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Posted on behalf of Dr Ellis ? please could you reply directly to him: [log in to unmask] Dear ACB List members We have a patient who visited our breast clinic and had some blood tests for bilateral breast development. His ALT was 55 (10-50 U/L) with normal bilirubin, alkaline phosphatase, and prolactin. LH & FSH were both suppressed (<1 U/L). Testosterone (Siemens Centaur) was 165 (10-30 nmol/L) Oestradiol (Architect ci1200) was 391 (0-160 pmol/L) He is a body builder and has taken Decca-Durabolin (nandrolone) and testosterone. Assuming values are real, with no immunoassay cross-reactivity: Would you expect that level of oestradiol by aromatisation of that level of testosterone? If he had an adrenal (or testicular: normal ultra-sound & HCG) tumour, if we can persuade him to stop his hormone supplements (and now his prescribed tamoxifen for his breast enlargement), how long should we wait to check his hormones again? While a long delay would be good to get his ?natural? levels, we don?t want to delay if he does have an adrenal tumour. Would a month be a good compromise? Are there any other tests/checks that we should do? (additional to getting an extraction assay oestradiol or a mass spec oestradiol, if values are high again). Does anyone have a mass-spec oestradiol method? Thank you Graham Ellis Clinical Biochemistry St. John?s Hospital Livingston West Lothian EH54 6PP. -- The University of Edinburgh is a charitable body, registered in Scotland, with registration number SC005336. ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/