Bioavailable Testosterone Test

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River Rat

Member
Hi Guys

I am getting ready to request that my doctor order additional blood tests and was wondering if I have a Bioavailable Testosterone test done, is the Total Testosterone and Free Testosterone still required. My doctor said the Bioavailable tells the whole picture and takes into account Total and Free. Do you feel this is correct or should I ask for Total and Free as well.

FYI, my new doctor has taken me off TRT for 2 months to conduct baseline testing so I want to get this right.
 
Defy Medical TRT clinic doctor
Hi Guys

I am getting ready to request that my doctor order additional blood tests and was wondering if I have a Bioavailable Testosterone test done, is the Total Testosterone and Free Testosterone still required. My doctor said the Bioavailable tells the whole picture and takes into account Total and Free. Do you feel this is correct or should I ask for Total and Free as well.

FYI, my new doctor has taken me off TRT for 2 months to conduct baseline testing so I want to get this right.

You're already on the wrong path with him and Free T is only a calculation of several factors like albumin and not a direct measurement anyway. Bioavail is the Free T and Albumin bound which is weakly bound unlike being bound to SHBG which is permanent. It wouldn't be wrong to target your Free T levels but I'd want Free T and can't see a reason to know Free T + weakly bound to albumin.
 

River Rat

Member
So I clearly understand, you think I should have Free T, Total T and no need for Bioavailable T. I am very new to TRT...

Also, what do you mean that I am on the wrong path. This is a new doctor who is an endocrinologist. My Urologist prescribed TRT but the Endocrinologist thought additional test would be prudent.
 
Last edited:

Systemlord

Member
It sounds like your doctors has something to prove, like maybe you don't need TRT at all. This is the only logical reason I can think of why he would want baseline numbers, be careful because it could backfire.
 

River Rat

Member
Thanks Vince. This is helpful. I have not had my SHBG tested yet but will in a month. I just want to make sure I have all my basis covered so I can get an accurate diagnosis. My Urologist said I have primary hypogonadism from 1 Total Testosterone Reading of 228, I had an MRI of my brain which came back fine with no issues in my pituitary gland so he ruled out type 2 hypogonadism.

Just don't want to leave anything out.
 
So I clearly understand, you think I should have Free T, Total T and no need for Bioavailable T. I am very new to TRT...

Also, what do you mean that I am on the wrong path. This is a new doctor who is an endocrinologist. My Urologist prescribed TRT but the Endocrinologist thought additional test would be prudent.

Whatever treatment youve been using, being cutoff for two months is really just cruel to you as a patient. YOu obviously had a Dr that performed tests and a diagnosis and treatment, there's no reason to get cutoff because this guy wants to as systemlord put it prove something. Baseline numbers are of no use. Don't be beguiled by an "endocrinologist", most if not all have been responsible for screwing up many guys with garbage just like this one is doing to you as they know little about TRT.

If you go with him, get his treatment plan and let us look over exactly what he tells you. You may get lucky, and probably not.
 
And, ask him if and how he tests for Estrogen (or Estradiol), if he says he doesn't test either, that's a bad sign. ask him if he uses the UltraSenstive Estradiol test LC/MS/MS, if he says no, that's a bad sign. If he says he doesn't treat elevated Estrogen, bad sign. If he prescribes you 1mg a day of Anastrozole, run and don't look back. Those are some basic red flags to be wary of.
 

River Rat

Member
Yes, there are red flags everywhere. Neither of the Docs spoke of Estradiol or SHBG or wanted to test. The Endocrinologist made a lot of good points as to the Urologists lack in testing LH and FSH so I thought she may have a better grasp on things. Also, my 1st testosterone test was 228, but I did have a 2nd test just before my 1st injection that was 401 which is low normal. I figured it was best to listen to the dr who appeared more knowledgeable. The endocrinologist will not treat with injection unless gel will not work.
 

Systemlord

Member
Yes, there are red flags everywhere. Neither of the Docs spoke of Estradiol or SHBG or wanted to test. The Endocrinologist made a lot of good points as to the Urologists lack in testing LH and FSH so I thought she may have a better grasp on things. Also, my 1st testosterone test was 228, but I did have a 2nd test just before my 1st injection that was 401 which is low normal. I figured it was best to listen to the dr who appeared more knowledgeable. The endocrinologist will not treat with injection unless gel will not work.

This statement is problematic, my first endo spewed this crap and in reality your doctor runs a business to make money and doctors make a crap ton of money prescribing gel v.s injectable, when injectable is by far cheaper than any treatment option and far and above the most effective treatment available. Think about for second, why would the doctor prescribe the most ineffective treatment more expensive option and not the most effective cheaper treatment option first? They don't care if you transfer it to children, are unable to swim or workout within 4 hours of application as long as they get their money.
 

River Rat

Member
It sounds like your doctors has something to prove, like maybe you don't need TRT at all. This is the only logical reason I can think of why he would want baseline numbers, be careful because it could backfire.

You might be correct. But do you think it is a good idea to see what my LH and FSH are prior to being on Testosterone to see if I am in fact Primary or Secondary or does it not make a difference.
 

Systemlord

Member
You might be correct. But do you think it is a good idea to see what my LH and FSH are prior to being on Testosterone to see if I am in fact Primary or Secondary or does it not make a difference.

It doesn't make any difference, at the end of the day you testosterone is still in the low 200's, knowing primary v.s secondary change what? This doctor is trying to prove you don't really need TRT, your 401 score is his motive to seek answers. I mean I get it they want to know the cause expect no SHBG or estrogen testing. Run from these doctors as this shows a lack of understanding in male hormones.

SHBG and estrogen testing are the two most important tests in male hormones testing, any doctor who doesn't believe in these two tests should be discarded quickly!
 

Systemlord

Member
I am requesting both the SHBG and estrogen testing. Should I get a consult from Defy

That's a smart move and is the popular choice. Lots of guys end up with Defy do to mismanaged protocols and doctors with a poor understanding of male hormones. You don't have to request SHBG when dealing with Defy, they know the importance of SHBG and estrogen testing.
 

River Rat

Member
This statement is problematic, my first endo spewed this crap and in reality your doctor runs a business to make money and doctors make a crap ton of money prescribing gel v.s injectable, when injectable is by far cheaper than any treatment option and far and above the most effective treatment available. Think about for second, why would the doctor prescribe the most ineffective treatment more expensive option and not the most effective cheaper treatment option first? They don't care if you transfer it to children, are unable to swim or workout within 4 hours of application as long as they get their money.

I would prefer to be on injection just for the reasons mentioned. I spend a lot of time on the water during the summer so I swim a lot, also, I have a daughter who I do not want to transfer T to.

I am now questioning if going off T was a bad descision. I feel like crap.
 

CoastWatcher

Moderator
I would prefer to be on injection just for the reasons mentioned. I spend a lot of time on the water during the summer so I swim a lot, also, I have a daughter who I do not want to transfer T to.

I am now questioning if going off T was a bad descision. I feel like crap.
This doctor is walking you right into hormone hell.
 

madman

Super Moderator
This statement is problematic, my first endo spewed this crap and in reality your doctor runs a business to make money and doctors make a crap ton of money prescribing gel v.s injectable, when injectable is by far cheaper than any treatment option and far and above the most effective treatment available. Think about for second, why would the doctor prescribe the most ineffective treatment more expensive option and not the most effective cheaper treatment option first? They don't care if you transfer it to children, are unable to swim or workout within 4 hours of application as long as they get their money.

Sure injectable is cheaper and more effective regarding absorption and a majority of men prefer injectable over transdermal but do not state that transdermal is an ineffective option for men pursuing trt as there are lots of men who have no issues with absorption using transdermal.

Do realize that patches or transdermal most closely mimic the natural circadian rhythm of a healthy young males daily testosterone production which injectable does not and many men feel great overall using transdermal.

Dr. Crisler prefers transdermal over injectable due to the pharmacokinetics/pharmacodynamics!
 

River Rat

Member
Yes, Dr Crisler stated in his recent book that he prefers transdermals as a first line of treatment. I am a bit concerned about transferring to my wife and daughter. Self injections did not bother me much but it would likely get old quick as I was only injecting for a month.
 

Nelson Vergel

Founder, ExcelMale.com

Nelson Vergel

Founder, ExcelMale.com

 
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