High bioavailable testosterone

[MMMM]

Male 50yo, generally in good shape slim and workout frequently. Never had T or steroids etc. Last two years started feel often irritated and like I lost some of my joy of life. Figured out it's T and went to get tested expecting low results and hoping for TRT.

To my surprise results show "abnormally high" bioavailable T. These results where then verified again. What can be going on here as these results don't seem to match my symptoms or age.

Testosterone 22.1 nmol/L
SHBG 47 nmol/L
Bioavailable testosterone 9.1 nmol/L (normal range 1.5-8.2)
FAI 47.0 %

 

[Systemlord]

Male 50yo, generally in good shape slim and workout frequently. Never had T or steroids etc. Last two years started feel often irritated and like I lost some of my joy of life. Figured out it's T and went to get tested expecting low results and hoping for TRT.

To my surprise results show "abnormally high" bioavailable T. These results where then verified again. What can be going on here as these results don't seem to match my symptoms or age.

Testosterone 22.1 nmol/L
SHBG 47 nmol/L
Bioavailable testosterone 9.1 nmol/L (normal range 1.5-8.2)
FAI 47.0 %

That’s not the uncommon to have Free T above normal, the top and bottom 2% are excluded from the normal ranges.

Your hormone panel is very limited, no DHT or estrogen testing.

TRT isn’t a panacea or quick fix.

 

[MMMM]

Thank you! Does this basically mean TRT is not for me ATM ?

(I assume estrogen is low as I have very low body fat and no real symptoms of too much estrogen)

 

[Systemlord]

Does this basically mean TRT is not for me ATM ?

No. I prefer a Free T measurement using the equilibrium dialysis method instead of the bioavailable test. The bio available T doesn’t always track well with Free T measurements, often showing a high value versus Free T.

I had your symptoms, lack of joy and irritability with Free T midrange.

(I assume estrogen is low as I have very low body fat and no real symptoms of too much estrogen)

I have seen members with very low body fat and high estrogen or high aromatizers.

 

[Systemlord]

Are you on any medications, like hair loss drugs?

 

[MMMM]

No no medications, just supps - fish oil, protein powder, creatine, vit D, minerals etc

What tests should I ask for ?

 

[Systemlord]

What tests should I ask for ?

Total T and Free T, equilibrium dialysis method. The Direct method shouldn't be used because it's known to be inaccurate.

If you run into resistance by your doctor, you can order it yourself.

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[MMMM]

OK thanks! apart from the equilibrium dialysis for T what test should I ask for Estrogen ? any other tests needed ?

 

[Cataceous]

It appears that the lab used the Vermeulen method to calculate bioavailable testosterone. Free testosterone is the more useful parameter. Your Vermeulen calculated free testosterone is 11.2 ng/dL, which is in the healthy normal range and makes it unlikely you would benefit from TRT.

It is reasonable to verify free testosterone with an accurate measurement. You might want to check the free thyroid hormones, fT3 and fT4. Also potentially of interest are CBC, CMP, lipids, estradiol, vitamin D status, prolactin and progesterone. If you're U.S.-based then Discounted Labs has some combination panels containing many of these. If LabCorp is more convenient than Quest then LEF is another source for such lab requisitions. If you wait a month or two they usually have a spring sale with good discounts.

 

[MMMM]

Thank you!