Free vs. bioavailable testosterone

[HarveyMushman]

Hi folks....I'm just curious, isn't bioavailable more important than free T? I have used Discount Labs and am certainly happy with the service but they don't give you a bioavailable number.

Btw I have been on testosterone replacement for a little over a year and have struggled with getting the right mix of testosterone, Anastrozole and sublingual HCG. I have gained 20 lbs of fat, my blood pressure is higher now and while my testosterone levels are now at the upper end of the normal range, I haven't gained any strength or energy....I'm really confused and frustrated...

 

[Vince Carter]

Post your latest lab with ref ranges...there's more going on here than FT.

 

[ERO]

And be sure you check your SHBG next time if that was not checked on these labs.

 

[CoastWatcher]

Welcome to Excelmale. If you're testing via Discountedlabs.com, you're certainly measuring your estradiol via the appropriate procedure. Make sure any other assessment of your estradiol is the "sensitive" test (LC, MS/MS).

 

[HarveyMushman]

Thanks for the replies....
Well 8-21-15 my Hematocrit was 46.6 normal range (37.5-51), testosterone total was 1043 (348-1197) testosterone free 35.4 which was out of range (7.2-24) estrodial sensitive was 14.9 low end of range (8-35)
After these results I reduced my Anastrozole to 1/2 of a 1MG tablet every week.
I retested 10-9-15
My hematocrit was 51.1 just over the high end (37.5-51) and while my testosterone stayed high....total 961 (348-1197) free testosterone 31.2 still out of range (7.2-24) but my Estrodial sensitive shot up to 74.9 way out of range (8-35)...my doctor assumed this estrodial result had to be a lab mistake but I increased my Anastrozole to 1MG per week.
I'm going to have another test this week and figured I should check with you folks first.

Honestly if it wasn't for the supposed health benefits of higher T levels I would have quit this a long time ago....like I said I am sluggish and have gained 20 of fat and no strength....
Thanks for the help...
Tom

 

[ERO]

With your high Free T levels, I would bet that you have low SHBG. Guys with low SHBG typically do best injecting smaller amounts EOD or daily instead of once a week. Far less conversion to E2 and more stable T levels that way. I have low SHBG myself so I know it can be a challenge.

Do you have any Thyroid labs by chance?

 

[HarveyMushman]

I had my first blood test for all this 1-14-15 and at that time my SHBG was normal 32 (10-50) and my TSH T4 and T3 were all in the normal range and I take Iodoral iodine every other day.

I guess I should mention I am taking;
150MG of testosterone daily in a jojoba based cream
1/4 of a 1MG Anastrozole every other day
1/2 of a 1000 IU HCG sublingually ever fourth day

 

[ERO]

Interesting...your SHBG number is great and with the transdermal T, you are getting daily doses, plus you are getting high Total T levels on the transdermal - which dosen't happen for a lot of guys.

The only thing that seems amiss is the sub-lingual HCG. HCG is typically injected as I have read a few different places that sub-lingual does not work - E.G., the HCG is not absorbed and is not usable by the body in that format. Your AI dose is relatively high as well, but for guys that convert a lot to E2 it might be just right.

Since you have never really felt good on the transdermal T, have you considered trying twice weekly Test injections and injectable HCG for 6 weeks? I mean, you know what you are doing now is not really working so there is no real down-side.

 

[HarveyMushman]

I am confused about the sublingual HCG as well.....I believe it is working because my testosterone levels shot WAY up when I started taking it in June. I was taking 300MG of testosterone per day and had a total testosterone reading of 628 (348-1197) and then when I added the HCG my total testosterone shot up to 2941 (348-1197) or more than double the max of the range!!! I have obviously reduced my T cream and HCG since then. My testicles have not returned to normal size though....

I was really hoping to do all this without having to inject anything if I could avoid it...
Also I think the sluggishness may have something to do with the 20lbs I gained right away...I believe when my estrogen levels were out of wack. I have been 200lbs for years and go to the gym a couple times a week...no body builder but more muscular than the average 56 year old...the 20 lbs came on very fast...
I just recently started taking a small dose of Metformin 250-500MG also to maybe help with the weight.

 

[HarveyMushman]

I talked to a couple pharmacists who have many customers on sublingual HCG before I started taking it and they told me they have had very positive results with it.... but then I have read the opposite too ???

 

[ERO]

I think that the fact that all of the best TRT Docs use injectable HCG makes a strong case in it's favor. Sublingual HCG seems popular for weight-loss, but that typically goes along with a 500 calorie a day diet, so when folks lose weight ('Cause they are only eating 500 calories a day) they say, "See, sublingual HCG works great"

 

[CoastWatcher]

A thread with interesting commentary on oral HCG (including thoughts from Dr. Crisler).

https://www.excelmale.com/forum/showthread.php?4914-Oral-HCG&highlight=Hcg+sublingual

 

[HarveyMushman]

Thanks for all your input....I just can't get my head around why my testosterone shot up in June when I started taking the sublingual HCG and didn't change anything else....weird.....Btw the sublingual is cheaper too....I'm getting it compounded locally here in Santa Monica CA and it's only costing me $40. for 20 1,000 IU tablets which ends up being a 4 or 5 month supply....I keep it in the refrigerator...
I'm already out a lot of money on this "experiment".....lol...

 

[HarveyMushman]

I am going to get another blood test this week with Discount Labs and am getting CBC with hermatocrit, testosterone free and total and estrodial sensitive....

 

[Vince Carter]

150mg daily...daily...in a cream?

 

[ERO]

HarveyMushman - I think you may be missing the point. The point is that sub lingual HCG doesn't work, so getting it inexpensively is still no bargain.

 

[torrential]

HarveyMushman,

Your result of 2941 (348-1197) is erroneous. The sample was contaminated by the T cream.

Even though it is somewhere between unlikely and impossible that sublingual HCG caused it, if you think HCG had a significant impact while supplementing T it raises the possibility that you are secondary and may benefit from a stimulatory therapy or restart protocal (HCG mono, Clomid) rather than TRT.

Pharmacology says HCG is destroyed in the mouth. Injection is the only viable delivery method.

 

[HarveyMushman]

@vince.....Actually it is 200MG/ML I ML equals 4 clicks on the dispenser and I am using 3 clicks

@ERO With all due respect, I think you are missing the point...in June, my testosterone levels tripled and the only thing I changed was adding oral HCG. Unless the lab screwed up that is the fact....

@Torrential....I'm not sure what "secondary" means so I will have to look that up..

Thank you everyone for your imput.....I have to admit this is much more complicated than I thought it would be....

 

[Vince Carter]

No matter how you administer HCG it's not, at all, going to triple your endo-T. I'd call that lab error if a result tripled from one time to the next.

 

[HarveyMushman]

Thanks Vince....
I'm getting another blood test this afternoon...