On TRT, total test within normal range, Free T sky high

[matter2003]

So I have been on TRT for a while, my Total T levels are fine, around 600 but my Free T levels are very high, over 150...

SHBG levels are very low, usually between 8-10 and estradiol is normal around 25 as I take Aromasin to keep that in line.

Do I need to adjust my dose down to lower my free T back to within normal range? Worried about the potential long term risks for sky high free T levels...would this be similar to being on steroids even tho my total T levels are well within normal range?

 

[sammmy]

Yes, reduce dose until your trough (lowest level before next dose) free T is in the middle of normal range. That is the lowest value and it should not be at the top of the normal range or above.

Was your SHBG that low before TRT?

 

[Systemlord]

Worried about the potential long term risks for sky high free T levels...

Free T testing is in it’s infancy, it can vary greatly lab company to lab company. I’ve heard of men going to Quest Diagnostics and coming in abnormally high, and run labs at Labcorp on the same protocol coming in closer to midrange.

The Total T lab test is more reliable.

 

[Systemlord]

So I have been on TRT for a while, my Total T levels are fine, around 600 but my Free T levels are very high, over 150...

We need a lot more context than just that you’re on TRT.

When are you drawing labs in relation to your injections?

What’s the dosage, injection frequency?

 

[Gman86]

What’s the range for ur free T lab? Regardless of ur free T level, ur absolutely fine man. Definitely would not lower ur dose. It’s literally impossible for u to have a free T that’s gonna be detrimental to ur health, with a total T of 600, no matter how low ur SHBG is. And u are in no way even remotely close to having the free T levels of someone running even the mildest steroid cycle.

We should get more info to make a proper assessment tho, like systemlord said. What ester ur using, how often ur injecting, when the labs were drawn in relation to the time of ur last injection.

 

[matter2003]

Free T testing is in it’s infancy, it can vary greatly lab company to lab company. I’ve heard of men going to Quest Diagnostics and coming in abnormally high, and run labs at Labcorp on the same protocol coming in closer to midrange.

The Total T lab test is more reliable.

Well, I go through Quest so that would be in line...

 

[matter2003]

We need a lot more context than just that you’re on TRT.

When are you drawing labs in relation to your injections?

What’s the dosage, injection frequency?

Honestly I've never really paid attention to when the labs are drawn in relation to when I last injected. I suppose that is something I should pay more attention to in the future.

I take 75mg every 5 days which comes out to 112.5 mg/week over a monthly period.

 

[tareload]

I take 75mg every 5 days which comes out to 112.5 mg/week over a monthly period.

Nope.

75 mg / 5 days × 7 days / week = 105 mg / week


Or the way you are trying to do it....

365.25 days in year
12 months in year
Hence
30.4375 days in month
7 days in week
Hence
4.34821.. weeks in month

75 × 30.4375 / 5 / 4.34821 = 105 mg / week

Not

75 × 30 / 5 / 4 = 112.5 mg/week


Or if you want more accuracy on days in a year:

Year - Wikipedia

en.m.wikipedia.org

 

[tareload]

So I have been on TRT for a while, my Total T levels are fine, around 600 but my Free T levels are very high, over 150...

SHBG levels are very low, usually between 8-10 and estradiol is normal around 25 as I take Aromasin to keep that in line.

Do I need to adjust my dose down to lower my free T back to within normal range? Worried about the potential long term risks for sky high free T levels...would this be similar to being on steroids even tho my total T levels are well within normal range?

Trusty ole Vermeulen calculator puts you at 20 ng/dl which is typically up to 20% higher than equilibrium dialysis. Hence, equilibrium dialysis would place you at 16 to 18 ng/dl. Perfectly reasonable FT levels on paper. Note Quest's FT range tops out at 15.5 ng/dl strangely. Is this your concern? My digging indicates that upper ref range is misleading given Quest's test is equivalent to Labcorp.
Reasonable FT range is 10 to 20 or even as high as 25 ng/dl on paper.

No you aren't running a "cycle".
Where's your bloodwork? How are you feeling? BP?

Numbers above trough? If so then @sammmy has a good point. Maybe some room to drop if symptoms still resolved.

I sympathize. Makes no sense for Quest's upper range to be almost 50% of Labcorp.

 

[Blackhawk]

I’ve heard of men going to Quest Diagnostics and coming in abnormally high, and run labs at Labcorp on the same protocol coming in closer to midrange.

The fickle nature of anecdote.

I just had the opposite happen (N=1): Testosterone assay experts... puzzling results

 

[tareload]

Remember Quest FT upper limit almost half that of Labcorp. Both assays give very similar absolute value. Hence the confusion when comparing against ref range.

 

[Blackhawk]

Honestly I've never really paid attention to when the labs are drawn in relation to when I last injected. I suppose that is something I should pay more attention to in the future.

I take 75mg every 5 days which comes out to 112.5 mg/week over a monthly period.

Nope.

75 mg / 5 days × 7 days / week = 105 mg / week


Or the way you are trying to do it....

365.25 days in year
12 months in year
Hence
30.4375 days in month
7 days in week
Hence
4.34821.. weeks in month

75 × 30.4375 / 5 / 4.34821 = 105 mg / week

Not

75 × 30 / 5 / 4 = 112.5 mg/week


Or if you want more accuracy on days in a year:

Year - Wikipedia

en.m.wikipedia.org

LOL!

How about the dose 75mg divided by 5, the number of days = 15mg/day times however many days you want?

times 7 days= 105mg

Times 365 days= 5475mg, buy how often do we adjust dosage based on the yeary total? LOL!

1 dose

 

[tareload]

LOL!

How about the dose 75mg divided by 5, the number of days = 15mg/day times however many days you want?

times 7 days= 105mg

Times 365 days= 5475mg, buy how often do we adjust dosage based on the yeary total? LOL!

1 dose

Correct. The first way I showed. Second way is long winded and not very entertaining way to show the critical number is still 7.

 

[Blackhawk]

Remember Quest FT upper limit almost half that of Labcorp. Both assays give very similar absolute value. Hence the confusion when comparing against ref range

They don't even use the same units for free T, EQ dialysis:

Labcorp 5-21 ng/dl

Quest 35-155 pg/ml

 

[Blackhawk]

Correct. The first way I showed. Second way is long winded and not very entertaining way to show the critical number is still 7.

So you did. The following excess threw me off.

 

[tareload]

They don't even use the same units for free T, EQ dialysis:

Labcorp 5-21 ng/dl

Quest 35-355 pg/ml

155 pg / ml = 15.5 ng/dl

Labcorp ED is 5 to 28 ng/dl. Will have to check back on Esoterix.

 

[Blackhawk]

Labcorp ED is 5 to 28 ng/dl. Will have to check back on Esoterix.

Zat right?

 

[tareload]

Zat right?

Thanks for this. Are there a couple of ED labs under Labcorp now. Let me check on that again.

500726: Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences) | Labcorp

Labcorp test details for Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences)

www.labcorp.com

 

[Systemlord]

Well, I go through Quest so that would be in line...

I already knew that.

 

[Systemlord]

Honestly I've never really paid attention to when the labs are drawn in relation to when I last injected.

Let’s say you draw labs 2 days after injections while on cypionate, you’ll be near peak levels. Draw labs at true trough, right before your injections and you’ll be 50% lower than day 2 if injecting every 7 days.

I’m on Jatenzo, 6 hour half-life, if I draw labs at 2 hours, I expect to see a 800-900 level, at 6 hours 453 and 12 hours 262. In the beginning my endocrinologist was clueless, had me testing right before my dosing and always scored >300, even after two dosage increases.

Lab timing is critical!