High Free Testosterone level concerns?

HHH · Apr 28, 2015

What concerns are there for having high Free Testosterone scores above the normal limits after two months of TRT when Total T, Estradiol, Hematocrit levels are all as expected? What are the next tests to consider if any?

Vince · Apr 28, 2015

HHH, I don't think I would worry about it but here's a post on SHBG that you may find interesting
https://www.excelmale.com/forum/sho...an-one-increase-SHBG-when-it-is-too-low/page2

Gene Devine · Apr 28, 2015

What is your Total Serum level?

Normally I wouldn't worry about as long at Total is within the physiological range.

My Free is always over the reference range but Total within.

Vince Carter · Apr 28, 2015

People will say in fact I think I read it in Dr Crislers new book and I presume you're a low SHBG guy, like me, reason your Free T is high. The reasoning that high Free T could be something of concern is that you have a corresponding free Estrogen (or E2), as well, because SHBG binds them equally. So if one is high, so is the other, or can make it tough to manage E2 effectively.

But how high is "high"? Top of the range or off the charts? My direct Free is off the charts but I do well, its been long enough and enough experience with Anastrozole that I can manage my E2 pretty well.

HulkSmash · Apr 28, 2015

I had to clean this up a little. I apologize for that. I am having the same issues. I have my first consult with Dr. Saya on Monday. Hopefully we can get things straight, my estrogen rises along with my testosterone, and I do have lumps under both breasts. My current endo wants me to decrease my weekly dose to 80mg, but I think I was actually injecting 120-130mg because of the oil in the needle as well as syringe (I pulled it all back one day and it went down to the next tick mark (0.6,0.7). Here are my labs for no particular reason.

TESTOSTERONE,TOTAL - Final result (04/15/2015 12:00 AM CDT)
Component Value Range
Testosterone,Total 1159 (193-836 ng/dL)

FREE TESTOSTERONE ADULT MALE - Final result (04/15/2015 12:00 AM CDT)
Component Value Range
Testosterone,Free 277

ESTRADIOL (E2) - Final result (04/16/2015 12:00 AM CDT)
Component Value Range
Estradiol 48.0

FOLLICLE STIMULATING HORMONE - Final result (04/16/2015 12:00 AM CDT)
Component Value Range
FSH 0.1 mIU/mL

LUTEINIZING HORMONE - Final result (04/15/2015 12:00 AM CDT)
Component Value Range
Luteinizing Hormone <0.1 mIU/m

DHEA SULFATE - Edited Result - FINAL (04/15/2015 12:00 AM CDT)
Component Value Range
DHEA 189.0 (110-424 ug/dL)

THYROID STIMULATING HORMONE (THYROID STIMULATING HORMONE-TSH) - Final result (04/16/2015 12:00 AM CDT)
Component Value Range
TSH 3.2 (0.28-5.13 uIU/mL)

TOTAL T3 (TRIIODOTHYRONINE) - Final result (04/16/2015 12:00 AM CDT)
Component Value Range
T3 (Total) 1.13 (0.8-2 ng/mL)

FREE T4(FREE THYROXINE) (FREE T4 (FREE THYROXINE) ONLY) - Final result (04/16
/2015 12:00 AM CDT)
Component Value Range
T4-Free 0.88 (0.76-1.46 ng/dL)

PSA SCREEN - Final result (04/16/2015 12:00 AM CDT)
Component Value Range
PSA Screen 0.70 (0-4 ng/mL)

Notes from Endo:
"Your free testosteorne is also very high, DHEA-S is in normal range, I still feel that the current testosterone dose is too high which could pose you at risk of side effects. I think with the lower dose 0.4 mg (80 mg) weekly, your testosterone level would still be in an optimal range (somewhere around 450-800 ng/dl). I d recommend lower the dose to 0.4 mg (80 mg) weekly,and repeat labs in early June 2015, we can always adjust it again if the level is not optimal. Thank you."

one way step · Apr 28, 2015

How would one increase Free T?

Nelson Vergel · Apr 28, 2015

Increasing T dose decreases sex hormone binding globulin.

If you have low Vit D, taking 5000 IU of Vit D3 per day may also decrease SHBG.

Some doctors prescribe a mild androgen like Danazol to decrease SHBG.

Vince Carter · Apr 29, 2015

HulkSmash said:
I had to clean this up a little. I apologize for that. I am having the same issues. I have my first consult with Dr. Saya on Monday. Hopefully we can get things straight, my estrogen rises along with my testosterone, and I do have lumps under both breasts. My current endo wants me to decrease my weekly dose to 80mg, but I think I was actually injecting 120-130mg because of the oil in the needle as well as syringe (I pulled it all back one day and it went down to the next tick mark (0.6,0.7). Here are my labs for no particular reason.

TESTOSTERONE,TOTAL - Final result (04/15/2015 12:00 AM CDT)
Component Value Range
Testosterone,Total 1159 (193-836 ng/dL)

FREE TESTOSTERONE ADULT MALE - Final result (04/15/2015 12:00 AM CDT)
Component Value Range
Testosterone,Free 277

ESTRADIOL (E2) - Final result (04/16/2015 12:00 AM CDT)
Component Value Range
Estradiol 48.0

FOLLICLE STIMULATING HORMONE - Final result (04/16/2015 12:00 AM CDT)
Component Value Range
FSH 0.1 mIU/mL

LUTEINIZING HORMONE - Final result (04/15/2015 12:00 AM CDT)
Component Value Range
Luteinizing Hormone <0.1 mIU/m

DHEA SULFATE - Edited Result - FINAL (04/15/2015 12:00 AM CDT)
Component Value Range
DHEA 189.0 (110-424 ug/dL)

THYROID STIMULATING HORMONE (THYROID STIMULATING HORMONE-TSH) - Final result (04/16/2015 12:00 AM CDT)
Component Value Range
TSH 3.2 (0.28-5.13 uIU/mL)

TOTAL T3 (TRIIODOTHYRONINE) - Final result (04/16/2015 12:00 AM CDT)
Component Value Range
T3 (Total) 1.13 (0.8-2 ng/mL)

FREE T4(FREE THYROXINE) (FREE T4 (FREE THYROXINE) ONLY) - Final result (04/16
/2015 12:00 AM CDT)
Component Value Range
T4-Free 0.88 (0.76-1.46 ng/dL)

PSA SCREEN - Final result (04/16/2015 12:00 AM CDT)
Component Value Range
PSA Screen 0.70 (0-4 ng/mL)

Notes from Endo:
"Your free testosteorne is also very high, DHEA-S is in normal range, I still feel that the current testosterone dose is too high which could pose you at risk of side effects. I think with the lower dose 0.4 mg (80 mg) weekly, your testosterone level would still be in an optimal range (somewhere around 450-800 ng/dl). I d recommend lower the dose to 0.4 mg (80 mg) weekly,and repeat labs in early June 2015, we can always adjust it again if the level is not optimal. Thank you."

As a rule, E follows T, your estradiol read of 48 by any measure or test, is much too high. 21-30 is a typical goal. I wouldn't necessarily manage it with less T for that rule I mentioned. Most certainly you're going to need an AI to control E2, having lumps is a bad sign of out of control E2. Dr Saya will definitely take better care of you.

HulkSmash · Apr 29, 2015

Vince Carter said:
As a rule, E follows T, your estradiol read of 48 by any measure or test, is much too high. 21-30 is a typical goal. I wouldn't necessarily manage it with less T for that rule I mentioned. Most certainly you're going to need an AI to control E2, having lumps is a bad sign of out of control E2. Dr Saya will definitely take better care of you.

Absolutely. My thoughts are along the same lines as your's but for a little bit these doctors almost had me convince. I cannot wait to be totally under Dr Saya or Dr Crislers care. I'm not sure if you all have visited the site lately, but he is included as part of the staff now. Thanks for the feedback Vince, I now don't feel as insane about my interpretations as I once did. This site was a blessing in disguise for me to validate what I already knew. I used to follow Dr. Crislers protocols while on AAS cycles back in the day (way back) and my buddy didn't. Guess who looked and felt like Superman and who looked and felt like the stay puffed marshmallow man? I'm not advocating using supraphysiological doses of hormones, but I am saying that the HCG protocol and AI protocol (along with SERMS as needed) worked! I stopped doing that stuff to my body long long ago.

Vince Carter · Apr 29, 2015

I'll have my physical tomorrow afternoon and will have everything to submit to Defy and get on their program, it'll also be cheaper for me so I'm winning all the way around!