218 Testosterone But Doc Says not Hypogonadism

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River Rat

Member
All - Attached find the labs that I have had done over the past few months. I have had two Testosterone readings under 230 but the Doc says I do not have Hypogonadism because my Bioavailable Testosterone is normal. I do not meet with her until next week but wanted to get your opinion. I am 48 years old and have felt terrible for almost 2 years. Typical symptoms of Low T, but have had a great deal of brain fog and always tired.

I have already seen a Urologist who prescribed TRT Injections but my PCP wanted me to see an endocrinologist who took me off TRT to run baseline tests.

What are your thoughts, my Testosterone is 218; should I be on T injections. I am thinking I must have low SHBG and I am concerned if I take T that my estrogen will get to high..
 

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Defy Medical TRT clinic doctor

1Draw

Member
Run and don’t look back if you want to feel better. Or just keep on getting improper medical advise and feeling awful. I would call Defy.
 

River Rat

Member
Thanks for the response. I am looking for advice to what a proper protocol would be. Seeing that my total Testosterone is only 218 but my Bioavailable is 59 (Range 40-250), should I be on TRT at all. I have not had SHBG tested but am assuming that by increasing Testosterone through TRT will increase Free T and Estrogen. Will I need something to reduce Estrogen if it spikes. Should I be on TRT at all.
 

OMI100

Member
Depending on where you are at (U,S, or other country) and finance situation Defy Medical (U.S. patients only I think) may be your answer.
They are telemed and a number of folks use them on this board. A+++++++++++
OR you can see if you can find another DR in your area that understands TRT.
May be like finding a needle in a hay stack.
I do not use them as I was lucky enough to find a DR that knows what he is doing.
I would also get a copy of Nelsons book for some great sound basic information on the subject.
 
From your attachment Riverrat you have never had a complete blood test. Not sure what kind of advice anyone can offer without one.
On your other post where you listed a low TT of 200 and yet your FT was mid range. That seemed very strange to me like a Labcorp screwup.

The only suggestion I can offer is to go to Nelsons blood test website and get a full panel of the correct tests an post that.
I believe you will get much better advice after that or just stop screwing around and contact Defy.
 

River Rat

Member
I live in New York and from what I understand, Defy can not order lab work in NY. I do not have a problem spending the money. Yes, my testosterone is 218 and Bioavailable Testosterone was 59 which is low normal. I have asked my endo for an SHBG test but she has not ordered. I did however enter my results in an SHBG calculator and it indicated an SHBG of 60 which is high. I thought if I had low total testosterone and low normal Bioavailable that I would have low SHBG.
 

Sean Mosher

Member
Dr. Rotman is a top notch urologist in NY.
Nelson has interviewed him on this site and has it posted.
He would also be an excellent option for you for quality local care.
 

River Rat

Member
Thanks. I am not sure why New York does not allow individuals to order tests through Defy. If I am willing to pay, what is the issue. I am very puzzled as how the dr can say I do not have hypogonadism with multiple total testosterone tests of 218 and 228. Just because my Bioavailable T is 59, the Dr says I do not have hypogonadism. I really do not understand how this works. If total testosterone is 228 and Bioavailable is 59, what would a best guesse of my SHBG. I found a SHBG calculator and it calculated a SHBG of around 60 which is high. I was thinking my SHBG would be low.
 

dnfuss

Active Member
Thanks. I am not sure why New York does not allow individuals to order tests through Defy. If I am willing to pay, what is the issue. I am very puzzled as how the dr can say I do not have hypogonadism with multiple total testosterone tests of 218 and 228. Just because my Bioavailable T is 59, the Dr says I do not have hypogonadism. I really do not understand how this works. If total testosterone is 228 and Bioavailable is 59, what would a best guesse of my SHBG. I found a SHBG calculator and it calculated a SHBG of around 60 which is high. I was thinking my SHBG would be low.

I am a Defy patient and live in New York. Initially I had the same concerns as you about blood tests, having heard New York does not allow self-ordered testing, etc.

Tests ordered by Defy are not self-ordered, they're ordered by your Defy physician. I've never had a problem. You figure out with your doctor at Defy what blood tests will be needed, they email you the order, you print it out and take it with you to the lab. You hand it to the receptionist and they'll ask you for your insurance information. You just tell them "No insurance, it's prepaid." They take the order and proceed to draw your blood. That's it.

It's never happened to me, but if they insist they need insurance info or a credit card don't give it to them, just keep telling them it's prepaid and to contact the doctor's office as shown on the order.

Again, I've never had a problem; couldn't be easier.
 

dnfuss

Active Member
Yes. I discussed with them today and I would have to go to a neighboring state for lab work.

That is very odd. Not sure who you talked to at Defy. As I stated earlier, I have had blood drawn numerous times in New York (NYC), most recently just over a month ago, and never had any problem whatsoever.
 

River Rat

Member
That is very odd. Not sure who you talked to at Defy. As I stated earlier, I have had blood drawn numerous times in New York (NYC), most recently just over a month ago, and never had any problem whatsoever.

I will call Labcorp tomorrow to see if they will draw blood based on Defy Lab orders. I am not sure who I spoke with at Defy but they said I would have to go to a neighboring state.
 

Vettester Chris

Super Moderator
Awesome, she treats the numbers and not the patient. She won't change, so if you want to pursue your wellness you will need to call a specialist, maybe one of the suggestions noted above?
 

River Rat

Member
Awesome, she treats the numbers and not the patient. She won't change, so if you want to pursue your wellness you will need to call a specialist, maybe one of the suggestions noted above?

I just don’t understand how having a total testosterone of 218 does not indicate hypogonadism. What am I missing.
 
snip...
I have already seen a Urologist who prescribed TRT Injections but my PCP wanted me to see an endocrinologist who took me off TRT to run baseline tests. snip...

Why don't you go back to your old Uro and get your scripts back and dump the PCP. They are a dime a dozen anyway.
 

blackebob

Member
I am not understanding why you keep juking and jiving the quality advice you are being given? I mean this is not your first thread where you said you should probably take the advice and call defy, that was back in March. Why are you hesitant?

I have been fighting this for three years, I wish someone would have told me to call defy in 2016.
 

Vettester Chris

Super Moderator
I just don't understand how having a total testosterone of 218 does not indicate hypogonadism. What am I missing.

Well, that's thing, it does put hypogonadism into play and on the table. My GP is also female, she is razor sharp in all sorts of areas, including cardiovascular, genetics, hematology, pathology, etc..., however, by her own admission she isn't all that up to speed with mens endocrine treatment.

For over 8 years, I have had my HRT treated through specialists, and currently for 2+ years at Defy. There's no secrets, I share everything with her, and I share her stuff with Defy and Dr. Saya. She seems fascinated with a lot of the science, and she's one of the few that is still able to learn new treatments and new technologies, long after she earned a doctorate degree.

Unfortunately, many are not of this mindset ... In the beginning, I had an endo that she had referred me to. He was a complete arrogant and ignorant fool. He told me any test serum level over 600ng/dl is a pathway to cancer. He told me it was illegal to take testosterone cyp home and that it was a Class III controlled substance, and he told me that this means it's controlled by the physician. I countered that with all the other Class III opiods, he just got frustrated and wouldn't answer. He said HCG did nothing and it was for people trying to be Manny Ramirez. And of course, estrogen was no factor in his world. I emailed him some journal transcripts from the Society of Endocrinologist, basically rebutting all of his profound statements. He fired me as a patient within 10 minutes and I was back to my GP.

Rat buddy, as bad as that sounds, it was the best thing that could have happened!! For the first time in my life I had a full understanding of how and why a physician could potentially do more harm than good. Sadly, the "why" in that case (and in many) was due to an out of control ego with an arrogant disposition. This actually was my kick-in-the-butt to grab hold of my health and start learning how this all works. That led me to align and learn from people with real life experiences, and from the professionals who really have their "A" game on, eating & breathing this stuff day-in and day-out (there's this guy named Nelson Vergel that falls into that category, some may have heard of him) ;)
 

River Rat

Member
I am not understanding why you keep juking and jiving the quality advice you are being given? I mean this is not your first thread where you said you should probably take the advice and call defy, that was back in March. Why are you hesitant?

I have been fighting this for three years, I wish someone would have told me to call defy in 2016.

I have hesitated as I believed that Defy could not order labs in New York State. Based on a previous comment, this might not be true. I am going to see if LabCorp will run labs ordered from Defy.
 
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