Bi annual basic lab panel

Here is my basic panel I do twice a year.
Done in trough at 3.5 days
Been on test cyp for 5 years.
.25 twice a week equals .5 a week for total of 100mg
I see my free is low and the dont match any online calculators.
Shbg seems high.
I am decent shape and eat well at 49 years old.
Sleep like shit and always have,go to bed at 930 on average and get up at 430 but toss and turn a lot and pee twice at least.
My biggest issue is fatigue and just no energy.
High stress personality with three teens.
I have a huge appetite and eat very clean and tried everything over the years as far as keto,carnivore,high carbs etc.
No change.
What can i do?I just need more energy for as disciplined as I am .
Lower shbg some how,up my test more to get the free to hopefully rise?
Thanks for any advice

Melatonin for better sleep?

I agree about the melatonin. Start with a very low dose 1 mg or less. My brother uses 2 mg a night. Once he doubled it and it kept him up.

Your calculated free testosterone is 330pg/ml. Far above range instead of low.

Maybe your high T levels are negatively impacting your sleep

Seagal said:

Your calculated free testosterone is 330pg/ml. Far above range instead of low.

Maybe your high T levels are negatively impacting your sleep

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Are you going off my free t off my test results?they show 127 so i thought that should be way higher.

Seagal said:

Melatonin for better sleep?

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I have not,seems like the doses recommended are all over the map so I never tried but will definitely give it a shot.

Have you ever done a sleep study to rule out apnea?? Frequent waking to urinate and/or tossing/turning are both signs… along with the fatigue obviously.

Phil Goodman said:

Have you ever done a sleep study to rule out apnea?? Frequent waking to urinate and/or tossing/turning are both signs… along with the fatigue obviously.

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Yes years ago,didn’t have then.
I have some lower back issues and seem to toss and turn a lot to reduce some discomfort.
Actually been sleeping on a pad on floor this last week and it’s seemed to help with back pain,especially at waking.
I’m going to continue another week and buy a new mattress if it continues to help.

Coopsdaddy said:

Yes years ago,didn’t have then.
I have some lower back issues and seem to toss and turn a lot to reduce some discomfort.
Actually been sleeping on a pad on floor this last week and it’s seemed to help with back pain,especially at waking.
I’m going to continue another week and buy a new mattress if it continues to help.

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Have you ever done a thyroid panel?

Have you ever tried different frequency (like switching to one shot per week)? IIRC, people with higher SHBG tend to do better on less frequent shots. Assuming thyroid is good, I’d say maybe start there and if that doesn’t improve things then consider increasing your dose to bring your free t to a higher level.

That’s just a general guess based on minimal information though, so further insight into what has been good and bad about the past five years would be helpful.

Coopsdaddy said:

Here is my basic panel I do twice a year.
Done in trough at 3.5 days View attachment 54769View attachment 54770
Been on test cyp for 5 years.
.25 twice a week equals .5 a week for total of 100mg
I see my free is low and the dont match any online calculators.
Shbg seems high.
I am decent shape and eat well at 49 years old.
Sleep like shit and always have,go to bed at 930 on average and get up at 430 but toss and turn a lot and pee twice at least.
My biggest issue is fatigue and just no energy.
High stress personality with three teens.
I have a huge appetite and eat very clean and tried everything over the years as far as keto,carnivore,high carbs etc.
No change.
What can i do?I just need more energy for as disciplined as I am .
Lower shbg some how,up my test more to get the free to hopefully rise?
Thanks for any advice

Click to expand...

I am decent shape and eat well at 49 years old.
Sleep like shit and always have,go to bed at 930 on average and get up at 430 but toss and turn a lot and pee twice at least.
My biggest issue is fatigue and just no energy.
High stress personality with three teens.
I have a huge appetite and eat very clean and tried everything over the years as far as keto,carnivore,high carbs etc.
No change.
What can i do?I just need more energy for as disciplined as I am .


Lack of quality sleep is a big red flag here!

Lack of sleep let alone a high stress personality is going to have a negative impact on cortisol.

Too many expect testosterone to be the end all be all when in fact having healthy adrenals/thyroid is critical let alone ones lifestyle (diet, sleep, exercise) will have a huge impact on how one feels overall physically/mentally regardless of having healthy T levels.

If you have dysfunctional thyroid/adrenals it can have a negative impact on the overall effectiveness of T-therapy as having healthy T levels is only one piece of the puzzle.




This is the panel you had done through Quest.



Would not even consider bumping up your dose until you see where your trough FT truly sits!

Your TT was not even tested using the most accurate assays (LC/MS-MS) as the standard IA was used.

More importantly your FT was calculated but Quest uses a modified Vermeulen method.

Keep in mind as of now the go to calculated method is the linear law-of-mass action Vermeulen (cFTV) which is considered the most accurate as it has been validated against a standardized ED assay which is the gold standard testing method for free testosterone.

Yes it tends to overestimate slightly but will still give a good approximation.

If we calculated your FT using the go to Vermeulen method with a high trough TT 1033 ng/dL, higher-end SHBG 43 nmol/L and Albumin 4.7 g//dL then your trough FT 20.5 ng/dL would be very healthy as in high-end!

You would be hitting a healthy trough FT 20.5 ng/dL and this is 3.5 days post-injection which means your peak TT and more importantly FT and estradiol will be higher.




Your SHBG is in the low 40s but not really high and you are hitting a high trough TT.

Remember what I have stated numerous times on here when it comes to testing the most critical fraction free testosterone you would need to have it tested using the most accurate assay the gold standard Equilibrium Dialysis in order to know where it truly sits especially in cases of altered SHBG.

Since your Quest trough calculated FT is 12.7 ng/dL and your cFTV 20.5 ng/dL is much higher then your best bet if you want to put your mind at peace here is to retest your FT using the most accurate assay ED.

Then you will know where it truly sits and decide if there truly is a need to address the FT.

Chances are cFTV is on point here but ED would be the only way to truly know especially when you have altered SHBG.

FT <5 ng/dL would be considerd low.

FT 5-9 ng/dL would be considered the grey zone where some men may experience symptoms of low-T.

FT 10-15 ng/dL would be healthy.

FT 20-25 ng/dL would be high-end/high.

If it turns out that your trough FT is closer to 12.7 ng/dL then you would easily have room to bring it up further.

You can easily pay out of pocket and use Nelson's discounted labs which would be the most cost effective option or if insurance covers the test then you can use Labcorp, Quest or Mayo clinic as they all offer the ED assay.

That an awesome response and I appreciate it.
The test I did was thru discount labs.
But the one you listed is the one I need correct?
I will get it ordered.
Do you recommend a specific thyroid panel?
Thanks again to all you !
Quinton

Coopsdaddy said:

That an awesome response and I appreciate it.
The test I did was thru discount labs.
But the one you listed is the one I need correct?
I will get it ordered.
Do you recommend a specific thyroid panel?
Thanks again to all you !
Quinton

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Yes you can have your FT tested using the gold standard ED assay through Quest, Labcorp or Mayo Clinic.












Message Nelson he will let you know.

Got some new labs per recommendation Got exactly what was listed.
Like I said in first post my energy levels are main concern.
Is this how my free t should read or is there a conversion formula?(16.4)

Coopsdaddy said:

Got some new labs per recommendation Got exactly what was listed.
Like I said in first post my energy levels are main concern.
Is this how my free t should read or is there a conversion formula?(16.4)

Click to expand...

You had your FT tested through Quest using the most accurate assay the gold standard ED.

Your trough FT is 164.6 pg/mL or 16.5 ng/dL which is healthy.

Would be considered high if you were to base it on Quests ED reference range 35-155 pg/mL or 3.5-15.5 ng/dL.

Quest bottom end is very low and the top-end is not that high as most of the other major labs ED assays are 5-21 or 5-28 ng/dL.

You are injecting twice-weekly and hitting a healthy trough FT 3.5 days (84 hrs) post-injection so your peak will be higher.

As I stated numerous times on the forum most men will do well with a trough FT 15-25 ng/dL.

Yes you would have room to increase it further if need be but I would address the red flags (lack of quality sleep/high stress) that I pointed out in my previous reply before even considering jacking it up further as your fatigue/no energy has nothing to do with your FT level being sub-optimal or too low.

Still would look into testing your cortisol.

Should have tested your estradiol too.

Your ferritin is healthy.

Free T4 sitting at the lower end.

As you can see your trough FT tested using the most accurate assay is higher than the calculated (modified cFTV) 12.7 ng/dL from your Quest results in your opening post which had you thinking that your trough FT was sub-par or too low.

This is why it is critical to always test your free testosterone using the most accurate assay especially in cases of altered SHBG.

You are hitting a. high trough TT 1054 ng/dL and even with highish SHBG 43 nmol/L your trough FT is very healthy!

Top it off that your peak TT and more importantly FT would be higher!

Sorry i should have ask about any other test to run.
I started 1mg melatonin,getting a new bed soon and will concentrate on that and redo labs with estrogen and cortisol than.
Any specifics on those two test,just want to make sure I get the correct ones.
Thanks again for your advice!

Coopsdaddy said:

Sorry i should have ask about any other test to run.
I started 1mg melatonin,getting a new bed soon and will concentrate on that and redo labs with estrogen and cortisol than.
Any specifics on those two test,just want to make sure I get the correct ones.
Thanks again for your advice!

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