will be more than happy to charge you twice for a test they will sell you as more "accurate".

 

[Nelson Vergel]

The sensitive test is based on liquid chromatography/mass spectrometry. It costs more to run that type of test that the regular ECLIA ( electrochemiluminescence immunoassay analysis) one.

My site has the lowest sensitive estradiol test in the U.S. ESTRADIOL , Sensitive (LC/MS/MS)