Labcorp E2 Test Results Comparison

[Sam]

It depends on how impatient I am or how quickly I want data for my results.  If I just want a broad, not-so-reliable ballpark idea of whether my E2 is too high or too low, I'll order my local E2 RIA test.  If I want something more specific, I'll order through LEF (ECLIA) and go to the next town over to get blood drawn.  Never had the chance (or the money) for an LC/MS, which I would definitely get if I could, but at the same time it's all about symptoms in conjunction with bloodwork, so I'm (contrary perhaps to Sam, who knows more about this than me) not going to lose sleep over "just" getting the ECLIA to determine levels.  Whatever you use, just keep it consistent.

Nah, we are in agreement on this.  I use LCMS because my insurance pays for it, but the Roche ECLIA test is good enough IMO if you are not on an AI and have a good feel for your E2/Symptoms balance.  If however, your a mess and you think E2 might be the culprit then I would only use LCMS.

[Peyt]

Ideally you should compare these to the LCMS test.

Estradiol Free, Equilibrium Dialysis, With Total Estradiol, HPLC/MS-MS (Endocrine Sciences)
Test Number: 500649 CPT Code: 82670; 84999


Or

Estradiol, LCMS (Endocrine Sciences)
Test Number: 500108 CPT Code: 82670

Hi Sam or anyone else who is knowledgeable in this subject,
I am trying to find the tests mentioned about online to order because it sounds like they are the latest and greatest, I cant find the 2nd one anywhere, but found the first one on "walk in labs" 's site for $89
The first one you mentioned (Estradiol Free, Equilibrium Dialysis, With Total Estradiol, HPLC/MS-MS (Endocrine Sciences) will have everything the 2nd one has and then some right?
So I should be good to go I hope.
I am starting DIM tomorrow and want to test myself before starting and then test every now and then again to make sure my E2 does not drop too much so I am trying to pick the best test from the get go... My insurance won't cover any of the tests since I have a very high deductible so might as well get the best one since I am paying for it.
Thanks so much

[helix26404]

So the first is regular and second ultrasensitive?

Do you know if both are RIA, ECLIA, or LC/MS?

The first test, #4515, is called "Estradiol" by Labcorp and is ECLIA.
The second test, #140244, is called "Estradiol, Sensitive" by Labcorp and is RIA.
Labcorp doesn't seem to have a test called ultrasensitive and their use of the word sensitive is misleading.

God, what a mess.  RIA has the least amount of biometric validity and reliability.  Translation: its results are going to be more variable, and generally won't reflect the actual, objective value you have.  ECLIA is better but not best; that would be LC/MS. 

So I'd trust the 4515 most.

I've seen you say this a couple of times on this forum and I don't understand how to reconcile your opinion vs LabCorp. Why is LabCorp, one of the most respected labs in the country, using RIA for a sensitive test if it is so "unreliable"? From LabCorp on test 140244:

"This sensitive estradiol assay is designed for the investigation of infertility, particularly in situations where low estradiol levels can be expected. The analytic range of the assay is appropriate for the assessment of the low levels of estradiol typically observed in men, prepubertal girls, and postmenopausal women."

Personal anecdote: I've found that LabCorp's regular E2 test is rarely correct vis-a-vis my symptoms, BUT...I am on Arimidex. Suspecting low E2 but having never run a sensitive E2 test, I recently ordered both regular and sensitive E2 from LEF through LabCorp. The sensitive test returned a value of 10 and the regular somewhere in the low 30s (don't have access to the actual numbers right now).

My doctor (and me) have been dosing Arimidex on the 4515 test, and it never shows me anything under the mid-20s. I have been feeling god awful for weeks because I am taking 2mg of Arimidex each week, but the test never reflects it so he keeps upping the dose thinking high E2, rather than low, is the problem.

Based on LabCorp's description and my personal experiences, I recommend anyone who is taking Arimidex to use the sensitive assay. Just my 2 cents.

EDIT: Adding reference to my recent thread on a related topic of Arimidex experiences and dosing based on test results: http://www.peaktestosterone.com/forum/index.php?topic=6008.0

[Kierkegaard]

So the first is regular and second ultrasensitive?

Do you know if both are RIA, ECLIA, or LC/MS?

The first test, #4515, is called "Estradiol" by Labcorp and is ECLIA.
The second test, #140244, is called "Estradiol, Sensitive" by Labcorp and is RIA.
Labcorp doesn't seem to have a test called ultrasensitive and their use of the word sensitive is misleading.

God, what a mess.  RIA has the least amount of biometric validity and reliability.  Translation: its results are going to be more variable, and generally won't reflect the actual, objective value you have.  ECLIA is better but not best; that would be LC/MS. 

So I'd trust the 4515 most.

I've seen you say this a couple of times on this forum and I don't understand how to reconcile your opinion vs LabCorp. Why is LabCorp, one of the most respected labs in the country, using RIA for a sensitive test if it is so "unreliable"? From LabCorp on test 140244:

"This sensitive estradiol assay is designed for the investigation of infertility, particularly in situations where low estradiol levels can be expected. The analytic range of the assay is appropriate for the assessment of the low levels of estradiol typically observed in men, prepubertal girls, and postmenopausal women."

Personal anecdote: I've found that LabCorp's regular E2 test is rarely correct vis-a-vis my symptoms, BUT...I am on Arimidex. Suspecting low E2 but having never run a sensitive E2 test, I recently ordered both regular and sensitive E2 from LEF through LabCorp. The sensitive test returned a value of 10 and the regular somewhere in the low 30s (don't have access to the actual numbers right now).

My doctor (and me) have been dosing Arimidex on the 4515 test, and it never shows me anything under the mid-20s. I have been feeling god awful for weeks because I am taking 2mg of Arimidex each week, but the test never reflects it so he keeps upping the dose thinking high E2, rather than low, is the problem.

Based on LabCorp's description and my personal experiences, I recommend anyone who is taking Arimidex to use the sensitive assay. Just my 2 cents.

EDIT: Adding reference to my recent thread on a related topic of Arimidex experiences and dosing based on test results: http://www.peaktestosterone.com/forum/index.php?topic=6008.0

You'd have to talk with Sam about the technicalities regarding RIA, ECLIA, and LC/MS.  The only reason I can think of for LabCorp is cheapness.  Paying ECLIA or LC/MS with the ultrasensitive would probably cost a fortune, and so wouldn't be a viable sell for a private lab. 

[Osprey]

The problem is that just saying the test uses RIA is not descriptive enough to determine how accurate the test will be. For example here is a paper that discusses the relative accuracy of direct RIA vs conventional RIA in measuring E2 in post menopausal women and in men.

http://cebp.aacrjournals.org/content/19/4/903.full

I also recently found another paper that discusses how to maximize the RIA testing procedure for measuring low E2 levels. It discussed using a larger sample size and a different reagent. Don't have the reference handy at the moment.

We don't know what specific type of RIA test Labcorp is using.

[PeakT]

K:  Men not on hrt or those on arimides must be careful:  they could walk around getting bone loss and not even know it due to low E2.  You cant always feel it:  we have seen it on here before.

[Steady]

Personal anecdote: I've found that LabCorp's regular E2 test is rarely correct vis-a-vis my symptoms, BUT...I am on Arimidex. Suspecting low E2 but having never run a sensitive E2 test, I recently ordered both regular and sensitive E2 from LEF through LabCorp. The sensitive test returned a value of 10 and the regular somewhere in the low 30s (don't have access to the actual numbers right now)

Helix, if you could get access both test results that were pulled together I would like to add to my original table for comparing the 2 tests.

[SomeGuy]

I've seen you say this a couple of times on this forum and I don't understand how to reconcile your opinion vs LabCorp. Why is LabCorp, one of the most respected labs in the country, using RIA for a sensitive test if it is so "unreliable"? From LabCorp on test 140244:

"This sensitive estradiol assay is designed for the investigation of infertility, particularly in situations where low estradiol levels can be expected. The analytic range of the assay is appropriate for the assessment of the low levels of estradiol typically observed in men, prepubertal girls, and postmenopausal women."

Also, in the "packages" offered by Labcorp/privatemdlabs, they use the "estradiol, sensitive" test in packages meant for men, and the "estradiol, serum" test in packages meant for women.  For example, the "Men's hormonal panel" and the "women's hormonal panel."  It would seem that the lab itself thinks that the sensitive test is the one meant for men.  Reading on other forums I've seen a couple of well-respected TRT doctors also saying that the sensitive test is the only one that yields reliable results for men on TRT.

Where I'm confused is how the recommended e2 ranges fit into this.  We commonly hear that men should shoot for an e2 level of around 20-30.  Is that on the sensitive test or the standard test?

[Hydranted]

I've seen you say this a couple of times on this forum and I don't understand how to reconcile your opinion vs LabCorp. Why is LabCorp, one of the most respected labs in the country, using RIA for a sensitive test if it is so "unreliable"? From LabCorp on test 140244:

"This sensitive estradiol assay is designed for the investigation of infertility, particularly in situations where low estradiol levels can be expected. The analytic range of the assay is appropriate for the assessment of the low levels of estradiol typically observed in men, prepubertal girls, and postmenopausal women."

Also, in the "packages" offered by Labcorp/privatemdlabs, they use the "estradiol, sensitive" test in packages meant for men, and the "estradiol, serum" test in packages meant for women.  For example, the "Men's hormonal panel" and the "women's hormonal panel."  It would seem that the lab itself thinks that the sensitive test is the one meant for men.  Reading on other forums I've seen a couple of well-respected TRT doctors also saying that the sensitive test is the only one that yields reliable results for men on TRT.

Where I'm confused is how the recommended e2 ranges fit into this.  We commonly hear that men should shoot for an e2 level of around 20-30. Is that on the sensitive test or the standard test?

The sensitive test.

[helix26404]

Personal anecdote: I've found that LabCorp's regular E2 test is rarely correct vis-a-vis my symptoms, BUT...I am on Arimidex. Suspecting low E2 but having never run a sensitive E2 test, I recently ordered both regular and sensitive E2 from LEF through LabCorp. The sensitive test returned a value of 10 and the regular somewhere in the low 30s (don't have access to the actual numbers right now)

Helix, if you could get access both test results that were pulled together I would like to add to my original table for comparing the 2 tests.

Same day, same blood draw test:

Labcorp 4515: 36
Labcorp 140244: 10

Again I did this after suspecting low E2 from constant feeling of "crash", even though standard assay tests were coming in either high or normal.

I am becoming quite passionate about this. I can't say it strongly enough. If you are on Arimidex and are having trouble finding an optimal dosing regimen, you owe it to yourself to get a sensitive test for comparative purposes.

I have realized I don't need an AI at all, and I'm on 3000ius of HCG (mono) a week! I am beginning to feel much better since dropping the AI.

Will run both tests again a couple of times over the next few months to add data to this study for you, Steady.

[Dallas]

Personal anecdote: I've found that LabCorp's regular E2 test is rarely correct vis-a-vis my symptoms, BUT...I am on Arimidex. Suspecting low E2 but having never run a sensitive E2 test, I recently ordered both regular and sensitive E2 from LEF through LabCorp. The sensitive test returned a value of 10 and the regular somewhere in the low 30s (don't have access to the actual numbers right now)

Helix, if you could get access both test results that were pulled together I would like to add to my original table for comparing the 2 tests.

Same day, same blood draw test:

Labcorp 4515: 36
Labcorp 140244: 10

Again I did this after suspecting low E2 from constant feeling of "crash", even though standard assay tests were coming in either high or normal.

I am becoming quite passionate about this. I can't say it strongly enough. If you are on Arimidex and are having trouble finding an optimal dosing regimen, you owe it to yourself to get a sensitive test for comparative purposes.

I have realized I don't need an AI at all, and I'm on 3000ius of HCG (mono) a week! I am beginning to feel much better since dropping the AI.

Will run both tests again a couple of times over the next few months to add data to this study for you, Steady.

I think I am on board with this now too.    I do have a quick question.  Is there a reason that some people simply do not convert much T to E...would that mean that I don't convert a lot of T to DHT either?  I have had my DHT taken when my Test was lower and it was low-normal.  For some reason I believe that I am not converting as much T to E2 as I used to.  Any idea why not?

[kquad]

The standard test seems to correlate to my symptoms. The only thing is my face is puffy no matter what. It just gets much bigger above 30.I think that may be due t the sodium retention caused by testosterone. I always gained weight first in my face. I need to get my testosterone level down, as it is still above 1500. I have slowly been cutting back. It must have been really high, because each test still says greater than 1500.

All things considered I do not convert much to estrogen it would seem

[PeakT]

Makes sense if u r not using arimidex to me anyway

[Dallas]

The standard test seems to correlate to my symptoms. The only thing is my face is puffy no matter what. It just gets much bigger above 30.I think that may be due t the sodium retention caused by testosterone. I always gained weight first in my face. I need to get my testosterone level down, as it is still above 1500. I have slowly been cutting back. It must have been really high, because each test still says greater than 1500.

All things considered I do not convert much to estrogen it would seem

Thats interesting doesnt look like I  either....not sure why.

[Dallas]

Makes sense if u r not using arimidex to me anyway

Im not using arimidex