Pre-trt bloodwork was done at 2pm

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cigpk

Active Member
I just looked at my pre trt blood work from 2015 because I was curious about some numbers. I was 26 at the time.

Turns out it was a 2 pm blood test and wasn’t fasted.

My numbers were as follows:
My total T: 159 (348-1197)
Free t: 4 (9-26)
E2: 10 (8-42)

I am concerned now that maybe my Total T wasn’t so bad and that maybe I didn’t need to be on trt - I’ve seen where some people say blood work later in the day is drastically lower than morning?

I also realize that 159 is an extremely low total T number, especially for my age. So I don’t know, maybe I’m overthinking it...
 
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madman

Super Moderator
I just looked at my pre trt blood work from 2015 because I was curious about some numbers. I was 26 at the time.

Turns out it was a 2 pm blood test and wasn’t fasted.

My numbers were as follows:
My total T: 159 (348-1197)
Free t: 4 (9-26)
E2: 10 (8-42)

I am concerned now that maybe my Total T wasn’t so bad and that maybe I didn’t need to be on trt - I’ve seen where some people say blood work later in the day is drastically lower than morning?

I also realize that 159 is an extremely low total T number, especially for my age. So I don’t know, maybe I’m overthinking it...


To get a true picture blood work should be done in the early am and in a fasted state as due to the natural 24 hr circadian rhythm a healthy young males testosterone levels are highest (peak) in the early am and decrease in the late afternoon/evening (trough).

Testosterone levels can be 25-30% lower when tested in the afternoon and if one is also not in a fasted state than it can negatively impact testosterone leading to lower levels on your blood test.

Seeing as your TT/FT were really low.....highly doubtful they would have been drastically higher if you were tested in the morning/fasted state.

Even though lab work is critical, symptoms is what matters and is that not the main reason you sought out trt?

If you feel better now since being on trt than why even worry about what was done in the past.

Although TT is needed a good to know FT is what truly matters as it is the unbound active fraction of testosterone responsible for the positive effects.
 
Last edited:

Systemlord

Member
It's not just about your extremely low testosterone, also concerning is the low estrogen. You don't need to fast for hormone labs.

Definitely overthinking it.
 

madman

Super Moderator
It's not just about your extremely low testosterone, also concerning is the low estrogen. You don't need to fast for hormone labs.

Definitely overthinking it.



These are his labs pre-trt and not only do ones testosterone levels need to be tested in the early morning but also in a fasted state!



He stated "I just looked at my pre trt blood work from 2015 because I was curious about some numbers. I was 26 at the time"

Turns out it was a 2 pm blood test and wasn’t fasted.

My numbers were as follows:
My total T: 159 (348-1197)
Free t: 4 (9-26)
E2: 10 (8-42)

He than goes on to say "I am concerned now that maybe my Total T wasn’t so bad and that maybe I didn’t need to be on trt - I’ve seen where some people say blood work later in the day is drastically lower than morning"
 
Last edited:

madman

Super Moderator
It's not just about your extremely low testosterone, also concerning is the low estrogen. You don't need to fast for hormone labs.

Definitely overthinking it.




Are you sure about that!


Oral glucose load and mixed meal feeding lowers testosterone levels in healthy eugonadal men




Conclusion

We demonstrate a significant reduction in concentrations of serum total testosterone in healthy men in response to an oral glucose load (mean reduction of 18% from baseline) and administration of a mixed meal (mean reduction of 26% from baseline. Therefore, measurement of serum testosterone in men presenting for evaluation of hypogonadism should be performed after an overnight fast.

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madman

Super Moderator
Burn this into your noggin!






Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline 2018





Technical remark
  • Testosterone concentrations exhibit significant diurnal and day-to-day variations and may be suppressed by food intake or glucose. Therefore, clinicians should measure total testosterone concentrations on two separate mornings when the patient is fasting. Clinicians should use an accurate and reliable method, optimally, an assay that has been certified by an accuracy-based standardization or quality control program [e.g., Centers for Disease Control and Prevention (CDC) Hormone Standardization Program for Testosterone].
 

cigpk

Active Member
Feeling much better about this - Just an update.. Got my labwork uploaded to my patient portal so I could see it all...

After that initial blood test above, they put me on 80mg test c, 1200 HCG and AI weekly (split into 2x dose)

My labs after 6 weeks were as follows (taken 9 am)

Total T: 386 (348-1197)
Free T: 7.2 (9-26)
E2: 12.8 (7-42)

So I would assume my total T number, had I not began any TRT 6 weeks prior to these labs, would have been significantly below range still even if my labs had been taken in the morning.
 

Systemlord

Member
So I would assume my total T number, had I not began any TRT 6 weeks prior to these labs, would have been significantly below range still even if my labs had been taken in the morning.

Your levels couldn't have been above 300 if you did labs earlier in the morning. Studies show the low testosterone cut off point to be higher than 300, the 300 cut off point isn't based off of any studies.

I just ended a protocol where my levels were in the low 400's and I felt a little similar to pre-TRT.

Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men:
 
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