sbstrum_MD
Member
Again, the FAI is a poor indicator and should be ignored.
Either do an equilibrium dialysis test for free T or calculate it with this calculator:
* For testosterone 1 nmol/l = 28.85 ng/dL
Normal calculated free T for young males is in the range 5 - 20 ng/dL:
Free Testosterone Levels [Update • 2025] The Ultimate Guide
Free testosterone levels dictate exactly how much of a “man” one feels. From sex drive to deciveness, free-T levels matter. Inside, you’ll find out why.www.testosterone.org
* Every free T lab test has its own range that may be different. You always compare your lab value to the range given in the lab test.
Your lab free T values (whatever tests were used), compared to their lab ranges, tell the same story as the calculated free T:
- in 2015, your calculated free T was low normal
- in May 2023, your calculated free T was way above the normal range.
You are clearly overdosing on T and that is why your estrogen is so high OR a supplement is messing up the tests (biotin most probable). For TRT, your free testosterone at trough, before the next dose, should be in the MIDDLE of the normal range, not at the top and not several times above it.
Otherwise, you are not doing TRT but a cycle, with all the bad side effects and consequences.
Again, the FAI is a poor indicator and should be ignored.
Either do an equilibrium dialysis test for free T or calculate it with this calculator:
* For testosterone 1 nmol/l = 28.85 ng/dL
Normal calculated free T for young males is in the range 5 - 20 ng/dL:
Free Testosterone Levels [Update • 2025] The Ultimate Guide
Free testosterone levels dictate exactly how much of a “man” one feels. From sex drive to deciveness, free-T levels matter. Inside, you’ll find out why.
* Every free T lab test has its own range that may be different. You always compare your lab value to the range given in the lab test.
Your lab free T values (whatever tests were used), compared to their lab ranges, tell the same story as the calculated free T:
- in 2015, your calculated free T was low normal
- in May 2023, your calculated free T was way above the normal range.
You are clearly overdosing on T and that is why your estrogen is so high OR a supplement is messing up the tests (biotin most probable). For TRT, your free testosterone at trough, before the next dose, should be in the MIDDLE of the normal range, not at the top and not several times above it.
Otherwise, you are not doing TRT but a cycle, with all the bad side effects and consequences.
I am a hematologist/oncologist that has specialized in prostate cancer since 1983. Most often lay websites have a lot of nonsense posted. But I will say that many of the comments on Excelmate are of high quality and I am pleasantly surprised to see some of the comments that are trying to steer you in the right direction. However, I see your replies and the protests within. Yes, Sammmy is right. You have overdosed your testosterone dose and with it you have up-regulated aromatization of T ⇢ Estradiol (E2). And with the ↑ in E2 you have stimulated prolactin and that is not good for reasons in the list below:
Prolactin actions:
1) acts synergistically with LH to stimulate testosterone secretion from testicles by increasing the number of LH receptors in the testis;
2) influences adrenal androgen formation;
3) enhances testosterone uptake by prostatic cells;
4) alters intra-prostatic androgen metabolism
5) increases uPA to dissolve ECM (extracellular matrix) and facilitate spread of CA
6) enhances angiogenesis
7) decreases libido
8) decreases cognitive function
Sammmy's recommendation to use an Aromatase Inhibitor like exemestane (Aromasin®) is perfectly reasonable but he correctly points out that the preceding culprit (the chicken and not the egg) is the overdose of testosterone.
With an ↑ E2 and also a higher than normal hematocrit (HCT), you put yourself at risk for thrombosis (i.e., deep vein thrombosis, pulmonary embolism, myocardial infarction). Then all your plans for having a child in the future are kaput. Take the lead from many on this forum to lower your exogenous testosterone dose. Then follow-up with labs. If your free testosterone is in the target range but your E2 is still high then lower it with Aromasin or anastrozole (Arimidex®). Most men I treat with Arimidex only require 0.5 mg twice a week but the proof of the pudding so to speak, is in the follow-up labs documenting success. The key word in most of your woes is "titration." Titration is the essence of biofeedback used intelligently.
Stephen B. Strum, MD, FACP
