Of the minority of men taking steroids who actually get blood tests, 99% of them get inaccurate assays.
Most doctors don't realize the importance of high sensitivity testing when it comes to men in general, and even more so in steroid users.
The difference between high sensitivity testing and what you have probably been getting in the past can be the entire reference range, or in some cases, it may even be detecting metabolites or analogs of other hormones.
This is not limited to just testosterone either.
Measuring Estradiol via Roche ECLIA (Electrochemiluminescence Immunoassay) instead of liquid chromatography with tandem mass spectrometry (LC/MS-MS) has similar limitations, as do other hormone tests with insufficient analytical sensitivity.
Table of Contents
The Most Accurate Total Testosterone Blood Test
The gold standard for accurately measuring total testosterone levels is high-performance liquid chromatography with tandem mass spectrometry (LC/MS-MS).
Recent studies have shown that the current assays used in total testosterone testing lack the required sensitivity to produce accurate results when working with very low concentrations.
This can be especially problematic when trying to accurately measure total testosterone levels in severely testosterone deficient men, normal or testosterone deficient women, and children.
In addition, these tests have proven via my own personal tests to detect synthetic anabolic androgenic steroids as testosterone.
This issue can be corrected by newer methods based on mass spectrometry.
The Most Accurate Free Testosterone Blood Test
The gold standard for accurately measuring free testosterone levels is equilibrium dialysis.
Equilibrium ultrafiltration is also sufficient.
A comparison of results obtained via equilibrium dialysis and equilibrium ultrafiltration found that the two methods correlated closely (r = 0.97) [R].
Direct analog enzyme immunoassay (EIA) is inaccurate and has shown in my own personal tests to detect synthetic anabolic androgenic steroids as testosterone.
My Blood Test Results Comparing ECLIA And EIA Vs. LC/MS-MS And Equilibrium Ultrafiltration
This is an example that very clearly shows how important high sensitivity testing can be.
I went in for a blood test during a Nandrolone-only experiment.
I had no Testosterone in my system whatsoever.
Expectedly, by assessing my Total Testosterone level via liquid chromatography with tandem mass spectrometry (LC/MS-MS) and my Free Testosterone level via equilibrium ultrafiltration, we can see that my Testosterone levels were crashed.
Both the total and the free were lower than a healthy female.
This is what you should see in your blood work if you’re on just Nandrolone.
The only Testosterone being produced in my body was indirectly via the trace amounts of androgens produced in my adrenal cortex, which is why the value wasn't completely bottomed out at 0.
I've mentioned many times the importance of getting high sensitivity testing done for hormone levels and how Nandrolone will register as Testosterone in primitive garbage blood tests.
This is another great example of this.
In addition to high sensitivity testing, I had the same blood tested using electrochemiluminescence immunoassay (ECLIA) for my Total Testosterone level, and direct analog enzyme immunoassay (EIA) for my Free Testosterone level.
These were the test results using the exact same blood sample with the terrible default assays that doctors will use to determine how to treat you, and that labs will give you in the majority of your blood work panels.
This just one example of why getting accurate hormone testing is critical.
My Testosterone levels were actually in the gutter, but ECLIA and EIA couldn't even tell the difference between Testosterone and 19-nortestosterone in my blood.
Where To Order Accurate Blood Tests
Most labs offer total testosterone (LC/MS-MS), and some offer free testosterone (equilibrium ultrafiltration).
However, very few self-pay labs offer free testosterone (equilibrium dialysis).
Of the ones that do offer it, it is extremely expensive and it does not come in a package with a total testosterone test.
If your doctor will write you a requisition for it, great.
If not, just get equilibrium ultrafiltration.
Personally, I drive to the US just so I can get LC/MS-MS and equilibrium ultrafiltration testing done.
This is the exact test I order every time to accurately check my testosterone levels: Testosterone, Free, Equilibrium Ultrafiltration With Total Testosterone, LC/MS-MS