Extremely low FREE T conversion 0.14%. Why is that?

[vladgh]

Hello,

Started TRT 2 months ago, 120/week split in 2pins. My blood test came back today. Here is a before and after:

Test: 383 -> 735 Ng/Dl
Free Test: 7.1 -> 12.8 Pg/Ml
Conversion: 0.185% -> 0.136%
SHBG: 23 -> 16.9 Nmol/L
Albumin: 5.4 -> 4.7 G/Dl

Started with extremely low conversion of FREE T and was hoping it would balance with TRT. It got worse.
Shouldn't it be around 2% ?
SHBG and Albumin levels are on the lower end of the scale. Any other metric that influences the conversion?

As for how I feel on TRT: I am marginally more energic and have morning wood again. But I can only wonder how it would feel if my free test was 10x bigger..

Anyone that has seen this situation before? What should I do next? Thank you

 

[vladgh]

@Nelson Vergel

 

[Nelson Vergel]

Are you sure it’s not 12.8 ng /dL?

 

[Cataceous]

Most likely this is an immunoassay-based free testosterone test. These are highly inaccurate and should not be used. Instead use either an equilibrium dialysis-based test or the Vermeulen calculator. According to Vermeulen your free testosterone increased from 8.2 ng/dL to 20.9 ng/dL. I view the healthy normal range as being about 10-20 ng/dL, meaning you've gone from low to high. I suggest cutting back so that you can spend some time midrange before reevaluating. 80 mg TC/week is a more reasonable starting dose. In case you're not aware, healthy young men create testosterone at an average rate equivalent to 60-70 mg TC/ week. Your current dose is approaching double that.

 

[vladgh]

Really appreciate your responses.

Attached a photo of the results. Free test is in pg/ml , both in this test and the one before I started on TRT.

The reference range of my lab is way off track, it also says that 280 ng/dl of total test is in range.

All ranges I can find on the internet state that 35 pg/ml is borderline low and over 100 is the sweet spot.

Is this range reliable? Did you see any case like this before? Thanks

@Cataceous @Nelson Vergel

 

[madman]

Hello,

Started TRT 2 months ago, 120/week split in 2pins. My blood test came back today. Here is a before and after:

Test: 383 -> 735 Ng/Dl
Free Test: 7.1 -> 12.8 Pg/Ml
Conversion: 0.185% -> 0.136%
SHBG: 23 -> 16.9 Nmol/L
Albumin: 5.4 -> 4.7 G/Dl

Started with extremely low conversion of FREE T and was hoping it would balance with TRT. It got worse.
Shouldn't it be around 2% ?
SHBG and Albumin levels are on the lower end of the scale. Any other metric that influences the conversion?

As for how I feel on TRT: I am marginally more energic and have morning wood again. But I can only wonder how it would feel if my free test was 10x bigger..

Anyone that has seen this situation before? What should I do next? Thank you

The only way to know where your FT level truly sits is to have it tested using what would be considered the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).

Looking over your labs the FT method used was the ELISA, DSX Elisa Systems-Dynextechnology which is the direct FT immunoassay which is known to be inaccurate.

*Free Testosterone ELISA is for the direct quantitative determination of Free Testosterone by enzyme immunoassay in human serum

If you do not have access to the most accurate assays (ED/UF) than you would need to use/rely upon the cFT method.

Using the cFTV with a high-end TT 735 ng/dL, lowish SHBG 16.9 nmol/L and Albumin 4.7 g/dL your FT 20.9 ng/dL would be high.

If your labs were done at the true trough than your TT/FT would be even higher.

But I can only wonder how it would feel if my free test was 10x bigger..

Not a chance in hell you would need to drive up your TT/FT any higher.

Dynex Technologies — ELISA Testing Systems

US-based manufacturer of fully automated ELISA processing systems for laboratories and research clinics of all sizes, including the DS2®, DSX®, and Agility® ELISA systems.

www.dynextechnologies.com

 

[madman]

Hello,

Started TRT 2 months ago, 120/week split in 2pins. My blood test came back today. Here is a before and after:

Test: 383 -> 735 Ng/Dl
Free Test: 7.1 -> 12.8 Pg/Ml
Conversion: 0.185% -> 0.136%
SHBG: 23 -> 16.9 Nmol/L
Albumin: 5.4 -> 4.7 G/Dl

Started with extremely low conversion of FREE T and was hoping it would balance with TRT. It got worse.
Shouldn't it be around 2% ?
SHBG and Albumin levels are on the lower end of the scale. Any other metric that influences the conversion?

As for how I feel on TRT: I am marginally more energic and have morning wood again. But I can only wonder how it would feel if my free test was 10x bigger..

Anyone that has seen this situation before? What should I do next? Thank you

Look over post #2/4/11

Direct Measurements of Free Hormones Using Mass Spectrometry-Based Methods

Only at Excel, are we gonna take you deep! Clinical Utility and Analytical Aspects of Direct Measurements of Free Hormones Using Mass Spectrometry-Based Methods (2022) Mark M. Kushnir, Heather A. Nelson, and Kelly Doyle Background The free hormone (FH) hypothesis states that hormone...

www.excelmale.com

 

[sammmy]

Something is going on with these free testosterone ELISA tests - the normal range listed as 1-28 pg/mL would look correct if it was ng/dL. I've noticed this several times already.

It is as if, someone got the units wrong long time ago and this error keeps perpetuating.

The bottom line is do not waste your money on free testosterone tests in Europe - doctors there know they are not reliable. Use the Vermeulen free testosterone calculator instead.

 

[vladgh]

Thank you all for your responses. I get it now. Kind of sucks that the labs in my country can't test these metrics properly. I will rely on the calculator to keep an eye on my free test.

Really appreciate this community.