High TT...Low FT

JimBob

Active Member
On 1/14/19 TT...603, FT...15.7
On 4/8/19 TT...711, FT...14.4

I'm not on TRT. I'm pretty sure no doctor would prescribe TRT with my TT numbers. But, can my FT be raised without TRT? I have no other lab numbers pertaining to SHBG, E2...I guess these are okay numbers for a 61 year old, but could they be better? As far as symptomology goes, morning wood doesn't occur much anymore, but, I don't have ED either. Increased irritability/anxiety/moodiness has increased substantially in the last 2 years. Maybe some other hormone imbalance?
 
Your numbers would point to likely fairly high SHBG.
If you are symptomatic then a knowledgeable and good doc would treat you.
The only way to overcome what is most likely high SHBG in order to increase your freeT is with exogenous testosterone.
I think it would be safe to assume that when you were optimal you were likely a decently high total T guy.
 
I'm on TRT and recently had labs drawn only to find Total T at 406 and Free T 16.0 (lower SHBG) and most definitely had symptoms. While your numbers appear to be normal, they may not be normal for you.

Normal for me must have been higher than normal for Free T which 2% of the population is known to be higher than normal. As men get older SHBG increases and Free T decreases, TRT is the only way to increase testosterone for older men.

No sick care doctor would prescribe TRT with your numbers because insurance will refuse coverage, but a private doctor who is cash pay only is another story.

Defy Medical or Prime Body would most likely prescribe TRT to folks in your situation.
 
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I see. Compared to the symptoms of others here, I would have to say mine are mild. I'm able to hit the gym 4 days a week and resistance train without much trouble recovering. I don't have the terrible fatigue that so many here report. It's mainly the irritability and temper which are new to me. Lots of negativity to go along with it.
 
Okay, last question. When FT is low, but E2 is elevated, won't exogenous testosterone drive the E2 up even further?

TRT it will increase estrogen and an aromatase inhibitor (Anastrozole) can block some of that estrogen, excess body fat can be the reason why estrogen is high, so losing the weight can go a long way towards lowering estrogen.

Some men are AI over-responders and need a small amount, .125 1-2x times per week. You should start on the lower end until you know how you respond to anastrozole.

Another method to lowering estrogen is frequent dosing, daily, every 2 day and every 3.5 day dosing will also go a long way towards lowering estrogen. More frequent the better in most cases.

Just make sure you use the correct test as Vince Carter pointed out, the E2 sensitive or LC/MS/MS method.
 
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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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