Recommended Ultrasensitive Estradiol Tests for Men

[Nelson Vergel]

The first study posted (chart review from Low T Centers) used the old estradiol test that has been shown not to be good for men. The second one used mass spectrometry but not the ultrasensitive type. The Low T Center review shows that all men are given anastrozole with testosterone irrespective of their baseline estradiol blood levels. So, yes DHM....I agree with you about the fact that is poor management of men on TRT.

Look at this paper comparing the two estradiol tests used in men:

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."

This is the most precise estradiol test for me provided by Labcorp:

Estradiol, LCMS (Endocrine Sciences)

Test Number: 500108Specimen:orfrozenVolume:Minimum Volume:Note: notContainer:orCollection:please submit separate frozen specimens for each test requestedStorage Instructions:Freeze.frozenMethodology:

[TD="class: tableCell1, colspan: 2"]	CPT Code: 82670[/TD]
[TD="class: tableCell1 detailsTitle, align: right"]	[/TD] [TD="class: tableCell1"]Serum (preferred)	plasma,	[/TD]
[TD="class: highlight detailsTitle, bgcolor: #BCD4EC, align: right"]	[/TD] [TD="class: highlight, bgcolor: #BCD4EC"]3 mL[/TD]
[TD="class: tableCell1 detailsTitle, align: right"]	[/TD] [TD="class: tableCell1"]1.5 mL (	This volume does	allow for repeat testing.)[/TD]
[TD="class: highlight detailsTitle, bgcolor: #BCD4EC, align: right"]	[/TD] [TD="class: highlight, bgcolor: #BCD4EC"]Gel-barrier tube, lavender-top (EDTA) tube,	green-top (heparin) tube[/TD]
[TD="class: tableCell1 detailsTitle, align: right"]	[/TD] [TD="class: tableCell1"]Serum/plasma must be separated from cells within 45 minutes of venipuncture. Send serum/plasma in a plastic transport tube. To avoid delays in turnaround time when requesting multiple tests on frozen samples,	.[/TD]
[TD="class: tableCell1 detailsTitle, align: right"]	[/TD] [TD="class: tableCell1"]	at room temperature or refrigerated for two days.	for two years	.[/TD]
[TD="class: tableCell1 detailsTitle, align: right"]	[/TD] [TD="class: tableCell1"]Liquid chromatography/tandem mass spectrometry (LC/MS-MS)[/TD]

This is the test performed by Quest Diagnostics:

Estradiol, Ultrasensitive, LC/MS/MS

Test Code

30289

CPT Code(s)

82670
Preferred Specimen(s)

0.5 mL serum collected in a red-top tube (no gel)
Minimum Volume

0.2 mL
Collection Instructions

Specify age and sex on test request form. Plasma, fluid and serum collected in SST's are not acceptable specimen types.Ship frozen. Do not thaw.
Transport Temperature

Frozen
Specimen Stability

Room temperature: 48 hours
Refrigerated: 7 days
Frozen: 2 years
Methodology

Liquid Chromatography Tandem Mass Spectrometry (LC/MS/MS)