Help - Conflicting Testosterone Test Results - Salvia vs Blood Test

[jriptide]

I am hoping someone can shed some light on blood vs saliva testing of Testosterone levels.
I just had my testosterone level checked via a saliva test, the results were over 2000 > (not sure of the units used) , which my “new” doctor told me were way too high. However just a week earlier I had a blood test to measure my testosterone after being on a 5 g of gel (50 mg) for 2.5 months and my testosterone increased from 8.1 to 12.6 nmol/L. Which to me seems still too low for a 49 year that regularly weight lifts.

My concern is that based on the saliva test results my new doctor wants to cut my Androgel dosage from 50mg to 10mg. But if you look at my blood tests instead of the saliva tests, logic would lead one to believe my Androgel dosage should be increased not decreased. My “new” doctor dismissed blood tests as a not an effective way of measuring testosterone, stating saliva is far more accurate. I asked him why doctors used blood tests for Testosterone and he said he had no idea. I have provided my Testosterone tests below to provide some history. I am worried going on this lower dosage will make me feel like crap again maybe even worse as my testicles have shrunk to half size since going on Gel. I went to this new Doctor as he works at clinic that specialized in hormone balance. I also have thyroid issues and was diagnosed hypothyroid back in 2005.

Here is a list of my blood results

March 26 2017 – Saliva Hormone Test included Testosterone = <2000 (not sure of what units were used but my results exceeded upper test limit for Saliva test)

March - 21 2017 - Testosterone 12.7 nmol/L – Switched to 50mg gel after pills had very little impact on my testosterone levels.

January 2017 - Testosterone Test Results -= 8.1 nmol/L – TRT Medications - pms-Testosterone (testosterone undecanoate) 40mg pills – 3 pills a day for 1.5 years -

May – 2015 - Test Results = 7.4 nmol/L - First diagnosed Low Testosterone

Note I am requesting my full saliva lab results as the doctor did not give them to me just let me see them. But I can share that the results showed I was too low on DHEA, Progesterone and E1 ,E2 , and E3. While also being too high on Testosterone and Androstenedione.
One thing I wondered about was contaminated the salvia sample by potentially getting gel residue on my hands and transferring to my salvia while holding the tubes as I spit in them. My new doctor said that was a possibility but said that does not explain the high Androstenedione results.

 

[johndoesmith]

I am hoping someone can shed some light on blood vs saliva testing of Testosterone levels.
I just had my testosterone level checked via a saliva test, the results were over 2000 > (not sure of the units used) , which my “new” doctor told me were way too high. However just a week earlier I had a blood test to measure my testosterone after being on a 5 g of gel (50 mg) for 2.5 months and my testosterone increased from 8.1 to 12.6 nmol/L. Which to me seems still too low for a 49 year that regularly weight lifts.

My concern is that based on the saliva test results my new doctor wants to cut my Androgel dosage from 50mg to 10mg. But if you look at my blood tests instead of the saliva tests, logic would lead one to believe my Androgel dosage should be increased not decreased. My “new” doctor dismissed blood tests as a not an effective way of measuring testosterone, stating saliva is far more accurate. I asked him why doctors used blood tests for Testosterone and he said he had no idea. I have provided my Testosterone tests below to provide some history. I am worried going on this lower dosage will make me feel like crap again maybe even worse as my testicles have shrunk to half size since going on Gel. I went to this new Doctor as he works at clinic that specialized in hormone balance. I also have thyroid issues and was diagnosed hypothyroid back in 2005.

Here is a list of my blood results

March 26 2017 – Saliva Hormone Test included Testosterone = <2000 (not sure of what units were used but my results exceeded upper test limit for Saliva test)

March - 21 2017 - Testosterone 12.7 nmol/L – Switched to 50mg gel after pills had very little impact on my testosterone levels.

January 2017 - Testosterone Test Results -= 8.1 nmol/L – TRT Medications - pms-Testosterone (testosterone undecanoate) 40mg pills – 3 pills a day for 1.5 years -

May – 2015 - Test Results = 7.4 nmol/L - First diagnosed Low Testosterone

Note I am requesting my full saliva lab results as the doctor did not give them to me just let me see them. But I can share that the results showed I was too low on DHEA, Progesterone and E1 ,E2 , and E3. While also being too high on Testosterone and Androstenedione.
One thing I wondered about was contaminated the salvia sample by potentially getting gel residue on my hands and transferring to my salvia while holding the tubes as I spit in them. My new doctor said that was a possibility but said that does not explain the high Androstenedione results.

So a saliva test showed high levels, while blood tests, which are the gold standard showed low normal testosterone levels that are usually found with guys on gels?

Seems pretty simple to me, especially because no one else uses saliva tests for testosterone. They suck.

 

[Vince Carter]

No one here is using saliva it's just not reliable, as JDS states blood is the standard here.

 

[madman]

Run it must be a quacky bio-identical hormone so called specialist, they rely only on saliva and the levels you will achieve through saliva testing will never allow you to reach true effective serum levels. I originally tried a bio identical specialist and she wanted to start me on 10mg compounded topical testosterone cream, what a joke. Most males will need anywhere from 50-100mg of a topical to reach mid/high normal range for testosterone barring they even respond well to the topical as many have absorption issues and even than many end up switching to injections. On 5mg of androgel/day your total went from 8.1-12.6 nmol/L you are still in the grey zone as far as levels and definitely need to have your dose increased to 10mg of androgel/day to see if that dose can get you into the mid/high normal range and achieve relief of your low t symptoms and you may eventually need to switch to injections if 10mg can not get your levels into a healthy range which relieves your symptoms. Run from this quack and do not look back, seek better care!

 

[jriptide]

Thank you for all the responses.

I would agree it seems obvious that the blood tests should trump the saliva tests. I was looking for confirmation that my lab results (Testosterone > 2000 pg/ml) don't add up based on my Androgel dosage of 50mg while also according to the saliva tests being low on DHEA (0.1ng/ml) and Progesterone (1pg/ml). At the same time low E2 <1.0 pg/ml and E3 <1.0 pg/ml .

Note Madman you nailed it about the doctor I went to being a so called "Hormone Expert" . I went to him because I could not find a good TRT doctor local (Victoria, Canada) and because my family doctor put me on Testosterone, but did not believe it was necessary to monitor other hormones other than Testosterone. I was worried I could end up converting to much T to Estrogen and also wanted to see about doing a better job tracking my Hypothyroidism.

 

[CoastWatcher]

I am in Toronto, and realize how hard it is to find capable TRT care if one lives in Canada. My own doctor has met a Victoria urologist, Dr. Peter Pommerville, who has been quoted as being an advocate of TRT. Does she know how he practices? No. It may be a name you wish to consider.

 

[jriptide]

I am in Toronto, and realize how hard it is to find capable TRT care if one lives in Canada. My own doctor has met a Victoria urologist, Dr. Peter Pommerville, who has been quoted as being an advocate of TRT. Does she know how he practices? No. It may be a name you wish to consider.

Thanks Coastwatcher, I read a local newspaper article that quoted Dr Pommererville regarding TRT, I was also looking at Dr David Miller, as Pommerville does not get great reviews on ratemds.com but will dig deeper.