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<blockquote data-quote="madman" data-source="post: 273932" data-attributes="member: 13851"><p>Was your blood work done in the early AM in a fasted state?</p><p></p><p>Did you have your FT tested using an accurate assay (Equilibrium Dialysis or Equilibrium Ultrafiltration)?</p><p></p><p>You need to post the testing method (calculated, direct immunoassay, ED, or UF) along with the reference ranges.</p><p></p><p>The only way to know where your FT level truly sits is to have it tested using what would be considered the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration, especially in cases of altered SHBG.</p><p></p><p>Most of the endos we consider clueless should still know this as it has been hammered home by the Endocrine Society for years!</p><p></p><p>Chances are your FT was tested using the calculated linear law-of-mass action Vermeulen (cFTV).</p><p></p><p>If we plug in your descent TT 525 ng/dL, high SHBG 62 nmol/L, and Albumin 4.3 g/dL (default) your FT 7.22 ng/dL would be close to the bottom-end and far from stellar but not flagged as low.</p><p></p><p>FT 5 ng/dL or < would be considered low.</p><p></p><p>Keep in mind that cFTV tends to overestimate when compared to a standardized Equilibrium Dialysis assay so your FT level may very well be somewhat lower.</p><p></p><p>Either way, your FT level is well under where a healthy young male would sit which would be 13-15 ng/dL when using/relying upon the cFTV method.</p><p></p><p>Again even though you are hitting a descent TT your FT is sub-par seeing as you have high SHBG.</p><p></p><p></p><p>[ATTACH=full]40696[/ATTACH]</p><p></p><p></p><p>Also, keep in mind that it would be wise to rule out any dysfunctional thyroid/adrenals that can easily mimic low-t symptoms let alone hinder the effectiveness of a TRT protocol.</p><p></p><p>Need a more thorough set of labs which should include estradiol, LH/FSH, prolactin, and CBC.</p><p></p><p>Either way, your FT is far from stellar.</p><p></p><p></p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/threads/a-high-throughput-method-for-accurate-measurement-of-ft-in-serum-using-ed-coupled-with-id-uhplc-ms-ms.28949/[/URL]</p><p></p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/threads/discrepancies-in-four-algorithms-for-the-calculation-of-free-and-bioavailable-t.28865/[/URL]</p></blockquote><p></p>
[QUOTE="madman, post: 273932, member: 13851"] Was your blood work done in the early AM in a fasted state? Did you have your FT tested using an accurate assay (Equilibrium Dialysis or Equilibrium Ultrafiltration)? You need to post the testing method (calculated, direct immunoassay, ED, or UF) along with the reference ranges. The only way to know where your FT level truly sits is to have it tested using what would be considered the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration, especially in cases of altered SHBG. Most of the endos we consider clueless should still know this as it has been hammered home by the Endocrine Society for years! Chances are your FT was tested using the calculated linear law-of-mass action Vermeulen (cFTV). If we plug in your descent TT 525 ng/dL, high SHBG 62 nmol/L, and Albumin 4.3 g/dL (default) your FT 7.22 ng/dL would be close to the bottom-end and far from stellar but not flagged as low. FT 5 ng/dL or < would be considered low. Keep in mind that cFTV tends to overestimate when compared to a standardized Equilibrium Dialysis assay so your FT level may very well be somewhat lower. Either way, your FT level is well under where a healthy young male would sit which would be 13-15 ng/dL when using/relying upon the cFTV method. Again even though you are hitting a descent TT your FT is sub-par seeing as you have high SHBG. [ATTACH type="full" alt="Screenshot (32087).png"]40696[/ATTACH] Also, keep in mind that it would be wise to rule out any dysfunctional thyroid/adrenals that can easily mimic low-t symptoms let alone hinder the effectiveness of a TRT protocol. Need a more thorough set of labs which should include estradiol, LH/FSH, prolactin, and CBC. Either way, your FT is far from stellar. [URL unfurl="true"]https://www.excelmale.com/threads/a-high-throughput-method-for-accurate-measurement-of-ft-in-serum-using-ed-coupled-with-id-uhplc-ms-ms.28949/[/URL] [URL unfurl="true"]https://www.excelmale.com/threads/discrepancies-in-four-algorithms-for-the-calculation-of-free-and-bioavailable-t.28865/[/URL] [/QUOTE]
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