T Nation

Found a Lab in Vancouver

Through much diligence, and many phone calls, and e-mails, I’ve finally found a lab in Vancouver, B.C. Canada, that performs the “Sensitive Assay” Estradiol test!

It’s the blood lab at:

B.C. Children’s Hospital
4480 Oak St.
Vancouver, B.C.
(604)875-2345 Local 7509 (Ask for the Department that does Estradiol testing)

I phoned them, and confirmed twice that they do in fact perform the “Sensitive Assay” Estradiol test for Adult Male Patients.

Both B.C. Biomedical Labs, and LifeLabs do not perform this test.

However, I was talking with someone at B.C. Biomedical Labs, and they are going to inform their labs that the B.C. Children’s Hospital does run this blood test, so they may be able to ship out the samples to the Hospital to get the necessary work done there. That way patients should be able to have the blood collected at any B.C. Biomedical Lab for the Sensitive Assay Estradiol test as long as their Dr. specifically requests that test, in the very near future.

But until that happens, at least it’s available AT the B.C. Children’s Hospital.

Just thought I’d pass that along to other TRT/HRT patients/members on this board in the Vancouver area who would like the sensitive assay Estradiol test.

Just want to mention that I’ve now received conflicting reports from the hospital whether or not they actually perform this test.

Why can’t they get their information accurate?

I apologize for any inconvenience. I’m only trying to help.

How is a sensitive Estradiol test useful in a TRT context, or even in a bodybuilding/performance enhancement context?

Aren’t likely male levels high enough to detect without using this particular test?

It’s useful because males don’t want their Estrogen levels to get too high!

Why it Matters

There are basically two very important reasons that we need to care about Estradiol.

The first is that Estradiol is a powerful Testosterone receptor antagonist. What this means to us men is that Estradiol creates a very strong bond to the Androgen Receptors of Testosterone and renders them useless.

However, when testosterone binds to an Androgen Receptor, it activates that receptor and we get the physiological effects we’re all looking for. Now, when Estradiol binds to that same receptor it blocks Testosterone from binding, yet it does not activate the receptor, so in short nothing happens.

This means that if your Estradiol serum level is high, no matter how much exogenous testosterone you take it isn’t going to help you as it should because too many of your androgen receptors are now blocked by Estradiol and your Free Testosterone has nowhere to go.

Exogenous Testosterone can’t do you any good if it doesn’t have receptors available to activate?simple enough.

Now, things can get worse believe it or not… some believe that elevated levels of Estradiol can cause the down regulation of Androgen Receptors. What this potentially means is that your body may respond to higher levels of Estradiol by creating fewer Androgen Receptors as cells are replaced in a normal regeneration cycle .

So, not only does Estradiol block the available Androgen Receptors as noted, it may cause your body to produce fewer of them in the future!

This is where many Docs get it wrong and is one primary reason why just ?raising Testosterone serum levels? alone as a mono-therapy may not have any immediate effect on a man. It may be that the receptors have been down regulated and so there will be a need to lower Estradiol levels and increase Testosterone levels in order to get a man?s body to up-regulate again and this could take some time.

The second reason we care about Estradiol in men is that we also have Estrogen Receptors and Estradiol will bind to them and cause them to activate. This is fine if you want to grow man boobs (Gynocomastia) add belly fat and get an enlarged prostate, among other things, but not so good if you want to look and feel like a healthy man.

Keep in mind, the aromatase enzyme lives in the skin and has a propensity for abdominal fat. Meaning the more belly fat you have the higher level of aromatase you will have.


Why the “Sensitive Assay” test is vital for males:

In Dr. John Crisler’s own words, and he’s probably the leading expert in the field of HRT/TRT…

"A word about Estradiol ?Sensitive? Testing

Unless your Doctor specifically requests a ?Sensitive? assay the lab will default to the standard Estradiol assay designed specifically for women, which is useless for men. The reason for the difference between the two assays is the bell curve from which the test was designed sits within the ?normal? range for women and not men.

Therefore, the hormone concentration range appropriate for adult men falls on the flat slope of that bell curve making it completely inaccurate for testing men?s E2 serum levels. Always, ask for the ?Sensitive? assay when your Doctor is conducting a blood test and testing for Estradiol."

He goes on to say that a reading from the “standard” Estradiol test could show much higher levels of Estradiol/Estrogen than the patient actually has…"

Which could lead to the unnecessary prescribing of a very powerful aromatase inhibitor such as Arimidex/Anastrozole when it actually isn’t even necessary.

Hope this helps.

The definition of “Sensitive Assay” is whatever a lab wants to make it be. Note the same in BC, Labcorp or Quest. Need to look at the ranges that the test covers and reports. So Crisler’s comments are out of context. This seems to be a mess as there are no standards. Many have been very frustrated by this. Need to order a lab’s specific test number or code.

http://ask.lef.org/5198/RE-HRT?PageIndex=2#bm7573

Concerning the effects of E2: It is way more than receptors. Steroid hormones alter gene expression in the cells. A hormone can increase or decrease gene expression and estrogen and hormones balance gene expression. And the changes to gene expression can also be inhibitory.

Good answers on too much E2, but I meant to emphasize the “sensitive” part of the sensitive E2 test in my question. My understanding was that a sensitive test is for minute levels of E2, and wouldn’t a regular E2 test be close enough?

Dr. Crisler’s answer about the “flat slope of the bell curve” led me to Google the test ranges, which are hard to find, but I gather that generally they are greater than 50 pg/ml for regular, and 3-70 pg/ml for sensitive. So, yes, the sensitive E2 test is appropriate for men.

It’s probably in the stickies. I just needed to see it again.

OK, I was probably wrongly associating the problems with “ultra sensitive” E2 tests.

My apologies for posting misleading information. I was only trying to help.

So as far as the Estradiol test goes, the “standard” Estradiol (E2) test that B.C. Biomedical Labs perform/offer, where their reference range is < 156 pmol/L ( < 42.5 pg/ml) which according to Dr. Crisler is geared specifically toward women, seems accurate enough for a man on HRT/TRT, since according to the link that KSman provided above, the reference range for the Estradiol test for men that LabCorp performs/offers is 7.6-42.6 pg/ml, which is exactly where the reference range of the B.C. Biomedical Labs test cuts off. (The only difference is the type of “units” the range is shown in.)

Unless I’m missing something, or don’t understand something about the ranges.

So I guess my E2 level of 327 pmol/L (or 89 pg/ml) is significantly high, and taking an A.I. would be rather appropriate. At least until I get it down into a more manageable, or “normal” range for an adult male.

[quote]killergoalie wrote:
It’s useful because males don’t want their Estrogen levels to get too high!

Why it Matters

There are basically two very important reasons that we need to care about Estradiol.

The first is that Estradiol is a powerful Testosterone receptor antagonist. What this means to us men is that Estradiol creates a very strong bond to the Androgen Receptors of Testosterone and renders them useless.

However, when testosterone binds to an Androgen Receptor, it activates that receptor and we get the physiological effects we’re all looking for. Now, when Estradiol binds to that same receptor it blocks Testosterone from binding, yet it does not activate the receptor, so in short nothing happens.

This means that if your Estradiol serum level is high, no matter how much exogenous testosterone you take it isn’t going to help you as it should because too many of your androgen receptors are now blocked by Estradiol and your Free Testosterone has nowhere to go.

Exogenous Testosterone can’t do you any good if it doesn’t have receptors available to activate?simple enough.

Now, things can get worse believe it or not… some believe that elevated levels of Estradiol can cause the down regulation of Androgen Receptors. What this potentially means is that your body may respond to higher levels of Estradiol by creating fewer Androgen Receptors as cells are replaced in a normal regeneration cycle .

So, not only does Estradiol block the available Androgen Receptors as noted, it may cause your body to produce fewer of them in the future!

This is where many Docs get it wrong and is one primary reason why just ?raising Testosterone serum levels? alone as a mono-therapy may not have any immediate effect on a man. It may be that the receptors have been down regulated and so there will be a need to lower Estradiol levels and increase Testosterone levels in order to get a man?s body to up-regulate again and this could take some time.

The second reason we care about Estradiol in men is that we also have Estrogen Receptors and Estradiol will bind to them and cause them to activate. This is fine if you want to grow man boobs (Gynocomastia) add belly fat and get an enlarged prostate, among other things, but not so good if you want to look and feel like a healthy man.

Keep in mind, the aromatase enzyme lives in the skin and has a propensity for abdominal fat. Meaning the more belly fat you have the higher level of aromatase you will have.


Why the “Sensitive Assay” test is vital for males:

In Dr. John Crisler’s own words, and he’s probably the leading expert in the field of HRT/TRT…

"A word about Estradiol ?Sensitive? Testing

Unless your Doctor specifically requests a ?Sensitive? assay the lab will default to the standard Estradiol assay designed specifically for women, which is useless for men. The reason for the difference between the two assays is the bell curve from which the test was designed sits within the ?normal? range for women and not men.

Therefore, the hormone concentration range appropriate for adult men falls on the flat slope of that bell curve making it completely inaccurate for testing men?s E2 serum levels. Always, ask for the ?Sensitive? assay when your Doctor is conducting a blood test and testing for Estradiol."

He goes on to say that a reading from the “standard” Estradiol test could show much higher levels of Estradiol/Estrogen than the patient actually has…"

Which could lead to the unnecessary prescribing of a very powerful aromatase inhibitor such as Arimidex/Anastrozole when it actually isn’t even necessary.

Hope this helps.
[/quote]
Excellent points.I read that in regards to Neuroreceptor’s,Androgenrecetor’s etc. The cells i.e. receptor sites live for a period of time,similar to telemers the dna strand,it gets shorter as we age and or abuse it.Scientists have different opinions on receptors and there self life.Also muscle building.People believe it’s causes by breaking down and rebuilding.The other camp thinks it’s a result of new satellite cells being developed,hence new muscle tissue. have a good day john

Way too much techno babble stuff for me, Johnny. LOL!!

Why can’t articles ever just get down to the nitty gritty about whether or not something works, how much to take, and cut out all the extra mumbo jumbo blah blah blah that most people don’t care to read anyway, as all they are after is a quick, straight, answer…does such and such product work? How much to take? When to take it? Or, why I shouldn’t take it.

Or maybe that’s just me. haha

These posts are for the benefit of anyone who read them. We do get technical. Sorry if not quite what you are needing.

Read the protocol for injections sticky. It recommends dosing, labs and corrective measure to refine anastrozole dosing. That sticky got messed up by guys by people posting inappropriately.

My apologies, KSman, I didn’t mean to sound unappreciative. All I meant is that I’m sure a lot of us aren’t really interested in “HOW” things work, just “THAT” they work. Basically cut out all the yada yada yada, and “get to the point”. Again, unless it’s just me.

Although I’m sure there are a lot of people who are interested in the “long winded” stories, and the “science” behind things, and that’s great. But for me, I like things short, sweet, and to the point.

No offense meant.

“THAT” they work for who?

There are two groups frequenting this forum: Those who are interested in maximizing their exo and endo T, and those who would like to supplement the T that they “should have naturally”.

The first group seems to have a protocol that works well for their purposes, and which also appears to be the primary interest of this website. I don’t belong to this group, so maybe I’m being inaccurate here. Someone correct me, please.

The second group, my group, is the one trying to achieve “normal”. This the group needing most of the yadda yadda the poster above objects to. IMO we don’t have nearly enough yadda here. Bring it on, I say!

Should “T Replacement” be forked into two forums, to accommodate these two different interests? I would be in favor of this, and I think the first group above might agree as well.

Door right: Most who drop in here are concerned with TRT. For the others, we do discuss how thyroid problems can lower T and resolving thyroid problems can improve T. We also look for other contributing factors such as over training, starvation diets, hyperprolactinemia [high prolactin, adinomas], low cholesterol, low EFA intake, low DHEA-S, low cortisol, iodine deficiencies, low vit-D25, liver conditions, elevated E2, effects from OTC, testicular cancer, disorders of the testes and Rx drugs. We do appropriately deal with the group that you have identified and we also ask questions to uncover cases where doctors introduce TRT when they should be dealing with root causes.

The advice for new guys sticky addresses most of the above concerns. While not all of the above are mentioned explicitly, the questions help the veterans get there. The problem is that most who arrive here do not read the stickies.

We also help guys attempting to restart their HPTA’s. Sometimes after steroid use or a doctor’s inappropriate TRT or after hair loss drugs, or things more idiopathic.

In many cases with young guys, there can be some complex issues. With old guys, there HPTA is past its best before date.

There are things going on here that you are not seeing.