Total T or Free T?

TLawyer

Active Member
I have been playing around a bit with difference dosages and frequency of enclomiphene to see where I can the minimum dose and get a decent result on testosterone levels while keeping estrogen levels in check. I also got tired of losing my hair, so after a year and half stoppage, I'm back on Propecia (no rock throwing, please, I now DHT is important). I recently went off enclomiphene for about month before the below blood test (blood test was a few weeks ago), and also had been on Propecia for about 2 weeks. Here is where I ended up:

Total T - 342 ng/dl
Free T - 17.6 pg/ml
DHT - 14 ng/dl
E2 (Sensitive) - 16 pg/ml
SHBG - 22 nmol/L
Prolactin - 11.7 ng/ml

These are about the levels I was in November 2019 before I started TRT (I subsequently stopped TRT and flipped over enclomiphene to give that a try).

So, yes, my Total T is "normal" but I know the average for like an 80-year-old. I guess my question is whether I should really just be focusing on Free T, which based on the studies I've seen would be considered above average for even someone in their 20's (which I think is like 12 pg/ml). I don't feel awful at these levels. Sexual function is good, good EQ and morning erections, still building muscle. Maybe my body hurts a bit more (aches and pains). And with a lower SHBG, perhaps that can also help compensate for a lower Total T.

So with that said, should I really just look at Free T and be happy with that level, considering it is above average for even someone in their 20's? I understand that it is about how you feel in large part. I'm just trying to get a sense of how much I off from the "norm" in light of all of these numbers working together.
 

Systemlord

Member
Your estrogen levels are low, anything below 20 is considered low for an adult male. This is why you have aches and pains because estrogen is needed for joint and bone health.

Naturally estrogen is made in the testis and via aromatase, so more LH stimulation = more T and more estrogen.

The Total T, Free T and SHBG provider a clearer picture, but you should be using the Equilibrium Dialysis or Ultrafiltration for Free T testing. The Direct Immunoassay is garbage and shouldn't be relied upon.
 
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Cataceous

Super Moderator
Free estradiol may be more important than total, and the multi-ligand calculator puts yours at about 0.43 pg/mL, which is in the normal range. Of course this isn't definitive. If you want to be more certain you'd need to measure it. You could also test bone mineral density to ensure all's well there.

The free T calculators are giving lowish values. But in the absence of symptoms I wouldn't be in a hurry to resume treatment. You might look into Nastesto or Empower's equivalent as another option that avoids HPTA shutdown.
 

TLawyer

Active Member
Free estradiol may be more important than total, and the multi-ligand calculator puts yours at about 0.43 pg/mL, which is in the normal range. Of course this isn't definitive. If you want to be more certain you'd need to measure it. You could also test bone mineral density to ensure all's well there.

The free T calculators are giving lowish values. But in the absence of symptoms I wouldn't be in a hurry to resume treatment. You might look into Nastesto or Empower's equivalent as another option that avoids HPTA shutdown.
Are the calculators really giving a low free T value though? I came up with 11.55 ng/dl, but then I see that he average for a man in his 20's (I'm 44) is about 12 ng/dl. I know that I have read that the goal is in the 20's (and this is also what Defy told me), but that seems higher than the natural average.

I have never looked into Nastesto. Very interesting and thanks for the recommendation.
 

Cataceous

Super Moderator
...
Total T - 342 ng/dl
...
SHBG - 22 nmol/L
...
With default albumin, the Vermeulen calculator returns 8.5 ng/dL. I consider the healthy normal range for this calculator to be about 10-20 ng/dL. It doesn't mean that problems are guaranteed below 10 ng/dL, but they do seem to become more likely. The Tru-T result you cite, 11.55 ng/dL, is compared to a healthy normal range of 16-31 ng/dL. Once again, problems become more likely with values below the lower threshold, but are not for certain.

Where did you see that figure of 12 ng/dL as an average for young men? If it wasn't provided for Tru-T specifically then it can't be used. Just about every free T test and calculator has its own unique reference range.
 

TLawyer

Active Member
With default albumin, the Vermeulen calculator returns 8.5 ng/dL. I consider the healthy normal range for this calculator to be about 10-20 ng/dL. It doesn't mean that problems are guaranteed below 10 ng/dL, but they do seem to become more likely. The Tru-T result you cite, 11.55 ng/dL, is compared to a healthy normal range of 16-31 ng/dL. Once again, problems become more likely with values below the lower threshold, but are not for certain.

Where did you see that figure of 12 ng/dL as an average for young men? If it wasn't provided for Tru-T specifically then it can't be used. Just about every free T test and calculator has its own unique reference range.
There is a chart buried in this article, which has a cite to a 1996 study.

 

Cataceous

Super Moderator
There is a chart buried in this article, which has a cite to a 1996 study.

It appears that Vermeulen himself had a hand in getting this data. So the best way to compare yourself to this is to use the Vermeulen calculated value of 8.5 ng/dL. This is the average for subjects aged 55-64. My "healthy normal range" for Vermeulen is intentionally somewhat higher than the population reference range of +/- 2 standard deviations, which for young men ends up being 6.7-17.9 ng/dL. I see a few guys in the 6.7-10 ng/dL range with symptoms of hypogonadism, but virtually none with free testosterone above 10.
 

Match

Member
Se entendi, um calculadora t-tru aponta valor mais alto, mas em relação a sua própria referência, que tb é mais alta, ok?
Onde consta a faixa normal 16-31 ng/dl nessa calculadora?
 

Cataceous

Super Moderator
If I understand correctly, a t-tru calculator points to a higher value, but in relation to its own reference, which tb is higher, ok?
Where does the normal range 16-31 ng / dl appear on this calculator?
Details here:
 

Match

Member
OK. Li o tópico. Obrigado
Nesse caso, com 9 ng/dl, estou ruim de TF.
Meu 637 de TT não é tão ruim, de modo que SHBG 62 seria então a origem da TF baixa, provavelmente, ok ??
E 32 pg/ml
 

Zibernet

Member
Your estrogen levels are low, anything below 20 is considered low for an adult male. This is why you have aches and pains because estrogen is needed for joint and bone health.

Naturally estrogen is made in the testis and via aromatase, so more LH stimulation = more T and more estrogen.

The Total T, Free T and SHBG provider a clearer picture, but you should be using the Equilibrium Dialysis or Ultrafiltration for Free T testing. The Direct Immunoassay is garbage and shouldn't be relied upon.

So with low estrogens like this, could he benefit from a transdermal testosterone application to normalize them and prevent long term deleterious effects ?
 

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