Low serum. Normal free?

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Tjay

New Member
Hi guys!

1st post have been reading for a while. Here goes....

I went the route of many. I was told I was low normal mid 30's and basically ignored it. I am over weight 30 bmi, used to be a heavy drinker and have a very irregular sleep schedule because of my career. My thinking at the time was I'll just lose some weight and all will be well.

Fast forward 7 years. I'm 43, still over weight, same career issues, but less drinking. I went for my 1st exam after 7 years and was told I was low T and had sleep apnea. I had been tired, fatigued , had brain fog, emotional issues, poor workout recovery and a tad lower libido. My equipment still worked and often just not as well.

I got a cpap for sleep apnea hoping it would correct issues, but no go.

So my gp starts me on trt. Started at about 230 serum test. Nothing else was checked. I didn't know any better at the time? Figured my Doc knew what he was doing? 100mg test cypt 1x per week for 8 weeks. New labs numbers close to 500. Backed off to 100mg 1x every 2 weeks. That's when thing started going south. Sore nips, extreme emotions and a couple anxiety attacks out of the blue. Had never experienced that before?

So I start doing my own research on here and other places. Bought a few books. Gained some knowledge . Figure my estrogen had spiked? (FYI if that was what it is like to be a women I take back anything and everything I have every said about any woman ever. Including my 2 ex wives lol.)

So I plead with my doc for additional labs and a AI. No go he keep up his protocol and tells me after more labs he wants to scale back to once a month!

At this point I break out all my own research and books. He throws his hand in the air and says either I take the anti depressents he keeps trying to shove down my throat or he is going to refer me to someone else. I say refer me I'm not depressed, something is wrong!

The referral process takes 2 months. During that time I'm off trt. I get past the Roller coaster and am back where I started.

The new anti aging doc is a little more knowledgeable but still doesn't do all the labs recommended on here. What I did learn after two months off trt...250 serum test, 11ng free, E2 23 and prostate numbers 1.0.

So I now realize I don't have the complete picture. My question is how is my serum low, but my free is in the "normal" range? Doc said I was one of the best converters of natural test he had every seen?

He agreed I should should shoot for 800-1000 serum for now. Three months then retest. Started me on 100mg test cypt, 1mg armidex and hcg per week?

Is this a good starting point? Seems like this doc is willing to work with me?
 
Defy Medical TRT clinic doctor
First off welcome, you seem to be getting the same piss poor treatment many guys seem to get that drives them online.

Backed off to 100mg 1x every 2 weeks. That's when thing started going south. Sore nips, extreme emotions and a couple anxiety attacks out of the blue. Had never experienced that before?

Much too low. I imagine the nipple issues were from the huge fluctuations in test levels, going from nothing to something is rough on the body. I don't understand why any doctor would reduce a dose because it's working well. That makes no sense at all.

Figure my estrogen had spiked?

Doubt it. It makes no sense, why would E2 be higher with less testosterone?

o go he keep up his protocol and tells me after more labs he wants to scale back to once a month!

Oh dear God.

What I did learn after two months off trt...250 serum test, 11ng free, E2 23 and prostate numbers 1.0.

We need lab ranges. We also need ALL the labs you had.


My question is how is my serum low, but my free is in the "normal" range?

You probably have low SHBG. It's not exactly a good thing. You will need your injection frequency to at least 2x a week maybe more.

Doc said I was one of the best converters of natural test he had every seen?

That makes no sense. Your doc isn't aware of SHBG? That's really really concerning.

Started me on 100mg test cypt, 1mg armidex and hcg per week

Why are you on an AI preventatively? Yeah your E2 is probably high for your total, but without a range, and assuming since your doctor didn't know what SHBG is, that he didn't use the proper test for E2.

How much HCG per week?

Seems like this doc is willing to work with me?

Seems like it, but, he doesn't seem to be very informed on TRT so you may have to manage your own protocol. I don't think that's a great idea, and recommend someone who's experienced. The site sponsors are great, I use defy personally, and there's no way I know more than my doctor!
 
Hi guys!

1st post have been reading for a while. Here goes....

I went the route of many. I was told I was low normal mid 30's and basically ignored it. I am over weight 30 bmi, used to be a heavy drinker and have a very irregular sleep schedule because of my career. My thinking at the time was I'll just lose some weight and all will be well.

Fast forward 7 years. I'm 43, still over weight, same career issues, but less drinking. I went for my 1st exam after 7 years and was told I was low T and had sleep apnea. I had been tired, fatigued , had brain fog, emotional issues, poor workout recovery and a tad lower libido. My equipment still worked and often just not as well.

I got a cpap for sleep apnea hoping it would correct issues, but no go.

So my gp starts me on trt. Started at about 230 serum test. Nothing else was checked. I didn't know any better at the time? Figured my Doc knew what he was doing? 100mg test cypt 1x per week for 8 weeks. New labs numbers close to 500. Backed off to 100mg 1x every 2 weeks. That's when thing started going south. Sore nips, extreme emotions and a couple anxiety attacks out of the blue. Had never experienced that before?

So I start doing my own research on here and other places. Bought a few books. Gained some knowledge . Figure my estrogen had spiked? (FYI if that was what it is like to be a women I take back anything and everything I have every said about any woman ever. Including my 2 ex wives lol.)

So I plead with my doc for additional labs and a AI. No go he keep up his protocol and tells me after more labs he wants to scale back to once a month!

At this point I break out all my own research and books. He throws his hand in the air and says either I take the anti depressents he keeps trying to shove down my throat or he is going to refer me to someone else. I say refer me I'm not depressed, something is wrong!

The referral process takes 2 months. During that time I'm off trt. I get past the Roller coaster and am back where I started.

The new anti aging doc is a little more knowledgeable but still doesn't do all the labs recommended on here. What I did learn after two months off trt...250 serum test, 11ng free, E2 23 and prostate numbers 1.0.

So I now realize I don't have the complete picture. My question is how is my serum low, but my free is in the "normal" range? Doc said I was one of the best converters of natural test he had every seen?

He agreed I should should shoot for 800-1000 serum for now. Three months then retest. Started me on 100mg test cypt, 1mg armidex and hcg per week?

Is this a good starting point? Seems like this doc is willing to work with me?

Work with you, yes, that's good but this guy is only marginally better than what you're trying to trade up to. The most glaring is 1mg AI...that should never be prescribed as a basic component of HRT, it should only be used if testing the RIGHT, testing is done and there are negative symptoms of high (>40) E2. If you have some room to maneuver on your own and get a test here and there out of pocket (discountedlabs), maybe this could work. But if he insists and then cuts you off...
And No it's not that unusual to see Free in range and total be low, common no, but it's not too crazy a thing.

How much HCG and how often?
 
The AI is from me insisting ...According to Jay Campbell's book if you are overweight with a bmi over 30 .5mg armidex 2 a week as a preventative is recommended. Fat increases aromitase? Based on my emotional swings several months back I thought it was a good idea. The last numbers I posted where fasting a.m. after two months off trt?
 
Not sure on hcg? Pharmacy tech couldn't read it. I was kind of overwhelmed. Will call next week to clarify. Haven't started yet. The pharmacy has to order hcg. Planned to pick all three up at once when it comes in.
 
Latest labs. This is all I have. Currently off trt for 2 months. Baseline/normal....

Testosterone, Serum 252 ng/dl
Free Testosterone 11.0 pg/ml
Estradiol 23.1 pg/ml
Prostate-Specific Ag, Serum 1.0 ng/ml
 
The AI is from me insisting ...According to Jay Campbell's book if you are overweight with a bmi over 30 .5mg armidex 2 a week as a preventative is recommended. Fat increases aromitase? Based on my emotional swings several months back I thought it was a good idea. The last numbers I posted where fasting a.m. after two months off trt?

We tend to discourage "feeling" your way through this. Symptoms coupled with testing are valid points to prompt adjustments but that's a recipe for failure go by your feelings or whatever, especially when it may be "on the fly" as I say. Besides that...1mg per week is a rather heavy dose sure to crash E2 for most every guy.
 
Latest labs. This is all I have. Currently off trt for 2 months. Baseline/normal....

Testosterone, Serum 252 ng/dl
Free Testosterone 11.0 pg/ml
Estradiol 23.1 pg/ml
Prostate-Specific Ag, Serum 1.0 ng/ml

Always post the reference ranges with any lab tests.
 
New Doc is a naturopath and seems to be willing to let me do whatever I want? He said 2x a week is fine. We will retest again after 3 months?
 
Is this reference ranges? I have been off of everything for 2 months. It's all I have right now. It is trt specific . I have a normal physical from 6 months back with other stuff, but no lh, shbg, dht...
 
New Doc is a naturopath and seems to be willing to let me do whatever I want? He said 2x a week is fine. We will retest again after 3 months?

When I first started TRT, I used 70mg of T and 500iu of HCG every 3 1/2 days and no AI. I felt great and still do, I also did labs after 12 weeks. Still no AI.:)
 
Thanks Vince! I live in a small town. Lake Havasu City, AZ. Finding a competent trt doc has been a challenge.

I am determined! I will learn and continue to challenge local docs. Seems to me that this needs to become a normal gp protocol. The more guys that push their docs the more common place it becomes?
 
Is this reference ranges? I have been off of everything for 2 months. It's all I have right now. It is trt specific . I have a normal physical from 6 months back with other stuff, but no lh, shbg, dht...

When you get a lab test, with the result comes a reference range, say 0-100, for instance.
 
Updated....
(Reference)
Testosterone, Serum 252 ng/dl 343 - 1197
Free Testosterone 11.0 pg/ml 6.8 - 21.5
Estradiol 23.1 pg/ml 7.6 - 42.6
Prostate-Specific Ag, Serum 1.0 ng/ml 0.0 - 4.0


Assumed all references where standard across the board. Sorry.
 
Updated....
(Reference)
Testosterone, Serum 252 ng/dl 343 - 1197
Free Testosterone 11.0 pg/ml 6.8 - 21.5
Estradiol 23.1 pg/ml 7.6 - 42.6
Prostate-Specific Ag, Serum 1.0 ng/ml 0.0 - 4.0


Assumed all references where standard across the board. Sorry.

That's fair, you're new, but FYI they are not.

If you go back, and answer some of the questions I had asked you it will help us help you.

Plus, do you have ONLY those 4 tests? I sure hope you had more ran that you just didn't include here. Post pictures.
 
Updated....
(Reference)
Testosterone, Serum 252 ng/dl 343 - 1197
Free Testosterone 11.0 pg/ml 6.8 - 21.5
Estradiol 23.1 pg/ml 7.6 - 42.6
Prostate-Specific Ag, Serum 1.0 ng/ml 0.0 - 4.0


Assumed all references where standard across the board. Sorry.

Your doctor slipped yet again by ordering the wrong estradiol test. Your value reflects the resukts from a standard assay; it is unreliable in the management of estradiol in men. You want to always measure estradiol with the sensitive lab test, LC, MS/MS. Again, a doctor,who practices in this area should know that.
 
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