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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Free Testosterone targets for the best Libido
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<blockquote data-quote="jacb" data-source="post: 277612" data-attributes="member: 18836"><p>Thank you FunkOdyssey for your well-considered reply regarding FT and Libido.</p><p></p><p>You are quite correct the Anabolic Doc did talk of dose frequency of every 4-6 days. I appreciate that would give a larger peak/trough swing than my every other day protocol.</p><p></p><p>I don’t know what ester he was advocating. I use a medium term ester, Cypionate.</p><p></p><p>The Anabolic Doc used a Quest (<em>Quest Diagnostics</em>) EqD (<em>equilibrium dialysis</em>) Free Testosterone test. I don’t have access to that test. You say that the Quest EqD FT test usually gives a result somewhat lower than the Vermeulen calculated Free Testosterone (cFT)</p><p></p><p>The Free testosterone test available to me is an “electrochemiluminescence immunoassay (ECLIA) competition principle test”. I believe therefore, that I am advised to use a cFT for titrating purposes.</p><p></p><p>My last lab results were:</p><p></p><p>Total Testosterone: 1015 ng/dL</p><p>SHBG: 36 nMol/L</p><p>Albumin: 4.6 g/dL</p><p>Free Testosterone (<u>ECLIA</u>) <strong>24</strong> ng/dL</p><p></p><p>Calculated Free Testosterone (cFT)</p><ul> <li data-xf-list-type="ul">FT Calculator Based on <a href="https://www.omnicalculator.com/health/free-testosterone" target="_blank">Dr Alex <strong>Vermeulen</strong> Calculations</a>: <strong>22</strong>.43 Nu/dL</li> <li data-xf-list-type="ul"><a href="https://www.issam.ch/freetesto.htm" target="_blank">University Hospital of Ghent</a>: <strong>22</strong>.6 ng/dL</li> <li data-xf-list-type="ul"><a href="https://tru-t.org/" target="_blank">Tru-T</a>: <strong>33</strong>.82 ng/dL</li> </ul><p> The Tru-T result is obviously <strong>VERY</strong> different.</p><p></p><p>You also said “You put all of this together and this "Optimal Libido Protocol" has men spending a majority of the time with a cFT in the 20-30 ng/dL range which is consistent with most other TRT-focused practitioners.</p><p></p><p>I have therefore run both the Anabolic Doc’s recommendations (130, 155, 175 pg/mL = 13.0, 15.5, 17.5 ng/dL) and your recommendations (20 ng/dL & 30 ng/dL) through the Vermeulen based calculator to see what value Total Testosterone it gives. I have also shown my current values.</p><table class='post-table ' style='width: 100%'><tr><td ><p><br /> <p style="text-align: right">SHBG - g/dL</p></p></td><td ><p><br /> <p style="text-align: center">4.6</p></p></td><td ><p><br /> <p style="text-align: center">4.6</p></p></td><td ><p><br /> <p style="text-align: center">4.6</p></p></td><td ><p><br /> <p style="text-align: center">4.6</p></p></td><td ><p><br /> <p style="text-align: center"><strong>4.6</strong></p></p></td><td ><p><br /> <p style="text-align: center">4.6</p></p></td><td ><p><br /> <p style="text-align: center"></p></p></td></tr><tr><td ><p><br /> <p style="text-align: right">Albumin – nMol/L</p></p></td><td ><p><br /> <p style="text-align: center">36</p></p></td><td ><p><br /> <p style="text-align: center">36</p></p></td><td ><p><br /> <p style="text-align: center">36</p></p></td><td ><p><br /> <p style="text-align: center">36</p></p></td><td ><p><br /> <p style="text-align: center"><strong>36</strong></p></p></td><td ><p><br /> <p style="text-align: center">36</p></p></td><td ><p><br /> <p style="text-align: center"></p></p></td></tr><tr><td ><p><br /> <p style="text-align: right">cFT – ng/dL</p></p></td><td ><p><br /> <p style="text-align: center">13</p></p></td><td ><p><br /> <p style="text-align: center">15.5</p></p></td><td ><p><br /> <p style="text-align: center">17.5</p></p></td><td ><p><br /> <p style="text-align: center">20</p></p></td><td ><p><br /> <p style="text-align: center"><strong>22.43</strong></p></p></td><td ><p><br /> <p style="text-align: center">30</p></p></td><td ><p><br /> <p style="text-align: center"></p></p></td></tr><tr><td ><p><br /> <p style="text-align: right">Total Testosterone - ng/dL</p></p></td><td ><p><br /> <p style="text-align: center">648</p></p></td><td ><p><br /> <p style="text-align: center">751</p></p></td><td ><p><br /> <p style="text-align: center">830</p></p></td><td ><p><br /> <p style="text-align: center">926</p></p></td><td ><p><br /> <p style="text-align: center"><strong>1,015</strong></p></p></td><td ><p><br /> <p style="text-align: center">1,280</p></p></td><td ><p><br /> <p style="text-align: center"></p></p></td></tr></table>My Points:</p><p></p><p></p><p></p><p>1. My Libido at 22.4 ng/dL, is I would say “So/So”, certainly sub optimal.</p><p> </p><p>2. Even with Dr Alex Vermeulen Calculations, the Anabolic Doc is suggesting a FT significantly below your recommendations for Libido. I appreciate that it takes a lot more than FT alone to sort out Libido.</p><p></p><p>3. My dilemma … increase or decrease my FT? I think I will titrate down since my intent is TRT, not Gym style gains and at 1015 ng/dL (<em>Trough</em>) my TT is I believe, too high.</p><p></p><p>Rgds.</p><p></p><p>PS I did find a paper put out by Melbourne Pathology which explains a bit more about the Vermeulen calculation background. See attached.</p></blockquote><p></p>
[QUOTE="jacb, post: 277612, member: 18836"] Thank you FunkOdyssey for your well-considered reply regarding FT and Libido. You are quite correct the Anabolic Doc did talk of dose frequency of every 4-6 days. I appreciate that would give a larger peak/trough swing than my every other day protocol. I don’t know what ester he was advocating. I use a medium term ester, Cypionate. The Anabolic Doc used a Quest ([I]Quest Diagnostics[/I]) EqD ([I]equilibrium dialysis[/I]) Free Testosterone test. I don’t have access to that test. You say that the Quest EqD FT test usually gives a result somewhat lower than the Vermeulen calculated Free Testosterone (cFT) The Free testosterone test available to me is an “electrochemiluminescence immunoassay (ECLIA) competition principle test”. I believe therefore, that I am advised to use a cFT for titrating purposes. My last lab results were: Total Testosterone: 1015 ng/dL SHBG: 36 nMol/L Albumin: 4.6 g/dL Free Testosterone ([U]ECLIA[/U]) [B]24[/B] ng/dL Calculated Free Testosterone (cFT) [LIST] [*]FT Calculator Based on [URL='https://www.omnicalculator.com/health/free-testosterone']Dr Alex [B]Vermeulen[/B] Calculations[/URL]: [B]22[/B].43 Nu/dL [*][URL='https://www.issam.ch/freetesto.htm']University Hospital of Ghent[/URL]: [B]22[/B].6 ng/dL [*][URL='https://tru-t.org/']Tru-T[/URL]: [B]33[/B].82 ng/dL [/LIST] The Tru-T result is obviously [B]VERY[/B] different. You also said “You put all of this together and this "Optimal Libido Protocol" has men spending a majority of the time with a cFT in the 20-30 ng/dL range which is consistent with most other TRT-focused practitioners. I have therefore run both the Anabolic Doc’s recommendations (130, 155, 175 pg/mL = 13.0, 15.5, 17.5 ng/dL) and your recommendations (20 ng/dL & 30 ng/dL) through the Vermeulen based calculator to see what value Total Testosterone it gives. I have also shown my current values. [TABLE][TR][TD] [RIGHT]SHBG - g/dL[/RIGHT] [/TD] [TD] [CENTER]4.6[/CENTER] [/TD] [TD] [CENTER]4.6[/CENTER] [/TD] [TD] [CENTER]4.6[/CENTER] [/TD] [TD] [CENTER]4.6[/CENTER] [/TD] [TD] [CENTER][B]4.6[/B][/CENTER] [/TD] [TD] [CENTER]4.6[/CENTER] [/TD] [TD] [CENTER][/CENTER] [/TD][/TR] [TR][TD] [RIGHT]Albumin – nMol/L[/RIGHT] [/TD] [TD] [CENTER]36[/CENTER] [/TD] [TD] [CENTER]36[/CENTER] [/TD] [TD] [CENTER]36[/CENTER] [/TD] [TD] [CENTER]36[/CENTER] [/TD] [TD] [CENTER][B]36[/B][/CENTER] [/TD] [TD] [CENTER]36[/CENTER] [/TD] [TD] [CENTER][/CENTER] [/TD][/TR] [TR][TD] [RIGHT]cFT – ng/dL[/RIGHT] [/TD] [TD] [CENTER]13[/CENTER] [/TD] [TD] [CENTER]15.5[/CENTER] [/TD] [TD] [CENTER]17.5[/CENTER] [/TD] [TD] [CENTER]20[/CENTER] [/TD] [TD] [CENTER][B]22.43[/B][/CENTER] [/TD] [TD] [CENTER]30[/CENTER] [/TD] [TD] [CENTER][/CENTER] [/TD][/TR] [TR][TD] [RIGHT]Total Testosterone - ng/dL[/RIGHT] [/TD] [TD] [CENTER]648[/CENTER] [/TD] [TD] [CENTER]751[/CENTER] [/TD] [TD] [CENTER]830[/CENTER] [/TD] [TD] [CENTER]926[/CENTER] [/TD] [TD] [CENTER][B]1,015[/B][/CENTER] [/TD] [TD] [CENTER]1,280[/CENTER] [/TD] [TD] [CENTER][/CENTER] [/TD][/TR][/TABLE] My Points: 1. My Libido at 22.4 ng/dL, is I would say “So/So”, certainly sub optimal. 2. Even with Dr Alex Vermeulen Calculations, the Anabolic Doc is suggesting a FT significantly below your recommendations for Libido. I appreciate that it takes a lot more than FT alone to sort out Libido. 3. My dilemma … increase or decrease my FT? I think I will titrate down since my intent is TRT, not Gym style gains and at 1015 ng/dL ([I]Trough[/I]) my TT is I believe, too high. Rgds. PS I did find a paper put out by Melbourne Pathology which explains a bit more about the Vermeulen calculation background. See attached. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Free Testosterone targets for the best Libido
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