Low Free T with Very High Total T - Where to go now?

[DaytonaJonah]

A few months ago I looked over my past blood tests and found that my free T levels were 10% of what most men are posting here...and I have never felt dialed in. In times past, my Test-enanthate doses have ranged from 50mgs to 90mgs weekly and I've tried daily, EOD, E3.5D, & weekly.

With that background, about 12 weeks ago I decided to up my weekly dosage to see if I could get my free T off the mat and move the needle. So, I upped to 130mgs split every 3.5 days.

I had blood drawn yesterday at trough:

Total Test: 11.400 ng/mL ref. range 2.410 - 8.700
Free Test: 0.068 ng/mL ref. range 0.015 - 0.050
E2 Estro: 61.8 pgr/mL ref. range 7.6 - 42.6
Ferritin: 291.90 ng/mL ref. range 30.00 - 400.00
Hematocrit: 48.4%

One thing I learned here at Excelmale, is that most guys will report back as doing their best at or near 2% free T to total T. Well, my results show I'm only at approx. 25% of where it should be to reach that 2% ratio.

I still don't feel much better.

What could be causing such a suppression of free T in spite of such large amounts of total T?

For reference: Free T testing here used the "Chemluminscience" method. I live in an area in Mexico where we don't always have access to the most recent testing protocols, so I have to go off what is available along with my own "How do you feel" test.

 

[madman]

A few months ago I looked over my past blood tests and found that my free T levels were 10% of what most men are posting here...and I have never felt dialed in. In times past, my Test-enanthate doses have ranged from 50mgs to 90mgs weekly and I've tried daily, EOD, E3.5D, & weekly.

With that background, about 12 weeks ago I decided to up my weekly dosage to see if I could get my free T off the mat and move the needle. So, I upped to 130mgs split every 3.5 days.

I had blood drawn yesterday at trough:

Total Test: 11.400 ng/mL ref. range 2.410 - 8.700
Free Test: 0.068 ng/mL ref. range 0.015 - 0.050
E2 Estro: 61.8 pgr/mL ref. range 7.6 - 42.6
Ferritin: 291.90 ng/mL ref. range 30.00 - 400.00
Hematocrit: 48.4%

One thing I learned here at Excelmale, is that most guys will report back as doing their best at or near 2% free T to total T. Well, my results show I'm only at approx. 25% of where it should be to reach that 2% ratio.

I still don't feel much better.

What could be causing such a suppression of free T in spite of such large amounts of total T?

For reference: Free T testing here used the "Chemluminscience" method. I live in an area in Mexico where we don't always have access to the most recent testing protocols, so I have to go off what is available along with my own "How do you feel" test.

You had your FT tested using the direct immunoassay and even then it has your trough FT 0.068 ng/mL which is over the top-end of the reference range 0.015-0.050 ng/mL for that specific assay.

Your estradiol is high due to high FT.

Your hitting a very high trough TT 1140 ng/dL.

Where does your SHBG sit?

Have no idea where your SHBG sits as of now (you mention 39 nmol/L) in an older thread from 2022.

Even if your SHBG was high as in 60 nmol/L with a very high trough FT 1140 ng/dlL there is no way your FT would be low let alone sub-par.

Not a chance!

If we calculate your FT using the linear law-of-mass action cFTV with a very trough high TT 1141 ng/dL, throw in a high SHBG 60 nmol/L and use the default for Albumin 4.3 g/dL then your trough FT 19.3 ng/dL would be on the high-end.

 

[madman]

Where does your SHBG sit as of now?

 

[madman]

Older post from 2020 where your SHBG was sitting much lower around 26 nmol/L with a very high TT 954.8 ng/dL which has your estradiol high and more importantly your FT high!

Again if we use/rely upon the cFTV with a very high TT 954.8 ng/dL, SHBG 26.9 nmol/L use the default Albumin 4.3 g/dL your cFT 25.4 ng/dL would be high!

8 Months on Daily Scrotal T Cream, E2 Still High

Advice Needed From Others In The Same Boat... I've been on a daily regime of scrotal T cream application of 100mg and running my TT at around 950 ng/dL after about 8 solid months. My E2 has settled around 80 pg/ml and while I feel generally alright, I'm wishing for a better libido feeling...big...

www.excelmale.com

TT= 954.85 ng/mL
FT= 66.40 pg/mL
E2= 78.91 pg/mL
SHBG= 26.90 nmol/L

 

[DaytonaJonah]

Where does your SHBG sit as of now?

My SHBG in the past has ranged historically(appr. a 5 year period) between: 36-39 nmol/mL

My last SHBG test however was about 18 months ago, so not sure where it sits as of now. I will get it tested again this week.

 

[DaytonaJonah]

Older post from 2020 where your SHBG was sitting much lower around 26 nmol/L with a very high TT 954.8 ng/dL which has your estradiol high and more importantly your FT high!

Again if we use/rely upon the cFTV with a very high TT 954.8 ng/dL, SHBG 26.9 nmol/L use the default Albumin 4.3 g/dL your cFT 25.4 ng/dL would be high!

View attachment 44104

8 Months on Daily Scrotal T Cream, E2 Still High

Advice Needed From Others In The Same Boat... I've been on a daily regime of scrotal T cream application of 100mg and running my TT at around 950 ng/dL after about 8 solid months. My E2 has settled around 80 pg/ml and while I feel generally alright, I'm wishing for a better libido feeling...big...

www.excelmale.com

TT= 954.85 ng/mL
FT= 66.40 pg/mL
E2= 78.91 pg/mL
SHBG= 26.90 nmol/L

Madman, thanks for posting my old post! I don't have that test result in my records, so I didn't have it for reference.

 

[Systemlord]

I still don't feel much better.

Heavy metal toxicity will prevent one from feeling the effects of hormones, especially if you have low receptor density. I’m sure there are other medical conditions that will do the same.

 

[DaytonaJonah]

Older post from 2020 where your SHBG was sitting much lower around 26 nmol/L with a very high TT 954.8 ng/dL which has your estradiol high and more importantly your FT high!

Again if we use/rely upon the cFTV with a very high TT 954.8 ng/dL, SHBG 26.9 nmol/L use the default Albumin 4.3 g/dL your cFT 25.4 ng/dL would be high!

View attachment 44104

8 Months on Daily Scrotal T Cream, E2 Still High

Advice Needed From Others In The Same Boat... I've been on a daily regime of scrotal T cream application of 100mg and running my TT at around 950 ng/dL after about 8 solid months. My E2 has settled around 80 pg/ml and while I feel generally alright, I'm wishing for a better libido feeling...big...

www.excelmale.com

TT= 954.85 ng/mL
FT= 66.40 pg/mL
E2= 78.91 pg/mL
SHBG= 26.90 nmol/L

Going back in time to my old test results...if I take my FT at 66.40 pg/mL and convert to ng/dL it gives only 6.64 ng/dL...and that is a very big difference from the calculated FT. I know the debate re calculations, gold-standard tests, sub-standard tests...but, even though the "calculated" FT was in a high range, I still didn't have any real positive results in how I felt. Still lacking libido.

I've used the calculation method to determine its FT for my TT trough numbers in the past and none of them have correlated to feeling "dialed in".

I feel I'm shooting at a moving target. When I read reports of others who have reached 14-18 ng/dL of FT on trough testing and they say: "Man, I feel great and my FT is around 2% of my overall TT amount...", what FT testing method are they using???

 

[madman]

Going back in time to my old test results...if I take my FT at 66.40 pg/mL and convert to ng/dL it gives only 6.64 ng/dL...and that is a very big difference from the calculated FT. I know the debate re calculations, gold-standard tests, sub-standard tests...but, even though the "calculated" FT was in a high range, I still didn't have any real positive results in how I felt. Still lacking libido.

I've used the calculation method to determine its FT for my TT trough numbers in the past and none of them have correlated to feeling "dialed in".

I feel I'm shooting at a moving target. When I read reports of others who have reached 14-18 ng/dL of FT on trough testing and they say: "Man, I feel great and my FT is around 2% of my overall TT amount...", what FT testing method are they using???

TT= 954.85 ng/mL
FT= 66.40 pg/mL
E2= 78.91 pg/mL
SHBG= 26.90 nmol/L



As I have stated numerous times on the forum if you do not have access to the most accurate assays (Equilibrium Dialysis or Ultrafiltration) for testing FT then you need to use/rely upon the cFTV.

The direct immunoassay should not be used.

Again with a very high TT 954.8 ng/dL, normalish SHBG 26.9 nmol/L, and default Albumin 4.3 g/dL your cFTV 25.4 ng/dL would be high!

No way in hell that someone hitting a TT almost 1000 ng/dL with normal SHBG is going to have low let alone sub-par FT!

Again even if one had high SHBG 60 nmol/L with a TT 1000 ng/dL their FT 16.3 ng/dL would still be healthy.

Most healthy young males are hitting a cFTV 13-15 ng/dL and this is at the short-lived peak!

 

[DaytonaJonah]

Here where I live, none of the clinics use cFTV testing. To access that, or the possibility of Equilibrium Dialysis or Ultrafiltration methods, is a 4-hour drive away to Guadalajara. So, that just isn't going to happen.

 

[madman]

My SHBG in the past has ranged historically(appr. a 5 year period) between: 36-39 nmol/mL

My last SHBG test however was about 18 months ago, so not sure where it sits as of now. I will get it tested again this week.

As I already stated find out where your SHBG currently sits and use the free testosterone calculator (cFTV)!

Free & Bioavailable Testosterone calculator

Plug in your current very high trough TT 1140 ng/dL, SHBG ? and Albumin to get your trough FT.

 

[madman]

Here where I live, none of the clinics use cFTV testing. To access that, or the possibility of Equilibrium Dialysis or Ultrafiltration methods, is a 4-hour drive away to Guadalajara. So, that just going to happen.

It is available online for free!

Free & Bioavailable Testosterone calculator

 

[DaytonaJonah]

Okay, got it.