defy / blood labs pre trt, thoughts?

[madman]

View attachment 28470View attachment 28471View attachment 28472My previous post was accidentally deleted so here we go.
Im 50 185 lbs / fit, somewhat...
I had various labs done & my numbers arent tanked. The clinics make it sound like a cure-all / used care salesman....
Im dealing with irritability / moodiness, may be just my personality & has nothing to do with my levels...
Cant sleep to save my life, bed at 8, 9, 11 doesnt matter, im up at 1;30 am & cant go back to sleep afterwards..
memory & train of thought is in the toilet, may be age related...
ed / bedroom performance issues, wasnt what it was....
The first clinic I went to labs were dont about 11 am fasted. They did do a free direct test. But also did some sort of calculation to find what my bioavailable usable calculated free testosterone level was & state im a low normal at the 643 total T value along with the 15.2 free test value. They stated they feel I would really benefit from trt....
Since then my defy labs are the lowest.

Just trying to get some thoughts from guys that really understand this stuff as I dont,
I know I can fix some issues & bring-on other issues.
My numbers arent tanked & trying to make the right decision for the right reasons...
I did labs with a local clinic & then due to discussing things with madman & was made aware of Defy I opted to do some additional test & free test, igf1, etc labs & here we are!
The attachment is the recent blood work ordered from defy.
what does the high igf1 mean???
Once again sorry for starting over & would love some thoughts on the matter.
thx
most recent blood draw is bottom attachment
estradiol sens 28.1
igf1 353
test 503
free test 11.2

Hard to believe you tested TT/estradiol using the most accurate assays (LC/MS-MS) yet did a 360 on one of the most critical markers FT!

Go figure!



One of the highlights from a recent lecture

*Results from the American College of Pathologists Proficiency Testing Survey CAP Y-B, 2021

*Total number of 34 laboratories with 5 different platforms participated:

*1-4: 4 commercial IA manufacturers; 5: Mass spectrometry -based-assay




Proficiency Testing survey (2021)

Here is the graph showing the data from the recent CAP survey on one sample. There are 34 laboratory participants and they are grouped by the different assay platforms used. There are four different immunoassay platforms and the mass spec is grouped into one category.

So we demonstrated the results for the report from CAP the measured free testosterone concentration at medium, lowest, and highest levels, and the mean with 3 standard deviations if the peer group has sufficient participants.

So you can see very clearly that is kind of consistent with this finding there is a big difference between the mass spec generated levels versus immunoassay results.

Here we see up to a tenfold difference with the mass spec results much higher and within the immunoassay group which you can also see on the right side so also the obvious variability is observed among the groups and also within the group.

So for one survey even with this limitation with the sample commutabilities and also it is not an accuracy-based survey but this data still clearly indicate the high variability across methods.

 

[Slater]

Have no clue who deleted your previous thread.

I told you to get your blood work done using accurate assays, TT (LC/MS-MS) let alone FT (Equilibrium Dialysis or Ultrafiltration), especially in cases of altered SHBG and not the direct immunoassay that you had done.

I gave you the link for the panel.

Testosterone, Free (Dialysis) and Total, MS

Get an affordable and accurate testosterone test results with our Total Testosterone, M and Free (Equilibrium Dialysis) test. Visit DiscountedLabs.com for more information.

www.discountedlabs.com

All you needed to do was up the $44 for the most accurate assays.

Yet you went and retested using the same FT assay!

Again I would not rely on the direct immunoassay, especially in cases of altered SHBG.

You posted a TT 643 and 500s yet no SHBG value for your second test.

Forget what your results were when you tested at 11 am as I already told you that it is critical when testing TT/FT/BAT it needs to be done in the early AM in a fasted state let alone using the most accurate assays.

If you want to rely on the calculated method then make sure when getting blood work done that you have TT (LC/MS-MS), SHBG, and albumin.

Just to be clear I already gave you advice that you did not follow.

If you want to rely on your most recent labs and jump in head first then go nuts.

Do what you feel is best for you.

Still no reason to ghost me & not respond to my dm's...
Not trying to be the buggaboo, just seems like youre so passionate about your knowledge & then nothing.....
Mentioned I was clueless & this crap is over my head, I just know how I feel...
Talking to Mary at Defy on the phone i straight-up mentioned some folks on excelmale mentioned that the type of free test. calculation in my first lab results were inaccurate & deamed useless & mentioned specifically that I had a "Equilibrium Dialysis free test" from discounted labs in my cart & was getting ready to pull the trigger. She mentioned that in some cases our pricing is cheaper & allow me to order the needed labs along with good idea to check igf1 per her recc...
So turns out Defy did same thing my other clinic did.
Apparently my bad for not understanding & verifying the proper tests were actually ordered. Thought her & I were on the same page & ordered the correct test but obviously & didnt think I needed to verify since they do this stuff every day.
Wasnt ignoring the recommendation, just thought it was handled correctly this time!!
Went through the trouble of re-doing labs & thought we had it right this time around. Freaking Kiaser drew like 5-6 tubes to re-test everything!!!
Im running-out of blood!!

 

[Slater]

Finally received the igf1 results back from Kaiser, still waiting on pc doc to get back to me on thoughts & plan of action....
labcorps range is 81-263 vs kaiser 50-317???

 

[Slater]

Hi

Your IGF-1 is slightly elevated at 320. I discussed your labs with endocrinology and they recommend we check some additional early morning labs (you can do around 8 AM and don't need to fast). Also, they want you to get an MRI of your pituitary gland, which I have ordered and you can book with radiology (If radiology department does not contact you within 5 business days to schedule your MRI, then you should call them to schedule it.)

After the labs and MRI are back, I will refer you for consultation with an endocrinologist.

Sincerely,

 

[Slater]

So gave the trt rabbit hole decision a rest for a bit.
51 years old...
Continue to deal with typical low t symptoms, bedroom issues, concentration / memory loss, mostly moody / irritable, belly fat regardless of eating healthy & clean, training 4-5 days a week, sleeping sucks, cpap machine really doesnt improve my sleep, afternoon fatigue, joint pain as been a mechanic for 35 years & have aches everywhere. 1 lower back surgery, 1 neck fusion, both shoulders are shot but still train regardless, torn rotator cuffs & arthritis build-up as they want to perform re-section surgery which is shaving end of collar bone to make more room in joints...
Trying to be responsible & make an informed decision as I do understand alot of people overhype trt, I understand nobody can really tell me if trt will truly be beneficial for me as my #'s arent tanked.
I have numerous past tests where my labs tt were at low 500's
thoughts from those who are educated on the subject & been there...

Well heres some more most recent labs & ill be the first to say, I dont understand any of this....
I know trt clinics state a free test level of 10 is an official low diagnosis as they want to optimize you into the 20's so you feel your best....
My tt went up, but appears my free t went down some using "dialysis" compared to my previous tests, thoughts?
Should I just continue to stick with the boring average natty life......
or optimize....

 

[FunkOdyssey]

Should I just continue to stick with the boring average natty life......

You won't have as much support for starting with those levels, but I will say that if it were me, I would try it. If it doesn't seem like it is helpful, you can just stop. Your chances of permanently damaging your HPTA output with 3-6 months of TRT are minimal.

Otherwise you'll never know.

 

[Systemlord]

The last time I checked, insufficient Free T doesn't cause elevated calcium, A/G ratio and high potassium, which I believe is the smoking gun.

I overdosed calcium and potassium supplements countless times, both cause low-T like symptoms.

This is where your symptoms are coming from.

 

[CKO]

TRT Will not help with joint issues. Nandrolone as an addition to TRT can help. I would really look into supplementing with collagen one, two and three products. This helps your joints immensely.

 

[Slater]

I’m not taking any calcium supplementation.
Multivitamin, DHEA 25mg, d3 & k2, omega 3 fish oil 1k mg, b complex, magnesium glycinate 500mg, zinc 50mg
These labs were from beginning to mid 2023