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Can someone help me bread down my labs? As far as what I should be concerned about, and if TRT is something I should be getting started. I’ve had some great information on an old thread, definitely wouldn’t hurt to get a second opinion..

Is my free T in range?
Is my estradiol in range?
If not what should they be in?

Prescribed SSRI made me feel 10x worse. Tired, Fog headed, Irritability typical side effects. Thanks fellas
 

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Defy Medical TRT clinic doctor

swoops36

Active Member
Total T isn’t horrible but FT and e2 are very low. Likely why you feel bad, coupled with the SSRI which I’ve heard can have nasty side effects.
 

madman

Super Moderator
Can someone help me bread down my labs? As far as what I should be concerned about, and if TRT is something I should be getting started. I’ve had some great information on an old thread, definitely wouldn’t hurt to get a second opinion..

Is my free T in range?
Is my estradiol in range?
If not what should they be in?

Prescribed SSRI made me feel 10x worse. Tired, Fog headed, Irritability typical side effects. Thanks fellas


Although your TT is almost 600 ng/dL your FT is sub-par.

Should have tested your SHBG as it may be on the higher end and top it off with the fact that your Albumin is high 5.2 g/dL which can bind up more T.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

Most men tend to do well having FT levels in the upper end of the reference range or slightly higher.

If you decide to start trt and seeing as you are going to be self-treating using UGL gear than I would proceed with caution.

Definitely start low and go slow and getting blood work done is critical!

Most men on trt are using anywhere from 100-200mg/week of T.

Would be sensible to start off on 100mg/week (50mg every 3.5 days) and then have blood work done at 6 weeks to see where such dose has your TT/FT/e2 levels among other blood markers than make adjustments if necessary depending on how you feel overall regarding relief/improvement of low-t symptoms.

Mind you when starting trt blood levels will be in FLUX during the weeks leading up until levels stabilize (6 weeks) and your hpta will be shutting down (2-6 weeks depending on T dose used so you may very well experience ups/downs during the transition.

Even then once blood levels stabilize at 6 weeks it can take 2-3 months for the body to adjust and this is the most critical time period when everyone should gauge how they TRULY feel on such protocol.

Do not fall into the trap of increasing your dose after 6 weeks if you do not feel well unless your testosterone levels were too low and a dose increase is obvious as again no matter what protocol you are on when we start tweaking T doses (increase/decrease) let alone injection frequency (once weekly, twice weekly (every 3.5 days), M/W/F, EOD or daily) it will take 6 weeks for blood levels to stabilize and during this TRANSITION levels will be in FLUX and it is normal to experience ups/downs as this would not be the time to TRULY gauge how you feel on the said protocol.

2-3 months is needed as the body has to adapt to those new levels.

Also, get the more T is a better mentality out of your head as again although most men are using 100-200mg/week that 200mg is rarely needed to achieve a healthy FT let alone experience the beneficial effects of testosterone.

Although most will say treating symptoms is what truly matters the levels you choose to run are still of importance as there is such a thing as running too high of a level let alone not only is the ultimate goal relief/improvement of low-t symptoms and overall well-being but we want to avoid/minimize any potential side-effects while also keeping blood markers in a healthy range long-term.

Here is another reason why you need to be cautious regarding the dose of T used as when on trt the use of exogenous T will result in an increase in your RBC's/hemoglobin/hematocrit and we want to avoid/minimize pushing these too high.

Higher doses of T and running very high TT/FT levels will have a big impact on elevating these blood markers.

Your RBC's/hemoglobin/hematocrit is already in the high end and your use of exogenous T is going to drive these up!

Screenshot (1742).png
 

Cataceous

Super Moderator
This idea is a little out there, but with a plan to go UGL anyway I might first do a little experimenting with test base, i.e. pure testosterone in oil. The idea would be to get results similar to those with nasal testosterone gel: boosts in testosterone that give benefits but don't last long enough to cause HPTA suppression. I'm talking about tiny doses here, maybe 0.5 to 2 mg at most, maybe two or three times day. There might even be a chance of improving estradiol by injecting into fatty tissue; unlike testosterone esters, pure testosterone is immediately able to interact with aromatase.
 
Although your TT is almost 600 ng/dL your FT is sub-par.

Should have tested your SHBG as it may be on the higher end and top it off with the fact that your Albumin is high 5.2 g/dL which can bind up more T.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

Most men tend to do well having FT levels in the upper end of the reference range or slightly higher.

If you decide to start trt and seeing as you are going to be self-treating using UGL gear than I would proceed with caution.

Definitely start low and go slow and getting blood work done is critical!

Most men on trt are using anywhere from 100-200mg/week of T.

Would be sensible to start off on 100mg/week (50mg every 3.5 days) and then have blood work done at 6 weeks to see where such dose has your TT/FT/e2 levels among other blood markers than make adjustments if necessary depending on how you feel overall regarding relief/improvement of low-t symptoms.

Mind you when starting trt blood levels will be in FLUX during the weeks leading up until levels stabilize (6 weeks) and your hpta will be shutting down (2-6 weeks depending on T dose used so you may very well experience ups/downs during the transition.

Even then once blood levels stabilize at 6 weeks it can take 2-3 months for the body to adjust and this is the most critical time period when everyone should gauge how they TRULY feel on such protocol.

Do not fall into the trap of increasing your dose after 6 weeks if you do not feel well unless your testosterone levels were too low and a dose increase is obvious as again no matter what protocol you are on when we start tweaking T doses (increase/decrease) let alone injection frequency (once weekly, twice weekly (every 3.5 days), M/W/F, EOD or daily) it will take 6 weeks for blood levels to stabilize and during this TRANSITION levels will be in FLUX and it is normal to experience ups/downs as this would not be the time to TRULY gauge how you feel on the said protocol.

2-3 months is needed as the body has to adapt to those new levels.

Also, get the more T is a better mentality out of your head as again although most men are using 100-200mg/week that 200mg is rarely needed to achieve a healthy FT let alone experience the beneficial effects of testosterone.

Although most will say treating symptoms is what truly matters the levels you choose to run are still of importance as there is such a thing as running too high of a level let alone not only is the ultimate goal relief/improvement of low-t symptoms and overall well-being but we want to avoid/minimize any potential side-effects while also keeping blood markers in a healthy range long-term.

Here is another reason why you need to be cautious regarding the dose of T used as when on trt the use of exogenous T will result in an increase in your RBC's/hemoglobin/hematocrit and we want to avoid/minimize pushing these too high.

Higher doses of T and running very high TT/FT levels will have a big impact on elevating these blood markers.

Your RBC's/hemoglobin/hematocrit is already in the high end and your use of exogenous T is going to drive these up!

View attachment 10332
How far off is my FT compared to a normal range?
 

madman

Super Moderator
How far off is my FT compared to a normal range?

Unfortunately, when it comes to the reference ranges for measured or calculated FT they vary between different labs, and as of now, there is no standardization let alone a harmonized reference range.

Efforts are underway to standardize the procedures for FT and to generate harmonized reference ranges.

Most men do well having FT in the 20-30 ng/dL range.

Others may run slightly higher levels.

Many tend to feel better with TT/FT levels on the higher end but again this is not set in stone as it comes down to the individual.

There are many individuals who tend to feel much better running average TT/FT levels.




If we look at the reference range for your FT test which was done using an accurate testing method (ED) than 60.5 pg/mL would be under the mean 95.0 pg/mL RR (35.0-155.0 pg/mL) well off from the top end.


Here are the reference ranges for 2 of the most accurate FT assays from Labcorp:

Equilibrium Dialysis 52−280 pg/mL


Equilibrium Ultrafiltration 5.00−21.00





I would prefer the reference range that Labcorp uses for their ED FT assay 52−280 pg/mL.

Personally I would want my FT to be close to the top end or slightly higher of the reference range.



Again keep in mind that the goal of trt is to relieve/improve low-t symptoms and the overall well-being of the patient while at the same time avoiding/minimizing any potential side-effects while keeping blood markers in a healthy range (long-term).


You are most likely not familiar with the name Abraham Morgentaler who would be considered a pioneer in the field of testosterone replacement and is a highly respected Urologist who has made a huge contribution to men's health and hormones.

He has published over 200 articles in various journals.

If a man had symptoms with FT level of less than 100 pg/mL he would consider them a candidate for treatment.
 
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