I was told by Quest that the 0-39 pg/ml has replaced the 4021 test with the range of 13-54. I have had the new test done twice and it has been consistant with the old test. My e2 levels are very stable and they did not change with the new test.
Thanks PureChance… I did request all those tests: FT4, FT3, Cortisol, etc, but doc said insurance wouldn’t cover & cost would be like over $300. I would absolutely pay for it myself if I could, I can’t. But I’ll check out the link on thyroid. Also will check back for TSH levels on my most recent past tests. Yeah, that E2 test is what Quest uses now. Thanks man for looking at this and for your input!
Thanks also ground control. Yeah, I thought this E2 test was wrong but other guys here have said their Quest labs are now using it, as you also confirm. I am just confused and don’t understand ranges I guess. If I could ask you, do you mean that, for instance, if my result is 33 pg/mL on the new test (0-39 pg/mL), that is the same as being 33 pg/mL on the old test (13-54 pg/mL) ? I know this is probably not right but I don’t understand how it works. Please excuse my ignorance on this. If this is too much to hassle with explaining, I understand. I’m just trying to get a handle on what the equivalent of E2-22 pg/mL on old Quest would be on this new one. Many guys here have posted that 22 is the optimal E2 level to shoot for, but that is using the old Quest ranges. I know there may not be one perfect value for all guys, as seekonk pointed out, but it gives a point of reference, etc. Would be nice if there were like standardized lab ranges for these things.
Anyway, thank you guys for your help, always!!
[quote]ground control wrote:
I was told by Quest that the 0-39 pg/ml has replaced the 4021 test with the range of 13-54. I have had the new test done twice and it has been consistant with the old test. My e2 levels are very stable and they did not change with the new test.[/quote]
Good info. Can you please repost this into the “Estradiol: Why you should care” stickey?
Yeah, my e2 has been been a constant 23 to 23.1 for over a year and my last 2 tests have been the same 23 pg/ml with the new test. The important thing to look at when comparing tests is the units.
VTBalla34, That last post was in response to StevieA’s question. I wasn’t trying to tell you how to read a test. I would also like to say thanks for your contributions to this forum. I have learned alot and have been helped greatly by your input and others.
ground control, thanks very much for the info on test comparison and for giving your E2 levels: basically same on both old and new tests. So I conclude that, basically, approx E2: 22-23 pg/mL is a good value to shoot for on the new test as well. This helps a great deal.
Yeah, I add my thanks to VTBalla34 as well. As ground control said, your insights throughout this forum are invaluable. It was one of your posts that first made me aware that my E2 test was not an error but a new one by Quest.
And thanks to all for your input and taking the time to look at my stats. Every single reply I’ve gotten has helped me understand how to proceed and it can be pretty confusing trying to do it on one’s own. I’ll post new results, etc, as I can. Again, many thanks!
[quote]StevieA wrote:
So I conclude that, basically, approx E2: 22-23 pg/mL is a good value to shoot for…[/quote]
That’s just a bro-myth.
Optimal E2 is very much dependent on the individual and the “correct” level is determined by how a person feels, not by some arbitrary average number. Not everybody will do well at 22-23. But don’t take my word for it - this is what both Drs Mariano and Crisler say (TRT docs well regarded here). Dr Mariano, by the way, said at one point that most people do better with E2 around 30 (like yours), though some do best either higher or lower than 30.
It is best to avoid taking an aromatase inhibitor if you can, certainly it is better to avoid it if you feel good already.
20-30 is not an arbitrary number but an observation based on reviewing hundreds of case threads throughout the www. Agree that “22” is a little too in the weeds and specific. But 20-30 has validity.
Having all the info gives me a better chance of balancing my system. Certainly how I actually feel and any symptoms, or lack of, is the most important, but if symptoms of any kind occur, then understanding my labs will help me discover the cause. As long as I feel good and everything is working well, I’m not going to try to alter anything just to match an optimal lab value, but if something goes wrong and I discover a problem, then knowing those optimal values gives me at least a point of reference, you know. So I keep asking questions and trying to learn. Thank you all for giving your time and knowledge!
I haven’t posted in awhile but all is going well except one problem: finding a pharmacy to fill my script. I found a good urologist who examined me and immediately agreed to prescribe HCG. I gave him what info I’ve gotten here and he also did some checking, so he wrote a script for Novarel but with option to substitute generic, just to cover the bases so to speak. Well, to make a long story shorter I cannot find a single pharmacy here in Nashville that has HCG in any brand or generic. They say they can order but it’s on backorder(?) and could be months. Well, it’s now been over a month since I first tried and today I got the same story.
I checked every compounding pharmacy as well, same thing. I also went to a compounding pharm so I could have it supplied in 2,000 iu vials (for reasons I don’t need to go into here) but they say they cannot get it period. But at this point I would take the 10,000 iu if I could find it, even if I had to waste over half.
Anyway, if anyone has any info on this I would greatly appreciate it, like an legit out-of-town pharmacy (online or otherwise)… have searched those too, no luck. The one Dr. Crisler recommends does not ship to Tennessee. I’ve read all the posts and haven’t found an answer or I wouldn’t be posting, but I may have missed something. It sure sucks to have done the legit thing (not easy) only to find I can’t use the script. I have another appointment with urologist in the morning (4/17/12) and wondering if I should have him write a different script (like for Pregnyl, etc)… but I don’t know how or if it would help. Thanks for any advice.
Costco ordered me a vial. I can’t remember what brand. You might want to go talk to them and see if they can get it for you. You don’t need a membership to use their pharmacy.
Thanks VTBalla34! I didn’t know Costco pharmacy could be used by non-members. That’s a huge help and I’ll check it out for sure! I just came from my appointment with my urologist. Man what a nice change to see a doc that isn’t totally ignorant about TRT.
And he’s open to learning about any new treatments, protocols, etc. Anyway, to make things easier & faster, etc, he said that when I find a pharmacy that can supply HCG to just have them phone him and he would prescribe as I requested. So I’ll check Costco and hopefully have some luck, if not will continue to look. Thanks again!
StevieA, please update with regards to the HCG, i’m interested. as far as your issues with your testicles and
pain, the HCG should work to aliviate pain and as for returning to normal size and function will take some
time. i think Bushudiobadboy commented that people who had issues 2 yrs or longer were able to gain function
back though i’m not sure about beyond 5 yrs although it wouldn’t hurt to try. you may need AI bc HCG can
make your E2 higher and how high, i do not know. you have a pm from me check it out.
Bart
Thanks Bart… I just now got online and saw your post, also got your PM & replied. Yeah, I meant to update here before now but was waiting until I resolved some issues and had more solid stats to report. I’ll still do that when I get things more on track, as I’m still having trouble getting my script filled, but will give brief update:
When my urologist examined me and definitely recognized my need for HCG (which I already knew) I went to fill his script and, as I’ve said, was unsuccessful. So I acquired some online just until I could get my script filled. As I’ve been well-advised here, I know it’s best to have a script but I was hurting and had been waiting a long time already with no relief. So I got some just until I can get my script filled and yeah, it has totally helped!! In fact more than I expected. I’ve been on TRT for 8 years with no ancillaries of any kind so as you said it was uncertain how effective the HCG would be.
But within a week I saw results and into 2 weeks my testes were almost back to where they always were before TRT. Size is still a bit less than they were pre-TRT but they are still increasing. Also, it has helped my mood and erection quality, etc. So I’m very, very pleased and relieved! I’m having blood work done in about a month to re-check E2, T… full panel. But I need to get my legit script filled and get a routine established, you know.
Thanks Bart for the info you sent via PM. I think between your info and a pharmacy I found online I should have my script filled within a few days to a week and will post again then. Man, it just amazes me the kind of time and effort I’ve spent simply trying to get this HCG therapy in place. And most amazing is that is wasn’t getting a doc to write it that has been the biggest challenge, but getting the damn thing filled. Now I understand how committed you gotta be to get things right. Well, I’m going to get there, and will post my progress when I do. Thanks to all for the great help and support!
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What’s the latest StevieA? I was reading this because your situations was very similar to mine. I’m not sure if I can get HCG but only difference in your situation, is that I’m only 34, have been on androgel for 12 years, and am worried about feature fertility.
I’ve had ache before, but now it just feels like my nut is going to explode as it wants to suck up into my body when I have an orgasm. (Not in a good way) worried this is a bad sign, and HCG should be taken before my balls are gone for good.
Stevie A,
It’s been a long time since your last posts but I’m hoping you can give an update. My situation is identical to what you discribed. Do you still think hCG is the best course of action. Your response and advice would be greatly appreciated.
Best Regards, T
Hey t_m0,
Yeah, I haven’t been on here in quite awhile but fortunately I get an email when someone comments on one of my posts, or asks a question, etc. Yes, I continue to do well with HCG. I’ve read a great deal, here and elsewhere, and it can get confusing, especially for those doing cycles. I don’t do cycles, just do daily T replacement with transdermal gel: AndroGel, Testim, etc- have used most of them. I know many people say this form doesn’t work as well as injections but for me it has worked very well, keeping my T levels between 800 and 1345 TT (Quest, 241-827mg/dl).
Anyway, as my posts here describe, my main problem has been atrophy of testicles, and pain from tightness, etc. I got good results from using HCG from the very beginning. My main concern was/is to restore function and size of my testicles and I haven’t found anything other than HCG that works for this. One thing I have changed is the protocol I’m using. I was injecting 250iu every other day (EOD) for a couple of years and the results were good, but at one point I had to find a new source and had to make my supply last longer while I arranged it. So I began injecting the same dosage but every 3 days (E3D). To my surprise I actually got better results! Can’t explain it.
The change hasn’t been huge but very noticeable. My testicles have increased even more in size, the bit of tightness that had remained on the previous, higher dose is gone and ejaculations are better in all respects. Also I had a slight bit of swelling in ankles, which is gone now on this E3D protocol. My doc had suspected this was from aromatization and now I think he was right, since the dose change has fixed it. So for whatever reason, using the HCG E3D rather than EOD has made a difference for the better.
I suppose the decreased aromatization (and thus less ankle swelling) makes sense because of lower T levels from the less frequent use of HCG (since HCG stimulates T production), but I don’t know why this change in protocol is more effective in all other aspects. Now this may not work the same for someone else, I don’t know. But for me it has. So far I’ve had no negative side effects from HCG so will continue to use it. Hope this has been of some help.
Steve,
Thank you very much for the response.
I am 55 years old and have been on TRT for about 10 years. I have used Androgel and Fortesta (5 pumps daily) to offset low T caused by childhood mumps. My healthcare is through the military and is pretty down and dirty. My doc is not a specialist, so that might explain why he is hesitant to let my levels go over 400. He feels 700-800 is too high. Your thoughts?
Overall my health is very good and I have a super strong sex drive (daily sex). My biggest concern is that my testicals have completely shrunk to the size of large peanuts and have almost completely ascended into my abdomen - they are MIA (missing in action)!
It sure would be nice to get them back to even half their original size. Do you think it’s possible? I’m guessing that without a true medical need, my doctor will deny my request for HCG. Any advice on justifying the need to grow my balls back?
One other question involves sex drive… even with a T count of 400, I have a super high drive. If I got my count up to 700-800 I would probably drive my girlfriend crazy. Do you think it’s risky for a 55 yo to have a T count of 800?
Thanks again for your response!
Regards, Tmo
Hey tmo… I’m not an expert on these things but can tell you what my experience has been and what my doctors have told me. My doc said that for many years the standard medical opinion was that a T level of 200-400 was adequate, but in the last decade or more it’s generally accepted (by most docs anyway) that levels of approx 600 are desirable, and even up to 800, just depending on overall stats.
I don’t know if you are seeing a urologist at the VA but if not, my best suggestion would be, if at all possible to see a urologist. I know expense is a concern, so maybe they have one at the VA. I had to find a good urologist before I got things worked out. Certainly a general practitioner that is up on TRT and current info can be fine but it sounds like yours isn’t into it, and many are not. If you are going to find a private urologist maybe do a Google search, or whatever, on urologists in your area and find out in advance which are most likely to be up to date on TRT & HCG use. I did this as well & some even advertise this.
No, I do not think 800 is too high for a 55 year old. But it sounds to me like your T level is fine. I think the important thing is if you are having symptoms of low T, if not then your levels should be fine. Sounds like you are ok in that respect: high sex drive, etc,. In fact the testicle atrophy pretty much indicates the replacement therapy is working well.
I totally understand the problem, I hated having them shrink, plus I also had that drawing up, hated it. It took awhile for the HCG to return them completely but now they are back to normal size, and I described the other benefits. So my advice is to try to find a urologist that is current and knowledgeable on this. If not you could maybe print out some literature about this and give to your doctor (although some are not willing to be told anything). There are papers online I’m sure, written by legit doctors in the field. There were a few years ago because I did this myself. Also I guess you have searched through the info here at T-Nation, it’s very good and I’m sure there are links well.
So that’s about all I can tell you. I just know that HCG has solved the problem for me and I’ve had no side-effects after using it for approx 5 years or so. Best of luck! Steve
I know this is an old thread, but to all those that have experienced atrophy whilst on TRT, how long did it take to regain size?
Thanks