1. #1

    Free T vs Total T question

    So I have been having the following symptoms for a while: low libido, moody sometimes and lack of energy. Low libido is really most concerning and what brought me to ask my doctor to check my hormones (and to this sight).

    My doctor would only measure my total T and free T so thatís all Iíve got to work with at the moment. He takes a look at both and says everything is normal and Iím in range so nothing to worry about. It looks to me like my total T is probably on the low end for a 39 year old but maybe free T is where it should be. So I guess my questions are: which is the more important number, total T or free T? Based on my results should I continue investigating the hormone angle as a cause of my symptoms? I understand of course that these are just internet opinions. Just looking for other's perspectives.

    My results are (quest labs):

    Total T: 358 ng/dL range 250-1100 ng/dL

    Free T: 85.5 pg/mL range 35-155 pg/mL


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  3. #2
    Common ill-informed Dr response is that you're inrange and that ends the conversation without addressing your symptoms. First serious clue that you need a new Dr if you're going to pursue TRT. Of the two, Free T is what matters, yours is not bad but can be better. Also should have tested your LH and FSH levels to know if youre primary or secondary hypogonadal. This will tell if its a testes problem or a Pituitary problem.

  4. #3
    Moderator Vince's Avatar
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    Also make sure to have your complete thyroid panel checked, a lot of men that have low T also have hypothyroidism. Hypothyroidism can cause low testosterone.
    I am not a medical practitioner. Any suggestions I provide are not medical recommendations and are just my opinions. Please consult with your physician on any matters concerning your health.

  5. #4
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    Quote Originally Posted by SenorFuggled View Post
    So I have been having the following symptoms for a while: low libido, moody sometimes and lack of energy. Low libido is really most concerning and what brought me to ask my doctor to check my hormones (and to this sight).

    My doctor would only measure my total T and free T so that’s all I’ve got to work with at the moment. He takes a look at both and says everything is normal and I’m in range so nothing to worry about. It looks to me like my total T is probably on the low end for a 39 year old but maybe free T is where it should be. So I guess my questions are: which is the more important number, total T or free T? Based on my results should I continue investigating the hormone angle as a cause of my symptoms? I understand of course that these are just internet opinions. Just looking for other's perspectives.

    My results are (quest labs):

    Total T: 358 ng/dL range 250-1100 ng/dL

    Free T: 85.5 pg/mL range 35-155 pg/mL
    I've always been told free T is what you feel.
    I'll bet your SHBG is quite low that is why you have so much FT with so little TT.

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    Wow thanks for the quick responses Vince and Vince. So do you think libido issues could be hormone related?

    As far as labs go is it the men's complete hormone and wellness panel that is recommended.

  7. #6
    Quote Originally Posted by Vince View Post
    Also make sure to have your complete thyroid panel checked, a lot of men that have low T also have hypothyroidism. Hypothyroidism can cause low testosterone.
    Vince

    The information/studies I have seen is that replacing thyroid hormones can have a general but not very large increase in testosterone levels however it doesn't seem to have a large in any impact on males over 40.

    Do you know HOW big an effect in general thyroid has on testosterone levels in men, and if it is age dependent?

    For instance, if I have low but in range TotalT, IE: 350 ng/dl, and low but in range thyroid hormones, I think I would still get on TRT as I doubt a mono-therapy of raising thyroid hormones alone would be enough to raise total TT above 500 ng/dl.

    To me, understanding the likely degree of effect of various treatments, supplements and changes is one key to determining how to proceed.

  8. #7
    LIbido as in the desire to have sex can be hormone related.

  9. #8
    Quote Originally Posted by DragonBits View Post
    Vince

    The information/studies I have seen is that replacing thyroid hormones can have a general but not very large increase in testosterone levels however it doesn't seem to have a large in any impact on males over 40.

    Do you know HOW big an effect in general thyroid has on testosterone levels in men, and if it is age dependent?

    For instance, if I have low but in range TotalT, IE: 350 ng/dl, and low but in range thyroid hormones, I think I would still get on TRT as I doubt a mono-therapy of raising thyroid hormones alone would be enough to raise total TT above 500 ng/dl.

    To me, understanding the likely degree of effect of various treatments, supplements and changes is one key to determining how to proceed.
    Ive not read one instance on the forums of any guy that treated hypothryoidism having corrected his low T problem. having both conditions doesn't at all mean one has something to do with the other and is often just the opposite, both are unrelated.

  10. #9
    Quote Originally Posted by FeelingLost View Post
    I've always been told free T is what you feel.
    I'll bet your SHBG is quite low that is why you have so much FT with so little TT.
    My results are (quest labs):

    Total T: 358 ng/dL range 250-1100 ng/dL

    Free T: 85.5 pg/mL range 35-155 pg/mL



    My own guess is that he is NOT measuring freeT but is measuring free +weakly bound T, as the range of 35-155 pg/mL is more typical of F+W T.

  11. #10
    Moderator Vince's Avatar
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    Quote Originally Posted by DragonBits View Post
    Vince

    The information/studies I have seen is that replacing thyroid hormones can have a general but not very large increase in testosterone levels however it doesn't seem to have a large in any impact on males over 40.

    Do you know HOW big an effect in general thyroid has on testosterone levels in men, and if it is age dependent?

    For instance, if I have low but in range TotalT, IE: 350 ng/dl, and low but in range thyroid hormones, I think I would still get on TRT as I doubt a mono-therapy of raising thyroid hormones alone would be enough to raise total TT above 500 ng/dl.

    To me, understanding the likely degree of effect of various treatments, supplements and changes is one key to determining how to proceed.
    I don't think we have a true answer on how does thyroid affect men testosterone. I wish doctors would the first treat hypothyroidism and then if necessary treat their low T. Now that hypothyroidism treating is becoming more mainstream hopefully one day we will get a real answer.
    I am not a medical practitioner. Any suggestions I provide are not medical recommendations and are just my opinions. Please consult with your physician on any matters concerning your health.

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