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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Considering starting TRT. My blood work is attached.
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<blockquote data-quote="madman" data-source="post: 268247" data-attributes="member: 13851"><p>Hard to believe after all these years on here this guy is still posting this!</p><p></p><p>His FT was never even tested using an accurate assay.</p><p></p><p>The only way to know where his FT truly sat is to have it tested using the most accurate assays Equilibrium Dialysis or Ultrafiltration, especially in cases of altered SHBG.</p><p></p><p></p><p><strong>PRE TRT LABS:</strong></p><p><strong></strong></p><p><strong>8-5-15</strong></p><p><strong>ON NOTHING</strong></p><p><strong></strong></p><p><strong>Total T - 584 (348-1197 ng/dL) </strong></p><p><strong>Free T - 7.3 (9.3-26.5)</strong></p><p><strong>SHBG - 57.1 ( 16.5 - 55.9). </strong></p><p>E2 NOT sensitive - 14.6 (7.6-42.6)</p><p>Prolactin - 9 (2.0-18.0)</p><p>LH - 3.5 (1.7-8.6)</p><p>FSH - 2.3 (1.5-12.4)</p><p>TSH - 1.2 (0.450-4.500)</p><p>T4 free - 1.15 (0.82-1.77)</p><p>T3 free 3.4 ( 2.0-4.4)</p><p>DHEA-S 486.0 (138.5-475.2)</p><p></p><p></p><p>He had FT tested using the known to be inaccurate direct immunoassay which had his FT flagged as low.</p><p></p><p>As I have stated numerous times on the forum over the years if one does not have access to the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration then they would need to use/rely upon the cFTV.</p><p></p><p>The analog/direct immunoassays are known to be inaccurate and should not be used/relied upon when testing free testosterone, especially in cases of altered SHBG.</p><p></p><p>As you can clearly see if we take his robust TT 584 ng/dL, high SHBG 57.1 nmol/L, and Albumin 4.3 g/dL (default) his cFT would be 8.72 ng/dL which is lowish as in near the bottom end but would not be flagged as LOW!</p><p></p><p>His FT level is definitely sub-par and well under where a healthy young male would be but again it is not LOW as in <5 ng/dL.</p><p></p><p>Keep in mind as of now cFTV tends to overestimate slightly when compared against the gold standard Equilibrium Dialysis but even then his FT would still be above the low-end of 5 ng/dL and not flagged as low.</p><p></p><p>Regardless these are definitely shitty FT levels.</p><p></p><p>[ATTACH=full]38568[/ATTACH]</p><p></p><p></p><p></p><p></p><p>Here is where it gets even better!</p><p></p><p></p><p><strong>11-2-15</strong></p><p><strong>ON NOTHING </strong></p><p><strong></strong></p><p><strong>Total T - 691 (250-1100 ng/dL) </strong></p><p><strong>Free T - 73.9 (46.0-224.0) </strong></p><p>Bio T - 161.6 (110.0-575.0 ng/dL) </p><p><strong>SHBG 45 (10-50) </strong></p><p>E2 Sensitive- 25</p><p>IGF 1 - 294 (63-373)</p><p>DHEA-S - 411 (106-464)</p><p><strong>Albumin - 4.7 (3.6-5.1)</strong></p><p></p><p></p><p>Again as you can see his FT was never even tested using an accurate assay (ED or UF).</p><p></p><p>His FT was still in range but well under the mid-range of the reference range (46.0-224.0).</p><p></p><p>He is hitting a very robust TT 691 ng/dL which is 97 ng/dL higher than his previous set of labs (594 ng/dL), SHBG 45 nmol/L is highish but not really high and is 12 nmol/L lower than his previous set of labs which had it at 57.1 nmol/L.</p><p></p><p>As you can clearly see if we calculate his FT using cFTV with a very robust TT of 691 ng/dL, highish SHBG 45 nmol/L, and Albumin 4.7 g/dL then his cFT would be 12.1 ng/dL which is at least mid-range of the cFTV reference range and far from low as in <5ng/dL.</p><p></p><p>Again his FT level is under where a healthy young male in his prime would be (13-14 ng/dL) but again it is still in a healthy range and far from low as in <5 ng/dL.</p><p></p><p>As I stated previously keep in mind as of now cFTV tends to overestimate slightly when compared against the gold standard Equilibrium Dialysis but even then his FT would most likely still be around/just above 10 ng/dL which is close to mid-range for cFTV and far from low as in <5 ng/dL.</p><p></p><p>Now we can get into what we call the grey zone for free testosterone where some men may struggle with low-T symptoms in the 5-10 ng/dL range but this is not a given and even then if he had his FT tested using the most accurate assay such as the gold standard Equilibrium Dialysis he would most likely still be hitting a FT 10 ng/dL.</p><p></p><p>Top it all off when we start getting into the borderline/grey zone levels for FT one needs to make sure there is no dysfunction thyroid/adrenals which can easily mimic low-T symptoms.</p><p></p><p>[ATTACH=full]38569[/ATTACH]</p><p></p><p></p><p></p><p>The point being stressed here is making sure that you are testing your FT using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration, especially in cases of altered SHBG so you know where your free testosterone truly sits.</p><p></p><p>Top it all off in cases of borderline/grey zone FT levels 5-10 ng/dL dysfunction thyroid/adrenals need to be ruled out before blaming the FT.</p><p></p><p>This guy has been on the forum for 7 years and not once has tested his FT using an accurate assay (ED/UF).</p><p></p><p>The same guy caught up on that more T is better mentality let alone jacked up on T from the get-go.</p><p></p><p>Go figure!</p><p></p><p><strong><em>The last person you want to be taking advice from when it comes to testing free testosterone let alone jumping on TRT!</em></strong></p><p></p><p>If you are going to test free testosterone let alone post labs then make sure you are using accurate assays before claiming where your FT level truly sits.</p><p></p><p>Maybe on one of those other dime-a-dozen bro forums but it will not fly on here!</p><p></p><p></p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/direct-measurements-of-free-hormones-using-mass-spectrometry-based-methods.28144/[/URL]</p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/when-binding-proteins-interfere-with-immunoassays.25729/[/URL]</p></blockquote><p></p>
[QUOTE="madman, post: 268247, member: 13851"] Hard to believe after all these years on here this guy is still posting this! His FT was never even tested using an accurate assay. The only way to know where his FT truly sat is to have it tested using the most accurate assays Equilibrium Dialysis or Ultrafiltration, especially in cases of altered SHBG. [B]PRE TRT LABS: 8-5-15 ON NOTHING Total T - 584 (348-1197 ng/dL) Free T - 7.3 (9.3-26.5) SHBG - 57.1 ( 16.5 - 55.9). [/B] E2 NOT sensitive - 14.6 (7.6-42.6) Prolactin - 9 (2.0-18.0) LH - 3.5 (1.7-8.6) FSH - 2.3 (1.5-12.4) TSH - 1.2 (0.450-4.500) T4 free - 1.15 (0.82-1.77) T3 free 3.4 ( 2.0-4.4) DHEA-S 486.0 (138.5-475.2) He had FT tested using the known to be inaccurate direct immunoassay which had his FT flagged as low. As I have stated numerous times on the forum over the years if one does not have access to the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration then they would need to use/rely upon the cFTV. The analog/direct immunoassays are known to be inaccurate and should not be used/relied upon when testing free testosterone, especially in cases of altered SHBG. As you can clearly see if we take his robust TT 584 ng/dL, high SHBG 57.1 nmol/L, and Albumin 4.3 g/dL (default) his cFT would be 8.72 ng/dL which is lowish as in near the bottom end but would not be flagged as LOW! His FT level is definitely sub-par and well under where a healthy young male would be but again it is not LOW as in <5 ng/dL. Keep in mind as of now cFTV tends to overestimate slightly when compared against the gold standard Equilibrium Dialysis but even then his FT would still be above the low-end of 5 ng/dL and not flagged as low. Regardless these are definitely shitty FT levels. [ATTACH type="full" alt="1698334703805.png"]38568[/ATTACH] Here is where it gets even better! [B]11-2-15 ON NOTHING Total T - 691 (250-1100 ng/dL) Free T - 73.9 (46.0-224.0) [/B] Bio T - 161.6 (110.0-575.0 ng/dL) [B]SHBG 45 (10-50) [/B] E2 Sensitive- 25 IGF 1 - 294 (63-373) DHEA-S - 411 (106-464) [B]Albumin - 4.7 (3.6-5.1)[/B] Again as you can see his FT was never even tested using an accurate assay (ED or UF). His FT was still in range but well under the mid-range of the reference range (46.0-224.0). He is hitting a very robust TT 691 ng/dL which is 97 ng/dL higher than his previous set of labs (594 ng/dL), SHBG 45 nmol/L is highish but not really high and is 12 nmol/L lower than his previous set of labs which had it at 57.1 nmol/L. As you can clearly see if we calculate his FT using cFTV with a very robust TT of 691 ng/dL, highish SHBG 45 nmol/L, and Albumin 4.7 g/dL then his cFT would be 12.1 ng/dL which is at least mid-range of the cFTV reference range and far from low as in <5ng/dL. Again his FT level is under where a healthy young male in his prime would be (13-14 ng/dL) but again it is still in a healthy range and far from low as in <5 ng/dL. As I stated previously keep in mind as of now cFTV tends to overestimate slightly when compared against the gold standard Equilibrium Dialysis but even then his FT would most likely still be around/just above 10 ng/dL which is close to mid-range for cFTV and far from low as in <5 ng/dL. Now we can get into what we call the grey zone for free testosterone where some men may struggle with low-T symptoms in the 5-10 ng/dL range but this is not a given and even then if he had his FT tested using the most accurate assay such as the gold standard Equilibrium Dialysis he would most likely still be hitting a FT 10 ng/dL. Top it all off when we start getting into the borderline/grey zone levels for FT one needs to make sure there is no dysfunction thyroid/adrenals which can easily mimic low-T symptoms. [ATTACH type="full" alt="1698335540431.png"]38569[/ATTACH] The point being stressed here is making sure that you are testing your FT using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration, especially in cases of altered SHBG so you know where your free testosterone truly sits. Top it all off in cases of borderline/grey zone FT levels 5-10 ng/dL dysfunction thyroid/adrenals need to be ruled out before blaming the FT. This guy has been on the forum for 7 years and not once has tested his FT using an accurate assay (ED/UF). The same guy caught up on that more T is better mentality let alone jacked up on T from the get-go. Go figure! [B][I]The last person you want to be taking advice from when it comes to testing free testosterone let alone jumping on TRT![/I][/B] If you are going to test free testosterone let alone post labs then make sure you are using accurate assays before claiming where your FT level truly sits. Maybe on one of those other dime-a-dozen bro forums but it will not fly on here! [URL unfurl="true"]https://www.excelmale.com/forum/threads/direct-measurements-of-free-hormones-using-mass-spectrometry-based-methods.28144/[/URL] [URL unfurl="true"]https://www.excelmale.com/forum/threads/when-binding-proteins-interfere-with-immunoassays.25729/[/URL] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Considering starting TRT. My blood work is attached.
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