How lowering Test dosage increase my TT, Low SHBG guys this is for you, the less is the better!

[HealthMan]

Something I don't understand here. I just pulled out my last lab results from Quest Labs. Quest states that the Reference Range for Free Testosterone is 30.0 - 135.0 pg/mL. What am I missing?

Exactly! Read my post. Different methodologies. This is probably where the 54.7 number came from. If that 54.7 number was really comparable to labcorp numbers you would see A LOT of people with natural free T of 20+

 

[HealthMan]

Forgot to say that a lot can be physiologically possible. A gene mutation etc might make someone have FT of 60. So if you can find 10 people in the world with FT of 60 that means that 60 is a physiological value that applies to you and other people?? that is just wrong.
These are abnormalities.
Increase your dosage to achieve 54.7 FT (measure by labcorp) and in a few months check your cholesterol, HCT, estradiol, blood pressure etc. Chances are some (if not all) will be at unhealthy levels.
However i am sure you would have put a lot of muscle mass on

 

[madman]

Again, I did not share believes, I shared proof and rationale, read the post:
https://www.excelmale.com/forum/sho...levels-achieved-naturally&p=102943#post102943

As explained in the post, the top of the free T range in some countries like Spain is 42.5pg/ml, and ranges in other places ended at 54.7 pg/ml, therefore 54.7 pg/ml is a physiologically possible value, naturally (it was part of a range for a reason).
There is evidence of a general decline in T levels due to plastics, stress, lack of sleep, worse nutritional value of the food we eat, pollution, etc. If labs use sick people to determine ranges that does not reflect optimal levels that were possible 100 years ago.

Saying that > 25pg/ml is outside of the physiological range is therefore innacurate, as well as the Labcorp test being representative about what is physiologically possible. Those assumptions are wrong, and in the post referenced above you have anecdotal evidence of men walking around in the 1400s without TRT as well (also outside of Labcorp's range, interestingly).

Regardless even if a certain percentage of men in the past that may have naturally had total t/free t levels in the ranges you stated, TT 1543 ng/dl and free T 54.7 pg/ml.

Do understand that the natural circadian rhythm of a healthy young male where testosterone is highest (peaks) in the early am and declines throughout the day to lower (nadir) levels in the late afternoon/early evening is not comparable to trt.

Naturally testosterone levels peak and decline and the peaks are short lived as oppose to trt when ones reaches a steady state 24/7 (albeit minor fluctuations) especially when using injections as oppose to the patch or transdermal which would be the closest one could get to mimicking the natural circadian rhythm.

Even if the reference ranges have been lowered over time, an argument can easily be made for the lower end of the range being too low as oppose to the high end of the physiological range which has been lowered from 1200 to 900 (Labcorp).

Simply because trt is about replacement of ones testosterone to healthy levels within the physiological range to relieve/improve symptoms of low t and overall well being.

Whether that requires having ones testosterone levels in the mid-normal or high/normal physiological range.

Believe it or not if you search the literature many men see improvements in low t symptoms having trough levels just above >500 ng/dl and others need to have levels closer to the top end of the range.

Highly doubtful anyone would need to have a trough above 1000+ to experience relief from low t symptoms.

The average healthy young male has a total t of 600-800 ng/dl at peak.

 

[madman]

Again, I did not share believes, I shared proof and rationale, read the post:
https://www.excelmale.com/forum/sho...levels-achieved-naturally&p=102943#post102943

As explained in the post, the top of the free T range in some countries like Spain is 42.5pg/ml, and ranges in other places ended at 54.7 pg/ml, therefore 54.7 pg/ml is a physiologically possible value, naturally (it was part of a range for a reason).
There is evidence of a general decline in T levels due to plastics, stress, lack of sleep, worse nutritional value of the food we eat, pollution, etc. If labs use sick people to determine ranges that does not reflect optimal levels that were possible 100 years ago.

Saying that > 25pg/ml is outside of the physiological range is therefore innacurate, as well as the Labcorp test being representative about what is physiologically possible. Those assumptions are wrong, and in the post referenced above you have anecdotal evidence of men walking around in the 1400s without TRT as well (also outside of Labcorp's range, interestingly).

Before the industrial age total t/free t levels may very well have been higher compared to the top end of the physiological range now but as I stated comparing natural testosterone production (circadian rhythm) with steady state achieved by trt is not the same.

I think you would be hard pressed to find a man on trt with a testosterone peak of 1500+ let alone trough without negative issues regarding elevated e2/hematocrit/hemoglobin/possibly lipids (elevated ldl/lower hdl)!

 

[HealthMan]

Before the industrial age total t/free t levels may very well have been higher compared to the top end of the physiological range now but as I stated comparing natural testosterone production (circadian rhythm) with steady state achieved by trt is not the same.

I think you would be hard pressed to find a man on trt with a testosterone peak of 1500+ let alone trough without negative issues regarding elevated e2/hematocrit/hemoglobin/possibly lipids (elevated ldl/lower hdl)!

Very well said Madman

 

[Gianluca]

that's good point, I got confused last year as well when I tested with Quest, anyway My talking of FT levels refers to LabCorp ranges

You are wrong. Here we go:

> medical Definition of physiological. 1 : of or relating to physiology. 2 : characteristic of or appropriate to an organism's healthy or normal functioning.

> In health-related fields, a reference range or reference interval is the range of values for a physiologic measurement in healthy persons (for example, the amount of creatinine in the blood, or the partial pressure of oxygen).

https://en.m.wikipedia.org/wiki/Reference_range

Free Testosterone ranges are calculated using statistical normal range distributions. So they use a sample of the population and usually use 95% percentile to determine the range.

“Values outside a reference range are not necessarily pathologic, and they are not necessarily abnormal in any sense other than statistically. Nonetheless, they are indicators of probable pathosis.”

The study you showed that referenced normal upper range as 54.7 probably used a different methodology to calculate FT therefore not being comparable with Labcorp ranges. For example Quest reference range for FT is 35-155 pg/ml that does not mean FT upper range from Quest is more than 5x of Labcorp range. So the high value is probably due to a different methodology.

So the reference range is usually 95% percentile of the population which means that 2.5% of the population has levels above the upper range and 2.5% of the population has levels below the lower range. If you want to extrapolate that to 99% of the population you just need adjust the range by multiplying the z-value for the desired confidence levels by sample standard deviation divided by square root of sample size.

So physiological value is characteristic of a normal organism. A 99% percentile is very representative of a normal population. So you might be correct saying that stating that FT level above 25 is above physiological range might be incorrect. But if we adjust that upper range to 99 or even 99.9% of the population we will not get even close to 54.7.
I am using labcorp as an example because most here use labcorp. So again the higher reference ranges you saw are probably using a different methodology so not comparable.

You can find the plenty of studies in the internet calculating FT levels for healthy individuals, general population, and even broken down by age.

My educated guess based on some data i saw in some studies looking at FT levels for healthy individuals aged 25-34 (where testosterone levels are the highest) the most you can push FT to talk about normal physiological levels is 30 pg/ml using Labcorp methodology.

This is why most members here ask labwork to be posted with reference range.

I should have asked Bonneti which Laboratory he used before making any assessment.

And last. Yes 1400 i agree might be still considered physiological range (and I never said otherwise) But not 54.7 FT!!

 

[IronKnight]

The study you showed that referenced normal upper range as 54.7 probably used a different methodology to calculate FT therefore not being comparable with Labcorp ranges. For example Quest reference range for FT is 35-155 pg/ml that does not mean FT upper range from Quest is more than 5x of Labcorp range. So the high value is probably due to a different methodology.

You are confusing things again:

35-155 pg/ml suggests Bio available Testosterone (Free Testosterone + Testosterone bound to albumin", which could be used by the body later). Some labs call "Bio available Testosterone" "Free Testosterone" but it's really the full Bio available one.
"probably" = you are especulating, I'm not, all values provided refer to "Free Testosterone": 42.5pg/ml is the upper range Spain (this is fact, not opinion), 54.7pg/mL is or has been the upper range in other locations (this is also fact, not opinion). "Free Testosterone" is "Free Testosterone" and while different methodologies could result in different values you are again speculating and it's hard to justify an error from 30pg/ml to 54.7pg/ml. The decline in T levels due to pollution, soil and nutritional value degradation, rampant obesity, etc. is a much more logical and data-backed explanation.​

​

And last. Yes 1400 i agree might be still considered physiological range (and I never said otherwise) But not 54.7 FT!!

54.7 FT is the highest I could find evidence for, and is as real as the TT 1593 ng/dl, yes these are outliers but the values are naturally possible for genetically gifted individuals. I'm only talking about what has been proven to be physiologically possible through natural means, and I'm not interested in what the declining values of a largely obese, etc. population look like.

All that being said, madman has a point with T levels fluctuating during the day (that's fact also, not speculation) and we all must find a sweet spot level where we can feel good, manage the side effects and perhaps meet our body composition goals, as long as we stay within the real physiological boundaries (read: "naturally possible values").​

 

[HealthMan]

You are confusing things again:

35-155 pg/ml suggests Bio available Testosterone (Free Testosterone + Testosterone bound to albumin", which could be used by the body later). Some labs call "Bio available Testosterone" "Free Testosterone" but it's really the full Bio available one.
"probably" = you are especulating, I'm not, all values provided refer to "Free Testosterone": 42.5pg/ml is the upper range Spain (this is fact, not opinion), 54.7pg/mL is or has been the upper range in other locations (this is also fact, not opinion). "Free Testosterone" is "Free Testosterone" and while different methodologies could result in different values you are again speculating and it's hard to justify an error from 30pg/ml to 54.7pg/ml. The decline in T levels due to pollution, soil and nutritional value degradation, rampant obesity, etc. is a much more logical and data-backed explanation.​

​

54.7 FT is the highest I could find evidence for, and is as real as the TT 1593 ng/dl, yes these are outliers but the values are naturally possible for genetically gifted individuals. I'm only talking about what has been proven to be physiologically possible through natural means, and I'm not interested in what the declining values of a largely obese, etc. population look like.

All that being said, madman has a point with T levels fluctuating during the day (that's fact also, not speculation) and we all must find a sweet spot level where we can feel good, manage the side effects and perhaps meet our body composition goals, as long as we stay within the real physiological boundaries (read: "naturally possible values").​

So if you think 54.7 is physiological go ahead and have your levels there.
If your goal is to improve body composition by pushing FT higher thats fine. But don’t say that 54.7 FT is physiological it is not. Most of people trying to achieve this levels of FT (using labcorp as a reference) will have issues with HCT, cholesterol, blood pressure etc
You trying to say that FT at 54.7 is physiological hence it is fine to anyone try to achieve is detrimental to uninformed people that might read this information and try to achieve those levels on TRT

 

[HealthMan]

From labcorp website:

Methodology: Direct analog enzyme immunoassay (EIA)

https://www.labcorp.com/test-menu/35496/testosterone-free-direct

From Quest website:

Methodology: LC/MS/MS

https://www.questdiagnostics.com/testcenter/BUOrderInfo.action?tc=90572&labCode=DAL

 

[IronKnight]

So if you think 54.7 is physiological go ahead and have your levels there. Good luck in living a long life!

This is not something that I think, I have simply shared the facts with you.
For TRT we need to shoot for a level that is physiological AND where we can manage the side effects AND where we actually feel good AND maybe meet possible side goals like body composition.

re Quest vs. Labcorp: Again and from your links and ranges. Quest is measuring Bio available testosterone (including the one bound to albumin, and calling it "Free"), and LabCorp is measuring free Testosterone (Testosterone not bound to SHBG or albumin). My personal measurements and the ones I shared (i.e. 42.5pg/ml or 54pg/ml) are like LabCorp (direct free T).

I didn't mean to hijack this thread and we may talk about my health once my protocol is more stable and tuned in (hopefully in the next few months), will welcome your input

 

[HealthMan]

This is not something that I think, I have simply shared the facts with you.
For TRT we need to shoot for a level that is physiological AND where we can manage the side effects AND where we actually feel good AND maybe meet possible side goals like body composition.

re Quest vs. Labcorp: Again and from your links and ranges. Quest is measuring Bio available testosterone (including the one bound to albumin, and calling it "Free"), and LabCorp is measuring free Testosterone (Testosterone not bound to SHBG or albumin). My personal measurements and the ones I shared (i.e. 42.5pg/ml or 54pg/ml) are like LabCorp (direct free T).

I didn't mean to hijack this thread and we may talk about my health once my protocol is more stable and tuned in (hopefully in the next few months), will welcome your input

As long as you run labwork on a bunch of health parameters and they all come back “normal” it should be ok to push your FT higher way above lab ranges. Like you said you have to find a balance. What some people do they do the so called “blasts” while on TRT which are short cycles of supraphysiological testosterone levels.
My whole point is just to send a message that achieving 50+ FT levels on TRT is most likely not safe/healthy for most people. And that to achieve improvement of low T symptoms a FT of 17.5-22.5 should be more than enough. However a bunch of guys on TRT are more interested in body composition than anything else and push for higher dosages trying to find excuses to have their doctors prescribe such dosages. And then have issues with HCT, estradiol, blood pressure, lipids etc (not saying that these issues only happen with high dosages but are much more frequent)

I have been lifting weight for over 20 years and also had an interest in improving body composition. Before TRT my FT was below 10. And it has been as high as 37 and as low as 19 during TRT (measured on trough in a twice a week injection protocol). I can tell you that I haven’t noticed any difference at the gym or in body composition from 37 to 19 FT. Back in the day i did a few “cycles” using 500mg of testosterone a week and that yes had a huge impact on body composition.

 

[IronKnight]

I can tell you that I haven’t noticed any difference at the gym or in body composition from 37 to 19 FT. Back in the day i did a few “cycles” using 500mg of testosterone a week and that yes had a huge impact on body composition.

That is very interesting, do you know where your FT was when using 500mg of testosterone a week?
Also, are you aware of any studies that correlate FT with body composition? I found one that only mentioned Total T had to be > 950, but no clear FT mention. Thanks!

 

[HealthMan]

That is very interesting, do you know where your FT was when using 500mg of testosterone a week?
Also, are you aware of any studies that correlate FT with body composition? I found one that only mentioned Total T had to be > 950, but no clear FT mention. Thanks!

My TT was 3000-3500 and FT around 100 if i am not mistaken (it was a long time ago). I have seen some studies yes but i have to find them again. However TT and FT will correlate very well (specially when looking at supraphysiological values when it comes to body composition) but if you want to look at absolute values comparison then yes you would need to see a FT study.

 

[madman]

That is very interesting, do you know where your FT was when using 500mg of testosterone a week?
Also, are you aware of any studies that correlate FT with body composition? I found one that only mentioned Total T had to be > 950, but no clear FT mention. Thanks!

Sure when one is on trt there will be positive changes in body composition (increase muscle tissue -actin/myosin, intra- cellular water due to increased glycogen storage) and of course extra-cellular water due to water retention from elevated e2 (unless on is using an aromatase inhibitor).

The body composition changes on trt whether one has mid-normal physiological levels (total t/free t) or high-normal physiological levels (total t/free t) or even slightly above the top end of the physiological range will be nowhere comparable to one using steroid doses to attain supra-physiological levels.

On average most on trt are using anywhere from 100-150 mg/week of testosterone whether injected once weekly or split up into more frequent injections as every 3.5 days (common trt), M/W/F, EOD, or daily depending on one's SHBG among other things.

Most men injecting 100 mg/week will attain t levels in the mid-normal range whereas others may end up attaining high-normal t levels, of course, some men that are aiming for t levels on the higher end of the physiological range are usually injecting 120-150 mg/week and even than 150 mg/week will have most men's FT very high.

Sure there is a small percentage of men that need 200 mg/week on trt but it is rare and uncommon as 200 mg/week would put most men's levels into the higher supra-physiological range.

Of course, each individual responds differently to testosterone due to one's SHBG/sensitivity of the AR (androgen receptor)/polymorphism of the AR and CAG repeat lengths (short/long) and lastly regarding the negative effects one may encounter due to testosterones metabolites estradiol/dht are due to genetics as some experience sides even using lower trt doses and other can use higher doses before negative sides manifest.

One will definitely notice improvements in muscle gains/strength/recovery and fat loss on trt especially if diet/training are in check but a big increases in muscle/strength are only seen when one's testosterone levels are in the higher supra-physiological range as in 2000-5000 ng/dl and usually requires at a minimum of 250-600 mg/week of testosterone.

Mind you there are some that may consider 200 mg T/week a low-dose steroid cycle and there is a good percentage of men blessed with good genetics that will gain a lot of muscle on such a dose.

I would say most on trt that are into weight training and have a good diet/training protocol can make good gains in muscle/strength but to really see benefits one would need to blast/cruise which some choose to do or use high dosages of testosterone to attain higher supra-physiological levels as in many of the studies big gains in muscle mass are attained using 300-600 mg/week.

Trt doses of 100-150 mg/week will result in muscle gains but not as much as one using high doses of 300-600 mg/week.

Higher testosterone doses which result in very high supra-physiological T levels will cause much better gains in muscle/strength up to a point where the negatives (side effects) will outweigh the positive effects of the hormone and its metabolites.

Even then also do understand that even though one will build overall muscle mass faster when using supra-physiological doses of testosterone the quantity gains (intra/extracellular water, increased glycogen) will be noticed right away and the quality dry gains (actin/myosin) will be faster than when one has average natural testosterone levels but even on steroids gains in actin/myosin (muscle tissue) still takes time.

Always found it humorous when guys use steroids (cycling/blasting and cruising) and gain quite a large amount of muscle when in reality sure they have increased pure muscle gains in new tissue (actin/myosin) but at least 1/2 -3/4 of their gains can be from increased water weight (intra-cellular) due to increased glycogen storage and (extra-cellular) due to excess e2/retention of sodium which one pisses out when one's testosterone levels return to baseline after the cycle. Then the goal is pct if cycling to try and attain most of the muscle tissue or cruise back on lower doses (whether on trt or blasting/cruising) to keep the new gains (actin/myosin).

 

[Gianluca]

well said HealthMan, Lots of guys me included, when I had started, have the idea to keep levels as high as possible to achieve body composition benefits, than complain of high E2, go donate blood, use blood pressure meds, all wrong approach, thanks for sharing what was the different for you at the gym btw 19FT to 37

As long as you run labwork on a bunch of health parameters and they all come back “normal” it should be ok to push your FT higher way above lab ranges. Like you said you have to find a balance. What some people do they do the so called “blasts” while on TRT which are short cycles of supraphysiological testosterone levels.
My whole point is just to send a message that achieving 50+ FT levels on TRT is most likely not safe/healthy for most people. And that to achieve improvement of low T symptoms a FT of 17.5-22.5 should be more than enough. However a bunch of guys on TRT are more interested in body composition than anything else and push for higher dosages trying to find excuses to have their doctors prescribe such dosages. And then have issues with HCT, estradiol, blood pressure, lipids etc (not saying that these issues only happen with high dosages but are much more frequent)

I have been lifting weight for over 20 years and also had an interest in improving body composition. Before TRT my FT was below 10. And it has been as high as 37 and as low as 19 during TRT (measured on trough in a twice a week injection protocol). I can tell you that I haven’t noticed any difference at the gym or in body composition from 37 to 19 FT. Back in the day i did a few “cycles” using 500mg of testosterone a week and that yes had a huge impact on body composition.

 

[Re-Ride]

Something I don't understand here. I just pulled out my last lab results from Quest Labs. Quest states that the Reference Range for Free Testosterone is 30.0 - 135.0 pg/mL. What am I missing?

MyHealthOnline is currently reporting "standard range" Free T 35-155 pg/mL

My pre-TRT values in 2015 were Free=87.8 pg/mL with Tot T= 298 (240-871)

In 2016 I reported on these pages: 1133 / 325.4 No typo, F=325.4 pg/mL. Symptom resolution excellent , all chemistry lipids was close to textbook perfect.

At the time I could find no consensus here on what an upper limit free T should be. It wasn't in the Lab Corp information. Coastside replied to my thread, IIRC, "In Canada several leading experts are dismissing the direct tests and advising to go with calculated."

SHBG started at 22 and tapered down to 10 then recently increased to 13.3. I await the T/Free T assay results for that draw which is being done by LC/MS MS.

Other labs I have for TT and FT from 2015 to 2016 are all over the map with not believable ratios. IMO certain men should treat by symptom resolution rather than T FT numbers.

Standard Range240 - 871 ng/dL35.0 - 155.0 pg/mL

[TH="class: name fixed, align: left"]Name	[/TH] [TH="class: scroll, align: left"]2/10/15[/TH] [TH="class: scroll, align: left"]5/21/15[/TH] [TH="class: scroll, align: left"]9/8/15[/TH] [TH="class: scroll, align: left"]11/13/15[/TH] [TH="class: scroll, align: left"]12/1/15[/TH] [TH="class: scroll, align: left"]12/31/15[/TH] [TH="class: scroll, align: left"]1/19/16[/TH] [TH="class: scroll, align: left"]6/1/16[/TH] [TH="class: scroll, align: left"]11/7/16[/TH] [TH="class: scroll, align: left"]1/17/17[/TH] [TH="class: buffer scroll, align: left"][/TH]
[TD="class: name fixed"]Testosterone Total	[/TD] [TD="class: scroll"]298[/TD] [TD="class: scroll"]693[/TD] [TD="class: scroll"]541[/TD] [TD="class: rsltflag_4 scroll"]116 L[/TD] [TD="class: scroll"]725[/TD] [TD="class: scroll"]459[/TD] [TD="class: scroll"]429[/TD] [TD="class: scroll"]574[/TD] [TD="class: rsltflag_5 scroll"]1,133 H[/TD] [TD="class: rsltflag_5 scroll"]invalid[/TD] [TD="class: buffer rsltflag_5 scroll"][/TD]
[TD="class: name fixed"]Testosterone Free	[/TD] [TD="class: scroll"]87.8[/TD] [TD="class: scroll"][/TD] [TD="class: scroll"]113.4[/TD] [TD="class: scroll"][/TD] [TD="class: scroll"][/TD] [TD="class: scroll"]82.9[/TD] [TD="class: scroll"]17.2[/TD] [TD="class: scroll"]153.0[/TD] [TD="class: rsltflag_5 scroll"]325.4 H[/TD] [TD="class: scroll"][/TD]

 

[Olsman]

0,13ml daily is...

I have been trying everyday (ED) injection for the past 4/5 months, wow how the time goes by, Doc put me on 0,13ml daily, about 200mg weekly ..

Sorry, i haven¨t read the whole thread but I didn´t because the opening message.

Isn´t 0,13ml daily 0,91ml, then less than 100mg weekly?

Thank You!

 

[Vestpocket]

I agree with the bulk of the original poster's post, but one thing is not true. With low SHBG, testosterone will NOT lower SHBG further. In fact, for higher doses of testosterone, due to excess estradiol, SHBG will usually go up 1-3 nmol/L from the baseline.

In my case, it will start around 11-13 at low T doses, and go from 13-17 for high doses.

 

[Gianluca]

my T Cypionate is 200mg/ml so precisely is about 180mg, which is way too much for ED injections, at least for me

Sorry, i haven¨t read the whole thread but I didn´t because the opening message.

Isn´t 0,13ml daily 0,91ml, then less than 100mg weekly?

Thank You!

 

[Gianluca]

interesting feedback, I will test my SHBG again once I find the proper dose that work with no o little side effects to see what changed, by the way I gave up on AI since I lowered dose, that is another factor why mt TT increased for sure, didn't actually think about that.

Good point Vestpocket

I agree with the bulk of the original poster's post, but one thing is not true. With low SHBG, testosterone will NOT lower SHBG further. In fact, for higher doses of testosterone, due to excess estradiol, SHBG will usually go up 1-3 nmol/L from the baseline.

In my case, it will start around 11-13 at low T doses, and go from 13-17 for high doses.