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Testosterone Replacement, Low T, HCG, & Beyond
When Testosterone Is Not Enough
ED ongoing issues
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<blockquote data-quote="madman" data-source="post: 155085" data-attributes="member: 13851"><p>Unfortunately the FT testing method Quest uses is a modified form of the linear law-of-mass action Vermeulen calculated method and this model/equation is based off of a faulty understanding of SHBG:T binding.</p><p></p><p></p><p></p><p></p><p></p><p>As has been stated on TruT:</p><p></p><p><strong><span style="color: rgb(26, 188, 156)">" However, we have demonstrated that even the calculated fT values derived from the prevailing equations, based on linear law-of-mass action models or empiric equations, </span></strong><span style="color: rgb(251, 160, 38)"><strong>differ systematically from free testosterone measured by equilibrium dialysis by as much as </strong></span><span style="color: rgb(184, 49, 47)"><strong>40%"</strong></span></p><p></p><p></p><p></p><p></p><p>Again if we look at your labs: </p><p></p><p><span style="font-size: 26px">Labs on 4-30-19</span></p><p><span style="font-size: 26px">Protocol: 17.5mg prop ED </span></p><p></p><p><span style="color: rgb(69, 69, 69)"><span style="font-size: 22px">Total T - 1423 (250-1100 ng/dL) </span> </span></p><p><span style="color: rgb(69, 69, 69)"><span style="font-size: 21px">Free T - 134.8 (46.0-224.0) </span></span></p><p><span style="color: rgb(69, 69, 69)"><span style="font-size: 21px">Bio T - 265.5 (110.0-575.0 ng/dL) </span></span></p><p><span style="color: rgb(69, 69, 69)"><span style="font-size: 21px">SHBG 63 (10-50) </span></span></p><p></p><p></p><p>Using the newer TruT calculated method (which has been shown to be on par with results obtained by the gold standard Equilibrium Dialysis).</p><p></p><p>TT 1423, SHBG 63 nmol/L and Albumin 4.3 g/dL (mean) than your FT is 48.24 ng/dL (well over the top end of the reference range of 16-31 ng/dL).</p><p>[ATTACH=full]7999[/ATTACH]</p><p></p><p></p><p><span style="color: rgb(69, 69, 69)"><span style="font-size: 26px">Labs on 7-23-19</span></span></p><p><span style="color: rgb(69, 69, 69)"><span style="font-size: 26px">Protocol: 42mg prop EOD</span></span></p><p></p><p><span style="color: rgb(69, 69, 69)"><span style="font-size: 21px">Total T - 1002 (250-1100 ng/dL) </span></span></p><p><span style="color: rgb(69, 69, 69)"><span style="font-size: 21px">Free T - 134.2 (46.0-224.0) </span></span></p><p><span style="color: rgb(69, 69, 69)"><span style="font-size: 21px">Bio T - 287.7 (110.0-575.0 ng/dL) </span></span></p><p><span style="color: rgb(69, 69, 69)"><span style="font-size: 21px">SHBG 39 (10-50) </span></span></p><p></p><p></p><p>TT 1002 ng/dL, SHBG 39 nmol/L and Albumin 4.3 g/dL (mean) than your FT is 35.05 ng/dL (just over the top end of the reference range of 16-31 ng/dL).</p><p>[ATTACH=full]8000[/ATTACH]</p><p></p><p></p><p>So you can clearly see the difference in FT levels between protocols 48.24 ng/dL vs 35.05 ng/dL.....mind you we also need to keep in mind the variations in protocols.</p><p></p><p>Why you are dead set on comparing FT levels using calculated testing methods that are outdated let alone have been shown to grossly underestimate FT values when compared to the gold standard Equilibrium Dialysis is beyond me.</p><p></p><p>Again regarding FT testing methods whether direct immunoassay or tracer analog both have been shown to be inaccurate let alone no longer recommended by the Endocrine Society and as for the linear law-of-mass action calculated methods the models/equations are based off of a faulty understanding of SHBG:T binding.</p><p></p><p>As we know ones SHBG level is critical to what FT level is achieved at said TT level.</p><p></p><p>The only way to truly know where ones FT levels sits is to use an accurate testing method such as the gold standard Equilibrium Dialysis or Ultrafiltration and now we have the newer calculated TruT method which model/equation is based off of the new research.................</p><p>understanding of SHBG:T binding and the TruT calculated method is on par with results obtained by ED.</p><p></p><p>So again if you want to keep on using/relying/comparing your FT levels whether using the piss poor inaccurate direct immunoassay or the outdated linear law-of-mass action equtaions if it truly makes you feel better so be it.</p><p></p><p>But do not go on claiming such about your FT levels based off inaccurate testing methods.</p><p></p><p>Get back to me when you start testing your FT levels on varying trt protocols using accurate testing methods such as Equilibrium Dialysis or Ultrafiltration.</p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p>As has been stated on the TruT:</p><p></p><ul> <li data-xf-list-type="ul">Commonly available free testosterone calculators (issam.ch, nebido.com, pctag.uk) <span style="color: rgb(26, 188, 156)"><strong>use models of testosterone:SHBG binding (proposed by Vermeulen et al. and Sodergard et. al) which were developed before the crystal structure for SHBG:T complexes were available. </strong></span><span style="color: rgb(184, 49, 47)"><strong>These models assume that the two SHBG monomers behave identically in binding testosterone. </strong></span><span style="color: rgb(26, 188, 156)"><strong>Detailed experimental data show that the "simplified linear model is erroneous." </strong></span><a href="https://tru-t.org/evidence/#existing-calculators-are-inaccurate" target="_blank">References</a>.</li> </ul><p></p><p> </p><ul> <li data-xf-list-type="ul"><strong><span style="color: rgb(44, 130, 201)">The TruT™ calculator provides the ideal solution by using measurements of total testosterone, SHBG, and albumin to calculate free testosterone while taking into account the complex, non-linear allostery in SHBG's association with testosterone. </span></strong><span style="color: rgb(184, 49, 47)"><strong>TruT™ is the only calculator available that uses this more complex formulation. </strong></span><a href="https://tru-t.org/evidence#trut-improvements" target="_blank">References</a></li> </ul></blockquote><p></p>
[QUOTE="madman, post: 155085, member: 13851"] Unfortunately the FT testing method Quest uses is a modified form of the linear law-of-mass action Vermeulen calculated method and this model/equation is based off of a faulty understanding of SHBG:T binding. As has been stated on TruT: [B][COLOR=rgb(26, 188, 156)]" However, we have demonstrated that even the calculated fT values derived from the prevailing equations, based on linear law-of-mass action models or empiric equations, [/COLOR][/B][COLOR=rgb(251, 160, 38)][B]differ systematically from free testosterone measured by equilibrium dialysis by as much as [/B][/COLOR][COLOR=rgb(184, 49, 47)][B]40%"[/B][/COLOR] Again if we look at your labs: [SIZE=26px]Labs on 4-30-19 Protocol: 17.5mg prop ED [/SIZE] [COLOR=rgb(69, 69, 69)][SIZE=22px]Total T - 1423 (250-1100 ng/dL) [/SIZE] [SIZE=21px]Free T - 134.8 (46.0-224.0) Bio T - 265.5 (110.0-575.0 ng/dL) SHBG 63 (10-50) [/SIZE][/COLOR] Using the newer TruT calculated method (which has been shown to be on par with results obtained by the gold standard Equilibrium Dialysis). TT 1423, SHBG 63 nmol/L and Albumin 4.3 g/dL (mean) than your FT is 48.24 ng/dL (well over the top end of the reference range of 16-31 ng/dL). [ATTACH=full]7999[/ATTACH] [COLOR=rgb(69, 69, 69)][SIZE=26px]Labs on 7-23-19 Protocol: 42mg prop EOD[/SIZE][/COLOR] [COLOR=rgb(69, 69, 69)][SIZE=21px]Total T - 1002 (250-1100 ng/dL) Free T - 134.2 (46.0-224.0) Bio T - 287.7 (110.0-575.0 ng/dL) SHBG 39 (10-50) [/SIZE][/COLOR] TT 1002 ng/dL, SHBG 39 nmol/L and Albumin 4.3 g/dL (mean) than your FT is 35.05 ng/dL (just over the top end of the reference range of 16-31 ng/dL). [ATTACH=full]8000[/ATTACH] So you can clearly see the difference in FT levels between protocols 48.24 ng/dL vs 35.05 ng/dL.....mind you we also need to keep in mind the variations in protocols. Why you are dead set on comparing FT levels using calculated testing methods that are outdated let alone have been shown to grossly underestimate FT values when compared to the gold standard Equilibrium Dialysis is beyond me. Again regarding FT testing methods whether direct immunoassay or tracer analog both have been shown to be inaccurate let alone no longer recommended by the Endocrine Society and as for the linear law-of-mass action calculated methods the models/equations are based off of a faulty understanding of SHBG:T binding. As we know ones SHBG level is critical to what FT level is achieved at said TT level. The only way to truly know where ones FT levels sits is to use an accurate testing method such as the gold standard Equilibrium Dialysis or Ultrafiltration and now we have the newer calculated TruT method which model/equation is based off of the new research................. understanding of SHBG:T binding and the TruT calculated method is on par with results obtained by ED. So again if you want to keep on using/relying/comparing your FT levels whether using the piss poor inaccurate direct immunoassay or the outdated linear law-of-mass action equtaions if it truly makes you feel better so be it. But do not go on claiming such about your FT levels based off inaccurate testing methods. Get back to me when you start testing your FT levels on varying trt protocols using accurate testing methods such as Equilibrium Dialysis or Ultrafiltration. As has been stated on the TruT: [LIST] [*]Commonly available free testosterone calculators (issam.ch, nebido.com, pctag.uk) [COLOR=rgb(26, 188, 156)][B]use models of testosterone:SHBG binding (proposed by Vermeulen et al. and Sodergard et. al) which were developed before the crystal structure for SHBG:T complexes were available. [/B][/COLOR][COLOR=rgb(184, 49, 47)][B]These models assume that the two SHBG monomers behave identically in binding testosterone. [/B][/COLOR][COLOR=rgb(26, 188, 156)][B]Detailed experimental data show that the "simplified linear model is erroneous." [/B][/COLOR][URL='https://tru-t.org/evidence/#existing-calculators-are-inaccurate']References[/URL]. [/LIST] [LIST] [*][B][COLOR=rgb(44, 130, 201)]The TruT™ calculator provides the ideal solution by using measurements of total testosterone, SHBG, and albumin to calculate free testosterone while taking into account the complex, non-linear allostery in SHBG's association with testosterone. [/COLOR][/B][COLOR=rgb(184, 49, 47)][B]TruT™ is the only calculator available that uses this more complex formulation. [/B][/COLOR][URL='https://tru-t.org/evidence#trut-improvements']References[/URL] [/LIST] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
When Testosterone Is Not Enough
ED ongoing issues
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