T Nation

Wild Variations E2 Quest vs Labcorp

T Replacement
#1

I’m trying to narrow down what my issue is with libido the past few years after I had a long run of successful hormone replacement therapy with no side effects. I’m leaning a lot towards it being a dopamine issue, I’m concerned about dopamine desensitization from T and at the same time blunting of dopamine because of Vicadin use.

However I think my estrogen could be an issue obviously and also my thyroid not bein dialed in totally.

That is why I have another thread on here that I’m asking to get some help on getting very specific about comprehensive labs so I can sit there with the doctor and make him check off exactly what I need to get to start sorting my libido issue out.

But within recent months just concerning my estrogen I’ve gotten two insanely different results when I’ve stuck to the same protocol that I’ve been on for years and got the blood draw on the exact same day of the week within the same morning fasted time frame.

Typically over the years my E2 has been consistently between 21-27. Now a few months ago on a Quest lab I got 36. Hmm. Ok maybe my E2 is creeping up for some odd reason. Now Labcorp results say my E2 is less than 6!!! That’s using the Roche method. Quest doesn’t say what method it used, but I know on lab sheet the doc checks the box for “male profile” CP317986. On Quest results it has some note saying if you’re a male who anticipates low Estradiol levels to get an ultra sensitive assay. And if you are on faslodex (which I’m not) cross reactivity could lead to falsely high results so use ultra sensitive.

So a few months ago on Quest:
TT 826 (range 250-1100)
FT 225.6 (35-155)
Estradiol 36

Now with LabCorp
TT 826 (264-916)
FT 22.7 (6.8-21.5)
Estradiol less than 6

Literally exact same TT numbers but E2 results opposite end of the Spectrum!

I’ve tried reading on the differences of estrogen labs but it’s confusing to me. I’ve seen threads guys get crazy variance like I just did and others guys get similar results. I re-read stickies here again and seems my doc did the correct E2 labs right just different lab company?

Is it realistically possible for my E2 to swing from 36 to less than 6 on the exact same protocol within months? Drawing labs on exact same day of week? And if it was under 6 wouldn’t I be experiencing extremely negative side effects??
Is there something that can throw off these tests drastically?

I want to do labs soon again (hence the other thread asking for help on what to do precisely) so I can sort out what’s going on with my dead libido and lack or any sexual pleasure, concerning dopamine, thyroid, E2…

Thanks for any insight on the matter and what estrogen labs I should be getting.

#2

I’ve read on other forums that the Roche E2 test is meant for women and can be highly inaccurate with men.

If that’s the case I may have upped my Arimidex dose 4 years ago in error and killed my E2 levels hence killing my libido…

Gonna try to get new labs this week with LC/MS/MS E2 test. See if it’s really less than 6 or something else.

#3

When I see E2<number from Labcorp I am concerned that this is a lab error.

#4

Just a few weeks after the labcorp results with standard E2 test saying less than 6, I did quest labs with both standard E2 AND ultra sensitive E2.

there is a significant difference in regular E2 test and the ultra sensitive test.

Exact same blood draw FYI
Regular E2 test = 25
Ultra sensitive E2 = 14

Hence all these years using regular E2 it seems I may have taken too much Arimidex thinking it was high, and stayed on the higher dose thinking I was in the “ideal range” of 20-30 using the standard E2 testing.

So low E2 seems to at least be a contributor to my libido issues.

Any input on how to go about changing my Arimidex dose is appreciated. Go cold turkey for a while and hop back on half the dose after my morning wood comes back seems to be advice on other threads where guys had similar low E2 libido issues . Or cut dose in half and slowly let E2 come back rather than let it run free with no AI and then manage it again with AI once morning wood comes back (I hope!).

DHT 132 H (range 16-79)
DHEA S 156 (70-495)
Sensitive E2 14
TT 1164 (250-1100)
FT 281.3 H (35-155)
SHBG 21 (10-50)

TSH 2.02 (.4-4.50)
T4 Free 1.3 (.8-1.8)
T3 Free 3.0 (2.3-4.2)
Reverse T3 21 (8-25)

Any other values that might be helpful let me know. Living with no libido is no fun.

#5

What’s your current AI dose? Need to know that in order to determine new dose.

#6

This is how this all started - I was cruising along HRT doing awsome with nothing but great results doing 200mg week T split into initially two doses IM, and for a period 3 doses weekly SubQ, along with 250iu HCG 3x week and .5mg adex 3 times week. I was 7% BF and jacked. I got my E2 results back at 59 using the standard Roche test, and worried it was way too high so got on here and did calculations and doubled adex. So starting 4 years ago based off E2 of 59 was taking 3mg week of adex. In past 4 years my libido slowly has dwindled to nothing, with ED issues, and even if it does work it doesn’t even have sensation. I also kept having elbow and shoulder pain issues that docs would evaluate and x Ray and kept telling me must be tendonitis and arthritis from all that lifting. Libido wise we (here and other forums) thought it was stress or dopamine densensitization issues (which certainly could have contributed as well), and also being on vicodIn it may have hurt libido by lowering dopamine. So here I am with joint pains and no libido but E2 labs always in 21-27 range using standard E2 lab so not crossing my mind at all it’s an issue. Then a fewmonths ago I get an E2 of 36 and I’m like what the hell im on so much adex why would it keep climbing…then recently get another E2 of less than 6, so like wow what a fluctuation!! I kept reading various forums and there are guys with exact same issues as mine that took adex or too much adex because of falsely HIGH E2 readings, crashing their estrogen and losing libido, having ED, inability to orgasm or not feeling an orgasm or sensitivity on their penis during sex plus joint pain. And some guys did labs with standard E2 and sensitive E2 at same time and the standard test often read WAY higher than the sensitive test…and with frequent blood labs they experienced the standard E2 test being all over the place inconsistent while the sensitive LC/MS lab was consistent and showing their E2 being low. So I did same thing got both E2 labs done at exactly same time same blood draw same lab results, and standard test makes it seem I’m in great shape while sensitive says I’m pretty damn low. So this is a warning to everyone -
Maybe it won’t affect you or maybe it will over the long haul, but you might wanna be careful about what E2 test you use. And certainly be way careful about messing with your Arimidex dose based off one lab result of the standard E2 test!!! I had low BF, was injecting subQ 3 times week smaller doses, and had no symptoms of high E2 but based off one lab result doubled my adex dose and most likely caused 4 years of progressively worse and worse libido and ED, and severe elbow and shoulder pains. I’m sure dopamine issues played a role too (from Vicodin lowering it and maybe the whole desensitization from T itself that Dr Mariano writes about) and so did major stress I went thru during that period too…but right now I’m feeling like crashing my E2 was the biggest culprit.

So my guess would be go back to .5mg 3 x a week like I was prior to crashing my E2. But since it’s been 4 years on 1mg 3x a week, and my libido just totally gone with ED and lack of any pleasure or sensation even when I can perform…I’m wondering if I should stop adex for a significant period of time to let estrogen climb up (other forums guys say it takes a while to come back and they suggest staying off adex until you get morning wood back then start up adex again at whatever lower dose), or go back to .5mg 3x week right away? Thoughts appreciated.

Also any suggestions on the dopamine? I stopped Vicodin cold turkey after 4 years consistent use. Also taking DLPA as some suggest to help wean off opiates. Have read KSman in older threads talk about using caber and selegaline (and Wellbutrin) to boost dopamine. Doc said those are expensive meds and wanted to wait to see if adjusting adex and getting off Vicodin helped first. But I’d appreciate any feedback on that front as I’ll beg one of my docs for additional meds if it would help get my libido back! Or supps other than DLPA (in past I also tried tyrosine, mucuna, muira puama, wild green oat extract, etc).

#7

I wouldn’t stop Adex cold turkey. Based on my reading, by stopping cold your body may experience a huge estrogen surge which will cause high E2 symptoms. Adjusting the dose is a simple algebra problem. You need to know your current AI dose, lab readings, and desired lab reading. Solve for X (desired). Short of making a liquid solution, off the top of my head you may want to consider 1mg per week. This would allow your E2 to theoretically increase to the 20-30 range.

I can’t speak to Vicodin, but can speak to Wellbutrin. For me Wellbutrin has been OK. It initially provided me with a nice little boost, almost like drinking a second cup of coffee in the morning. Now, after several months, I don’t even notice it but assume/hope it’s still working. If you have a medical condition that warrants treatment such as depression or a million other things, I’d say give it a shot. Also, if you have insurance it’s super cheap…probably is without insurance too.

#8

Thanks…so is taking Wellbutrin common now with TRT, and specially to deal with dopamine desensitization?

#9

I wouldn’t say it’s common or that there is any direct correlation between TRT and Wellbutrin. For guys that need both they seem to compliment each other and provide cross benefits.

For instance, I take Wellbutrin for depression however coupled with TRT both my body and mind feel better. Also, TRT helps reactivate my body, while Wellbutrin gives me that little extra motivation to stick to my diet and workout plan. With TRT I feel stronger when I workout, I get better results, my mood improves, and now due to the two treatments, plus a lot of hard work, I’m capable of creating a positive feedback loop.

#10

I used Labcorp regular E2 for many years with E2=22pg/ml target. Never used Labcorp Sensitive E2. There are no absolutes :frowning: