Good Total T with Low Free T.

[busydad]

Should I just disregard the total T number, as my free T is on the low side and I'm pretty symptomatic with low energy (even though I sleep well), no libido, no morning wood, hard to get / maintain erections even with cialis (no desire), sometimes irritable, sometimes depressed. They didn't check my SHBG this time though its been high in the past. My LH and Estridiol are very high.

 

[Vince]

If you can tolerate Viagra/ Cialis It will lower your estrogen and increase your testosterone levels . Also good levels of magnesium will improve your free testosterone.

Magnesium increases free testosterone primarily by inhibiting sex hormone-binding globulin (SHBG), a protein that binds to testosterone and makes it inactive. By reducing the amount of bound testosterone, magnesium ensures that more free, usable testosterone is available in the bloodstream.

 

[WhiteMale]

Indicative of high SHBG and agree your E is the more likely driver in your symptoms than Free/Total T but it all goes hand-in-hand. I think it's silly to think Cialis/Viagra is going to push down your Estradiol that's just forum non-sense.
Everyone is typically deficient on Mag.

 

[Systemlord]

You’re severely estrogen dominant. If your C-reactive protein marker is elevated and you use the standard non-sensitive estrogen test it’s going to show a false high value.

What’s your height and body weight?

Any supplementation, vitamins, minerals, medications or hair loss drugs?

 

[busydad]

You’re severely estrogen dominant. If your C-reactive protein marker is elevated and you use the standard non-sensitive estrogen test it’s going to show a false high value.

What’s your height and body weight?

Any supplementation, vitamins, minerals, medications or hair loss drugs?

I'm 5' 11" currently 217lbs. I've lost about 60 lbs in the past 3 years, but my labs have always looked similar to this. The values may change, but I'm always decent Total T, Low Free T, High SHBG, High Estridiol, and High FSH and LH.

No supplements except for a couple of protein shakes.

I already take Cialis daily 5mg.

 

[madman]

I'm 5' 11" currently 217lbs. I've lost about 60 lbs in the past 3 years, but my labs have always looked similar to this. The values may change, but I'm always decent Total T, Low Free T, High SHBG, High Estridiol, and High FSH and LH.

No supplements except for a couple of protein shakes.

I already take Cialis daily 5mg.

Should I just disregard the total T number, as my free T is on the low side and I'm pretty symptomatic with low energy (even though I sleep well), no libido, no morning wood, hard to get / maintain erections even with cialis (no desire), sometimes irritable, sometimes depressed. They didn't check my SHBG this time though it's been high in the past. My LH and Estridiol are very high.

I'm 5' 11" currently 217lbs. I've lost about 60 lbs in the past 3 years, but my labs have always looked similar to this. The values may change, but I'm always decent Total T, Low Free T, High SHBG, High Estridiol, and High FSH and LH.


Although TT is important to know FT is what truly matters as it is the active unbound fraction of T responsible for the positive effects.

Most likely mild or subclinical primary hypogonadism (also called compensated hypogonadism).

* High FSH levels indicate seminiferous tubule dysfunction (reflecting reduced inhibin B negative feedback) and impaired sperm production but is a more sensitive indicator of primary testicular dysfunction than high LH levels. If high LH and FSH are measured in the same sample as an initial testosterone measurement, men with normal serum testosterone with high LH and/or FSH concentrations might be identified. These men have mild or subclinical primary hypogonadism (also called compensated hypogonadism), analogous to subclinical hypothyroidism.

Robust TT inflated due to high SHBG with a lowish/low FT.

Even then with a robust TT, high SHBG and the symptoms you are having keep in mind you never had your FT tested using an accurate assay.

No one should be using/relying upon the known to be inaccurate immunoassay.

You would need to have your FT tested using what would be considered the most accurate assay the gold standard Equilibrium Dialysis especially in cases of altered SHBG to know where it truly sits.

This is the panel you want which tests using the most accurate assays for TT (LC/MS-MS) and FT (Equilibrium Dialysis).

Testosterone, Free (Equilibrium Dialysis) and Total, MS | Discounted Labs

Get an affordable and accurate testosterone test results with our Total Testosterone, M and Free (Equilibrium Dialysis) test. Visit DiscountedLabs.com for more information.

www.discountedlabs.com

Moving forward if you end up starting therapy make sure you always test your TT/FT using the most accurate assay.

Post in thread 'Regular testosterone test overestimates hypogonadism in men compared to the LC-MS/MS assay'

May 18, 2025

@madman

Could I get your opinion on these values, as to whether one would consider TRT? And why my LH and FSH are high?

Hematocrit 43.7

Estradiol 14 pg/mL (Ultrasens,LC/MS)

FSH 21.5 mIU/mL
LH 14.7 mIU/mL

PSA 0.20 ng/mL

Testosterone, Total 764 ng/dL (MS)
Testosterone, Free 90.2 pg/mL (dialysis)

SHBG 58 nmol/L

I would say mild or subclinical primary hypogonadism (also called compensated hypogonadism).

Robust TT...

• madman

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[madman]

If you can tolerate Viagra/ Cialis It will lower your estrogen and increase your testosterone levels . Also good levels of magnesium will improve your free testosterone.

Magnesium increases free testosterone primarily by inhibiting sex hormone-binding globulin (SHBG), a protein that binds to testosterone and makes it inactive. By reducing the amount of bound testosterone, magnesium ensures that more free, usable testosterone is available in the bloodstream.

Need to renege on that one!

You should know better that this is far from a given.

Some critical info here!

Small number of patients to boot LOL!


* In our study we observed a significant decrease of plasma E levels AFTER A TREATMENT PERIOD OF 12 MONTHS with tadalafil on demand at a flexible dosage (5, 10, and 20 mg), with a significant increase in T:E ratio, although no changes in T and fT serum levels were observed.

* In this study we show for the first time a REDUCTION IN E LEVELS in patients with ED AFTER CHRONIC EXPOSURE TO TADALAFIL and a concomitant increase in the T:E ratio. This hormonal pattern was found MOSTLY IN LEAN SUBJECTS , independent of the etiology of ED, comorbidities, and concomitant drug treatments.

* In conclusion, in this study we demonstrated that LONG-TERM ADMINISTRATION OF TADALAFIL is ASSOCIATED with increase in T:E ratio mainly due to significant reduction of E levels.

* ANY PRESUMABLE EFFECT OF PDE5i ON AROMATASE ACTIVITY SHOULD BE FURTHER CONFIRMED WITH BOTH IN VITRO AND IN VIVO STUDIES because it MAY open a new research avenue




post #4/6

Post in thread 'Cialis Lowered Libido?'

Oct 14, 2024

Hey there, to get right to it I took 20mg before an outing with a girl last weekend as some insurance. Oddly enough before taking the Cialis libido felt strong, and erections were normal, but about an hour after taking it I noticed my libido start to fade. This is resulted in inability to come to orgasm. While I know Cialis can cause delayed ejaculation I always just assumed it was due to reduced sensitivity. Is there any evidence that there is more going on causing this i.e. increased prolactin, significantly lowered estrogen (although even with low estrogen I've never had this issue)...

• madman

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