Questions regarding DiscountedLabs.com tests

[Someguy]

I've used privatemdlabs in the past. I've been checking out DiscountedLabs.com and the prices look great, but I have a few questions:

1. Estradiol test: I've been using the "Estradiol, Sensitive" test at privatemdlabs with good accuracy and results. I believe that it's the RIA method, but not 100% sure. I see that the only estradiol test offered at DiscountedLabs.com is the "Estradiol, Ultrasensitive LC/MS/MS" test. Would results from this lab be comparable to the "Estradiol, Sensitive" test I've been using? I.e., can I compare previous levels from the "Estradiol, Sensitive" test with new levels from the "Estradiol, Ultrasensitive" test and still keep an accurate picture of how my E2 levels have changed over time? Is the range to shoot for on the Ultrasensitive test still 20-30?

2. Testosterone F&T at DiscountedLabs: Is this the testosterone test that can accurately give TT results over 1500, or will it just show up as ">1500"?

3. Any chance of a discounted combo package that includes Total Testosterone and Estradiol? These are the two that I, and probably most other guys, order together the most often.

 

[Nelson Vergel]

1. Estradiol test: I've been using the "Estradiol, Sensitive" test at privatemdlabs with good accuracy and results. I believe that it's the RIA method, but not 100% sure. I see that the only estradiol test offered at DiscountedLabs.com is the "Estradiol, Ultrasensitive LC/MS/MS" test. Would results from this lab be comparable to the "Estradiol, Sensitive" test I've been using? I.e., can I compare previous levels from the "Estradiol, Sensitive" test with new levels from the "Estradiol, Ultrasensitive" test and still keep an accurate picture of how my E2 levels have changed over time? Is the range to shoot for on the Ultrasensitive test still 20-30?

The LC/MS/MS is the more accurate than the RIA based estradiol test as shown by this study:



Comparisons of Immunoassay and Mass Spectrometry Measurements of Serum Estradiol Levels and Their Influence on Clinical Association Studies in Men


"In conclusion, our findings suggest interference in the standard immunoassay-based E2 analyses, possibly by CRP or a CRP-associated factor. Although this interference does not seem to affect association studies between immunoassay E2 levels and skeletal parameters, we propose a reevaluation of previous association studies between immunoassay-based E2 levels and inflammation-related outcomes. In addition, MS-based assays are to be preferred for the quantification of E2 levels in men."

2. Testosterone F&T at DiscountedLabs: Is this the testosterone test that can accurately give TT results over 1500, or will it just show up as ">1500"?

Over 1500 ng/dL the test becomes inaccurate, so it is expressed as > 1500 ng/dL

3. Any chance of a discounted combo package that includes Total Testosterone and Estradiol? These are the two that I, and probably most other guys, order together the most often.

DiscountedLabs.com has one of the most affordable Total+Free Testosterone and Ultrasensitive Estradiol tests online.
We are thinking about coming up with a membership program for frequent users.

 

[Someguy]

Would the recommended optimum range of the LC/MS/MS E2 test be 20-30 for most men on TRT?

 

[Vince Carter]

Im wondering if 20-30 remains the standard for the various testing methods.

 

[Nelson Vergel]

This is the only study that looked at higher estradiol blood levels

This study found that estradiol levels of < 21.80 pg/ml and > 30.11 pg/ml resulted in greater mortality in men. It was not well controlled and randomized.


Abstract

CONTEXT:

Androgen deficiency is common in men with chronic heart failure (HF) and is associated with increased morbidity and mortality. Estrogens are formed by the aromatization of androgens; therefore, abnormal estrogen metabolism would be anticipated in HF.


OBJECTIVE:

To examine the relationship between serum concentration of estradiol and mortality in men with chronic HF and reduced left ventricular ejection fraction (LVEF).


DESIGN, SETTING, AND PARTICIPANTS:

A prospective observational study at 2 tertiary cardiology centers (Wroclaw and Zabrze, Poland) of 501 men (mean [SD] age, 58 [12] years) with chronic HF, LVEF of 28% (SD, 8%), and New York Heart Association [NYHA] classes 1, 2, 3, and 4 of 52, 231, 181, and 37, respectively, who were recruited between January 1, 2002, and May 31, 2006. Cohort was divided into quintiles of serum estradiol

quintile 1, < 12.90 pg/mL;
quintile 2, 12.90-21.79 pg/mL;
quintile 3, 21.80-30.11 pg/mL;
quintile 4, 30.12-37.39 pg/mL;
and quintile 5, > or = 37.40 pg/mL.

Quintile 3 was considered prospectively as the reference group.


MAIN OUTCOME MEASURES:

Serum concentrations of estradiol and androgens (total testosterone and dehydroepiandrosterone sulfate [DHEA-S]) were measured using immunoassays.


RESULTS:

Among 501 men with chronic HF, 171 deaths (34%) occurred during the 3-year follow-up. Compared with quintile 3, men in the lowest and highest estradiol quintiles had increased mortality (adjusted hazard ratio

---

, 4.17; 95% confidence interval [CI], 2.33-7.45 and HR, 2.33; 95% CI, 1.30-4.18; respectively; P < .001). These 2 quintiles had different clinical characteristics (quintile 1: increased serum total testosterone, decreased serum DHEA-S, advanced NYHA class, impaired renal function, and decreased total fat tissue mass; and quintile 5: increased serum bilirubin and liver enzymes, and decreased serum sodium; all P < .05 vs quintile 3). For increasing estradiol quintiles, 3-year survival rates adjusted for clinical variables and androgens were 44.6% (95% CI, 24.4%-63.0%), 65.8% (95% CI, 47.3%-79.2%), 82.4% (95% CI, 69.4%-90.2%), 79.0% (95% CI, 65.5%-87.6%), and 63.6% (95% CI, 46.6%-76.5%); respectively (P < .001).

Reference:

Circulating estradiol and mortality in men with systolic chronic heart failure.
JAMA 2009 May 13;301(18):1892-901.

 

[Someguy]

Today I had blood drawn at the same time for both the Labcorp Ultrasensitive Estradiol LC/MS/MS test and the Labcorp "Estradiol, sensitive" (RIA?) test. I'm interested to see how well the two results match up.

 

[Nelson Vergel]

Someguy

Excellent! Let us know when you get the results.

 

[Someguy]

I got the results back today. After reading the information on the lab reports, it sounds like what privatemdlabs calls the "estradiol, sensitive" and what discountedlabs calls "estradiol, ultrasensitive" are actually the same test. They're both done through Labcorp.

The "sensitive" test from privatemdlabs report said "Methodology: Liquid chromatography tandem mass spectrometry (LC/MS/MS)"

The "Ultrasensitive" test from discounted labs said "LCMS".

The results were 50 pg/ML for the "ultrasensitive" and 50.8 pg/ML for the "sensitive."

It sounds like they're one and the same test. I'll be ordering from discountedlabs from now on since they're cheaper.

 

[Nelson Vergel]

We just added a total and free testosterone test that can accurately measure testosterone blood levels over 1500 ng/dL

http://www.discountedlabs.com/testosterone-free-direct-with-total-testosterone-lc-ms-ms/