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 Posted 10/29/2012 7:32:36 AM
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Your message has been forwarded to the person at Life Extension who oversees the various Health Concern sections.

D Dye
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Post #7508
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 Posted 11/6/2012 1:35:56 PM
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[quote]outlier (10/27/2012)
http://www.lef.org/protocols/male_reproductive/male_hormone_restoration_01.htm
The article on male hormone restoration linked above is misleading and frustrating because of its failure to address the major difficulties facing readers trying to follow its glib suggestions for testing,  supplementation, and monitoring of male hormones in the real world.


1. The reader is casually warned of difficulties in standardizing these male hormone tests, and instructed to always get them done by the same lab. This suggestion is useless to those who live in jurisdictions like British Columbia, Canada, where testing for Free Testosterone is no longer done unless the serum testosterone level tests low, and where DHEA testing is unheard of and unavailable in these same government labs.


The nearest Labcorp outlet to my location is in Post Falls, ID, a five hour drive according to Google maps, excluding delays at the border and bad weather - obviously not a feasible option for regular monitoring of estradiol, serum and free testosterone, and DHEA levels, even if it were affordable.


The measurements  and normal ranges for estradiol from British Columbia's labs (there are no local alternatives) are not even in the same ballpark as results from labs in the neighbouring jurisdiction of Alberta, Canada, let alone the figures offered by LEF.

For example, the "reference"  range (ie. considered normal) for men's  Estradiol  in the Interior Health Region of British Columbia is given as “0-146 pmol/L”. How is the reader to make meaningful comparisons between such results and  LEF's

 "optimal" estradiol range of


serum estradiol levels between 21.80 and 30.11 pg/mL” ?

The conversion chart at


http://www.unc.edu/~rowlett/units/scales/clinical_data.html


gives the conversion factor for estradiol pg/mL to pmol/L as 3.671


By my calculation, that would make  30.11 pg/mL equal to 110.53 pmol/L


The online unit conversion app at:


http://dwjay.tripod.com/conversion.html


gives a result of 111 pm/L and the same conversion factor.


For 21.8 pg/mL it gives 80pmol/L



Because I don't perform such conversions except very rarely, and the conversion calculators are not as user-friendly as the should be (in this case, I repeatedly entered "pg/mL" and got an error message I misunderstood), I ended up spending a good half-hour on this simple task to be sure of my answer.


And in the end, I'm left with one lab's "normal" reference range of "0-146pmol/L to compare with another (unidentified) lab's "optimal" reference range of "80-111pmol/L".


Does anyone else reading this know how to make sense of this comparison? I don't.


Everything I've read in LEF's materials suggests that "0" serum estradiol is not "normal", and an optimal serum concentration that is 32% higher than the normal range seems implausible too.


If I get a result of 110pmol/L from my lab, can I be certain that this indicates optimal estradiol levels?







outlier@hushmail.com
Post #7556
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 Posted 11/8/2012 7:38:34 AM
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Life Extension's Advisor Department provided the following:

We at Life Extension understand your concerns andf rustration. We have the same ones when we review scientific studies dealingwith hormones. Unfortunately, hormone testing is problematic due to a lack of standardization across different laboratories. Even within the same laboratory there are different ways (methodologies) to test the same hormone. For example, total testosterone can be tested via ECLIA gen 1 or gen 2(electrochemilluminescene immunoassay) and LC - MS/MS (liquid chromatography tandem mass spec). These issues with hormone testing have lead to frustration among doctors, researchers and us here at Life Extension. We would like nothing more than to be able to provide you with concerete answers, unfortunately we cannot because of the all the variables and lack of standardization in hormone testing as it exist today.

In fact the CDC in the US has been spearheading a program to address issues in hormone testing. However, it is moving along slowly.  Here is a link to the program for more details:

http://www.cdc.gov/labstandards/hs.html

This site goes further into the problems and details we all face trying to make sense of hormone results.

Your question of the conversion factor for estradiol is agood one; however, as much as we would like to give you a definite answer, we can't because the conversion factor alone is not enough. It also depends on which lab did the test and what was the exact methodology they used for the your test. There are no conversion factors that take those variables into account.

Thus, the best way we have found over the years is to make educated approximations using the reference range of the lab that did the test.

The LabCorp reference range for estradiol using the Roche ECLIA methodology for men is:

Adult male: 7.6-42.6 pg/mL

The LEF suggested optimal range for this specific test from LabCorp is:

Adult male: 20-30 pg/mL

Rather than trying to convert it (which doesn’t work well because of methodology differences), take a proportional approach. For example, our optimal range is basically right in the middle ofLabCorp’s reference range for estradiol, give or take a little on each side of the average of 25 pg/ml. Thus, we would suggest targeting the same using the reference range from your lab (not our lab). You should be around the average of your lab’s reference range, give or take a little. This approach is consistent with studies showing that for a man you don’t want estradiol too high or too low.

Is this a perfect approach? Of course not. Do we wish it could be more accurate and precise? Yes, but until such time as all labs start using the same methodologies, units and reference ranges this approach has been the most helpful.

 


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