T Nation

Estradiol: Why You Should Care


I’ve been doing my best to source a lab in the UK to get a more accurate E2 test done and from the research I’ve been doing E2 bloods can very a lot with many difference testing methods, including the sensitive E2 test done at Labcorp.

If anyone’s interested in learning more about E2 testing I found this a good read - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3615207/

Personally I really want to nail down the most reliable type of test for E2 and find a UK lab who can do it… I’m going to do my best to get something setup here in the UK if it’s not already available becuase so many people need this E2 sensitive test for their TRT.

What’s the consensus on the best/most reliable E2 testing method nowadays?


LC/MS/MS or bust. I’ve experienced low and high E2 and now know when I’m having issues.


I’ve just done both simultaneously. Immunoassay came back at 21 pg/mL and LC/MS/MS was 23 pg/mL. Unless your E2 is very low, (<15) you could probably go with the immunoassay.


Interesting but didn’t you say in your other post that the immunoassay = 39 pg/mL and
LC/MS/MS = 29 pg/mL?

I’m still trying to find a decent E2 testing option for us UK folk and have been talking to some of the labs directly here to see what options are available… This is one of the relies I got from one of the labs -

“We use the latest generation of Immunoassay method that is comparable to the MS method you have found in the US. I was talking to the head of the UK reference unit in Leeds and he was saying that the MS method is not very reliable and they use an extraction method which is even better.”

I’ll keep this thread updated (;


No, those were the normal ranges Quest gave.

Immunoassay is < = 39 pg/mL (mine was 21 pg/mL)
LC/MS/MS is < = 29 pg/mL (mine was 23 pg/mL)


Thanks for the clarification (;


I may have more information that could help you. I know someone who is a researcher for Pfizer. It occurred to me she may know about these lab methods and as it turns out, she does work with this equipment. I’m going to see her later this week and discuss immunoassay and liquid chromatography/mass spectrograph analysis. I’m interested to hear what she has to say.


I’d personally be very interested in hearing what she has to say and I’m sure others here would too. So please keep us all posted. Appreciate you taking the time to speak to her.


Today, I was able to meet with an acquaintance of mine who is a PhD researcher for Pfizer. She’s been doing vaccine research for the past three or four years (I don’t think she worked on Viagra years ago, but she did mention it was their biggest moneymaker until Lipitor came along). We spoke for over thirty minutes, wish I took some notes, so I’ll summarize what she said. She went into some serious detail regarding the techniques in question.

She uses both immunoassay and LC/MS in her work, and from the sound of it, daily. Overall, she was much higher on the immunoassay procedure. She said it was more reliable and repeatable. She said the LC/MS equipment was much more temper mental and more difficult to use, with the skill of the operator critical and results more likely to be impacted by user error.

I explained the issue with estradiol. She didn’t seem to grasp the problem, insisting that immunoassay was the way to go, unless, the level would be unperceivable by immunoassay, in which case LC/MS would be the method of choice.

I understand that the immunoassay can (or does) over state your true E2 levels, which is what surprised me with mine, since immunoassay was 21 ng/mL vs 23 ng/mL LC/MS.
She just shrugged when I asked about that, saying that if repeat tests were performed that the IA would more likely be the same while the LC/MS less likely. Essentially, according to her, unless you’re expecting levels below 15 there is no reason to use the LC/MS test.

My doctor maintains the immunoassay is fine and the 20-22 range is what we want to see for E2. If anyone comes back <15, he decreases their anastrozole dose, or, if test is still low, increases test dosage. But, he does rely on symptoms, especially if it’s higher.

Hope this helps. Regardless, next time I get blood work, I’m going to ask for both again. It’ll be interesting to see if they are consistent.


I am curious what the recommended starting TRT dose for hmG + hcG would be? I can get hmG in 75iu or 150iu vials.


This was VERY informative! Thanks


Fortunately much in the OP is not true. Estrogen actually enhances androgen receptor expression and this is one reason that estrogen contributes to prostate growth, hair loss, male aggression and most of all male personality traits.

It is known that homosexual men lack aromatization of testosterone to estrogen whereas lesbian women have enhanced aromatization of testosterone to estrogen.

Taking pharmaceutical anti-estrogens has taught me that low estrogen (low aromatization) is ALMOST worse than low testosterone for a man.




Shit. I was homosexual for a short time. Lmao

@nerdonroids is that why I watch gay porn ? Am kidding . I watch whatever I want.


How do I pm you? You have lots of knowledge in this topic


My T is 1300 and my E is 53. How did you get your E down?


That doesn’t seem that high for T at that level. Do you have any symptoms?


I have not been at T-Nation for quite a while, but I always try to help those who truly need it.



He is clearly joking. LOL


Same here in Spain, they claim is lastest immunoassay technology what they use comparable to LC/MS-MS but I don’t know if I believe it, it sounds like “We have no idea but I’m telling you that to be cool”.