Help with the wife's labwork

lestat210

New Member
I'm currently on TRT, and feel great, no issues. My wife is also on an HRT protocol with a local doc, and has been for the past eight years or so. For the last several years, she's been great. However, these last 6 months has seen her mental state and energy levels be very inconsistent. She's down more days than she's up. She's extremely fit, very slim, eats well and performs at least an 45 minutes of a cardio activity every day. Her libido is very hit and miss.

I asked to see her labs and was shocked at her T values. Are these accurate, as far as the units of measure? I'm fairly adept at reading my own labs (I've been on T for over a decade), but I'm not sure about my counterparts results.
Can one of you gurus take a quick look and let me know what stands out to you, if anything?? I'm all about treating symptoms and not numbers, but some of these values seem excessive to me for a female.

Thank you very much in advance


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Sorry, for to mention a few things. She's 54, and went through peri-menopause back in 14.

Let me know if I need to provide any additional details.

Thank you.
 
At first glance I'd say that total testosterone is way up there for a woman. The high SHBG is only part of the explanation. They are using the Vermeulen method to calculate free testosterone of 17.9 pg/mL. If you assume that number is correct and consider a midrange SHBG level of 70 nMol/L then total testosterone drops to 160 ng/dL, which is still excessive. If you want more certainty then you could measure free testosterone by equilibrium dialysis. But I don't think it's a close call: she's getting too much testosterone.

I don't know what good practice is with respect to progesterone and estradiol levels, so can't comment there. DHEA-S doesn't worry me too much because the range is age-adjusted, and it may be okay to have more youthful levels.

Clearly the B-12 is excessive and any supplementation should be reduced. Same with the vitamin D:
 
It's not uncommon to have post menopausal women run a bit higher on T than standard levels. My wife is 55 and also on HRT. The higher T levels seem to help in many regards (workouts, libido, body composition). However, she has struggled a bit the last six months with minor bleeding. She was checked out by her hormone doc and OB GYN, and it is likely due to imbalanced levels of Progesterone and Estrogen. She is on Progesterone pill and E pellet. She has blood work coming up this month and is going to express her concern about this side effect.

I will look up her T levels for a comparison when I get home, but your wife's seem more in line with a male. Is she on pellets?

Sorry I can't be more help. In my experience, it seems more difficult to dial in the ladies on HRT than the men.
 

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TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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