Decrease in Total Testosterone but consistent Free?

[rifter]

Has anyone ever noticed a significant decline in Total T, but Free T, SHBG and E2 remain the same between blood draws and if so, what was the cause?

I know Free T is the metric to be more concerned about, but I am curious as to potential reason for this.

Total T dropped from 743 to 401
Free T consistent at 115
SBHG consistent at 10
Albumin consistent at 4.5
E2 consistent at 40

I am using compounded Testosterone (Hallandale). 140mg total per week, injected bi-weekly on Saturday and Wednesday. Blood draw was just prior to Wednesday's shot.

Could this potentially be a dud or underdosed vial?

I'm a little confused because if my vial is underdosed, I would have assumed E2 and Free T would have been impacted.

I also did a blood donation about 2 days before my latest blood test, but unsure that would have had anything to do with it.

Any insight would be appreciated.

 

[Systemlord]

Has anyone ever noticed a significant decline in Total T, but Free T, SHBG and E2 remain the same between blood draws and if so, what was the cause?

Lab testing is only so accurate, so if the other biomarkers didn't change you pretty much know which test is likely inaccurate.

Also TRT isn't a set and forget therapy and so dosage adjustments will be needed from time to time.

 

[rifter]

I should have added that the time span between my bloodwork was 12 weeks. I’ve been on TRT for close to a decade and have never seen Total T drop without a decrease in related markers.

 

[Systemlord]

I’ve been on TRT for close to a decade and have never seen Total T drop without a decrease in related markers.

That's unusual, I would then conclude the test is inaccurate and trust the other biomarkers.

You can test again to confirm.

 

[Systemlord]

I will say that when my iron status is insufficient my mileage on TRT isn't the same.

I've been iron deficient multiple times.

 

[BillyJ03z]

I've always been under the impression that FREE T is only the measure of the % of the total Testosterone that is not bound, it's a % measurement of what is available, not a total measurement... basically meaning that a person could have a Total T level of 900 or 500 with a top of range FREE T level (which I usually have)....

Any thoughts?

 

[rifter]

That’s right, which was why its strange that you would see a stable level of FREE T if TOTAL T dropped significantly. Generally the level of FREE T and E2 would move in the same direction as your TOTAL T if the dose was increased or reduced. TOTAL T would either be bound to albumin, SHBG or converted to E2. So if albumin and E2 are stable and SHBG is not a problem, where did the rest of the T go? Feels like that test could be inaccurate, but I’m no expert.