39 yo Male, Bloodwork

39 year old male, 5'10 & 235 pounds with extreme fatigue.

My primary doctor has had me on 2 pumps of Fortesta 10 mg for three years now. I originally had a T level of 160 and it still stays around 200-450. Doctor refuses to up dose or go injectables so my labs don't flucuate so I'm switching over to Defy Medical. They put in my lab work with LabCorp last week and just got my results. I will now be scheuling my first consult with Dr. Saya, but wanted to see if there was anything in my results that I should bring up besides still having a testosterone level of only 226?

Thanks in advance!

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as had me on 2 pumps of Fortesta 10 mg for three years now. I originally had a T level of 160 and it still stays around 200-450. Doctor refuses to up dose or go injectables.
wanted to see if there was anything in my results that I should bring up besides still having a testosterone level of only 226?

Curious, what’s your doctors reasoning for keeping your hormone levels so low?

If this was my doctor, I would report him to the state medical board!

This is BS!
 
Curious, what’s your doctors reasoning for keeping your hormone levels so low?

If this was my doctor, I would report him to the state medical board!

This is BS!
My last labs with her about 3 months ago were 450 and she said that is completely acceptable, which is frustrating since I told her I still have all the same symptoms and need to up it!
FRUSTRATING
 
L r
My last labs with her about 3 months ago were 450 and she said that is completely acceptable, which is frustrating since I told her I still have all the same symptoms and need to up it!
FRUSTRATING
No, it’s not acceptable to only be testing the Total T without concern for the active Free T, which is what effects tissue and outcomes of men on TRT.

Certain data have shown increased CAG repeats are associated with decreased sensitivity in the receptor to testosterone and manifestation of TD symptoms despite “normal” serum testosterone levels.

Also, 450 isn’t acceptable if you’re stilling experiencing symptoms of low-T and therefore treatment failure.

Men on topicals need high peak levels due to the very short half-life, or else hormone levels fall rapidly. Some studies even show <500 to be where symptoms of low-T start to develop, mainly the lower libido and loss of vigor.


The exact serum testosterone level required to achieve maximal efficacy and safety is currently unknown.30 Many authors often cite low-to-mid level range of serum testosterone levels as a reasonable target in otherwise young, asymptomatic men.86 These authors target a mid-to-high range, due to the lower risk of necessary dosing adjustments and a better chance for immediate symptom improvement resulting in improved compliance.
 
Last edited:
L r

No, it’s not acceptable to only be testing the Total T without concern for the active Free T, which is what effects tissue and outcomes of men on TRT.



Also, 450 isn’t acceptable if you’re stilling experiencing symptoms of low-T and therefore treatment failure.

Men on topicals need high peak levels due to the very short half-life, or else hormone levels fall rapidly. Some studies even show <500 to be where symptoms of low-T start to develop, mainly the lower libido and loss of vigor.

Wow great info! Thanks for sharing this. It’s like you said they didn’t even test free T last time, so they are clearly missing things. Is there anything based on my labs I should bring up to my new Dr when I have my consult?
 
You’re working with one of the best private TRT clinics in the country as far as I’m concerned.

Dr. Says and Dr. Calkens are top notch!
 

hCG Mixing Calculator

HCG Mixing Protocol Calculator

TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

ℹ️ Input Parameters

Normal range: 300-1000 ng/dL

Predicted Hormone Levels

Enter your total testosterone value to see predictions

Results will appear here after calculation

Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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